Mindfulness

By: Ernest Shaw, MD
Last Reviewed on: April 16, 2002
Meditation is a practice that helps us to learn wise and skillful ways to harness the ordinary power of our minds. Mindfulness, the paying of bare or direct attention to each moment of our lives, is the most crucial aspect of meditation practice. Mindfulness may be used as a vehicle for change, healing, and stress reduction. This approach is based on a pioneering program developed more than 20 years ago by Dr. Jon Kabat-Zinn at the University of Massachusetts Medical Center in Worcester, Massachusetts.

Hippocrates said, "It is the job of the physician to help the patient find the healing power within himself." Mindfulness is the simple and attainable practice of potentially unlocking these powers by cultivating the healing potential of a mind that sees clearly and is focused. Mindfulness has been studied extensively during the last decade, and we are now beginning to understand its true utility.

Life View
How we view life determines, to a large degree, how much stress we have, as well as how anxious and depressed we become. We know that stress, anxiety, and depression?especially chronic stress, anxiety, and depression?can weaken the body and certainly may worsen many chronic medical and psychological conditions. Mindfulness may not only diminish stress, anxiety and depression, but may also transform a person?s actual approach to life itself.

Mindfulness Overview
Two years ago, a 44-year-old physician in my community, who was known by his colleagues to be fairly bright, but also intimidating and short-tempered, began a program of mindfulness-based stress reduction. He had high blood pressure and was willing to try anything before resorting to medications to control his condition. A few weeks after the completion of his program, he wrote to me that his blood pressure had fallen from a high of 160/100 to normal values around 120/80. His blood pressure has remained at these normal levels for more than three years. He also wrote, "my life feels so dramatically changed and transformed. My all too frequent experiences of tension and sense of constant urgency, irritability, frustration, and outright anger have given way to an overall calm and equilibrium I could not have foreseen. I feel a sense of peace and ease I have never been able to attain [before]. And I feel like a kinder man."
Another client, a 55-year-old department head of a major college had suffered chronic anxiety, depression, and persistent insomnia for which he had engaged in long periods of psychotherapy and psychopharmacology. Six months after his program, he wrote, "My years of insomnia and depression have diminished so radically it?s almost hard to believe they were so much a part of my daily life. This treatment course has opened up a renewed sense of joy in living and celebrating life and its diversity once again. It is the most powerful healing experience I?ve ever had."

What was it that was so instrumental in helping these people change? Mindfulness?the practice of simply paying attention with an open and non-judging attitude to things just as they are, moment to moment. This simple, but rich and complex practice of being awake to or aware of the moments of our lives can be of deep value, but is itself a very radical idea in our culture, particularly in medicine and psychiatry. We as individuals in this society are always on the move, always doing. We?re focused on getting somewhere, on being more successful, on acquiring something else, on avoiding discomfort, no matter what the price. And although we focus on an incessant and relentless "busyness." we have little time or use for something like mindfulness, which actually seems like doing nothing.

Our minds are racing all the time; we have great difficulty in sitting still and simply being at rest. We are either off in the future, planning, scheming, projecting, worrying, or we?re lost in the past, lamenting, daydreaming, caught up in memories, or berating ourselves. "If only I did this. If only I did that." We ruminate over all that should have or could have been. Even in the present, our minds are distracted?thinking, thinking, thinking. "If only I could figure this out, if only I could get there?wherever ?there? is, then I?ll be okay, then I?ll be comfortable." Like the White Rabbit in Alice in Wonderland, we?re always racing off, never pausing long enough to be where we are.
The Root of the Problem
Of course we are very uncomfortable remaining still when we feel disconnected, overloaded, stressed out, and when we feel a nagging undercurrent that something is wrong. This sense of unease may manifest itself both physically and psychologically - clients may have depression and anxiety; they may develop physical ailments and suffer from burnout; they may have difficulties with intimacy and interpersonal relationships. And while drug companies, physicians, and psychiatrists seek more efficient ways to approach and manage our symptoms, they may not more adequately address the central question: What is the cause of all these problems in the first place? What exactly is going on here? In order to see the forest for the trees we have to step back and step outside the usual treatment paradigm and open up to a wider way of thinking. This is the approach of mindfulness.

What is Mindfulness?
As I stated earlier, mindfulness is the practice of purposefully paying attention to each moment. Until you begin to try keeping the mind focused in the present, you have no idea how infrequently your mind is "here." And as a sign in Las Vegas states, "You have to be present to win." We need to learn to pay bare attention, as if we were looking through a camera viewer?we simply see what?s there, unadorned by our theories and opinions. As a wise Zen Master said, "Stop seeking the truth; seek to let go of your opinions." Or, as Sergeant Joe Friday said on the Dragnet TV series: "Just the facts, ma?am." We only get to live our lives moment by moment; either we are here for them, or we?re not. If we?re not, life will simply slip away. We experience this detached feeling as a loss of control, a loss of grounding. We get anxious and afraid and may feel life is slipping away. We get stressed from the threat of a life that has no meaning or is out of control. We hurry about and urgently try to catch up on things. We hurry and worry so much, we miss the life we are living. We?re afraid to let go and slow down. In a way, mindfulness is also the teaching of letting go.
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