Chapter 22: Examples of Recent Studies on Mindfulness-Based Therapies for treating Diseases

Mindfulness is also a “way of being;” development of the state of mind through meditative practice.  Buddhist mindfulness meditation is designed and intended to cultivate and maintain mindfulness throughout the day. We tend to lose the experiences of the beauty of our lives and the happiness, because we are often trapped in the past, dreaming about the (uncertain) future, or rushing from one moment to the next.  

The ability to maintain the mind in the present is a fundamental aspect that taught in all Buddhist mindfulness development methods.  The latter brings to a higher level when such practices are aligned with spirituality, compassion, and altruism.  As discussed below even truncated practices on mindfulness, (\as propagated in western countries have some benefits, albeit lasting a short duration.

The use of mindfulness-based intervention programs had been explored with basic clinical methods, such as assessing stress and anxiety reduction; weight reduction; as a therapy for cardiovascular disease and attention-deficient disorders.  Other have modified the standard MBSR to MBCT, testing acceptance and commitment therapy (ACT); as a behavioral therapy; and for mindfulness-based relapse prevention (MBRP), mindfulness-based therapeutic community (MBTC) treatment, and addictive disorders, etc.

In addition to the prevention of disease, there is a potential for curing certain disorders with the proper use of mindfulness development programs if the benefits are sustained. These can be used as an adjunct therapy (in contrast to using MBCT or MBSR) for individuals, allowing full recovery from their illnesses.

Most of the studies with MBSR had been used for demonstrating stress reduction. Mindfulness-based stress reduction intervention has also been mostly used as an intervention and treatment modality for stress, anxiety, and depression.  For example, a study conducted in pregnant women concluded that MBSR intervention improved self-reported prenatal stress and anxiety in comparison to a control group.  Researchers have reported that MBSR courses can be used to reduce anxiety and improve quality of life.

MBSR is thought to modify emotional responses following cognitive-affective processes. Reduction of symptoms of stress, anxiety, and depression following therapy with MBSR have tested in several clinical set-ups.

Compared with baseline, those who participated in MBSR programs have reported improving anxiety and depression symptoms, and self-esteem; social anxiety disorders (SAD).  In a short study of 14 patients reported that during the breath-focused attention, subjects demonstrated fewer negative emotions, reduction of activity of the amygdala, and increased activity in brain regions known to associated with attention.  Multiple short-term studies suggest that MBSR training in patients with SAD may reduce emotional reactivity while enhancing emotion regulation, SAD-related avoidance behaviors, clinical symptoms, and automatic emotional reactivity to negative self-beliefs.

Anxiety, depression, and chronic pain are major issues, especially among veterans. A complementary and alternative approach, using a brief 9 weeks course for MBSR had been examined in 79 veterans at an urban Veterans Health Administration medical facility. The authors used a pre- and post-MBSR questionnaires to assess pain, anxiety, depression, suicidal ideation, and physical and mental wellbeing of the participants.  They reported a significant reduction in anxiety, depression, and suicidal ideation following MBSR training, but not the intensity of pain and physical functionality. 

Changes in emotional clarity predict the status of social anxiety.  In comparison to those subjected to MBSR or a waitlist (WL) condition groups reported that the emotional clarity was significantly increased among patients who received cognitive-behavioral group therapy (CBGT) that persisted for one year.  Others have reported that CBT was more effective at reducing anxious arousal, while MBSR may be more effective at reducing worry and comorbid disorders.  Whereas, others have reported that MBSR attenuates maladaptive habitual self-views by facilitating automatic (i.e., uninstructed) recruitment of cognitive and attention regulation neural networks, highlighting a link between self-referential and the cognitive-attention regulation system. 

Anxiety and depression are common among those with adults with autism spectrum disorder (ASD).  The use of  MBSR and cognitive-behavioral therapies (CBT) have been demonstrated to be equally effective in reducing anxiety and depression symptoms among adults with ASD.  Study authors suggested that mindfulness and CBT are both promising treatment methods for reducing comorbid anxiety and depression in adults with ASD.  Others have reported MBSR can be used as an intervention to improve generalized anxiety disorder symptoms.

There are contradictory outcomes also reported in the literature.  For example, relative to MBSR and wait-list methods, cognitive-behavioral group therapy (CBGT) reported significantly improving positive affective empathy.  The latter also reported improving emotional empathy and social anxiety at follow-up assessments.  Whereas, others have suggested that intervention modalities should match the needs of patients with reference to the preferred form of treatment.

In future studies, researchers should focus on designing mindfulness-based, randomized controlled clinical trials with a modality that is effective in maintaining mindfulness for a longer duration. Mindfulness-based cognitive therapy has some effects on the relief of clinical signs and symptoms. The application of short-term, mindfulness-based cognitive therapy programs designed to evaluate immediate outcomes (analogous to testing the memory immediately after a training course), while having provided some basic information, is not the way forward into the future in this field.

What should be done to overcome the current research obstacles?

Considering this, the next level of research programs should address the following: (A) test hypotheses regarding the ability to reverse negative brain changes in those with chronic psychological stress disorders through the use of mindfulness meditation; (B) define methods to easily and affirmatively identify the right meditation technique for a given individual to aid the advancement of their meditative status, alleviating suffering or treating disorders; and (C) determine whether one could proactively use simple mindfulness development techniques to prevent the negative changes from happening in the brains of vulnerable people.

A recent systematic review concluded that early phases of mindfulness training (concerned with the development of focused attention) likely to associated with significant improvements in selective and executive attention, whereas advanced phases with non-judgmental monitoring of internal and external stimuli seem to be associated with improved, sustained attention and an enhanced capacity of the working memory and some executive functions.

Properly designed randomized control clinical studies would allow neuroscientists and other researchers to outline the effects of the practices of these techniques, in comparison with appropriate control groups, to evaluate the differences on behavior, cognitive function, underlying physiology and neurobiology, and clinical effectiveness in a more meaningful way.

The next chapter summarizes the modes of enhancing human cognition through meditation.

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Professor Sunil J. Wimalawansa, MD, PhD, MBA, DSc, is a physician-scientist, educator, social entrepreneur, and process consultant. He is a philanthropist with experience in long-term strategic planning and cost-effective investment and interventions globally for preventing non-communicable diseases [recent charitable work]. The author has no conflicts of interest and received no funding for this work.