April 15, 2012

Mindfulness-Based Stress Reduction

This winter, as part of my new job at a mindfulness and psychotherapy clinic, I lead a course in Mindfulness-Based Stress Reduction (MBSR). MBSR was developed by Jon Kabat-Zinn at the University of Massachusetts medical school. Mindfulness--a state of accepting and non-judging awareness and attention in the present moment--is originally a Buddhist concept, and Kabat-Zinn is credited with integrating it into mainstream medicine and psychology.

MBSR is an 8-week group course. The group meets weekly and each class involves a discussion of mindfulness as applied to a particular topic (e.g., emotions, physical pain, relationships), in-class exercises, and a guided meditation. The goal of MBSR is for participants to develop a daily mindfulness meditation practice ("formal mindfulness") and to become more mindful in daily life ("informal mindfulness").

How does mindfulness reduce stress, improve mental health, and increase quality of life?

1) Appreciation of experience. When we function on automatic pilot, we miss out on many of the moments of our lives. Mindfulness means paying attention to the depth and richness of the present moment--really noticing what's happening, with all five senses. Many MBSR participants report that they now notice things they didn't notice before, like a pretty garden they walk by every day on the way to the bus, the pleasant drumming of warm water on their back in the shower, or how good food tastes when they aren't wolfing it down.

2) Fewer symptoms of anxiety and depression. Increased focus on the present moment prevents us from spending all of our time in the past, ruminating and regretting, or in the future, inventing anxiety-provoking scenarios. In this way, mindfulness cuts out a lot of symptoms of depression and anxiety, improving mental health. MBSR participants often report that they're now quicker to catch themselves ruminating or creating scenarios, which allows them to consciously bring their attention back to the present rather than getting carried away with their thoughts.

3) Responding rather than reacting. The more attention and awareness you bring to your behaviour, the more you can notice patterns and modify automatic reactions that aren't working for you. With greater mindfulness, you might start to notice that your post-dinner trips to the fridge aren't random but rather are almost always directly preceded by feelings of loneliness or sadness; you might realize that you automatically tense up every time your boss walks by your office door, making you constantly jumpy and on edge. One MBSR participant reported that greater mindfulness allowed him to realize that his first reaction to any request or proposal--at work or at home--was "No, I can't, I don't have time" and that he often missed out on opportunities because of this automatic reaction. He began consciously giving himself 24 hours to respond to requests, cutting out his automatic reaction and giving himself the chance to consider his availability and interest and respond accordingly.

4) Decreased avoidance. Mindfulness involves bringing a receptive curiosity to all experience (e.g., "Oh look, my stomach clenched the instant the phone rang, before I even saw who was calling. What's that about?"), whether pleasant or unpleasant. Conceptualizing all of our experiences as interesting phenomena means that even doing things we dislike, fear, or avoid can be fascinating. MBSR participants report that experiences that they formerly avoided, like one-on-one time with their in-laws, public speaking, or going out to eat alone became opportunities for mindfulness awareness; they used the experience to learn about themselves by observing their physical, cognitive, and emotional responses to the situation. 

NB: Mindfulness is effortful. In MBSR, we often say that mindfulness is easy, but that remembering to be mindful is hard. No matter how many hours we meditate, there are still times when we snap at someone automatically, avoid a painful-but-necessary experience, ruminate all day, or (ahem) stand at the front door for fifteen minutes freaking out because we think we left our keys at work, without noticing that they're actually hanging in the lock directly in front of us. The good news is that each time we become aware of how unmindful we're being, it creates a "mindful moment."


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  2. Research on the usefulness of MBSR to encourage healing has found that the use of pain related drug use is reduced with MBSR and self esteem and activity levels are increased.It can also lower blood pressure,emotional reactivity and arousal.
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