Meditation And Mindfulness

Meditation and mindfulness

Author: Luke Langley

Mindfulness is the art of paying attention, non-judgementally, in the present moment. In the Pali language (language of the Buddha) meditation means cultivation. So, meditation is the formal practise/ cultivation of a state of mindfulness. Although mindfulness stems from practises of the Buddha 2600 years ago it has recently become prevalent in Western medicine and there are over 6,000 scientific papers examining the effects of mindfulness.

In essence mindfulness is a simple practise. Those just starting to practise mindfulness may start with a meditation of following the breath for 5 to 15 minutes. Naturally, thoughts will come up over this period. As the thought comes up, simply note it then return to following the breath. There are many excellent guided meditations to start you on this process which are provided at the bottom of this article in the resources section.

Although a relatively simple concept, mindfulness practise is difficult and it is easy to be distracted by what Buddhists term the “monkey mind.” Experienced practitioners may be able to sit in deep meditation for hours without being distracted. Luckily, this isn’t necessary to see a benefit from mindfulness; and research suggests 15 minutes per day of meditation can offer considerable benefits to participants. Similar to current physical exercise guidelines 30 to 45 minutes may provide more benefits, however any practise is much better than nothing.

Scientific trials have shown mindfulness to have significant improvements on anxiety, depression and allowing people to pull back from ruminating on negative ideas. Mindfulness has also shown to be significantly more effective at reducing stress than a stress reduction course, and has been show to lower blood pressure, improve sleep/ treat insomnia, and alleviate gastrointestinal issues (Havard Health, 2019)

Like any intervention it may take weeks or months before a positive effect is noticed. In her excellent documentary, My Year of Living Mindfully (2020), Australian journalist Shanon Harvey notes months of frustration and hating the practise of meditation, before ultimately seeing a dramatic improvement in sleep and pain levels.

Integrating mindfulness into daily life is an important part of the practise. This can be achieved through paying attention to cleaning a glass and observing all the properties of the glass, the touch, the way the light shines through it, any spots or fragmentations etc. Paying attention to sensations in the body is another important aspect of mindfulness. Sensations to note may be warmth or coldness, tightness or laxity, the presence of tingling or pulsating, or a feeling of empty space. Sensations may be dull or sharp.

Mindfulness has been scientifically proven to help with pain states, particularly chronic pain, and physiotherapists may employ mindfulness strategies as part of an intervention for successful recovery from chronic pain. Mindfulness concepts may also be used concurrently by other practitioners such as psychology to assist with depression, anxiety and sleep. Like any intervention it is important to explain how the intervention helps, and this is likely to lead to better outcomes.

Hence, some basic pain education is provided here to assist with explaining how mindfulness assists with chronic pain. Pain is always an opinion. Based on the information provided to the brain it may produce an output such as pain. Usually, this is helpful. If you roll your ankle, pressure and inflammation receptors deliver information to the brain which produce a pain response and forces you to rest the ankle for a few weeks while any damage heals. Pain can also occur without any damage. If you touch a hot stove, temperature receptors may produce a pain response which pulls your hand away before any damage occurs. The pain system is a lot like a smoke alarm. It is designed to go off before the whole house burns down. Sometimes our pain systems get sensitised and small physical or emotional threats can cause the pain system to fire. Mindfulness is one way to desensitise the pain system.

Leaning in or paying to attention to unpleasant sensations/ pain in the body has been to shown to reduce pain by up to 50% (Reiner et Al, 2013). Mindfulness can also be incredibly useful in reducing factors which can amplify pain. Thoughts and emotions can have an amplifying affect on danger signals received to the brain. Mindfulness is useful in paying attention to thoughts and emotions, and allows the participant to “step back” from and just observe the thought or emotion, which decreases its effect. As noted previously, it may take time for mindfulness to have a positive effect. Like anything, quick fixes are rare and committing to a long term practise can have great effects.

Despite a wealth of promising data on mindfulness, like any intervention it has its limitations. Of course some patients in clinical trials had limited response to mindfulness intervention strategies. Most people have some fixed unhelpful patterns of thinking or an underlying narrative which they believe in (I certainly do.) If this is causing problems it may be better challenged with cognitive behavioural therapy (CBT). Importantly, with regards to single interventions- mindfulness performed much better than CBT in scientific trials on chronic pain. Hence, it should be recommended before CBT with regards to pain; yet not including any CBT may be doing patients a disservice. A multifactorial approach is important in health, and diet and exercise have also been scientifically shown to have an effect on pain, sleep, depression and anxiety. Hence, practitioners should recommend mindfulness in addition to appropriate physical interventions and diet.

Overall, mindfulness is a tool that has a large bank of scientific data behind it. Either through the use of an app or being taught the process through a practitioner, the patient can be provided with tools to help independently manage their pain, depression and anxiety, as well as living fuller lives more grounded in the present in the moment. Given the evidence practitioners should incorporate mindfulness as part of the usual treatment they would provide such as physical rehabilitation and pain education. Resources are provided below for anyone interested in starting mindfulness practise

Resources

Insight Timer- An excellent free app with many free meditations. My favourite is Manoj Dias. Beginners should search on the app (website also available) for breath awareness and body scan meditations. Find a practitioner whose tempo and sound of voice you like (this is important)

Headspace App- Has many courses on anxiety, depression, pain; beginner, intermediate and advanced course on meditation and many others. Paid subscription for full access but some content is available free

Waking Up App- I’m currently working my way through this one which I’m really enjoying. Based on the book by Sam Harris which is a guide to spirituality without religion. Paid subscription

The Miracle of Mindfulness- The Classic Guide- Thich Nhat Hanh 2008 (Originally published 1975) An excellent practical guide to mindfulness from one of the Buddhist masters

My Year Of Living Mindfully Shannon Jones and Julian Harvey 2020 Available for purchase at www.myyearoflivingmindfully.com

*I have no conflicting interests and have not been paid (unfortunately) for any of the above recommended resources

References

Do Mindfulness-Based Interventions Reduce Pain Intensity? A Critical Review of the Literature

Keren Reiner, MA, MSc, Lee Tibi, BA, Joshua D. Lipsitz, PhD

Pain Medicine, Volume 14, Issue 2, February 2013, Pages 230–242, https://doi.org/10.1111/pme.12006

Benefits of Mindfulness Havard Health (2019) https://www.helpguide.org/harvard/benefits-of-mindfulness.htm Based on a review of scientific literature