Mindfulness has been defined as "a moment-to-moment awareness of one's experience without judgment" (1). This means having conscious awareness of one's own thoughts, feelings, sensations, and behaviors, without evaluation, or the formation of an opinion.
You're acting mindfully when you listen to a song you love, and notice every tiny detail in the sound. Or maybe you've felt anxiety before a big event like a wedding or a job interview, you acknowledged that feeling, and chose to simply accept it.
The opposite of mindfulness would be those times when your body works on "autopilot". Maybe you've eaten a meal and realized you didn't taste a thing, just because you weren't paying attention. Or maybe you've said something cruel out of anger, without realizing that your emotions were driving your actions, until it was too late.
Over the past decade, mindfulness has emerged as a popular component to many types of psychotherapy such as Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and Dialectical Behavior Therapy (DBT). But what does mindfulness actually do for us, and for our clients? Does it really help? We decided to dig through the research to find some answers.
Mindfulness and Mental Illness
In psychotherapy, mindfulness training is regularly used as a tool to treat depression, anxiety, and stress. The good news is that it works, and it works well. Multiple meta-analyses suggest that mindfulness reduces clients' anxiety, stress, and symptoms of mood disorder, and the positive effects are maintained long-term (2, 3). One study even found that mindfulness training was as effective as anti-depressants at preventing the relapse of depressive symptoms, 16 weeks after treatment (4).
Mindfulness-based treatments seem to work, but how? The most studied form of mindfulness training is called Mindfulness-Based Stress Reduction (MBSR). In MBSR, clients attend an 8-week course where they practice a variety of mindfulness exercises such as meditation, discuss their stressors, and complete regular homework which encourages further practice of mindfulness skills.
Other treatments, such as DBT, use mindfulness as a single part of a larger approach to therapy. In DBT mindfulness training is used to help clients learn to accept problems that they do not have control over, or cannot change.
In each of these interventions, various mindfulness exercises are used with the idea that practicing will lead to a higher level of trait mindfulness. Trait mindfulness refers to a person's frequent experience of mindfulness (as if it is a personality trait), as opposed to only experiencing mindfulness during the course of an exercise.
The verdict on increasing trait mindfulness seems to be positive. Some studies have found that those who regularly practice mindfulness develop changes in how their brain functions that contribute to emotional regulation, concentration, and cognitive processing speed (1). These changes may account for the long-term positive effects associated with mindfulness training.
Mindfulness may also help in the treatment of mental illness by facilitating the use of other coping skills. For example, a client dealing with anger will be more likely to use a relaxation skill if they are mindful of their emotions, and identify their anger early.
Mindfulness for Therapists
Some researchers are beginning to look at the benefits of mindfulness not only for clients, but also for therapists. Because this area has been studied less thoroughly, many questions are still unanswered, but what we do know is interesting.
Several traits of therapists that are associated with positive treatment outcomes are thought to be improved by mindfulness training. A few of these traits include empathy and compassion for clients, attentiveness during sessions, and increased comfort with silence (1). Therapists-in-training who were taught to use mindfulness meditation reported higher levels of self-awareness, improvements in their basic counseling skills, and overall wellness.
The effects of mindfulness on symptoms of mental illness, such as anxiety and mood symptoms, hold true for clinicians as well. Mindfulness training might result in better stress-management and reduced levels of burnout among therapists.
Unfortunately, treatment outcomes and their relationship with therapists' levels of mindfulness are still unclear. Initial studies indicate that there is no connection between a therapist's self-reported level of mindfulness and the treatment outcomes of their clients (1). However, when a therapist undergoes formal mindfulness training, their treatment outcomes tend to improve. This might just tell us that self-report is a poor measure of mindfulness, but further research will be required before making any assertions.
Other Benefits of Mindfulness
Mindfulness can clearly play a role in the treatment of mental illness, but how about its use in non-clinical issues? Individuals who practice mindfulness who are not suffering from mental illness still see psychological benefits such as an overall sense of wellbeing, improved concentration, and increased morality. Physical health benefits of mindfulness include improved immune functioning and improved cardiovascular health (1, 5).
Relationships also benefit when at least one of the individuals has a high level of trait mindfulness (1). A few of these benefits include less emotional stress and better communication. Trait mindfulness also acts as a predictor of overall relationship satisfaction.
After a review of the research, it's clear that mindfulness can play an important role in the treatment of several mental illnesses, and it can be used to improve the quality of life for normal-functioning individuals. If you would like to keep reading about mindfulness, and how it can be applied in treatment, I suggest picking up Jon Kabat-Zin's book, Wherever You Go, There You Are (linked below).
1. Davis, D. M., & Hayes, J. A. (2011). What are the benefits of mindfulness? A practice review of psychotherapy-related research. Psychotherapy, 48(2), pp. 198-208.
2. Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). Mindfulness-based stress reduction and health benefits: A meta-analysis. Journal of Psychosomatic Research, 57, pp. 35-43.
3. Hoffmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. Journal of Consulting and Clinical Psychology, 78(2), pp. 169-183.
4. Loucks E., Britton W., Howe C., Eaton C., & Buka S. (2014). Positive associations of dispositional mindfulness with cardiovascular health: The New England family study. International Journal of Behavioral Medicine.
5. Segal, Z. V., Bieling, P., Young, T., MacQueen, G., Cooke, R., Martin, L., ... Levitan, R. D. (2010). Antidepressant monotherapy vs sequential pharmacotherapy and mindfulness-based cognitive therapy, or placebo, for relapse prophylaxis in recurrent depression. Archives of General Psychiatry, 67(12), pp. 1256-1264.