‘Mindfulness’, meditative therapy that relieves but does not cure


Mindfulness is usually translated into Spanish as “mindfulness”, and encompasses a series of practices that seek to bring attention to the experience of the present moment. These practices come from Eastern traditions, mainly Vipassana Buddhism , Zen, the Tibetan and Hindu tradition, but there are also practices of mindfulness in the mystical roots of the Christian tradition.

In the historical roots of these practices we observed that meditation sought both to reduce suffering and desolation, as well as to promote spiritual search, enlightenment and vital sense. The psychological and the spiritual were amalgamated.

When these practices are incorporated in different health contexts in the West, they take different forms. First of all, Jon Kabat-Zinn designed a stress reduction program in 1979 based on mindfulness techniques, known as the Mindfulness- based Stress Reduction Program (MBSR), which was first applied in the workplace. University of Massachusetts as a chronic pain treatment.

Effective to avoid relapse in depression

The practice of mindfulness is also integrated into cognitive therapy based on mindfulness (MBCT), which has shown efficacy in the prevention of relapse in depression , with effects at least as good as those of psychotropic drugs .

In addition to these two structured programs (MBSR and MBCT), there are other interventions based on mindfulness . Regardless of the structure of the program in which they are integrated, mindfulness techniques are often divided into two categories: meditations that seek to sustain attention in an experience (for example, body sensations when taking and expelling air), and those that consist of trying to be aware of all the elements that are appearing in consciousness, not just one in particular.

These types of exercises are carried out in a wide range of contexts, in what has been considered a real boom : welfare promotion centers; programs in companies that seek to reduce the stress of their employees; in education, looking for attentive and emotionally regulated students; in hospitals and clinical centers inserted in therapies for different problems (MBCT, MBSR); in prisons …

Likewise, in the last 20 years multiple scientific studies have proliferated , many of them randomized controlled trials and meta-analyzes of maximum scientific rigor, which reveal a robust effect of mindfulness in health, in the reduction of stress, the prevention of relapse in the depression, the management of chronic pain and addictions. But is it the best possible treatment for these problems? Is the boom that mindfulnesshas generated justified ? Does it present dangers?

>What is it for?

When considering clinical populations, mindfulness is shown to be effective in preventing relapse in depression, especially when the patient has residual symptoms . Even some high-quality clinical guidelines, such as the National Institute for Health and Care Excellence in the United Kingdom, consider it the treatment of choice for the prevention of relapse (when there are three or more previous episodes of depression).

However, in other contexts only a moderate effect is observed, comparable to other treatments. For example, Mindfulness-Based Therapy (MBT) has a robust but equivalent effect to other therapies . Similarly, in cases of insomnia , mindfulness has only so far produced moderate results that allow it to be considered a promising treatment.

In general, mindfulness has shown to be very helpful in managing the symptoms of depression and, to a lesser extent, those of anxiety in various chronic ailments: cancer , chronic fatigue , fibromyalgia , irritable bowel syndrome , and vascular diseases (diabetes, hypertension, infarction …), but it is important to note that none of the meta-analyzes reveals a change in the physical condition of these diseases, but only (which is not little) a change in the psychological experience of them.

Moreover, in healthy people the mindfulness increases welfare, and in the case of minors , type meditation midnfulness has shown to have a beneficial impact on health, although smaller than when we consider people with some kind of disorder.

Misconceptions about it

Given the success that mindfulness has had for two decades, many people can seek in these meditative practices the solution that another psychological treatment could actually provide with greater efficiency, misinformation that can harm the resolution of certain difficulties.

For this reason, and in view of the results we have reviewed in this text, it is crucial that the trainers of these techniques have psychological or psychiatric training in order to discriminate and apply the most appropriate interventions according to the process of present disorder.

Different authors of the context of mindfulness training warn that it is being considered as a new panacea , when clearly the research shows that it is a valuable intervention in certain contexts and problems, but not in all.

In fact, in some it would not be advisable, for example, in processes of social anxiety .

Initial state of investigation

We are in an initial state of research, not so much to check the effectiveness of mindfulness (there are numerous meta-analyzes that support it in relation to a waiting list group), but to understand the processes responsible for its effectiveness.

We do not know if the reduction of psychological processes such as rumination or worry are the responsible mediators that end up generating changes in health. Changes have also been detected in the frequency band of brain activity and in the activity of telomerase , very suggestive physiological processes.

This situation of partial knowledge about the mechanism responsible for the change makes persuasive explanatory theories proliferate, but not scientifically founded.

I consider it especially dangerous to go to meditation as a way to avoid the painful experiences of life (losses, moments of acute stress before events …). Such uses can have detrimental effects, since using mindfulnessas a way to numb or reduce the adaptive emotional response in certain circumstances can cause or maintain further disorders.

On certain occasions, the best way to resolve an emotional pain is actually to cross it and process it, not avoid it or interrupt it. Along with the knowledge of the benefits it brings, it is also important to be aware of these dangers that come with mindfulness .

It is not effective for everything

In summary, mindfulness has extensive research that shows its effectiveness in the face of various difficulties, with robust results that are superior to the waiting list control group. In some cases, it would not be advisable to apply it, and in other processes, especially the prevention of relapse in depression, it is especially efficient.

At other times, it does not prove to be more efficient than other existing interventions, so it would be better to avoid considering it as a panacea in the face of all kinds of difficulties. It is important that we go to specialists in mindfulness and that in case of looking for it to alleviate some type of suffering, we go to a professional in sanitary psychology or clinical psychology. In any case, it should be emphasized that mindfulnessIt arises from the adaptation of a set of techniques and traditions that have searched for hundreds of years not only to reduce discomfort but to increase psychological and spiritual well-being, encouraging a search for an existential and ethical sense. This area has not received enough scientific attention when it should also be considered an area of ​​first order in the investigation.

Author Bio: Rafael Jódar Anchía is Director of the Master in Experiential Humanist Psychotherapy and Focused Therapy in Emotion at the Universidad Pontificia Comillas