Mindfulness is a term that gathered a lot of attention over the last few years, but what exactly is it? How do you practice it? Does it actually work? Well, this article hopes to answer these questions as well as possible based on the current scientific literature.
First of all, Mindfulness is a rather broad term, being used as a synonym of several exercises that use it as a base. The actual term is derived from a Buddhist concept that means “memory” or “being aware of something”, but is interpreted as “lucid awareness”1. Through this concept, several practices were created, but this text will focus on Mindfulness Meditation and its effects.
Simply put, mindfulness is moment-to-moment non-judgmental awareness. It is cultivated by purposefully paying attention to things we ordinarily never give a moment’s thought to. It is a systematic approach to developing new kinds of agency, control, and wisdom in our lives, based on our inner capacity for paying attention and on the awareness, insight, and compassion that naturally arise from paying attention in specific ways.2 p. 39
While Mindfulness Meditation is also a somewhat broad term, it is basically a practice of paying attention to present moment experience, and it can be done by a concrete approach of focusing on objects or your body, or by letting the mind wonder, while being aware of the different thoughts and emotions that may arise. One of the most popular ways to begin practicing it is to focus on determined parts of one’s body and to sustain that attention for a period, not allowing interference from distracting factors.1
There are several other practices that start with the same base, such as Mindfulness-Based Interventions (MBIs), adapted from Mindfulness-Based Stress Reduction (MBSR), and Mindfulness-Based Cognitive Therapy (MBCT). All of those have different advantages and varying degrees of sustained practice and teacher-participant relationship. The more structured and standardized practices came to be called Mindfulness-Based Programs (MBPs), focusing more on sustaining and developing the Mindfulness Meditation (MM) practices for all participants.
Now, before practicing, there is a need to inform that MM, although a simple and non-invasive practice, is not entirely without adverse effects. Even though they are incredibly rare, a subset of adverse reactions may occur during the awareness training, like panic attacks, trauma flashbacks and dissociation. These are more likely to affect people with Post Traumatic Stress Disorder (PTSD), but it does not classify as a contraindication to MM. The recommendation is that people who suffer from PTSD should be monitored during the practices by experienced teachers and in environments that stimulate self-compassion as a way to counter the shame-based mechanism of PTSD, which, in turn, can actually help reduce its symptoms.3
Moving on to the benefits of MM, neuroimaging studies have linked the practice of MM to the activation of different networks depending on the type of practice chosen. Due to the multitude of varied MM techniques, the evidence for each effect is difficult to appraise, but certain mechanisms should be highlighted. The first is the improvement of higher cognitive processes related to attention, namely memory, decision-making and behavior control,4 which are paramount to improving lifestyle choices, both by increasing awareness of better options and inhibiting automatic, less healthy, decisions1. It should also be noted that this particular mechanism can also increase cognitive function in older adults, mainly people with Mild Cognitive Impairment and early stage Alzheimer’s, improving quality of life.5
Another major neurologic function improvement is emotional regulation, which explains the evidence of MM techniques decreasing minor to moderate depression and anxiety symptoms in adults6, adolescents7 and the elderly.5 This may be due to stimulating a reappraisal mechanism, with mindfulness interrupting automatic emotional responses and allowing for conscious reflection e reinterpretation of situations, which leads to a lessened emotional impact and breaking cycles of self-deprecating thoughts and behaviors that perpetuate anxiety and depression symptoms.1
Also, in stress reduction approaches (MBSR), mindfulness has been shown to both improve stress coping mechanisms and decrease bother perception of menopause symptoms in older women. The decrease impact of hot flashes correlated with significant gains in quality of life and sleep.8
And last, some studies show that MM also helps control high blood pressure, one of the most common risk factor to cardiovascular diseases like strokes and heart attacks.9 The effects are more pronounced in adults with hypertension, presenting anxiety or depression disorders as commorbidities10, and in adults with higher blood pressure levels before interventions.9 The mechanisms for these effects is still under debate, but one must consider what was said before about behavior change helping improve lifestyle and also stress reduction decreasing adrenaline and cortisol blood levels, both hormones that increase blood pressure.
Mindfulness techniques, though varied, seem to improve a wide range of quality of life aspects, in the realms of both physical and mental health, through positive health promotion and disease management. These techniques show very rare adverse effects and constitute a simple and non-invasive approach to improving one’s health overall, with increasing interest being gathered over the recent decades and a promising future.
References
1. Schuman-Olivier Z, Trombka M, Lovas DA, Brewer JA, Vago DR, Gawande R, et al. Mindfulness and Behavior Change. Harvard Review of Psychiatry [Internet]. 2020;28(6):371–94. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7647439/
2. Kabat-Zinn J. Full catastrophe living : using the wisdom of your body and mind to face stress, pain, and illness. New York, N.Y.: Bantam Dell; 1990.
3. Gawande R, To MN, Pine E, Griswold T, Creedon TB, Brunel A, et al. Mindfulness Training Enhances Self-Regulation and Facilitates Health Behavior Change for Primary Care Patients: a Randomized Controlled Trial. Journal of General Internal Medicine [Internet]. 2018 Dec 3;34(2):293–302. Available from: https://link.springer.com/article/10.1007/s11606-018-4739-5
4. Diamond A. Executive functions. Annual Review of Psychology [Internet]. 2013 Jan 3;64(1):135–68. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4084861/
5. Whitfield T, Barnhofer T, Acabchuk R, Cohen A, Lee M, Schlosser M, et al. The Effect of Mindfulness-based Programs on Cognitive Function in Adults: A Systematic Review and Meta-analysis. Neuropsychology Review. 2021 Aug 4;32.
6. Lee SH, Cho SJ. Cognitive Behavioral Therapy and Mindfulness-Based Cognitive Therapy for Depressive Disorders. In: Major depressive disorder : rethinking and understanding recent discoveries. Singapore: Springer; 2021. p. 295–310.
7. Skeen S, Laurenzi CA, Gordon SL, du Toit S, Tomlinson M, Dua T, et al. Adolescent Mental Health Program Components and Behavior Risk Reduction: A Meta-analysis. Pediatrics [Internet]. 2019 Aug 1;144(2). Available from: https://pubmed.ncbi.nlm.nih.gov/31262779/
8. Carmody JF, Crawford S, Salmoirago-Blotcher E, Leung K, Churchill L, Olendzki N. Mindfulness training for coping with hot flashes. Menopause. 2011 Jun;18(6):611–20.
9. Chen Q, Liu H, Du S. Effect of mindfulness-based interventions on people with prehypertension or hypertension: a systematic review and meta-analysis of randomized controlled trials. BMC Cardiovascular Disorders. 2024 Feb 14;24(1).
10. Zhang H, Zhang H, Zhang H, Zhang H, Zhang H, Zhang H, et al. Mindfulness-based intervention for hypertension patients with depression and/or anxiety in the community: a randomized controlled trial. Trials. 2024 May 2;25(1).
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