Mindfulness has recently received a lot of attention as a therapeutic technique.
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Mindfulness is a mental state achieved by focusing one’s awareness on the present moment, while acknowledging and non-judgmentally accepting one’s feelings, thoughts and bodily sensations. Known in Sanskrit as smrti, meaning “to remember,” in Pali, the language of early Buddhist scriptures, it is recognized by the word sati (mindfulness).1
Derived from ancient meditative Buddhist disciplines, its customs date back several millennia; as a measure of its reach, over the ages mindfulness practices have been integrated into other spiritual traditions, such as Christianity, Hinduism, Islam, Judaism and Taoism.
In contemporary times, mindfulness has received much attention as a therapeutic technique, a success largely due to the work of its leading western practitioner, Jon Kabat-Zinn. In his foundational book, Full Catastrophe Living, Kabat-Zinn’s program known as Mindfulness Based Stress Reduction (MBSR) is presented.2 Initially targeted at the seriously ill, the program has been adapted and used more widely, with a demonstrated efficacy in other clinical settings. These include the chronic rheumatic diseases, notably rheumatoid arthritis and fibromyalgia, in which mindfulness techniques appear to alter patients’ experience with their disease.
Benefits
There are many ways in which mindfulness can assist patient recovery from a medical condition or cope with a chronic illness. Examples of its benefits include: a decrease in pain; a reduction in stress, anxiety or depression; diminished use of medication (particularly painkillers); improved medication compliance; enhanced motivation in the improvement in lifestyle; and improved interpersonal relationships.
Although its psychological benefits offer an intuitive basis for its efficacy, some believe that mindfulness practices alter biological pathways, thereby promoting healing through physiological mechanisms.
The Practice
Mindfulness as a way of life can be practiced formally and informally. Formal practice involves taking time out of each day to intentionally stop and focus on sensations, sounds, thoughts and emotions of the moment. With informal practice, individuals bring an awareness to one’s daily activity, whether exercising, eating, interacting with others, essentially any activity of daily living.1 With time and practice, one becomes more mindful of one’s inner state, resulting in an enhanced capacity to cope with stress, an improved self-esteem and a renewed enthusiasm for life and work.
Over the years, other mindfulness programs have been developed, most employing exercises in which attention is sustained by concentrating on one’s breath using a cycle of breathing with full attention on the activity and often external objects of focus. Despite the apparent simplicity of the methodology, interested healthcare professionals should respect these therapies for the systematic and serious practices that they are. In the case of Kabat-Zinn’s program, there are nearly 1,000 certified MBSR instructors, with representation in almost every state and in more than 30 countries.3 Further, much is required of the participant, because participation requires significant personal commitment and engagement, behaviors referred to as interior discipline. Given the rigors of the methodology, enrollment and participation in a formal certified program are recommended.
More Than a Fad
Mindfulness practices are much more that the latest self-help craze. Indeed, as seen from the vantage of the mindfulness practitioner, another way of conceptualizing mindfulness is to consider it a universal human capacity. Seen in this way, it becomes a personal competence, a capacity we can tap in our professional roles or within ourselves in order to foster clear thinking and openheartedness, essential capacities to the provision of fully engaged healthcare, as well as a satisfying, fulfilling life.
Enthusiasts everywhere see mindfulness as an essential tool, personal as well as professional, a potent adjunct in the treatment of acute and chronic disease, easing symptoms, promoting well-being and enhancing the capacity to cope with the stresses of life.
C. Ronald MacKenzie, MD, is an attending physician at The Hospital for Special Surgery and Professor of Clinical Medicine and Medical Ethics at Weill Medical College of Cornell University, N.Y. Recently named The C. Ronald MacKenzie Chair in Ethics and Medicine at the Hospital for Special Surgery, he has practiced rheumatology and general internal medicine and has provided perioperative care at this institution and New York Presbyterian Hospital for the past 30 years.
Editor’s note: For more information on mindfulness, see “Mindfulness May Improve Medical Efficacy in Rheumatology Patients”.
References
- Stahl B, Goldstein E. A Mindfulness-Based Stress Reduction Workbook. New Harbinger Publications. Oakland, Calif.: 2010.
- Kabat-Zinn J. Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. Dell Publishing. New York: 1990.
- Pickert K. The art of being mindful. Time. 2014 Feb 3.
