Mindfulness: The Power of Now
“Mindfulness is the awareness that arises from paying attention, on purpose, in the present moment, and non-judgmentally.”
– John Kabat-Zinn
The term "mindfulness" has most often been associated with spiritual disciplines such as sitting meditation or yoga. But it also refers to a state of awareness and a broad range of practices that can facilitate this awareness, a mode of being fully in the present moment, free from the distractions of our many thoughts, allowing for better processing of information. Mindfulness if defined as a moment-to-moment awareness of one's experience in a very particular way … without judgment. In this sense, mindfulness is a state and not a trait.
This state is developed and maintained through deliberate focus on the passing flow of moment-to-moment experience, without becoming overly attached or avoidant to whatever particular phenomena we might encounter. It can be described as a method to train oneself to focus attention and awareness in order to bring mental processes under greater voluntary control and thereby foster general mental well-being and development and/or specific capacities such as calmness, clarity and concentration.
Two core elements define mindfulness are:
consciousness and awareness: noticing our thoughts, feelings, physical sensations and our environment without trying to control them.
focus on the present moment: staying connected with what is happening right now, instead of thinking about the past or worrying about the future.
Mindfulness is often linked with meditation, but they’re not the same. Meditation is a structured technique that involves setting time aside to train our minds to focus. Mindfulness means being present in the moment wherever you are and whatever you are doing, so it can happen at any time.
Mindfulness improves mental health by cultivating non-judgmental, present-moment awareness, allowing individuals to break free from automatic thoughts and reactions, leading to reduced chronic stress, and better manage of negative thought patterns. By focusing on breathing and current sensations, it helps calm the nervous system, lowers cortisol levels, and reduces symptoms of anger, anxiety, and depression.
More specifically, research on mindfulness has identified these benefits:
Reduced rumination. Several studies have shown that mindfulness reduces rumination. In one study, for example, Chambers et al. (2008) asked 20 novice meditators to participate in a 10-day intensive mindfulness meditation retreat. After the retreat, the meditation group had significantly higher self-reported mindfulness and a decreased negative affect compared with a control group. They also experienced fewer depressive symptoms and less rumination. In addition, the meditators had significantly better working memory capacity and were better able to sustain attention during a performance task compared with the control group.
Stress reduction. Many studies show that practicing mindfulness reduces stress. In 2010, Hoffman et al. conducted a meta-analysis of 39 studies that explored the use of mindfulness-based stress reduction and mindfulness-based cognitive therapy. The researchers concluded that mindfulness-based therapy may be useful in altering affective and cognitive processes that underlie multiple clinical issues.
Those findings are consistent with evidence that mindfulness meditation increases positive affect and decreases anxiety and negative affect. In one study, participants randomly assigned to an eight-week mindfulness-based stress reduction group were compared with controls on self-reported measures of depression, anxiety and psychopathology, and on neural reactivity as measured by fMRI after watching sad films (Farb et al., 2010). The researchers found that the participants who experienced mindfulness-based stress reduction had significantly less anxiety, depression and somatic distress compared with the control group. In addition, the fMRI data indicated that the mindfulness group had less neural reactivity when they were exposed to the films than the control group, and they displayed distinctly different neural responses while watching the films than they did before their mindfulness training. These findings suggest that mindfulness meditation shifts people's ability to use emotion regulation strategies in a way that enables them to experience emotion selectively, and that the emotions they experience may be processed differently in the brain (Farb et al., 2010; Williams, 2010).
Boosts to working memory. Improvements to working memory appear to be another benefit of mindfulness, research finds. A 2010 study by Jha et al., for example, documented the benefits of mindfulness meditation among a military group who participated in an eight-week mindfulness training, a nonmeditating military group and a group of nonmeditating civilians. Both military groups were in a highly stressful period before deployment. The researchers found that the nonmeditating military group had decreased working memory capacity over time, whereas working memory capacity among nonmeditating civilians was stable across time. Within the meditating military group, however, working memory capacity increased with meditation practice. In addition, meditation practice was directly related to self-reported positive affect and inversely related to self-reported negative affect.
Focus. Another study examined how mindfulness meditation affected participants' ability to focus attention and suppress distracting information. The researchers compared a group of experienced mindfulness meditators with a control group that had no meditation experience. They found that the meditation group had significantly better performance on all measures of attention and had higher self-reported mindfulness. Mindfulness meditation practice and self-reported mindfulness were correlated directly with cognitive flexibility and attentional functioning (Moore and Malinowski, 2009).
Less emotional reactivity. Research also supports the notion that mindfulness meditation decreases emotional reactivity. In a study of people who had anywhere from one month to 29 years of mindfulness meditation practice, researchers found that mindfulness meditation practice helped people disengage from emotionally upsetting pictures and enabled them to focus better on a cognitive task as compared with people who saw the pictures but did not meditate (Ortner et al., 2007).
More cognitive flexibility. Another line of research suggests that in addition to helping people become less reactive, mindfulness meditation may also give them greater cognitive flexibility. One study found that people who practice mindfulness meditation appear to develop the skill of self-observation, which neurologically disengages the automatic pathways that were created by prior learning and enables present-moment input to be integrated in a new way (Siegel, 2007a). Meditation also activates the brain region associated with more adaptive responses to stressful or negative situations (Cahn & Polich, 2006; Davidson et al., 2003). Activation of this region corresponds with faster recovery to baseline after being negatively provoked (Davidson, 2000; Davidson, Jackson, & Kalin, 2000).
Relationship satisfaction. Several studies find that a person's ability to be mindful can help predict relationship satisfaction — the ability to respond well to relationship stress and the skill in communicating one's emotions to a partner. Empirical evidence suggests that mindfulness protects against the emotionally stressful effects of relationship conflict (Barnes et al., 2007), is positively associated with the ability to express oneself in various social situations (Dekeyser el al., 2008) and predicts relationship satisfaction (Barnes et al., 2007; Wachs & Cordova, 2007).
Other benefits. Mindfulness has been shown to enhance self-insight, morality, intuition and fear modulation, all functions associated with the brain's middle prefrontal lobe area. Evidence also suggests that mindfulness meditation has numerous health benefits, including increased immune functioning (Davidson et al., 2003; see Grossman, Niemann, Schmidt, & Walach, 2004 for a review of physical health benefits), improvement to well-being (Carmody & Baer, 2008) and reduction in psychological distress (Coffey & Hartman, 2008; Ostafin et al., 2006). In addition, mindfulness meditation practice appears to increase information processing speed (Moore & Malinowski, 2009), as well as decrease task effort and having thoughts that are unrelated to the task at hand (Lutz et al., 2009).
The effects of meditation on therapists and therapist trainees
While many studies have been conducted on the benefits of applying mindfulness approaches to psychotherapy clients (for reviews, see Didonna, 2009 and Baer, 2006), research on the effects of mindfulness on psychotherapists is just beginning to emerge. Specifically, research has identified these benefits for psychotherapists who practice mindfulness meditation:
Empathy. Several studies suggest that mindfulness promotes empathy. One study, for example, looked at premedical and medical students who participated in an eight-week mindfulness-based stress reduction training. It found that the mindfulness group had significantly higher self-reported empathy than a control group (Shapiro, Schwartz, & Bonner, 1998). In 2006, a qualitative study of therapists who were experienced meditators found that they believed that mindfulness meditation helped develop empathy toward clients (Aiken, 2006). Along similar lines, Wang (2007) found that therapists who were experienced mindfulness meditators scored higher on measures of self-reported empathy than therapists who did not meditate.
Compassion. Mindfulness-based stress reduction training has also been found to enhance self-compassion among health-care professionals (Shapiro, Astin, Bishop, & Cordova, 2005) and therapist trainees (Shapiro, Brown, & Biegel, 2007). In 2009, Kingsbury investigated the role of self-compassion in relation to mindfulness. Two components of mindfulness — nonjudging and nonreacting — were strongly correlated with self-compassion, as were two dimensions of empathy — taking on others' perspectives (i.e., perspective taking) and reacting to others' affective experiences with discomfort. Self-compassion fully mediated the relationship between perspective taking and mindfulness.
Counseling skills. Empirical literature demonstrates that including mindfulness interventions in psychotherapy training may help therapists develop skills that make them more effective. In a four-year qualitative study, for example, counseling students who took a 15-week course that included mindfulness meditation reported that mindfulness practice enabled them to be more attentive to the therapy process, more comfortable with silence, and more attuned with themselves and clients (Newsome, Christopher, Dahlen, & Christopher, 2006; Schure, Christopher, & Christopher, 2008). Counselors in training who have participated in similar mindfulness-based interventions have reported significant increases in self-awareness, insights about their professional identity (Birnbaum, 2008) and overall wellness (Rybak & Russell-Chapin, 1998).
Decreased stress and anxiety. Research found that premedical and medical students reported less anxiety and depressive symptoms after participating in an eight-week mindfulness-based stress reduction training compared with a waiting list control group (Shapiro et al., 1998). The control group evidenced similar gains after exposure to mindfulness-based stress reduction training. Similarly, following such training, therapist trainees have reported decreased stress, rumination and negative affect (Shapiro et al., 2007). In addition, when compared with a control group, mindfulness-based stress reduction training has been shown to decrease total mood disturbance, including stress, anxiety and fatigue in medical students (Rosenzweig, Reibel, Greeson, Brainard, & Hojat, 2003).
Better quality of life. Using qualitative and quantitative measures, nursing students reported better quality of life and a significant decrease in negative psychological symptoms following exposure to mindfulness-based stress reduction training (Bruce, Young, Turner, Vander Wal, & Linden, 2002). Evidence from a study of counselor trainees exposed to interpersonal mindfulness training suggests that such interventions can foster emotional intelligence and social connectedness, and reduce stress and anxiety (Cohen & Miller, 2009).
Similarly, in a study of Chinese college students, those students who were randomly assigned to participate in a mindfulness meditation intervention had lower depression and anxiety, as well as less fatigue, anger and stress-related cortisol compared to a control group (Tang et al., 2007). These same students had greater attention, self-regulation and immunoreactivity. Another study assessed changes in symptoms of depression, anxiety and post-traumatic stress disorder among New Orleans mental health workers following an eight-week meditation intervention that began 10 weeks after Hurricane Katrina. Although changes in depression symptoms were not found, PTSD and anxiety symptoms significantly decreased after the intervention (Waelde et al., 2008). The findings suggest that meditation may serve a buffering role for mental health workers in the wake of a disaster.
Other benefits for therapists. To date, only one study has investigated the relationship between mindfulness and counseling self-efficacy. Greason and Cashwell (2009) found that counseling self-efficacy was significantly predicted by self-reported mindfulness among masters-level interns and doctoral counseling students. In that study, attention mediated the relationship between mindfulness and self-efficacy, suggesting that mindfulness may contribute to the development of beneficial attentional processes that aid psychotherapists in training (Greason & Cashwell, 2009). Other potential benefits of mindfulness include increased patience, intentionality, gratitude and body awareness (Rothaupt & Morgan, 2007).
Outcomes of clients whose therapists meditate
While research points to the conclusion that mindfulness meditation offers numerous benefits to therapists and trainees, do these benefits translate to psychotherapy treatment outcomes?
So far, only one study suggests it does. In a study conducted in Germany, randomly assigned counselor trainees who practiced Zen meditation for nine weeks reported higher self-awareness compared with nonmeditating counselor trainees (Grepmair et al., 2007). But more important, after nine weeks of treatment, clients of trainees who meditated displayed greater reductions in overall symptoms, faster rates of change, scored higher on measures of well-being and perceived their treatment to be more effective than clients of nonmeditating trainees.
However, the results of three other studies were not as encouraging. Stanley et al. (2006) studied the relationship between trait mindfulness among 23 doctoral-level clinical psychology trainees in relation to treatment outcomes of 144 adult clients at a community clinic that used manualized, empirically supported treatments. Contrary to expectation, therapist mindfulness was inversely correlated with client outcome.
This is consistent with other findings that suggest an inverse relationship exists between therapists' mindfulness and client outcomes (Bruce, 2006; Vinca & Hayes, 2007). Other research suggests that no relationship exists between therapist mindfulness and therapy outcome (Stratton, 2006).
What might be behind these results? It could be that "more mindful" people are likely to score lower on self-reports of mindfulness because they are more accurately able to describe their "mindlessness." Conversely, people who are less mindful may not realize it and therefore may be inclined to rate themselves higher on such measures.
Overall, while the psychological and physical health benefits of mindfulness meditation are strongly supported by research, the ways in which therapists' mindfulness meditation practice and therapists' mindfulness translate to measureable outcomes in psychotherapy remain unclear. Future research is needed to examine the relations between therapists' mindfulness, therapists' regular mindfulness meditation practice and common factors known to contribute to successful treatment outcomes.