In this episode of Mindfulness Off the Cushion, we delve deeper into a topic hinted at in Episode 4 - the westernization of mindfulness. Or is it the medicalization of mindfulness? Either way that you shake it, this episode explores the impact mindfulness has on western medicine in general, and on western therapeutic modalities in particular.
If you’ve been following along with us since Season 1, then you probably know that we enjoy taking various definitions of mindfulness to the task. However, in this episode, Dr. Sears wants to remind us of a basic framework for understanding what mindfulness means. To keep things as simple as possible, mindfulness means attentiveness. When we are able to draw our attention to the reality of the present moment, we are better able to change our responses to difficult situations. With that said, let's begin.
From the Subjective to Objective in Westernized Mindfulness
As we discussed in the previous episode, America has seen a rapid expansion of interest in mindfulness since the mid-twentieth century. The subjective experiences of scores of Americans learning to meditate or practice mindfulness techniques seem to amplify each other. When you experience something good, something life-changing, you often want to share it with others, right? Well, that experience of the subjective experience of mindfulness, coupled with decades of growing objective evidence in support of its effects on the brain, coalesced in the field of psychology to produce a number of useful mental health therapy modalities in use in the clinical setting today.
One of the true ‘founding fathers’ of westernized, medicalized mindfulness, Jon Kabat-Zinn, had his own personal experiences with eastern traditions of mindfulness and saw the potential for benefitting others therein. Notably, he wasn’t a trained mental health therapist, but a molecular biologist working in a hospital setting. Motivated by a desire to help patients cope with stress, illness, and chronic pain, Kabat-Zinn created a secularized, eight-session program called Mindfulness Based Stress Reduction (MBSR). The first instance of this formalized mindfulness training program took place at UMass Medical Center in 1979. MBSR is still in use across hundreds of settings today and has been studied in its application to a whole host of populations and presenting issues.
Impact of Mindfulness Based Stress Reduction on Other Therapy Modalities
As the reputation of MBSR spread, many clinicians, therapists, and counselors took advantage of the training themselves in order to develop personal resilience, along with new tools to help their patients. As a direct result of this blossoming of mindfulness in western medicine, new mental health therapy modalities emerged in the field of psychology.
Mindfulness Based Cognitive Therapy
Interestingly, the three people responsible for developing this modality were not overtly interested in promoting mindfulness or meditation. Instead, Zindel Segal, Mark Williams, and John Teasdale were on a mission to research and assist people who suffer from clinical depression. The trio noticed that depression sufferers often lacked a method for paying attention to when their mood dips. One the dip has already occurred, the negative thought patterns and emotional affects tend to slip further, creating a vicious cycle.
While the Mindfulness Based Cognitive Therapy (MBCT) is still fairly new, with its first clinical trial published in the year 2000, the modality has shown usefulness. How? Similarly to its predecessor, MBSR, MBCT is an eight week intensive program that teaches patients how to use mindfulness and other cognitive techniques to help stop seemingly automatic negative thoughts from completely overwhelming them. In addition to depressive symptoms, MBSR has also been used to assist groups of patients with:
Obsessive Compulsive Disorder (OCD)
Generalized Anxiety Disorder (GAD)
Post Traumatic Stress Disorder (PTSD)
Dialectical Behavioral Therapy
Dialectical Behavioral Therapy (DBT), was developed in the 1980s by Dr. Marsha Linehan, who sought a more effective modality for treating patients with suicidal thoughts and behaviors. DBT has since grown to encompass Borderline Personality Disorder and other complex mental disorders ranging from Bipolar Disorder, to PTSD, to eating disorders, Attention Deficit Hyperactivity Disorder, and more.
DBT draws upon the influence of mindfulness and MBSR techniques to help patients deal with extremes of emotion by recognizing, validating, and accepting difficult emotions. In time, this ability to pay attention and recognize their feelings can build up into behavioral and cognitive skill sets that help with navigating change and other difficult everyday life situations. Like mindfulness, DBT must be practiced in order to work for us, but the tools are latent within us all - and with a bit of help.
Acceptance and Commitment Therapy
Acceptance and commitment therapy (ACT) is Dr. Sears’ admitted favorite of the bunch. This therapeutic modality involves a broad scientific understanding of the human mind and how it processes change. Just like the name implies, ACT teaches patients how to accept the things they cannot change, and then commit to changing the things they can. What can we change? Well, like we touched on in the previous episode, we can change our minds as far as how we respond to change, challenges, and troubling thoughts.
Psychologist Steven C. Hayes developed ACT in the 1980s as a response to his own personal struggle with panic attacks. Hayes recognized that not every troubling experience in life needs to be fixed or managed. Likewise, not every difficult thought or emotion needs to be controlled. Instead, he affirms that attentiveness, present mindfulness, flexibility, and acceptance are key approaches to living a more fulfilling, less stressful life. ACT provides patients with a framework to develop these approaches across a wide range of presenting issues.
We have no doubt that as western medicine continues to incorporate mindfulness techniques into its mental healthcare research, even more useful modalities will develop. As these mindfulness based modalities continue to take root in the clinical setting, we have more tools at our disposal than ever for imparting real, lasting change on the minds of people who suffer - which is all of us! Be sure to tune in wherever you listen to podcasts for more guided meditations to help you incorporate some of the tools we discuss.
Listen to the Mindfulness Off the Cushion podcast and learn how to be as alive as you can be while you have the chance!