Mindfulness is the latest addition to the armamentarium of cognitive behavioral therapists. Mindfulness methods from the wisdom traditions, as well as from current psychological theories, are beginning to be used as cognitive behavioral strategies for alleviating psychological distress and for personal transformation. The use of mindfulness as a clinical tool is in its infancy, with attendant growing pains in theory, research and practice. We briefly discuss the historical context of the use of mindfulness, recent developments in theory, research and practice, and future developments. We conclude that mindfulness shows a lot of promise as a clinical treatment modality, but there are inherent pitfalls in the developing approaches.
<p>Cognitive-behavioral approaches to alcohol and drug use disorders have received considerable empirical support over the past 20 years. One cognitive-behavioral treatment, relapse prevention, was initially designed as an adjunct to existing treatments. It has also been extensively used as a stand-alone treatment and serves as the basis for several other cognitive and behavioral treatments. After a brief review of relapse prevention, as well as the hypothesized mechanisms of change in cognitive and behavioral treatments, we will describe a "new" approach to alcohol and drug problems called mindfulness-based relapse prevention. Preliminary data in support of mindfulness-meditation as a treatment for addictive behavior are provided and directions for future research are discussed.</p>
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Some individuals with autism engage in physical aggression to an extent that interferes with not only their quality of life, but also that of their parents and siblings. Behavioral and psychopharmacological treatments have been the mainstay of treatments for aggression in children and adolescents with autism. We evaluated the effectiveness of a mindfulness-based procedure, Meditation on the Soles of the Feet, in helping three adolescents to manage their physical aggression. This procedure required the adolescents to rapidly shift the focus of their attention from the aggression-triggering event to a neutral place on their body, the soles of their feet. Incidents of aggression across the three adolescents ranged from a mean of 14–20 per week during baseline, 4–6 per week during mindfulness training, including zero rates during the last 4 weeks of intervention. Aggression occurred a rate of about 1 per year during a 3-year follow-up. Our results suggest adolescents with autism can learn, and effectively use, a mindfulness-based procedure to self-manage their physical aggression over several years.
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Despite the availability of various substance abuse treatments, alcohol and drug misuse and related negative consequences remain prevalent. Vipassana meditation (VM), a Buddhist mindfulness-based practice, provides an alternative for individuals who do not wish to attend or have not succeeded with traditional addiction treatments. In this study, the authors evaluated the effectiveness of a VM course on substance use and psychosocial outcomes in an incarcerated population. Results indicate that after release from jail, participants in the VM course, as compared with those in a treatment-as-usual control condition, showed significant reductions in alcohol, marijuana, and crack cocaine use. VM participants showed decreases in alcohol-related problems and psychiatric symptoms as well as increases in positive psychosocial outcomes. The utility of mindfulness-based treatments for substance use is discussed.
Relapse is common in substance use disorders (SUDs), even among treated individuals. The goal of this article was to systematically review the existing evidence on mindfulness meditation-based interventions (MM) for SUDs. The comprehensive search for and review of literature found over 2000 abstracts and resulted in 25 eligible manuscripts (22 published, 3 unpublished: 8 randomized controlled trials, 7 controlled nonrandomized, 6 noncontrolled prospective, and 2 qualitative studies, and 1 case report). When appropriate, methodological quality, absolute risk reduction, number needed to treat, and effect size were assessed. Overall, although preliminary evidence suggests MM efficacy and safety, conclusive data for MM as a treatment of SUDs are lacking. Significant methodological limitations exist in most studies. Further, it is unclear which persons with SUDs might benefit most from MM. Future trials must be of sufficient sample size to answer a specific clinical question and should target both assessment of effect size and mechanisms of action.
The prevalence of mental health and addiction issues in the homeless population is very high. Mindfulness based interventions have been shown to have positive impacts on anxiety, depression and addiction in various populations. Mixed methods explored the impact of a mindfulness based stress reduction (MBSR) intervention for 12 homeless men. Quantitative measures of anxiety, depression, impulsivity and emotional reactivity were completed pre and post intervention, and participants were interviewed about their experiences of MBSR. Statistically significant changes in anxiety, depression, emotional reactivity and impulsivity were found. The qualitative data highlighted how mindfulness skills can easily be taught to this population, and through the use of these skills, participants were able to develop enhanced coping skills, mindful traits, well-being and an improved capacity to deal with their mental health and addiction issues. This study gives support to the promising potential of mindfulness interventions being implemented by mental health care professionals with homeless service users.
Children with ADHD are often non-compliant with parental instructions. Various methods have been used to reduce problem behaviors in these children, with medication and manipulation of behavioral contingencies being the most prevalent. An objection often raised by parents is that these management strategies require them to impose external control on the children which not only results in the children not learning self-control strategies, but also does not enhance positive interactions between them and their parents. Studies have shown that providing mindfulness training to parents, without a focus on reducing problem behaviors, can enhance positive interactions with their children and increase their satisfaction with parenting. We were interested to see what effects giving mindfulness training to two mothers, and subsequently to their children, would have on compliance by the children. Using a multiple baseline across mothers and children design, we found that giving a mother mindfulness training enhanced compliance by her child. When the children were subsequently given similar training, compliance increased even more markedly, and was maintained during follow-up. The mothers reported associated increases in satisfaction with the interactions with their children and happiness with parenting. We suspect that the mindfulness training produces personal transformations, both in parents and children, rather than teaching strategies for changing behavior.
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Research shows that after training in the philosophy and practice of mindfulness, parents can mindfully attend to the challenging behaviors of their children with autism. Parents also report an increased satisfaction with their parenting skills and social interactions with their children. These findings were replicated and extended with 4 parents of children who had developmental disabilities, exhibited aggressive behavior, and had limited social skills. After mindfulness training, the parents were able to decrease aggressive behavior and increase their children's social skills. They also reported a greater practice of mindfulness, increased satisfaction with their parenting, more social interactions with their children, and lower parenting stress. Furthermore, the children showed increased positive and decreased negative social interactions with their siblings. We speculate that mindfulness produces transformational change in the parents that is reflected in enhanced positive behavioral transactions with their children.
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OBJECTIVES: Breathing exercises are used by some asthmatic patients, yet are often difficult to perform and time-consuming. This study evaluated a simple, modified breathing exercise program regarding ease to perform and effectiveness as an adjunctive therapy.METHODS: Subjects age 18 to 65 with a current diagnosis of persistent asthma were enrolled. A program that incorporated three different breathing exercises (yoga pranayama techniques, diaphragmatic breathing and pursed lip breathing) was taught to subjects. The program was designed to be completed in less than 10 minutes per day. Subjects completed the Asthma Control Test (ACT) and mini-Asthma Quality of Life Questionnaire (AQLQ) at baseline and at 1-month follow-up. They also completed a survey that asked them to rate the effectiveness and difficulty of the exercises, and whether they would recommend them in the future.
RESULTS: A total of 74 subjects were enrolled in this study. The intervention improved breathing for 52.9% of the subjects, while 67.6% felt that their daily activity was improved and 66.1% noted that the exercises allowed decreased use of a rescue inhaler. Most subjects (80.9%) recommended breathing exercises as a complementary therapy for asthma and 79.4% of the subjects stated the exercises took less than 10 minutes per day total. Overall, ACT scores improved significantly (p = 0.002) with a statistically non-significant improvement in AQLQ scores.
CONCLUSION: A simple program of breathing exercises was found to be effective and could be completed in less than 10 minutes per day. Furthermore, there was a statistically significant improvement in ACT scores post-exercise.
Given that we live in highly complex social environments, many of our most important decisions are made in the context of social interactions. Simple but sophisticated tasks from a branch of experimental economics known as game theory have been used to study social decision-making in the laboratory setting, and a variety of neuroscience methods have been used to probe the underlying neural systems. This approach is informing our knowledge of the neural mechanisms that support decisions about trust, reciprocity, altruism, fairness, revenge, social punishment, social norm conformity, social learning, and competition. Neural systems involved in reward and reinforcement, pain and punishment, mentalizing, delaying gratification, and emotion regulation are commonly recruited for social decisions. This review also highlights the role of the prefrontal cortex in prudent social decision-making, at least when social environments are relatively stable. In addition, recent progress has been made in understanding the neural bases of individual variation in social decision-making.
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This paper presents a model of how the fundamental cognitive machinery of self emerges as an accident of sociality, reflecting Buber’s assertion of the primacy of I–Thou relationships. This stands in contrast with the standard ‘I first’ model of theory of mind, which suggests that we understand others’ thought processes by imagining ourselves in their heads. However, this standard model tacitly assumes that understanding oneself is in some way easy, counter to experience in knowledge elicitation, where experts find it hard to reflect on and externalise tacit thought processes. Furthermore, it is hard to create convincing evolutionary accounts for the spontaneous emergence of self. The paper argues that the reflexive understanding of self is both more plausible phylogenically as an evolutionary development and fully consonant ontogenically with research on childhood cognitive development. This reflexive understanding has practical implications for efforts to create artificial agents or robots that are in some sense conscious, and may also inform discussions of the ethical and spiritual implications of advances in artificial intelligence.
<p>This article outlines some of the potential problems and objections to an exchange between Buddhism and science and offers solutions by rethinking about the nature and practice of both disciplines. (Zach Rowinski 2004-05-17)</p>
The American Medical Association defines an "impaired physicain" as one who is unable to fulfill professional or personal responsibilities because of psychiatric illness, alcoholism, or drug dependency.1 Although this definition addresses only substance abuse and mental illness, medical problems that affect judgment and performance could compromise the ability to provide reasonable medical care, thus causing impairment. Likewise, issues surrounding clinical competency, such as medical knowledge, medical judgment, and clinical decision making, can compromise judgment and performance.
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There is growing recognition that humans are faced with a critical and narrowing window of opportunity to halt or reverse some of the key indicators involved in the environmental crisis. Given human activities’ scale and impact, as well as the overly narrow perspectives of environmental research's dominant natural sciences, a major effort is necessary to place the perspectives and insights of the humanities’ and social sciences’ perspectives and insights at the forefront. Such effort will require developing integrated approaches, projects, and institutions that truly do so. This article's goal is to help mobilize the social sciences and the humanities on the topic of sustainability transitions, but also call for a meaningful research agenda to acknowledge the profound implications of the advent of the Anthropocene epoch. We formulate the need for an innovative research agenda based on a careful consideration of the changing human condition as linked to global environmental change. The humanities and social sciences will need to change and adapt to this pressing, historic task.
The Relapse Prevention (RP) model has been a mainstay of addictions theory and treatment since its introduction three decades ago. This paper provides an overview and update of RP for addictive behaviors with a focus on developments over the last decade (2000-2010). Major treatment outcome studies and meta-analyses are summarized, as are selected empirical findings relevant to the tenets of the RP model. Notable advances in RP in the last decade include the introduction of a reformulated cognitive-behavioral model of relapse, the application of advanced statistical methods to model relapse in large randomized trials, and the development of mindfulness-based relapse prevention. We also review the emergent literature on genetic correlates of relapse following pharmacological and behavioral treatments. The continued influence of RP is evidenced by its integration in most cognitive-behavioral substance use interventions. However, the tendency to subsume RP within other treatment modalities has posed a barrier to systematic evaluation of the RP model. Overall, RP remains an influential cognitive-behavioral framework that can inform both theoretical and clinical approaches to understanding and facilitating behavior change.
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In this webcast, B. Alan Wallace, a scholar of Buddhism and science, looks at the history and philosophy of science. Drawing extensively on his background in the cognitive and physical sciences, he argues that subjectivity and consciousness have been systematically overlooked in the scientific pursuit of understanding reality, or, in other words, consciousness is "retinal blind spot" in our understanding of the universe. Based on his background in Buddhist and other contemplative traditions he offers a method of exploring the nature and origins of consciousness. (Zach Rowinski 2004-05-19)
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