Mindfulness Based Stress Reduction (MBSR) therapy is a meditation therapy, though originally designed for stress management, it is being used for treating a variety of illnesses such as depression, anxiety, chronic pain, cancer, diabetes mellitus, hypertension, and skin and immune disorders.
Stress refers to the consequence of the failure of a person to respond appropriately to emotional or physical threats, whether actual or imagined. Signs and symptoms of stress include a state of alarm and adrenaline rush, short-term resistance as a coping mechanism, exhaustion and irritability, muscular spasm, inability to concentrate, and a variety of physiological reactions such as headache and increased heart rate.
An online survey carried out by the American Psychological Association in September 2007 estimated stress levels among 1,848 adults. The results showed that seventy-nine percent of people agreed that “stress is a fact of life”. One–third of the people reported experiencing extreme levels of stress, and nearly 17% reported that they experience their highest level of stress 15 or more days per month.
The negative consequences of stress on helping professionals and first responders include increased depression, emotional exhaustion, and anxiety, psychosocial isolation, decreased job satisfaction, reduced self-esteem, disrupted personal relationships, and loneliness.
Stress may also harm professional effectiveness because it appears to negatively impact attention and concentration, impinge on decision-making skills, and reduce providers’ ability to establish strong relationships with patients. Further, stress can increase the likelihood of occupational burnout, a syndrome that involves depersonalization, emotional exhaustion, and a sense of low personal accomplishment. These findings highlight the importance of self-care for health care providers and first responders. The mindfulness-based stress reduction program is based on the premise that enhancing the capacity to be mindful, that is, to attend to present moment experience in a receptive manner will, over time, reduce the identification with self-focused thoughts and emotions that can lead to poorer mental health.
The Development of MBSR
Mindfulness-Based Stress Reduction (MBSR) program is a technique developed by Dr. Jon Kabat-Zinn in 1979. Although initially developed for stress management, it has evolved to encompass the treatment of a variety of health related disorders. These include anxiety, depression, skin diseases, pain, immune disorders, hypertension and diabetes. It employs mindfulness meditation to alleviate suffering associated with physical, psychosomatic and psychiatric disorders. It consists of a 2.5 hour/week, 8-weeks course with a 1-day retreat. Participants receive training in formal mindfulness meditation techniques involving simple stretches and postures. This article assesses the usefulness and applications of MBSR in the treatment of chronic diseases like depression, chronic pain, immune disorders, skin diseases, diabetes and hypertension.
The research on MBSR and Chronic diseases is sparse, but some studies show promising results. Studies have shown significant decrease in anxiety, stress and depression and enhanced the quality of life in patients with chronic diseases like hypertension, diabetes, chronic pain and skin disorders, after MBSR therapy. The following results from various studies were compiled by Asfandyar Khan Niazi and Shaharyar Khan Niazi in an article entitled Mindfulness-based stress reduction: a non-pharmacological approach for chronic illnesses.
A study of 14 patients was conducted in which the effects of MBSR on measures of blood pressure, body weight, and psychological symptoms, including anxiety, depression, somatization, and general psychological distress were observed. This study found a reduction in mean arterial pressure by 6 mmHg; decreases in depression, anxiety, and general psychological distress in patients undergoing MBSR therapy.
The relationship between MBSR and chronic recurrent depression was evaluated by a study in which MBSR was introduced with the usual treatment in one group and compared it with another group of patients which were being treated without MBSR. They found a decrease in reported symptoms in the MBSR group and no significant change in the usual-treatment group. Another study examined the effectiveness of MBSR on depression, anxiety and psychological distress across populations with different chronic somatic diseases. Eight published, randomized controlled outcome studies showed reduction of anxiety and depression in patients getting MBSR therapy.
Another study examined the impact of MBSR on a population of chronically depressed patients. The outcome measure, relapse/recurrence, was assessed over a 60-weeks period. Patients had significantly reduced episodes of depression after MBSR therapy. MBSR therapy has also been used to decrease stress levels in pregnant women. A study of 27 pregnant women participating in MBSR therapy during their third trimester of pregnancy showed statistically significant increases in mindfulness and positive effects and an improvement in pregnancy related anxiety and depression. Another study measured distress and positive mood states in students and found that brief training in mindfulness meditation reduces distress and improves positive mood states.
In a study, 22 participants were screened and selected for generalized anxiety disorder or panic disorders. Repeated measures analyses of variance documented significant reductions in anxiety and depression scores after treatment for 20 of the subjects—changes that were maintained at follow-up. The number of subjects experiencing panic symptoms was also substantially reduced. A group mindfulness meditation training program can effectively reduce symptoms of anxiety and panic and can help maintain these reductions in patients with generalized anxiety disorder, or panic disorder.
A study carried out to assess the effect of Mindfulness- based stress reduction therapy on hypertension was carried out in African-Americans of age greater than 55 years. Initial eligibility criteria were diastolic BP 90 to 109 mm Hg and systolic BP less than or equal to 189 mm Hg. The participants showed significant reductions in systolic and diastolic BP values. Although this research cannot be classified conclusive because of the narrow target population, it does give hope that MBSR meditation may help in lowering BP in hypertensive patients.
Another study was to assess the effects of participation in a mindfulness meditation-based stress reduction program on mood disturbance and symptoms of stress in outpatients. Patients in the treatment group had significantly lower scores on total mood disturbance and subscales of depression, anxiety, anger, and confusion and more vigor than control subjects. The treatment group also had fewer overall symptoms of stress; fewer cardiopulmonary and gastrointestinal symptoms; less emotional irritability, depression, and cognitive disorganization; and fewer habitual patterns of stress.
Overall reduction in total mood disturbance was 65%, with a 31% reduction in symptoms of stress. This program was effective in decreasing mood disturbance and stress symptoms in both male and female patients with a wide variety of cancer diagnoses, stages of illness, and ages.
The practice of MBSR has been found to improve patients’ coping with prostate cancer, and to decrease stress and mood disturbances in a group of patients with mixed types of cancer. Shifts in immune system markers (reduction in T1 pro-inflammatory lymphocyte to T2 anti-inflammatory lymphocyte ratio) have also been found in patients with breast cancer and in patients with prostate cancer following an 8-week MBSR program.
A randomized, controlled study was performed on the effects of an 8-week clinical training program in mindfulness meditation on brain functions. The electrical activity of the brain was measured immediately before the meditation and then 4 weeks and 8 weeks after the meditation. At the end of the 8-week period a report suggested “first time significant increases in left-sided anterior activation”, a pattern that is associated with positive effect, in the meditators. This finding demonstrates MBSR produces demonstrable effects on brain functions.
Thirty-seven patients with psoriasis about to undergo ultraviolet (UVB) phototherapy or PUVA photo-chemotherapy were randomly assigned to one of two regimens: a mindfulness meditation-based stress reduction intervention guided by audio-taped instructions during light treatments, or a control condition consisting of the light treatments alone with no taped instructions. Psoriasis status was assessed and the analysis showed that subjects in the tape groups reached the halfway point (p = .013) and the clearing point (p = .033) significantly more rapidly than those in the no-tape condition, for both UVB and PUVA treatments.
Fibromyalgia is a chronic illness characterized by widespread pain, fatigue, sleep disturbance, and resistance to treatment. A study was carried out to evaluate the effectiveness of a meditation-based stress reduction program on fibromyalgia. Seventy-seven patients took part in the program. Patients were evaluated before and after the program. Outcome measures included visual analog scales to measure global well-being, pain, sleep, fatigue, and feeling refreshed in the morning. Although all the patients completing the program showed improvement, 51% showed moderate to marked improvement and were counted as “responders”. These preliminary findings suggest that a meditation-based stress reduction program is effective for patients with fibromyalgia.
As shown in the various studies above MBSR Therapy is proving to be another productive therapeutic option. MBSR Therapy is a secular program and is one of the largest non-religiously based mindfulness meditation programs. Its roots do come from spiritual teachings, as do all mindfulness meditation programs, but it is largely based on proven medical and psychological research. Because of this, it is open to everyone and does not suggest any religion over another to its students.
What can Mindfulness-Based Stress Reduction do for me?
The program can train your attention to help you cultivate self-awareness, which allows you to make more fully reasoned out and wise decisions in your day-to-day life. You are invited to incorporate mindfulness into your routine, which will also help you be more aware of the present and focus on it. These strategies help you avoid rumination, either in the past or the future. You can learn to respond to stress, rather than reacting to it. You can also change your habitual reactivity patterns.
Kabat-Zinn also created the program to try to change people's focus from a narrative of the self where "I" and "me" are emphasized constantly. The question "Who am I?" is far more important than the answer.
MBSR cannot cure diseases. It is meant to be a complementary aid to traditional medical treatments or an aid to your life. It also should not be used in lieu of psychological or treatment from professionals, only in tandem with it. Residential treatment is a great opportunity for an individual to engage in MBSR as another tool to combating stress, anxiety and depression.
Research conducted in the decades since MBSR was created shows that the majority of people who complete the program later report significant benefits, including an increased ability to deal with both short and long-term stress, decreases in both physical and physiological symptoms, a strong sense of relaxation, reduction in pain, increased ability to deal with chronic pain, and a renewed excitement and energy to live.