The Mechanisms of Mindfulness in the Treatment of Mental Illness and Addiction, article 6/13 (Ellie)

This article dissects how mindfulness meditation has been linked to treated addiction.

Where mindfulness is rooted: Mindfulness is a 2600-year-old meditation technique that derives from Buddhist practice. Although contemplative techniques similar to mindfulness feature in many of the world’s religious and spiritual traditions, the type of mindfulness employed in mental health settings is largely based on the Buddhist model. A number of discourses or suttas  in the Buddhist canonical literature are specifically devoted to the practice of mindfulness, of which the principal ones are the ānāpānasati suttasatipaṭṭhāna suttamahasatipaṭṭhāna sutta, and kāyagatāsati sutta. we would can conclude from this that Buddhism has a direct translation link to the foundation of mindfulness practices.

There have been many forms in which people practice mindfulness, in its primal state when it was apart. of buddhist culture, or the new wave of practicing mindfulness influenced by Jon Kabat-Zinn, who claims mindfulness is paying attention in a particular way: on purpose, in the present moment, and non-judgmentally.

“mindfulness is advocated by the United Kingdom’s National Institute for Health and Care Excellence (NICE), American Psychiatric Association (APA), and Royal Australian and New Zealand College of Psychiatrists (RANZCP) for the treatment in adult populations of recurrent depression (NICE and APA) and binge eating disorder (RANZCP). Based on the above recommendations and emerging empirical evidence, the United Kingdom’s Mental Health Foundation recently called for mindfulness to be made more readily available through the National Health Service

In essence, mindfulness is growing popularity for it’s starting to be put in a new light in the medical world as it’s proven to be successful in many scenarios.

  1. Structural brain changes: there have been many proposals in terms of how mindfulness improves mental health or aspects of human behavior are generally regarded to control just one component in a difficult process. This paper analyzes findings from various scientific enquiries as well as summarizing what the authors of this article consider the ten most important and evidence-based mechanisms of mindfulness that have been proposed academic literature:Structural Brain Changes: Neuropsychological imaging studies have demonstrated that mindfulness can induce neuroplastic changes in various areas of the brain (including the anterior cingulate cortex, insula, default mode network structures, left hippocampus, temporo-parietal junction, and fronto-limbic network; Holzel et al., 2011a). The structural brain changes linked to mindfulness (and related forms of meditation) are typically associated with (i) increased learning and memory capacity (Holzel et al., 2011b), (ii) improved self-regulatory efficacy (i.e., an individual’s ability to regulate and remain in control of their choices, feelings, and behaviours; Luders et al., 2009; Tang et al., 2012), and (iii) greater interoceptive awareness (i.e., increased sensitivity to sensations that originate in the body as well as associated subjective awareness of the physical self as a sentient being; Lazar et al., 2005).
  2. Reduced Autonomic Arousal: Mindfulness and related meditative techniques have been shown to increase output in the vagus nerve – a primary cranial nerve responsible for regulating heart and breathing rate (Telles et al., 2013). In turn, reduced autonomic arousal is associated with increased relaxation response, including across both somatic and psychological relaxation indices (Khanna & Greeson, 2013). These findings are consistent with Buddhist teachings such as the aforementioned ānāpānasati sutta that outlines 16 breathing exercises specifically intended to induce bodily and mental stillness in order to foster (i) blissful affective states and (ii) spiritual insight.
  3. Perceptual Shift: Practising mindfulness is believed to create a perceptual shift in the way individuals respond and relate to thoughts, feelings, and sensory stimuli (e.g., sounds, sights, smells, pain, etc.; Jerath et al., 2012). This greater perceptual distance is understood to encourage the objectification of distressing psychological or painful bodily experiences (Ludwig & Kabat-Zinn, 2008). Likewise, perceptually ‘stepping back’ and observing the mind and body as they interact with the present moment can reduce inclination towards anger and help individuals regard psychological and sensory processes as ‘passing experiences’ (Shonin et al., 2015
  4. Increase in Spirituality: Mindfulness, particularly when practiced according to the second-generation model, can increase spirituality that helps to buffer against feelings of loneliness or being overwhelmed by life adversities (Van Gordon et al., 2016b). This growth in spiritual awareness is understood to help broaden an individual’s life perspective and cause them to re-evaluate their life priorities. Second-generation MBIs have also led to participants ‘glimpsing’ what might be described as profound or nuance spiritual truths such as non-self and emptiness (i.e., the notion that the self – and indeed all phenomena – are composite and devoid of intrinsic existence; Van Gordon et al., 2016b). A further example of growth in spirituality following receipt of an MBI is a greater awareness of death, including the fact that it is an inevitable occurrence. Increased death awareness is understood to facilitate the earlier-onset of the recovery and restorative phases of the grieving process, and to build resilience to trauma (Cacciatore & Rubin, 2015; Kumar, 2005; Wada & Park, 2009).
  5. Greater Situational Awareness: Mindfulness can help individuals better understand and connect with the physical and social environment in which they find themselves. More specifically, it can induce what has been termed the phenomena feedback effect that involves the mindfulness practitioner entering into a form of effortless communication with the present moment (Shonin & Van Gordon, 2015). This greater situational awareness is understood to improve (amongst other things) decision-making competency, job performance, and the ability to anticipate how a particular situation might unfold (Shonin & Van Gordon, 2015).
  6. Values Clarification : Values clarification is the recognition by individuals of what they truly value and find meaningful in life (Shapiro et al., 2006). Values clarification has been shown to partially mediate the relationship between mindfulness and psychological symptom reduction, suggesting that mindful awareness helps to clarify purpose in life that subsequently leads to improved mental health outcomes (Carmody et al., 2009). There are various explanations as to why mindfulness causes a clarification or reappraisal of life values but a plausible one is that the mindfulness practitioner begins to appreciate more fully that life can only unfold and be experienced in the present moment, and that fantasising about the future or ruminating over the past is ultimately a futile and fatiguing process.
  7. Increase in Self-Awareness: Mindfulness can augment self-awareness that, in-turn, is understood to improve ability to identify and label negative mood states and thinking patterns (Gillespie et al., 2012). This proposed mechanism relates closely to the ‘perceptual shift’ referred to above because increased accuracy in labelling mental states arguably makes it easier to objectify and observe them.
  8. Addiction Substitution: It has recently been proposed that the peaceful and blissful states associated with mindfulness can be used as a substitute for the ‘buzz’ or ‘high’ experienced by individuals with addiction problems (Shonin et al., 2014a). In essence, this mechanism of action involves substituting a ‘negative addiction’ (e.g., to drugs, alcohol, gambling, etc.) with a ‘positive addiction’ (i.e., to meditation/mindfulness). According to Van Gordon et al. (2016c), while individuals should eventually be encouraged to relinquish any dependency on meditation, it can be a useful technique in the early stages of addiction treatment.
  9. Urge Surfing: A further proposed mechanism of action relating to the use of mindfulness in addiction treatment contexts is that of ‘urge surfing’ (Appel & Kim-Appel, 2009). Urge surfing refers to the process of an individual observing and not reacting to mental urges. In other words, they ‘surf the urge’ and are thus better able to regulate addiction-related craving.
  10. Letting Go: By mindfully observing the arising and dissolution of cognitive, affective, and sensory processes, it is asserted that mindfulness practitioners cultivate a better understanding of the transient nature of existence (Van Gordon et al., 2016d). This helps to reduce attachment to (amongst other things) objects, people, situations, and concepts, and to encourage the ‘letting-go’ of negative affective states before they dominate thinking patterns and behaviour (Van Gordon et al., 2016e). Unlike Western psychology that generally deems attachment (e.g., in relationship contexts) to exert a protective influence over psychopathology, Buddhism asserts that attachment is an undesirable quality that leads to the reification of the ego-self (Sahdra et al., 2010). The Buddhist conceptualisation of attachment has been defined as “the over-allocation of cognitive and emotional resources towards a particular object, construct, or idea to the extent that the object is assigned an attractive quality that is unrealistic and that exceeds its intrinsic worth” (Shonin et al., 2014b, p. 126). Increased ability to let go of attachments is positively correlated with acceptance, non-reactivity, self-compassion, subjective wellbeing, and eudemonic wellbeing (Sahdra et al., 2010).

Shonin, Edo and International Journal of Mental Health and Addiction volume. “The Mechanisms of Mindfulness in the Treatment of Mental Illness and Addiction.” Springer Link, 2016, doi:10.1007/s11469-016-9653-7.

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