A theoretical framework for mindfulness

There is a lot of anecdotal – spoken – evidence for the effectiveness of mindfulness meditation practice. Even from my own experience I can say that most people who attend the MBSR Course report feeling some benefits, from a some people having a sensation of greater calm,  to the participants who say that the practice was  “life-changing”. And it would seem that this is consistent with what is said all around the world as well as being suggested by the popularity of the Course. That being said, the MBSR Course is part of a growing field of evidence-based initiatives in Mind-Body medicine and,  although it difficult to measure all the outcomes, it has been accompanied by scientific research from the start. As I have reported from time to time on this blog, much of this – increasingly expanding – research concerns itself with small studies on the application of MBSR and other mindfulness programmes to particular conditions, such as anxiety, ability to focus, exam stress or irritable Bowel Syndrome. However, from time to time we get another type of research which focuses on trying to understand why mindfulness works and come up with a theoretical framework which can explain that.

The best of the studies to this point in time has been published recently, entitled, “How Does Mindfulness Meditation Work? Proposing Mechanisms of Action From a Conceptual and Neural Perspective“. The lead author, Britta Hölzel, of Justus Liebig University,  has been a part of Sara Lazar’s lab at Harvard Medical School and has worked on the studies there on the effects of meditation on the brain. This excellent, detailed,  study suggests perhaps the most comprehensive framework to date for the different aspects of the person that are impacted upon through ongoing mindfulness meditation. As Dr Hölzel states, the goal of the research was to  “unveil the conceptual and mechanistic complexity of mindfulness, providing the ‘big picture’ by arranging many findings like the pieces of a mosaic”  And what they suggest is that Mindfulness Meditation is a multi-faceted mental practice that involves several different mechanisms, producing effects in four areas, namely, focusing attention, greater awareness of the body, regulation of emotion and a changed perspective on the self. They examine the empirical research, including practitioners’ self-reports and experimental data, which give evidence of these effects as well as looking at brain imaging techniques which explore the neural processes implicated in the process.

This paper is the most satisfying  outline to date for those who wish to reflect on the underlying process of mindfulness and understand it in the context of wider psychological understandings and theories. I find that its more complex framework corresponds to my own experience in working with the MBSR Programme. The mosaic metaphor is also quite apt, as the different elements seem to me to be related. For example, the way we regulate emotion and deal with the fearful situations which threaten us can have a direct impact on our sense of self . Furthermore, a  greater ability to work with the felt sense of the body means that one relates to one emotions in a different way. Grasping the relationships between these components, and the brain mechanisms that underlie them, will allow clinicians to better tailor mindfulness interventions for their patients, says Dr Hölzel. The paper firstly goes into each component and looks at research in that area, but then goes on to suggest the areas of further research that is needed to move understanding in this area beyond the “infancy stage” it is currently in. The authors hope that this research will “enable a much broader spectrum of individuals to utilize mindfulness meditation as a versatile tool to facilitate change – both in psychotherapy and in everyday life.”

Hölzel, B.K. Lazar, S.W.,  Gard, T., Schuman-Olivier, Z., Vago, D.R., Ott, U., (2011) “How Does Mindfulness Meditation Work? Proposing Mechanisms of Action From a Conceptual and Neural Perspective” Perspectives on Psychological Science, 6(6) 537– 559.

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