La pleine conscience incarnée : un concept unificateur entre les traditions orientales et occidentales de la pleine conscience

ObjectiveThe interest in mindfulness as a concept continues to grow as shown in the increase in the number of publications pertaining to mindfulness in the last four decades. This increase is also a reflection of the fact that the term “mindfulness” is currently used as an umbrella for a variety of approaches that assign different meanings to the same word. Although differences among varying conceptualizations and definitions of “mindfulness” have been previously highlighted, few efforts have attempted to compare these varying conceptual approaches as a means to address commonalties between them. Therefore, the objective of this paper is to review different conceptualizations of mindfulness in order to understand their common and distinctive components.MethodIn order to investigate commonalities and distinctions among different mindfulness conceptualizations, we conducted a thorough qualitative review of theoretical and empirical papers belonging to three approaches in mindfulness: Eastern Buddhist traditions, Western modern mindfulness meditation programs, and Langerian mindfulness. Each of these approaches is presented first at a conceptual level (i.e., how it defines mindfulness) and then at a practical level (i.e., how to operationalize mindfulness). Empirical research pertaining to the effectiveness of each approach is presented and discussed. As Buddhism incorporates different schools of thoughts, this paper focuses primarily on the conceptualization of mindfulness outlined within Theravada Buddhism. It operationalizes mindfulness through an engagement in intensive and daily meditative practice, which includes both concentrative and open-monitoring meditation. In addition, Buddhism includes a set of ethical principles. Western modern mindfulness meditation programs are conceptualized according to Kabat-Zinn and other western scholars. Definitions varied to some extent according to different scholars, each including a different set of components (e.g., attention, awareness, acceptance, nonjudgement, observation). Western modern mindfulness meditation programs are operationalized though the development and implementation of structured psychosomatic interventions, such as Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy. Langerian mindfulness is conceptualized as a general style or mode of functioning through which individuals actively reconstruct their environment by creating new categories or distinctions, and seeking multiple perspectives. Langer operationalized mindfulness through a set of sociocognitive tasks. The role of the body in these three approaches and more specifically the mind-body connection is highlighted through the analysis of clinical, behavioral, and neuroscientific research findings.Results and DiscussionDefinitions from both eastern and western approaches share self-regulation of attention and awareness as central common elements. Both attention and awareness processes increase interoceptive and exteroceptive body awareness and mind-body connection, therefore suggesting a role of embodiment in conceptualizing and operationalizing mindfulness across different approaches. We therefore introduce the new concept of Embodied Mindfulness as an integration of top-down and bottom-up processes and argue for its utility in the empirical study of mindfulness across the three conceptual approaches.ConclusionsThe new notion of embodied mindfulness integrates different conceptualizations of mindfulness by allowing a common understanding of the mechanisms of change across these conceptualizations. This new notion has also both research and clinical implications. This new notion suggests further emphasizing the body and mind-body connection in both studying/measuring mindfulness and in developing/validating clinical interventions.     

Comment mesurer la mindfulness ? Problèmes et perspectives

IntroductionThe concept of mindfulness is characterized by awareness and acceptance of experiences; flexible regulation of attention; an objective receptivity to experience and an orientation to the here-and-now. Interest in ‘mindfulness’ and ‘mindfulness meditation’ is recent and growing both at the levels of research and of clinical practice in the West as mindfulness is associated with health and well-being. It (mindfulness) is attained by the practice of certain types of meditation. One of the current key challenges is to evaluate and measure the level of mindfulness of a subject and its evolution.ObjectivesThe paper proposes a reflexion on the concept of mindfulness with a view to improving the operational evaluation of mindfulness level for clinical and non-clinical subjects.MethodsFirst, the problems with the use of existing self-report questionnaires assessing mindfulness level are discussed. Second, an analysis of the cognitive processes that come into play in mindfulness acquisition (by meditation) can highlight the significance of certain cognitive tools in a more accurate evaluation of the level of mindfulness of individuals.ConclusionSelf-regulation of attention, and orientation to lived experience could be operational candidates for assessing the level of mindfulness. The pertinence of well-known paradigms evaluating self-regulation of attention and orientation to experience are discussed.     

The influence of a mindfulness-based intervention on job satisfaction and work-related stress and anxiety

Workplace mindfulness is a recognised tool for enhancing health and well-being of university staff and may result in better task performance and satisfaction in the workplace. The study examined the beneficial effects of mindfulness meditation on job satisfaction, mindful awareness and anxiety levels in university personnel. Mixed methods with a quasi-experiment and in-depth interviews were used. Fifteen participants engaged in a mindfulness meditation approach and five volunteers were interviewed. The findings showed a significant increase in awareness, with staying focused (t(14) = –3.09, p = .00), noticing feelings of physical tension (t(14) = –4.00, p = .00), being aware of running automatically (t(14) = –3.55, p = .00) and not being preoccupied with the future or the past (t(14) = –2.69, p = .01), respectively. Mindfulness was also effective in reducing sleep disturbance. Qualitative results demonstrated the mindfulness approach contributed to calmness and relaxation, and increased ability to handle difficult matters in the workplace. Apart from helping participants to better manage emotions, the mindfulness intervention could promote better relationships towards family members and reduce blood pressure to normal levels. Therefore, mindfulness meditation should be promoted across academic settings to enhance job performance and satisfaction and reduce work-related stress.     

Investigation of mindfulness meditation practitioners with voxel-based morphometry

Mindfulness meditators practice the non-judgmental observationof the ongoing stream of internal experiences as they arise.Using voxel-based morphometry, this study investigated MRI brainimages of 20 mindfulness (Vipassana) meditators (mean practice8.6 years; 2 h daily) and compared the regional gray matterconcentration to that of non-meditators matched for sex, age,education and handedness. Meditators were predicted to showgreater gray matter concentration in regions that are typicallyactivated during meditation. Results confirmed greater graymatter concentration for meditators in the right anterior insula,which is involved in interoceptive awareness. This group differencepresumably reflects the training of bodily awareness duringmindfulness meditation. Furthermore, meditators had greatergray matter concentration in the left inferior temporal gyrusand right hippocampus. Both regions have previously been foundto be involved in meditation. The mean value of gray matterconcentration in the left inferior temporal gyrus was predictableby the amount of meditation training, corroborating the assumptionof a causal impact of meditation training on gray matter concentrationin this region. Results suggest that meditation practice isassociated with structural differences in regions that are typicallyactivated during meditation and in regions that are relevantfor the task of meditation.     

A treatment model for anxiety-related sexual dysfunctions using mindfulness meditation within a sex-positive framework

In this article, we propose a clinical model for treating anxiety-related sexual dysfunctions that hinges on the use of mindfulness meditation practices. First, theoretical and empirical evidence for anxiety as either a cause or condition of several different sexual dysfunctions is provided. Next, the concept of mindfulness and the research that supports the use of mindfulness meditation practices in addressing anxiety are explained. The inherent link between mindfulness and sex-positivity is also addressed while acknowledging the need to emphasize both mindfulness and sex-positivity in therapy. The proposed model for the treatment of anxiety-related sexual dysfunctions using mindfulness practices within a sex-positive framework is outlined. It utilizes mindfulness-based practices such as body scan meditation and sitting meditation as well as several preexisting sex therapy interventions, including directed masturbation and sensate focus assignments. A case study is provided as an example of the progression of therapy and as a demonstration of the clinical viability of the model. Ultimately, this model illustrates a potential way in which mindfulness practices can be utilized within a sex-positive approach to sex therapy.     

Meditation,mindfulness and executive control: the importance of emotional acceptance and brain-based performance monitoring

Previous studies have documented the positive effects of mindfulness meditation on executive control. What has been lacking, however, is an understanding of the mechanism underlying this effect. Some theorists have described mindfulness as embodying two facets—present moment awareness and emotional acceptance. Here, we examine how the effect of meditation practice on executive control manifests in the brain, suggesting that emotional acceptance and performance monitoring play important roles. We investigated the effect of meditation practice on executive control and measured the neural correlates of performance monitoring, specifically, the error-related negativity (ERN), a neurophysiological response that occurs within 100 ms of error commission. Meditators and controls completed a Stroop task, during which we recorded ERN amplitudes with electroencephalography. Meditators showed greater executive control (i.e. fewer errors), a higher ERN and more emotional acceptance than controls. Finally, mediation pathway models further revealed that meditation practice relates to greater executive control and that this effect can be accounted for by heightened emotional acceptance, and to a lesser extent, increased brain-based performance monitoring.     

A case study on the effects of the creative art therapy with stretching and walking meditation—Focusing on the improvement of emotional expression and alleviation of somatisation symptoms in a neurasthenic adolescent

The purpose of this study is to investigate how the creative art therapy with stretching and walking meditation can improve the emotional expression of a neurasthenic adolescent and alleviate her somatisation symptoms. The subject is a female third-year high-school student in D city in South Korea. The art therapy programme was conducted from 22 July 2012 to 30 August 2012, 3–4 times a week, for a total of 21 therapy sessions, with each session lasting 40–90 min. The following research tools were used in this study: a measure of alexithymia as a cognitive-affective disorder, and a measure of somatisation symptoms pre-test and post-test with a follow-up test were conducted and the results were compared. A content analysis of every session was also conducted. The results are as follows. First, creative art therapy led to an improvement in the emotional expression of a neurasthenic adolescent. Second, creative art therapy alleviated somatisation symptoms in the neurasthenic adolescent. The follow-up test revealed that the effects of the therapy continued beyond the treatment period. In conclusion, the creative art therapy with stretching and walking meditation improved the emotional expression and alleviated somatisation symptoms in a neurasthenic adolescent.     

Mindfulness-based eating awareness training for treating binge eating disorder: the conceptual foundation

This paper reviews the conceptual foundation of mindfulness-based eating awareness training (MB-EAT). It provides an overview of key therapeutic components as well as a brief review of current research. MB-EAT is a group intervention that was developed for treatment of binge eating disorder (BED) and related issues. BED is marked by emotional, behavioral and physiological disregulation in relation to food intake and self-identity. MB-EAT involves training in mindfulness meditation and guided mindfulness practices that are designed to address the core issues of BED: controlling responses to varying emotional states; making conscious food choices; developing an awareness of hunger and satiety cues; and cultivating self-acceptance. Evidence to date supports the value of MB-EAT in decreasing binge episodes, improving one's sense of self-control with regard to eating, and diminishing depressive symptoms.     

A randomized controlled trial of mindfulness meditation versus relaxation training: Effects on distress,positive states of mind,rumination, and distraction

BACKGROUND: Although mindfulness meditation interventions have recently shown benefits for reducing stress in various populations, little is known about their relative efficacy compared with relaxation interventions. PURPOSE: This randomized controlled trial examines the effects of a 1-month mindfulness meditation versus somatic relaxation training as compared to a control group in 83 students (M age = 25; 16 men and 67 women) reporting distress. Method: Psychological distress, positive states of mind, distractive and ruminative thoughts and behaviors, and spiritual experience were measured, while controlling for social desirability. RESULTS: Hierarchical linear modeling reveals that both meditation and relaxation groups experienced significant decreases in distress as well as increases in positive mood states over time, compared with the control group (p < .05 in all cases). There were no significant differences between meditation and relaxation on distress and positive mood states over time. Effect sizes for distress were large for both meditation and relaxation (Cohen's d = 1.36 and .91, respectively), whereas the meditation group showed a larger effect size for positive states of mind than relaxation (Cohen's d =.71 and .25, respectively). The meditation group also demonstrated significant pre-post decreases in both distractive and ruminative thoughts/behaviors compared with the control group (p < .04 in all cases; Cohen's d = .57 for rumination and .25 for distraction for the meditation group), with mediation models suggesting that mindfulness meditation's effects on reducing distress were partially mediated by reducing rumination. No significant effects were found for spiritual experience. CONCLUSIONS: The data suggest that compared with a no-treatment control, brief training in mindfulness meditation or somatic relaxation reduces distress and improves positive mood states. However, mindfulness meditation may be specific in its ability to reduce distractive and ruminative thoughts and behaviors, and this ability may provide a unique mechanism by which mindfulness meditation reduces distress.     

Electrophysiological evidence of the differential modulation of approach‐related processes toward attractive foods by immersive or mindful viewing conditions

Awareness of mental events as mere representations rather than as accurate depictions of reality, also known as dereification, is one of the key features of mindfulness meditation. Dereification is juxtaposed to subjective realism, the process of being lost or totally immersed in the contents of one's mind. Excessive subjective realism is a hallmark of several psychiatric disorders. Here, we investigated whether a “mindful” (dereified) compared with an “immersed” (highly subjectively real) attitude, induced by instructions, differentially modulates approach‐avoidance tendencies when processing visual stimuli. We presented novices and experienced meditators with neutral and attractive food images under both mindful and immersed states. Then, participants performed an approach–avoidance Task (AAT) during which we obtained behavioral data, salivary volume, EEG recordings, and self‐report measures. The approach bias toward attractive food was correlated with N2 amplitude, a marker of response inhibition, and the regulation of this bias by the mindful instruction compared to the immersed instruction was associated with a modulation of the visual N1 amplitude, a marker of early selective attention. Individuals with more expertise in mindfulness meditation engaged in less late affective reappraisal during mindfulness than during immersion, as measured by lower amplitude in the late positive potential (LPP). Additionally, the ERPs sensitive to the AAT manipulation was also associated to self‐report measures of subjective realism, food bias, and mindfulness meditation expertise but not to salivation measures. These findings provide novel insights into the mechanisms by which mindfulness‐based interventions could be effective in a range of psychiatric conditions.     

The effect of focused attention and open monitoring meditation on attention network function in healthy volunteers

Mindfulness meditation techniques are increasingly popular both as a life-style choice and therapeutic adjunct for a range of mental and physical health conditions. However, little is known about the mechanisms through which mindfulness meditation and its constituent practices might produce positive change in cognition and emotion. Our study directly compared the effects of Focused Attention (FA) and Open-Monitoring (OM) meditation on alerting, orienting and executive attention network function in healthy individuals. Participants were randomized to three intervention groups: open-focused meditation, focused attention, and relaxation control. Participants completed an emotional variant of the Attention Network Test (ANT) at baseline and post-intervention. OM and FA practice improved executive attention, with no change observed in the relaxation control group. Improvements in executive attention occurred in the absence of change in subjective/self-report mood and cognitive function. Baseline levels of dispositional/trait mindfulness were positively correlated with executive control in the ANT at baseline. Our results suggest that mindfulness meditation might usefully target deficits in executive attention that characterise mood and anxiety disorders.     

Meditation and psychotherapy: a rationale for the integration of dynamic psychotherapy, the relaxation response, and mindfulness meditation

A framework for the integration of meditation and psychotherapy is presented through a consideration of the psychobiological nature of meditation (the relaxation response) and discussion of a traditional meditation practice (mindfulness meditation) as an effective cognitive technique for the development of self-awareness. The mechanisms by which the emotional and cognitive changes of meditation can be of therapeutic value are explored and the synergistic advantages of the combination of psychotherapy and meditation are discussed.     

Mindfulness meditation training alters stress-related amygdala resting state functional connectivity: a randomized controlled trial

Recent studies indicate that mindfulness meditation training interventions reduce stress and improve stress-related health outcomes, but the neural pathways for these effects are unknown. The present research evaluates whether mindfulness meditation training alters resting state functional connectivity (rsFC) of the amygdala, a region known to coordinate stress processing and physiological stress responses. We show in an initial discovery study that higher perceived stress over the past month is associated with greater bilateral amygdala-subgenual anterior cingulate cortex (sgACC) rsFC in a sample of community adults (n = 130). A follow-up, single-blind randomized controlled trial shows that a 3-day intensive mindfulness meditation training intervention (relative to a well-matched 3-day relaxation training intervention without a mindfulness component) reduced right amygdala-sgACC rsFC in a sample of stressed unemployed community adults (n = 35). Although stress may increase amygdala-sgACC rsFC, brief training in mindfulness meditation could reverse these effects. This work provides an initial indication that mindfulness meditation training promotes functional neuroplastic changes, suggesting an amygdala-sgACC pathway for stress reduction effects.     

Impact of meditation training on the default mode network during a restful state

Mindfulness meditation has been shown to promote emotional stability. Moreover, during the processing of aversive and self-referential stimuli, mindful awareness is associated with reduced medial prefrontal cortex (MPFC) activity, a central default mode network (DMN) component. However, it remains unclear whether mindfulness practice influences functional connectivity between DMN regions and, if so, whether such impact persists beyond a state of meditation. Consequently, this study examined the effect of extensive mindfulness training on functional connectivity within the DMN during a restful state. Resting-state data were collected from 13 experienced meditators (with over 1000 h of training) and 11 beginner meditators (with no prior experience, trained for 1 week before the study) using functional magnetic resonance imaging (fMRI). Pairwise correlations and partial correlations were computed between DMN seed regions’ time courses and were compared between groups utilizing a Bayesian sampling scheme. Relative to beginners, experienced meditators had weaker functional connectivity between DMN regions involved in self-referential processing and emotional appraisal. In addition, experienced meditators had increased connectivity between certain DMN regions (e.g. dorso-medial PFC and right inferior parietal lobule), compared to beginner meditators. These findings suggest that meditation training leads to functional connectivity changes between core DMN regions possibly reflecting strengthened present-moment awareness.     

Integrating mindfulness meditation with cognitive and behavioural therapies: the challenge of combining acceptance- and change-based strategies.

Recent innovations in psychological treatments have integrated mindfulness meditation techniques with traditional cognitive and behavioural therapies, challenging traditional cognitive and behavioural therapists to integrate acceptance- and change-based strategies. This article details how 2 treatments, mindfulness-based cognitive therapy and dialectical behaviour therapy, have met this challenge. We review the integration rationale underlying the 2 treatments, how the treatments combine strategies from each modality to accomplish treatment goals, implications for therapist training, and treatment effectiveness. In addition, we discuss the challenges of assessing the benefits of incorporating acceptance-based strategies. Both therapies have integrated acceptance-based mindfulness approaches with change-based cognitive and behavioural therapies to create efficacious treatments.     

Neural correlates of mindfulness meditation-related anxiety relief

Anxiety is the cognitive state related to the inability to control emotional responses to perceived threats. Anxiety is inversely related to brain activity associated with the cognitive regulation of emotions. Mindfulness meditation has been found to regulate anxiety. However, the brain mechanisms involved in meditation-related anxiety relief are largely unknown. We employed pulsed arterial spin labeling MRI to compare the effects of distraction in the form of attending to the breath (ATB; before meditation training) to mindfulness meditation (after meditation training) on state anxiety across the same subjects. Fifteen healthy subjects, with no prior meditation experience, participated in 4 d of mindfulness meditation training. ATB did not reduce state anxiety, but state anxiety was significantly reduced in every session that subjects meditated. Meditation-related anxiety relief was associated with activation of the anterior cingulate cortex, ventromedial prefrontal cortex and anterior insula. Meditation-related activation in these regions exhibited a strong relationship to anxiety relief when compared to ATB. During meditation, those who exhibited greater default-related activity (i.e. posterior cingulate cortex) reported greater anxiety, possibly reflecting an inability to control self-referential thoughts. These findings provide evidence that mindfulness meditation attenuates anxiety through mechanisms involved in the regulation of self-referential thought processes.     

The neural substrates of mindfulness: An fMRI investigation

“Mindfulness” is a capacity for heightened present-moment awareness that we all possess to a greater or lesser extent. Enhancing this capacity through training has been shown to alleviate stress and promote physical and mental well-being. As a consequence, interest in mindfulness is growing and so is the need to better understand it. This study employed functional magnetic resonance imaging (fMRI) to identify the brain regions involved in state mindfulness and to shed light on its mechanisms of action. Significant signal decreases were observed during mindfulness meditation in midline cortical structures associated with interoception, including bilateral anterior insula, left ventral anterior cingulate cortex, right medial prefrontal cortex, and bilateral precuneus. Significant signal increase was noted in the right posterior cingulate cortex. These findings lend support to the theory that mindfulness achieves its positive outcomes through a process of disidentification.     

Mindfulness meditation regulates anterior insula activity during empathy for social pain

Mindfulness has been shown to reduce stress, promote health, and well‐being, as well as to increase compassionate behavior toward others. It reduces distress to one's own painful experiences, going along with altered neural responses, by enhancing self‐regulatory processes and decreasing emotional reactivity. In order to investigate if mindfulness similarly reduces distress and neural activations associated with empathy for others' socially painful experiences, which might in the following more strongly motivate prosocial behavior, the present study compared trait, and state effects of long‐term mindfulness meditation (LTM) practice. To do so we acquired behavioral data and neural activity measures using functional magnetic resonance imaging (fMRI) during an empathy for social pain task while manipulating the meditation state between two groups of LTM practitioners that were matched with a control group. The results show increased activations of the anterior insula (AI) and anterior cingulate cortex (ACC) as well as the medial prefrontal cortex and temporal pole when sharing others' social suffering, both in LTM practitioners and controls. However, in LTM practitioners, who practiced mindfulness meditation just prior to observing others' social pain, left AI activation was lower and the strength of AI activation following the mindfulness meditation was negatively associated with trait compassion in LTM practitioners. The findings suggest that current mindfulness meditation could provide an adaptive mechanism in coping with distress due to the empathic sharing of others' suffering, thereby possibly enabling compassionate behavior. Hum Brain Mapp 38:4034–4046, 2017. © 2017 Wiley Periodicals, Inc.     

Mindfulness Meditation for Chronic Pain: Systematic Review and Meta-analysis

Background

Chronic pain patients increasingly seek treatment through mindfulness meditation.

Purpose

This study aims to synthesize evidence on efficacy and safety of mindfulness meditation interventions for the treatment of chronic pain in adults.

Method

We conducted a systematic review on randomized controlled trials (RCTs) with meta-analyses using the Hartung-Knapp-Sidik-Jonkman method for random-effects models. Quality of evidence was assessed using the GRADE approach. Outcomes included pain, depression, quality of life, and analgesic use.

Results

Thirty-eight RCTs met inclusion criteria; seven reported on safety. We found low-quality evidence that mindfulness meditation is associated with a small decrease in pain compared with all types of controls in 30 RCTs. Statistically significant effects were also found for depression symptoms and quality of life.

Conclusions

While mindfulness meditation improves pain and depression symptoms and quality of life, additional well-designed, rigorous, and large-scale RCTs are needed to decisively provide estimates of the efficacy of mindfulness meditation for chronic pain.

     

Individuals with mental illness can control their aggressive behavior through mindfulness training

Verbal and physical aggression are risk factors for community placement of individuals with serious and persistent mental illness. Depending on the motivations involved, treatment typically consists of psychotropic medications and psychosocial interventions, including contingency management procedures and anger management training. Effects of a mindfulness procedure, Meditation on the Soles of the Feet , were tested as a cognitive behavioral intervention for verbal and physical aggression in 3 individuals who had frequently been readmitted to an inpatient psychiatric hospital owing to their anger management problems. In a multiple baseline across subjects design, they were taught a simple meditation technique, requiring them to shift their attention and awareness from the anger-producing situation to the soles of their feet, a neutral point on their body. Their verbal and physical aggression decreased with mindfulness training; no physical aggression and very low rates of verbal aggression occurred during 4 years of follow-up in the community.