INSTRUCTIONS

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Course Presenter(s):
Author(s): David Lukoff, Ph.D. | (click author name for biography)




Course Description: For over 30 years, Jon Kabat-Zinn has pioneered the integration of mindfulness meditation in mainstream medicine and healthcare. Though adapted from Buddhist practices, the contemporary practice of mindfulness used in the Mindfulness Based Stress Reduction (MBSR) program is not spiritually based and is therefore open to everyone no matter their religious commitments or life circumstances. This course describes the theory and research behind MBSR.
BACKGROUND AND DESCRIPTION
 
Jon Kabat-Zinn, PhD, the developer of MBSR, received his PhD in molecular biology in 1971 from MIT where he studied under Salvador Luria, Nobel Laureate in medicine. He was one of the earliest students of Korean Zen Master Seung Sahn and was a founding member and former director of  the Cambridge Zen Center in the early 1970s. His Buddhist training has included study with several other Buddhist teachers. Although he also studied karate and yoga, he described how he made the connection between healthcare applications and his Buddhist practice while interning in a hospital.
 
 
 
 
 
 
 

Ever since I began practicing meditation, I have felt an enormous need to bring meditation into the mainstream, particularly in environments like hospitals. They function in our society as "dukkha" (suffering) magnets: they draw in people whose lives are out of control with pain and suffering… it seemed that a hospital would be a perfect place to train people in meditative awareness. They could optimize their inner resources for healing and take responsibility for their health. John Kabat-Zinn in Mindful Medicine: An interview with Jon Kabat-Zinn

Yet Kabat-Zinn points out that the vast majority of his patients have no or  minimal interest in Buddhism per se:

The people we see, they don't know about enlightenment, they don't WANT it! They're coming because of their suffering; it's a situation made to order for Buddhist work. Jon Kabat-Zinn in Mindful Medicine: An interview with Jon Kabat-Zinn
 
The principle of mindfulness on which MBSR is based was originally articulated in Buddhist teachings, the essence of which Kabat-Zinn has defined as "above all the regular, disciplined practice of moment-to-moment awareness, or mindfulness, the complete 'owning' of each moment of your experience, good, bad, or ugly" (Kabat-Zinn J (1990). Full catastrophe living: Using wisdom of your body and mind to face stress. New York: Bantam Dell, p. 11.) Though adapted from Buddhist practices, the contemporary practice of mindfulness used in the MBSR program is not spiritually based and is therefore open to everyone no matter their life circumstances. MBSR has been practiced with youths and elders, sick and healthy, professionals and monks. Kabat-Zinn explained the universal applicability of MBSR as follows:
 

Although at this time, mindfulness meditation is most commonly taught and practiced within the context of Buddhism, its essence is universal. . . Yet it is no accident that mindfulness comes out of Buddhism, which has as its overriding concerns the relief of suffering and the dispelling of illusions. Kabat-Zinn J (2005) Coming to our senses: Healing  ourselves and the world through mindfulness, New York: Hyperion, p. 12-13.

The mindfulness taught as part of MBSR is actually a combination of 2 forms of Zen meditation:  Vipassana and Zen:
 
Mindfulness is often spoken of as the heart of Buddhist meditation. It was one of the major teachings of the Buddha, ramified through all of the different traditions of Asia. We try to teach in a way that combines intuitively the best of the Vipassana orientation with the most accessible and least cryptic of the Zen energy. The combination is quite wonderful. We use the breath as a major focus of awareness, and then we integrate it with a range of different experiences. Then we get mindfulness of breathing with emotional waves as they rise up in the mind and the body, mindfulness of sounds and thoughts and feelings and external situations that may be threatening or joyous or whatever. Mindful Medicine: An interview with Jon Kabat-Zinn 

Kabat-Zinn’s work has been instrumental in bringing Buddhist meditative practices, as he likes to say, "without the Buddhism" to full acceptance within the mainstream of medicine, psychology, and health care, and has shown them to be effective in people suffering from a wide range of psychological and medical condition

MBSR RESEARCH
 
The Mindfulness Based Stress Reduction (MBSR) program was developed by Jon Kabat-Zinn in the Stress Reduction Clinic at the University of Massachusetts Medical Center in 1979 and is now offered in over 200 medical centers, hospitals, and clinics around the world, including some of the leading integrative medical centers such as the Scripps Center for Integrative Medicine, the Duke Center for Integrative Medicine, and the Jefferson-Myrna Brind Center for Integrative Medicine. Many of the MBSR classes are taught by physicians, nurses, social workers, and psychologists, as well as other health professionals who are seeking to reclaim and deepen some of the sacred reciprocity inherent in the doctor-caregiver/patient-client relationship. Their work is based on a need for an active partnership in a participatory healthcare, one in which patient/clients take on significant responsibility for doing a certain kind of interior work in order to tap into their own deepest inner resources for learning, growing, healing, and transformation.
 

MBSR has evolved into a popular form of complementary treatment that has been clinically proven beneficial for people struggling with a variety of health problems. Dr. Kabat Zinn summarized findings:

Overall, controlled clinical studies carried out by the center have documented symptom reductions of between 29% and 46% among class participants. Breaking it down by condition, people with heart disease experienced a 45% reduction in symptoms; high blood pressure, 43%;     pain, 25%, and stress, 31%. Those are the kind of numbers that get the attention of health care providers trying to control costs. Insurance companies and HMOs like Tufts are now picking up at least some of the cost for about a quarter of the program’s participants. Shambala Sun Interview

A more complete summary of research findings on MBSR is available on the web site of the University of Massachusetts Center for Mindfulness.
 

KABAT-ZINN’S STUDIES PUBLISHED IN PEER-REVIEWED JOURNALS

First Peer Reviewed Publications:

Kabat-Zinn J (1992) An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: theoretical considerations and preliminary results. Gen Hosp Psychiatry. 4(1): 33-47.

Kabat-Zinn J, Massion AO, Kristeller J, Peterson LG, Fletcher KE, Pbert L, Lenderking WR, Santorelli SF (1992) Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. Am J Psychiatry 149(7): 936-43.

All of Jon Kabat-Zinn’s publications can be found on PubMed.

OTHER MBSR STUDIES IN PEER-REVIEWED JOURNALS
 
 

Chapman BP,  Moynihan J (2009). The brain-skin connection: Role of psychosocial factors and neuropeptides in psoriasis. Expert Rev Clin Immunol 5(6): 623-7.

Chiesa A,  Serretti A (2009). Mindfulness-based stress reduction for stress management in healthy people: A review and meta-analysis. J Altern Complement Med 15 (5): 593-600.

Carmody J, Crawford S, Churchill L (2006). A pilot study of mindfulness-based stress reduction for hot flashes. Menopause 13(5): 760-9.

Pradhan,EK, Baumgarten M, Langenberg P, Handwerger B, Gilpin AK, Magyari T, Hochberg MC, Berman BM (2007). Effect of mindfulness-based stress reduction in rheumatoid arthritis patients. Arthritis Care & Research 57(7): 1134-42.

Rosenzweig S, Greeson JM, Reibel DK, Green JS, Jasser SA, Beasley D (2010). Mindfulness-based stress reduction for chronic pain conditions: Variation in treatment outcomes and role of home meditation practice. J Psychosom Res 68(1): 29-36.

Additional Research on MBSR: 

Staying Well: A Clinical Trial of Mindfulness-Based Stress Reduction and Education Groups for HIV

A Mindfulness Based Approach to HIV Treatment Side Effects

Massage, Meditation, and Tai Chi for Chronic Lower Back Pain

The National Institutes of Health's National Center for Complementary and Alternative Medicine has provided a number of grants to research the efficacy of the MBSR program in promoting healing. Completed studies have found that pain-related drug utilization was decreased, and activity levels and feelings of self-esteem increased, for a majority of participants. More information on these studies can be found on the University of Massachusetts Medical School website:  Center for Mindfulness. See the abstracts here.

MBSR TRAINING PROGRAMS

The intensive MBSR training programs meet on a weekly basis for eight to ten weeks and consist of 2.5 hour weekly classes along with a single all-day class. Mindfulness practice has been found to be clinically effective at cultivating greater awareness of the unity of mind and body, as well as of the ways the unconscious thoughts, feelings, and behaviors can undermine emotional, physical, and spiritual health. The mind is known to be a factor in stress and stress-related disorders, and meditation has been shown to positively affect a range of autonomic physiological processes, such as lowering blood pressure and reducing overall arousal and emotional reactivity (See Herbert Benson course). In addition to mindfulness practices, MBSR uses yoga to help reverse the prevalence of disuse atrophy from our culture's largely sedentary lifestyle, especially for those with pain and chronic illnesses. The program brings meditation and yoga together so that the virtues of both can be experienced simultaneously. The non-judgmental awareness of contemporary practice of mindfulness, as exemplified by the MBSR program, has gained widespread practice in medicine and has numerous applications in health. Mindfulness is a lifetime engagement--not to get somewhere else, but to be where and as we actually are in this very moment, whether the experience is pleasant, unpleasant, or neutral. 

Although Dr. Kabat-Zinn has retired, the Center for Mindfulness at the University of Massachusetts carries on his research and provides training in MBSR. More information can be found here.

MEDIA
 
Mindfulness Stress Reduction And Healing

In thie following video, Jon Kabat-Zinn describes the revolution in medicine that has occurred over the past 30 years that has integrated the mind back into the body and developed a wide range of practices for integrating one's experience, reducing stress, healing the body, coping more effectively with emotions such as anxiety, anger, and depression, and cultivating greater well-being and happiness.

Mindfulness with Jon Kabat-Zinn

In the video above, Jon Kabat-Zinn leads a session on MBSR at Google on November 11, 2007. After an extended introduction and description, the meditation practice itself begins around minute 21.

 


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True/False Comprehension Quiz

QuestionAnswer
MBSR uses candle gazing as the major focus of awareness.
A brief mindfulness meditation program has no effect on the positive functioning of the immune system.
MBSR practice will sometimes include yoga or other movement-based practices, such as karate.
Ongoing practice with the MBSR technique has a physiological effect on the autonomic nervous system thereby reducing the person's emotional reactivity.
Patients with anxiety disorders show clinically and statistically significant improvements in their symptoms following participation in a 2-month MBSR intervention.
The mindfulness technique at the heart of MBSR is based on a Buddhist practice of cultivating moment-to-moment awareness of one’s present experience, whether it is good, bad, or neutral.
Mindfulness Based Stress Reduction (MBSR) requires that practitioners adopt a spiritual lifestyle prior to practicing the technique
The regular practice of mindfulness meditation practice has been shown to increase hormone levels linked with health and disease prevention.

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