Mindfulness and Psychotherapy

Fluffy piece at the New York Times about the use of mindfulness techniques in therapy. This is a very popular area, combining meditation, and meditative practices with psychotherapy. The article rightfully points out both that interest in mindfulness techniques has a faddish quality, but also that it has substantial therapeutic benefits. This has been done by several psychotherapists, as well as in medical settings.

The article also mentions that the research findings to the practice have been lukewarm (second quote below). The reason the research is so inconclusive is that mindfulness meditation is very difficult to quantify. It is very difficult to get researchers to decide 1) which practice is going to be researched and then 2) how it is going to be defined. It sounds simple enough, but it’s a complicated problem.

The article trails off into a muddy ending listing several mindfulness practices: Tai Chi, Transcendental Meditation, Mindfulness Meditation, and Yoga. These are wildly different practices, and if researchers were comparing results from each of these in one study it would be ludicrous (they don’t). Each of these ‘mindful’ practices potentially has therapeutic benefit. Placing them together in some kind of grab-bag mindfulness category is rather sloppy.

Here’s a description of one practice:

Mindfulness meditation is easy to describe. Sit in a comfortable position, eyes closed, preferably with the back upright and unsupported. Relax and take note of body sensations, sounds and moods. Notice them without judgment. Let the mind settle into the rhythm of breathing. If it wanders (and it will), gently redirect attention to the breath. Stay with it for at least 10 minutes.

After mastering control of attention, some therapists say, a person can turn, mentally, to face a threatening or troubling thought — about, say, a strained relationship with a parent — and learn simply to endure the anger or sadness and let it pass, without lapsing into rumination or trying to change the feeling, a move that often backfires.

One woman, a doctor who had been in therapy for years to manage bouts of disabling anxiety, recently began seeing Gaea Logan, a therapist in Austin, Tex., who incorporates mindfulness meditation into her practice. This patient had plenty to worry about, including a mentally ill child, a divorce and what she described as a “harsh internal voice,” Ms. Logan said.

After practicing mindfulness meditation, she continued to feel anxious at times but told Ms. Logan, “I can stop and observe my feelings and thoughts and have compassion for myself.”

And here’s some research responses:

For all these hopeful signs, the science behind mindfulness is in its infancy. The Agency for Healthcare Research and Quality, which researches health practices, last year published a comprehensive review of meditation studies, including T.M., Zen and mindfulness practice, for a wide variety of physical and mental problems. The study found that over all, the research was too sketchy to draw conclusions.

A recent review by Canadian researchers, focusing specifically on mindfulness meditation, concluded that it did “not have a reliable effect on depression and anxiety.”

Kalea Chapman, Psy.D.

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3 thoughts on “Mindfulness and Psychotherapy

  1. Pingback: Using Mindfulness Meditation for ADHD « pasadena therapist

  2. Banter

    The above commentary is both simplistic and out-of date with current research. See for example, this meta-analysis of 39 studies of mindfulness-based interventions.

    Hofmann, S. G., A. T. Sawyer, et al. (2010). “The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review.” Journal of Consulting and Clinical Psychology 78: 169-183.

    ABSTRACT
    OBJECTIVE: Although mindfulness-based therapy has become a popular treatment, little is known about its efficacy. Therefore, our objective was to conduct an effect size analysis of this popular intervention for anxiety and mood symptoms in clinical samples. METHOD: We conducted a literature search using PubMed, PsycINFO, the Cochrane Library, and manual searches. Our meta-analysis was based on 39 studies totaling 1,140 participants receiving mindfulness-based therapy for a range of conditions, including cancer, generalized anxiety disorder, depression, and other psychiatric or medical conditions. RESULTS: Effect size estimates suggest that mindfulness-based therapy was moderately effective for improving anxiety (Hedges’s g = 0.63) and mood symptoms (Hedges’s g = 0.59) from pre- to posttreatment in the overall sample. In patients with anxiety and mood disorders, this intervention was associated with effect sizes (Hedges’s g) of 0.97 and 0.95 for improving anxiety and mood symptoms, respectively. These effect sizes were robust, were unrelated to publication year or number of treatment sessions, and were maintained over follow-up. CONCLUSIONS: These results suggest that mindfulness-based therapy is a promising intervention for treating anxiety and mood problems in clinical populations.

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    1. kaleachapmanpsyd

      You might just be right about that. For those keeping up with the mindfulness research, I recommend Ken Pope’s page on the topic, where he keeps a freshly stocked list of references:

      http://kspope.com/memory/mindful.php

      There’s even a fresh meta-analysis from 2012:

      Klainin-Yobas, P., Cho, M. A., & Creedy, D. (2012). Efficacy of mindfulness-based interventions on depressive symptoms among people with mental disorders: a meta-analysis. International Journal of Nursing Studies, 49(1), 109-121. doi: 10.1016/j.ijnurstu.2011.08.014

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