The Art of Being Mindful

Mara Davidson, ND, MS, MBA

Vis Medicatrix Naturae

Decreasing Anxiety with Mindfulness Meditation

“Mind! Mind!” – a common warning given by my Scottish great-grandmother to take care and be cautious – is still frequently used by my family several decades after her death. The notion of being mindful to one’s surroundings has been ingrained in the back of my mind since childhood. But making a conscious effort to be mindful to oneself, although conceptually in place, is not always put into action. The practice of mindfulness in regards to meditation is something I strive for daily and try to impart to my patients, particularly those with high stress and anxiety, so that they may embark on their own mindfulness meditation journey.

Described as an intentional self-governance of attention, all within the realm of moment to moment, the objective of meditation is to both calm and relax the mind and body. Meditation is taken from 2 Latin words: meditari, meaning to think, exercise the mind, or dwell upon; and mederi, meaning to heal.1 Meditation provides for a gentle yet effective way to treat various conditions. These range from general health concerns to specific conditions, particularly those associated with stress.2 Additionally, meditation is thought to be only 1 of 3 strategies that are self-regulatory and are useful and efficacious in managing anxiety.3

Mindfulness is frequently referred to as the process by which a mental state is identified via nonjudgmental awareness within the experience of the present moment. Examples include one’s thoughts, consciousness, sensations, environment, and bodily states, while simultaneously encouraging curiosity, openness, and acceptance.4 Several mindfulness-based techniques are derived from and can be traced back to one of the most ancient forms of India’s meditative techniques, Vipassana meditation. Vipassana can be deconstructed into 2 words: Vi, meaning special, and passana, meaning to see or to observe. Vipassana is found in the Pali language; when translated into English, the Pali word Sati becomes “mindfulness.”3

Mindfulness Meditation

Achieving enhanced mindfulness can be accomplished through general meditative practices. Mindfulness meditation (MM), whose beginnings stem from Eastern contemplative practices, includes exercises such as a body scan during walking or seated meditations. A body scan exercise involves guiding one’s attention progressively through the body while focusing on the sensations within each area.5 The purpose of MM is to promote continuous and clear comprehension and awareness of ongoing objective and subjective occurrences. This awareness is then further combined with a mindset of both openness to and acceptance of any and all experiences that may emerge.1

While practicing MM, thoughts and feelings regarded as distracting should not be ignored, but rather recognized and accepted with a nonjudgmental attitude as they occur. This permits the individual to disassociate from them, with the goal of obtaining insight, compassion, and awareness, as well as developing the facility for more adaptive and flexible coping mechanisms. Researchers consider that growing and developing these characteristics may provide individuals with the realization of a larger sense and awareness of health and well-being. This important process allows the mind to be “still,” which allows the mind’s routine regulatory patterns to be suspended. This, in turn, increases one’s awareness of the present moment.1

Originating from Buddhist tradition and practices, MM is becoming ever more popular in Western countries. While a dramatically increasing interest in both mindfulness and meditation throughout several fields has emerged over the last few years, the use of MM has focused significantly on stress, pain, depression, and anxiety.6 In MM, slow and deep breathing strategies are used. These are believed to ease distress through the balancing of sympathetic and parasympathetic responses.1

Anxiety & Mindfulness

As of late, there has been an ever-growing interest in mindfulness-based interventions, as they are cost-effective, low-stigma, and quite obtainable treatment options for a number of psychological and medical symptoms, one being anxiety.5

Anxiety is an excessive fear and/or unwarranted fear that inhibits and interferes with a person’s overall functioning. Six subtypes are found within the category of anxiety disorders, all of which share common components of emotional experience along with cognitive and informational processes. These are characterized by the dysregulation of physiological, behavioral, emotional, and/or cognitive processes.3 Generalized Anxiety Disorder (GAD) is described as worry that is challenging to take hold of and control. Common symptomatology includes muscle tension, irritability, and poor sleep.5 Those with GAD chronically focus on negative events that have yet to occur, as well as feelings of an apprehension. Worry – a hallmark of GAD – evokes an experiential evasion of anxiety, consequently inhibiting emotional processing that is necessary to overcome anxiety. Persons with GAD customarily respond to an ungrounded/fabricated perceived threat, as opposed to focusing on the experience within the present moment, which would allow for an alternative response that may permit adaptive responding. In essence, the mechanism by which mindfulness works in anxiety is the development of effective emotional regulation skills, along with a process of separating external circumstances from internal experience, which is otherwise exacerbated by worry and other kinds of verbal activity.3

Another characterized form of anxiety is Social Anxiety Disorder (SAD). This is an oftentimes debilitating condition described as profound fear of evaluation in social and/or performance scenarios. SAD is strongly related to tremendous distress along with functional impairment regarding the work and social sphere.7 SAD patients have a significant propensity to focus on internal and external cues over the course of social situations. Examples of internal cues include self-image and negative thinking, whereas external cues might include individuals’ facial expressions.8

It has been found that mindfulness meditation training, when conducted as Mindfulness-Based Stress Reduction (MBSR), can lessen anxiety symptoms in individuals with GAD.5 MBSR includes multiple types of mindfulness practice, such as formal and informal meditation practices, and hatha yoga.8 Importantly, research has shown that formal meditative training is not necessary when a person has higher trait mindfulness. Mindfulness may reduce patients’ risk of developing anxiety and depression disorders.1 Furthermore, MBSR may provide assistance with mitigating avoidance while increasing attentional allocation in patients with SAD. This is further evidenced by a correlation between reduced SAD symptoms and increased neuronal response in brain regions related to visual attention.8 Additionally, individuals who learned MM have been found to cope better over the course of a laboratory stress challenge, allowing for the possibility that mindfulness could instill a bit of resistance to stressful psychological challenges.5

A common misconception exists regarding MM. It should be clear that MM is not an act of prayer or worship. Rather, MM is taught apart and independently from the originating cultural and spiritual traditions from which it began.1 Additionally, understanding important differences between MM and similar modalities, as well as knowing what MM is and what it is not, is key to appreciating its value. MM is distinct and different from relaxation. Although meditative practice can induce a comprehensive set of beneficial physiological changes, such as lowered heart, metabolic, and breathing rate, MM and its true practice produces an active and intentional state of awareness. Although a relaxing state may be a consequence of MM, its purpose is not to provide that calming effect. Rather, MM instructs its participants to mitigate prolonged reactivity to negative stimuli.1

Closing Comment

My great-grandmother had it right: “Mind! Mind!” Mindfulness is indeed the best way to improve all aspects of our lives, from coping with anxiety to finding better ways to stay healthy. It is a remarkably effective practice for both mind and body that can be used by all.

References:

  1. Edenfield TM, Saeed SA. An update on mindfulness meditation as a self-help treatment for anxiety and depression. Psychol Res Behav Manag. 2012;5:131-141.
  2. Goyal M, Singh S, Sibinga EM, et al. Meditation programs for psychological stress and well-being: A systematic review and meta-analysis. JAMA Intern Med. 2014;174(3):357-368.
  3. Sharma MP, Mao A, Sudhir PM. Mindfulness-based cognitive behavior therapy in patients with anxiety disorders: A case series. Indian J Psychol Med. 2012;34(3):263-269.
  4. Hofmann SG, Sawyer AT, Witt AA, Oh D. The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. J Consult Clin Psychol. 2010;78(2):169-183.
  5. Hoge EA, Bui E, Marques L, et al. Randomized controlled trial of mindfulness meditation for generalized anxiety disorder: Effects on anxiety and stress reactivity. J Clin Psychiatry. 2013;74(8):786-792.
  6. Laneri D, Schuster V, Dietsche B, et Effects of long-term mindfulness meditation on brain’s white matter microstructure and its aging. Front Aging Neurosci. 2016;7:254.
  7. Goldin P, Ramel W, Gross J. Mindfulness meditation training and self-referential processing in social anxiety disorder: Behavioral and neural effects. J Cognitive Psychother. 2009;23(3);242-257.
  8. Goldin P, Gross J. Effects of mindfulness-based stress reduction (MBSR) on emotion regulation in social anxiety disorder. Emotion. 2010;10(1):83-91.

    Mara Davidson, ND, MS, MBA, is a dual honors graduate of the University of Bridgeport College of Naturopathic Medicine and the Nutrition Institute (Master of Science in Human Nutrition). While in medical school, she also obtained her Master of Business Administration in Health Care Management from Davenport University. Practicing as a naturopathic physician at the Shalva Clinic in Westport, CT, Dr Davidson sees patients of all ages for acute as well as chronic conditions. Part of Dr Davidson’s practice is focused on anxiety and depression, anti-aging, and neurodegenerative diseases, as well as adjunctive oncological care. Email: drdavidson@shalvaclinic.org

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