While the primary goal of mindfulness training is to become more mindful and less judgemental towards experience, mindfulness training techniques and mindfulness training more generally have been shown to be effective in helping reduce stress symptoms and anxiety. Various meditation technques have long been used to produce relaxation and manage stress. MBSR was one program specifically designed to help people manage their stress and worry in relation to chronic pain. However, it has also been shown to be helpful for stress and anxiety associated with other physical and mental health disorders. While Cognitive Behaviour Therapy (CBT) remains the gold standard psychological intervention for many mood disorders, MBCT and mindfulness-based "third wave" CBT programs like Acceptance and Commitment Therapy (ACT) are increasingly being investigated as innovative new treatments and treatment components for a range of problems.
As mentioned on a number of other pages on this website, research has shown that meditation and mindfulness training are related to a number of general physical and psychological benefits. These benefits appear fundamental in reducing stress, anxiety and worry. For example meditation practice and mindfulness training appear to contribute to:
- A general relaxation response.
- Increased metacognitive awareness.
- Improvements in attention and cognitive flexibility.
- Improvements in emotion understanding and regulation.
Professor Tom Borkovec and Brian Sharpless have argued that mindfulness techniques are beneficial for people with generalized anxiety disorder (GAD). GAD involves high levels of stress and excessive worry, and may be a precursor to depression and other psychological problems. They propose that mindfulness techniques appear to increase flexibility in the way we think, behave, and react to perceived problems. Rigidity in thinking (e.g., excessive worry and catastrophising), behaviour, physical responding, and emotion appear to be fundamental to GAD and mood disorders more generally. Mindfulness and CBT they suggest appears to help people to develop a more balanced perspective on worrisome thoughts, problem solve more effectively, disengage from worrisome thinking, become more physically relaxed, and have more complete and balanced emotional responses. Professor Borkovec and his colleagues have thus successfully integarted mindfulness strategies into CBT for GAD. There is also a number of other researchers (see references below) attempting to integrate mindfulness training into more comprehensive psychological treatments for GAD, and for mood disorders more generally.
As I have shown in my own research (Craigie, 2006, Craigie et al., 2008), mindfulness training in the form of MBCT is associated with reduced depression, worry, and stress for adults with GAD as their primary problem. It is also associated with improved perceived quality of life, reduced fear of emotion, and an increased perception of control over anxiety. At this stage, the research suggests that MBCT is not yet a complete treatment for GAD. MBCT was associated with reliable improvements in GAD symptoms, but the recovery rate was only relatively modest. MBCT seems to be about equivalent to short duration single component CBT and the average of group-based CBT programs. As Teasdale and colleagues (2003) have argued, mindfulness training programs like MBCT may not have sufficient dosage and therapeutic components to completely alleviate symptoms of GAD. Rather MBCT may need to be modified or integrated into more comprehensive therapy programs. Present research suggests individual CBT combined with interpersonal and emotion focused therapy that is probably required for persons with more severe and complex forms of GAD. However, MBCT may be quite useful as an entry level therapy for adults with mild to moderate GAD, for individuals without GAD wishing to reduce their level of stress, or as an adjunct to existing anxiety and stress treatments.
General Reading:
- Harris, R. (2008). The happiness trap: How to stop struggling and start living. Boston: Trumpeter.
- Kabat-Zinn, J. (1990). Full catastrophe living. New York: Dell Publishing.
- Williams, M., Teasdale, J., Segal, Z., & Kabat-Zinn, J. (2007). The mindful way through depression: Freeing yourself from chronic unhappiness. New York: The Guilford Press.
Website Links:
- MBCT: www.mbct.co.uk.
- MBSR: www.umassmed.edu/content.aspx?id=41252
Technical References:
- Borkovec, T. D., & Sharpless, B. (2004). Generalized anxiety disorder: Bringing cognitive-behavior therapy into the valued present. In S. Hayes, V. Follette, & M. Linehan (Eds.) Mindfulness and Acceptance: Expanding the Cognitive-Behavioural Tradition (pp.209-242). New York: The Guilford Press.
- Baer, R. A. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice, 10 (2), 125-143.
- Benson, H., & Beary, J., & Carol, M. (1974). The relaxation response. Psychiatry, 37, 37-46.
- Brown, K. & Ryan, R. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84 (4), 822-848.
- Cahn, B. & Polich, J. (2006). Meditation states and traits: EEG, ERP, and neuroimaging studies. Psychological Bulletin, 13 (2), 180-211.
- Craigie, M. A. (2006). A comparison of cognitive constructs associated with generalized anxiety disorder and the impact of mindfulness training. PhD. Dissertation, Curtin University of Technology, Perth Australia.
- Craigie, M. A., Rees, C., Marsh, A., & Nathan, P. (2008). Mindfulness-based cognitive therapy for generalized anxiety disorder: A preliminary evaluation. Behavioural and Cognitive Psychotherapy, 36, 553-568.
- Craigie, M. A., Rees, C., Marsh, A, & Nathan, P. (2005). Mindfulness training for generalized anxiety disorder: Investigating changes in perceived control, fear of emotions, and intolerance of uncertainty. Paper presented at the European Association for Behaviour and Cognitive Therapy 35th Annual Conference, Thessaloniki Greece.
- Davidson et al. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine, 65, 564-570.
- Delmonte, M. M. (1985). Meditation and anxiety reduction: A literature review. Clinical Psychology Review, 5, 91-102.
- Kabat-Zinn, J., Maisson, A., Kristeller, J., et al. (1992). Effectiveness of meditation-based stress reduction program in the treatment of anxiety disorders. American Journal of Psychiatry, 149 (7), 936-943.
- Lazar, S. W. et al. (2000). Functional brain mapping of the relaxation response and meditation. Neuroreport: For Rapid Communication of Neuroscience Research, 11 (7), 1581-1585.
- Leher, P. M. (1996). Varieties of relaxation methods and their unique effects. International Journal of Stress Managment, 3 (1), 1-15.
- Lehrer, P. M. et al. (1994). Stress management techniques: Are they equvialent or do they have specific effects. Biofeedback and Self-Regulation, 4, 353-401.
- Mennin, D. S. (2006). Emotion regulation therapy: An integrative approach to treatment-resitant anxiety disorders. Journal of Contemporary Psychotherapy, 36, 95-105.
- Roemer, L., & Orsillo, S. M. (2002). Expanding our conceptualization of and treatment for generalized anxiety disorder: Integrating mindfulness/acceptance-based approaches with existing cognitive-behavioral models. Clinical Psychology: Science and Practice, 9 (1), 54-69.
- Roemer, L., Orsillo, S. M., Salters-Pedneault, K. (2008). Effiacacy of an acceptance-based behavior therapy for generalized anxiety disorder: Evaluation in a randomized controlled trial. Journal of Consulting and Clinical Psychology, 76 (6), 1083-1089.
- Teasdale, J. D., Segal, Z., & Williams, M. G. (2003). Mindfulness training and problem formulation. Clinical Psychology: Science and Practice, 10, 157-106.
- Teasdale, J. D., Moore, R. G., et al. (2002). Metacognitive awareness and prevention of relapse in depression: Empirical evidence. Journal of Consulting and Clinical Psychology, 70 (2), 275-287.
- Williams J. M. G. (2008). Mindfulness, depression, and modes of mind. Journal Cognitive Therapy and Research, 32, 721-733.
