Mindfulness and Mental Health

Psychotherapy and spirituality have mingled with one another since the early development of talk therapy. Early psychotherapists relied on their philosophical and spiritual beliefs as they worked towards an understanding of the soul, the spirit and the self. With the development of more concrete therapeutic techniques, the use of religion and spirituality in psychotherapy has fallen out of favor (especially with the growing interest in evidence-based practice). One exception to this is the major influence that meditation has had on modern day psychotherapy. Meditation has been a part of many different religious traditions (e.g., Hinduism, Taoism); however, I believe that most of us associate it with Buddhism. As a beginning point for my research, I conducted an online search using only the term “Mindfulness”. The results pointed to Jon Kabat-Zinn, a physician who has dedicated his career to highlighting the benefits of the use of meditation in health care. The results also helped to clarify the definition of the term “mindfulness” as a reference to the therapeutic application of meditation. This helps in understanding the interchangeable relationship between the terms meditation and mindfulness.
Understanding the use and benefits of mindfulness required more in-depth research, much of which lead to resources rather than answers. For example, Dr. Daniel Seigel has written several books on the process of incorporating mindfulness based practice with psychotherapy: Mindsight and The Mindful Brain.
Jon Kabat-Zinn, mentioned earlier, has written extensively on the use of mindfulness in reducing stress and anxiety. His books include: Full Catastrophe Living, The mindful Waythrough Depression, and Wherever You Go, There You Are.
Common to both these authors is their emphasis on the relationship between mind and body. Many who practice mindfulness in psychotherapy believe that awareness of the self in the present moment (including past repressed emotions and memories) is the pathway towards successful living. Through mindfulness, a clinician can help a client move away from the avoidance strategies implemented in the past. The goal, in this type of therapy, is to help a client gain awareness of the self by understanding and processing feelings throughout the body – notably while processing painful affect and memories. In essence, mindfulness is the opposite of mindlessness. This idea is rooted in the belief that negative emotions need to be processed before an individual can move towards successful living.
Now to the ultimate question, “Does Mindfulness Work?” For this question I moved away from “Google” research and utilized other resources (e.g., PsychInfo and PsychArticles databases). The results led to many articles with only a few catching my attention. For instance, an article titled “The Effect of Mindfulness-Based Therapy on Anxiety and Depression: A Meta-Analytic Review reviewed 39 studies with participants receiving mindfulness-based therapy for a range of conditions (i.e., cancer, generalized anxiety disorder, depression, and other psychiatric or medical conditions). The researchers found that mindfulness-based therapy was moderately effective for improving anxiety and mood symptoms, concluding that mindfulness-based therapy is a promising intervention for treating anxiety and mood problems in clinical populations. It is important to note that this study is a summary of 39 other studies on the topic of mindfulness. This is a convenient way of capturing a wide-range snapshot of the available research.
A study titled “Mindfulness-Based Stress Reduction and Health Benefits: A Meta-Analysis” concluded that Mindfulness-Based Stress Reduction (MBSR, “…a structured group program the employs mindfulness meditation to alleviate suffering associated with physical, psychosomatic and psychiatric disorders…”) may help a broad range of individuals to cope with their clinical and nonclinical problems. Finally, a study titled “The Effects of Mindfulness-Based Stress Reduction Therapy on Mental Health of Adults with a Chronic Medical Disease: A Meta-Analysis” concluded that the same intervention (MBSR) has small effects on depression, anxiety and psychological distress in people with chronic somatic diseases. They add that integrating MBSR in behavior therapy may enhance the efficacy of mindfulness based interventions. Here below is a link to the first MBSR article and an abstract of the second MBSR article
So, back to the question “Does mindfulness work?” In my opinion, the answer is that it does work, however (like all other interventions/techniques), not across all populations, conditions or contexts. Current research is primarily focused on understanding which populations, conditions and contexts would benefit most from mindfulness. The first meta-analysis covered above showed that the use of mindfulness is moderately effective while the following two studies resulted in less positive findings (e.g., “may help…” and “…has small effects…”). I think this speaks to the need for a more detailed understanding of mindfulness as a technique in psychotherapy. For instance, it may be the case that mindfulness successfully compliments certain traditional forms of psychotherapy while conflicting negatively with others. It may also be the case that mindfulness fits well when it comes to certain psychological/psychiatric conditions but not others. For now, it does seem that mindfulness based psychotherapy is a useful practice for addressing general anxiety and depression. 
By Ous Badwan
Ous is a Psy.D. Student from the University of Denver’s Counseling Psychology program  currently doing a research internship at MHCD.