How Effective Is Mindfulness Based Stress Reduction?
By: Julia Thomas
Updated February 03, 2020
Medically Reviewed By: Robin Brock
Stress is our body's natural reaction to our environment and situations we are faced with. In many ways, stress can be a good thing but when it goes unchecked, stress can lead to many adverse mind and body effects. This is where programs like Mindfulness Based Stress Reduction (MBSR) come in. The MBSR program, which has gained widespread recognition, teaches persons how to handle stressors in their lives. But just how effective is the MBSR? Does it really deserve all the high praises it has received?
To answer those questions, we will first have to look at stress and its ill effects; the principles of mindfulness behind the MBSR; and the techniques the program uses; as well as several studies which have investigated use of the MBSR with various groups of persons suffering from particular illnesses.
What Is Stress?
Stress is your body's natural physical and emotional reaction to changes in your environment which cause you to feel threatened. Those changes, called stressors, can be once-in-a-while major events, such as attending a job interview or your regular everyday events, such as your responsibilities at work.
Stress causes a region at the base of your brain, known as the hypothalamus, to trigger a series of nerve and hormonal signals in your body. As part of this chain reaction, your adrenal glands which sit on top of each of your kidneys, send out a rush of hormones including cortisol and adrenaline. The adrenaline, known as the fight-or-flight hormone, gives you a rush of energy by increasing your heart rate and blood pressure, getting more oxygen-rich blood to your brain and muscles in preparation for your response.
Cortisol, the body's main stress hormone, boosts the amount of glucose (sugar) in your blood while helping your brain to use the glucose more efficiently. It also increases metabolism of other nutrients, to help with energy production and tissue repair. Other functions of cortisol when you are stressed, include locking down or slowing some functions which are not deemed necessary in the situation. Those include your growth functions, and your reproductive digestive and immune systems.
Ordinarily, all of these body processes and functions return to normal and the stress you feel starts to fade once the threat is over. A problem arises if the stress response does not subside, perhaps because you are faced with one stressful situation after another. In those cases, you remain in your heightened ready-to-respond state for a prolonged period of time. You are now experiencing what is known as chronic stress, in which all of the body processes we just looked at continue to happen. This sets you up for developing some of those much talked about negative effects of stress, which we will look at next.
Effects of Stress
As the hormones involved in your stress response continue to be produced, a myriad of symptoms related to your chronic or prolonged stress begin to affect almost every system in your body, as well as your emotional state. Some of these adverse effects are readily noticeable, such as headaches, backache and sleep disturbance. Others may not be so obvious and include:
Weight gain - Sugar cravings set in due to the body's continued demand for energy in its heightened state of stress. Stress also contributes to chronic fatigue while making it more difficult for your cells to metabolize fat for energy.
Type II diabetes - Your body uses insulin, secreted by your pancreas, to metabolize blood sugar. Stress hormones play a role in insulin resistance, however, which along with higher blood sugar levels brought on by chronic stress can lead to the development of Type II diabetes.
Suppressed immune system - By suppressing your immune system, stress leaves you vulnerable to infections such as the flu or common cold. Coupled with your increased susceptibility to infections is the body's slower ability to heal itself. So with chronic stress, you get sick easier and stay sick longer.
Irritable bowel syndrome and stomach ulcers - The hormones produced by your thyroid glands play a role in metabolism. Chronic stress affects your thyroid glands and its hormone production which can lead to irritable bowel syndrome (IBS). This is often manifested as constipation but can also affect some people in the form of diarrhea.
Acne and hair loss - Stress causes a spike in the amount of androgen (a sex hormone) in your system. This not only leads to an increased risk of hair loss and acne breakouts, but when coupled with your lowered immune system response, it can cause you to develop rashes on other areas of your skin apart from your face.
Changes in brain structure - Stress hormones have been shown to cause long-term changes in your brain structure and how it functions. In short, prolonged heightened levels of cortisol are thought to lead to brain damage where the hippocampus (a section of your brain responsible for memory and emotions) begins to shrink. This can lead to memory loss and a host of emotional disorders.
Anxiety, irritability, depression - Along with memory loss, the effects of stress on your brain can directly lead to increased levels of anxiety, irritability and depression. These effects can also occur indirectly as a reaction to all the negative symptoms you are suffering from because of stress and the sense of helplessness you feel.
Sexual dysfunction - Apart from negatively affecting your sexuality in general, chronic stress can lead to low sperm production and erectile dysfunction in men. It also leaves them with an increased risk of developing infections of the prostate and testes. Women suffering from chronic stress may experience heavier, irregular and more painful periods or if they are going through menopause, its physical symptoms may be intensified.
Mindfulness and The MBSR Program
Jon Kabat-Zinn earned his PhD in molecular biology in 1971 at MIT where he was exposed to the Buddhist concept of mindfulness. Under the guidance of both a Buddhist monk and a Zen master, he went on to study mindfulness and other Buddhist practices. By 1979, he adapted what he had learnt into a structured 8-week program which he named Mindfulness Based Stress Reduction. That same year (1979), Kabat-Zinn established the Stress Reduction Clinic at the University of Massachusetts Medical School where he was, and still is, a professor.
Mindfulness in Buddhism
Mindfulness, or awareness, is one of the essential principles of Buddhism. It is rooted in Vedic tradition and is considered to be one of the important steps on the path to enlightenment (freedom from suffering). Buddhism teaches mindfulness as a way of living in the present moment so that the individual can cultivate both self-knowledge and wisdom. While mindfulness-based stress reduction techniques have been greatly influenced by the teachings of Buddhism, it is important to keep in mind that the MBSR program is not a religious one.
Mindfulness in Modern Psychology
In modern psychology, mindfulness is seen as a way of handling one's emotions whereby there is neither avoidance of nor overindulgence in your emotions. It is a way to develop behavioral recognition, awareness of self and metacognition (awareness of your own awareness). Mindfulness is sometimes viewed in three interrelated ways.
Firstly, it is a predisposition or a trait in some individuals who seem to be naturally more mindful than others. Secondly, mindfulness is a learned state of awareness where you are taught how to focus on the present moment. And thirdly, it is the practice of mindful meditation which takes you into the state of mindfulness.
Mindfulness in Medical Settings
Throughout history, medicine in many cultures has treated the mind and body as two interconnected and interdependent halves of a whole - the person. Western medicine veered away from this concept in the 1600s and has only recently returned to embracing the holistic nature of wellness.
Mindfulness, as it is now widely used in medicine, grew out of Jon Kabat-Zinn's MBSR program which he initially developed as a way to provide pain relief to the chronically ill. Currently, many hospitals and health centers around the world teach mindfulness as a coping strategy to patients suffering from chronic pain, anxiety and depression, among other conditions.
In fact, use of mindfulness-based stress reduction as a therapy in both inpatient and outpatient care, has been shown to provide comparable relief to painkillers. Added to this are new efforts to ensure there is access to mindfulness training for healthcare providers, as well.
How Does MBSR Work?
The MBSR is an 8-week program conducted as weekly 2.5-hour sessions plus a 7.5-hour full day retreat which takes place in the latter stages of the program. Participants are taught various techniques and encouraged to devote approximately 45 minutes to an hour each day to practicing them. To assist with practice, instructors assign daily tasks for participants to complete.
The MBSR is offered in a group, face-to-face setting but participants still receive one-on-one attention from instructors with some aspects of the course tailored to individual needs. The group setting is encouraged for the support participants can give and receive, which helps to ensure successful completion. This is not a strict requirement, however, as there are online options for those who cannot get to the in-person classes. In these cases, group interaction is still encouraged through forum posts, but is not mandatory. There are also intensive programs which cover the MBSR in 5 full days and which are best attended as residential courses, but again, this is not mandatory.
Throughout the course, participants are exposed to the foundations and theory of mindfulness. They also learn about stress as a physical and psychological process, how it affects mind and body, and how to temper their reaction to it. Importantly, while MBSR falls within the realm of what is commonly described as complementary and alternative medicine (CAM), it is not meant to replace formal medical or psychological care by your healthcare provider. That is, it is complementary and NOT an alternative.
The course focuses on
- Body scanning - Participants are taught to pay conscious attention to each part of the body. It is often done lying down and beginning at the toes then working your way up to the head. It can, however, be accomplished in any position and from head to toe, instead.
- Mindful eating - This is learning to focus on what and why you eat by becoming aware of whether it is in fact your mind, heart or body that is hungry. Participants are also taught to become more aware of both their hunger and when that hunger is satisfied. It is helpful in reducing binge eating and reliance on comfort food.
- Mindful breathing - A technique which aids concentration as you focus on each inhaled and exhaled breath. It develops your alertness and awareness while helping you to control anxiety and restlessness.
- Gentle stretches and mindful hatha yoga - A gentle and slow form of yoga poses and breathing exercises done in a relaxed manner. It is a good style for beginners as it allows them to get into poses easier and hold them longer.
- Sitting meditation - This is taught as a way to enhance concentration and focus on the body. It helps participants to apply mindfulness techniques in their everyday lives.
- Walking meditation - Participants learn to focus on the world around them as they also pay close attention to their own breathing and movement. It can be applied as you go about your daily routine.
- Interpersonal mindfulness - This involves learning to interact with others in a compassionate way, making it easier to handle differing points of view. It teaches awareness of how you are affected by the actions of others and how your actions affect them as well.
What Has Research into Use of MBSR Discovered?
The use of the MBSR as a complementary treatment has been studied extensively since its inception. The vast majority of these studies have found positive results which speak to the effectiveness of the program. Here is a brief look at a few of them:
MBSR and chronic illnesses - In 2011, the North American Journal of Medical Sciences published a study into use of MBSR for chronic illnesses such as depression, chronic pain and hypertension, as well as skin and immune disorders. The study took the form of a meta-analysis and looked at the results of 18 previous studies. The researchers concluded that "MBSR improves the condition of patients suffering from chronic illnesses and helps them cope with a wide variety of clinical problems."
MBSR and low back pain - The National Institutes of Health (NIH) highlights research conducted into the use of MBSR, Cognitive Behavior Therapy (CBT) and conventional approaches to treat patients ranging from 20 to 70 years old who were experiencing low back pain. Researchers found that both the MBSR and CBT groups showed marked improvement even 6 months and one year later. The lead researcher, Dr. Daniel Cherkin, noted, "The research suggests that training the brain to respond differently to pain signals may be more effective-and last longer-than traditional physical therapy and medication." The NIH also points to another research which found the MBSR to be a more cost-effective approach over conventional treatment alone.
MBSR and breast cancer - Mindfulness-Based Cognitive Therapy (MBCT) is an offshoot of the MBSR which is intended to specifically help persons struggling with recurrent depression. One study took the form of an analysis of cases in which MBSR and MBCT were used among various patients with breast cancer to see how their "health-related quality of life and psychological health" were impacted by the programs as compared with conventional care. The researchers concluded that there was "some evidence for the effectiveness of MBSR in improving psychological health in breast cancer patients."
MBSR and insomnia - In a study of 54 persons with chronic insomnia, researchers found marked and sustained improvements for those who took part in either the MBSR program or a mindfulness-based therapy for insomnia (MBTI) developed from the MBSR. This is when compared to the use of self-monitoring with sleep diaries. The greatest improvements were shown in the specially tailored MBTI.
MBSR and ulcerative colitis - Stress is known to be a cause of flare-ups in ulcerative colitis (incurable chronic inflammatory bowel disease). A study focused on the use of MBSR to manage and reduce stress in patients with ulcerative colitis found that they experienced reduction in perceived stress and enjoyed greater quality of life after exposure to the MBSR.
MBSR and social anxiety disorder - A small study (14 participants) used functional magnetic resonance imaging (fMRI) to measure brain activity in individuals suffering from social anxiety disorder before and after exposure to MBSR. The researchers reported positive results from the post MBSR scans, as well as "improvement in anxiety and depression symptoms and self-esteem" among the participants.
MBSR and multiple sclerosis - One 2014 study consisted of 40 women aged 20 to 50, all of whom had been diagnosed with multiple sclerosis. Researchers split the group in two and while one group received MBSR training, the other was treated as usual. Anxiety, depression and stress levels all showed significantly greater reduction among the group which was exposed to MBSR techniques.
So How Effective is Mindfulness Based Stress Reduction?
Stress is like a double-edged sword. On one hand it can cause you to develop an array of physical, mental and emotional illnesses. On the other hand, many illnesses lead to stress and are then, in turn, exacerbated by it. Finding effective methods of preventing and managing stress, both in healthy individuals and in those with existing medical conditions, becomes a priority. As we have shown, Mindfulness Based Stress Reduction is one such method whose effectiveness has been proven by scientific studies.
That effectiveness has been recognized by several government bodies, as well. The National Center for PSTD (post-traumatic stress disorder) at the U.S. Department of Veterans Affairs lists both MBSR and MBCT among the mindfulness therapies that "have been shown to be useful for problems commonly seen in trauma survivors such as anxiety and hyper arousal." It goes on to make the point that "Mindfulness practice has potential to be of benefit to individuals with PTSD." Furthermore, the National Institute on Aging lists mindfulness as one of several remedies which have been proven helpful for pain associated with several conditions as well as for the symptoms of menopause.
It has been almost 40 years since the Mindfulness Based Stress Reduction program was founded by Jon Kabat-Zinn, PhD. In that time, it has earned a well-deserved reputation as a very effective method for reducing the ill effects of stress, as well as for the coping strategies it teaches. Perhaps, the most fundamental fact about the MBSR is that it can be effective for just about anyone in their daily lives. If you would like to learn how to use MBSR, the very best time to start is now!
If you think your mental issues can't be cured with mindfulness and other techniques mentioned above, you could visit an online therapist through Betterhelp.com.
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