November 26, 2015

Better living through Mindfulness

A meditative technique called mindfulness can be useful in improving the functioning of people with mental health issues. It is also useful for people more generally and even has a role in improving the abilities of therapists in treating their clients or patients. This was the recent message of Canada's Dr. Meshal Sultan at the Royal Ottawa Hospital Grand Rounds. His talk dealt with a definition of the technique, some clinical applications, and the underlining mechanisms.

So what is mindfulness? 

Let us begin by an example.  You are to sit comfortably, close your eyes, and give your attention to breathing, blood flow, and the sensation of touch.  Now shift your awareness slowly first to your head, then to your chest, then to your hands, your fingers, your abdomen, and so on, till you end with your toes.  All other thoughts are excluded during this process.  This is a mindfulness exercise.  You can also conduct such an exercise in a shower or during a bath.

Mindfulness is an English translation of the Pali word sati, Pali being the language of original Buddhist scriptures, and it is a Buddhist practice dating back to 500 B.C.  The hallmarks of sati are awareness, attention, and remembering.  “It is,” said Sultan, “the opposite of auto-pilot.”  Buddha is said to have come to teach us liberation from suffering, and meditation is a tool toward that end.

In mindfulness, we are fully present in the moment and in a receptive state of mind, barely registering facts.  We pay attention on purpose, in the present moment.  This attention is non-judgmental.

The practice began its impact in North America in the 1960’s, when Zen became popular in the culture.  Over the subsequent decades, mental health practitioners have found ways of infusing mindfulness in various psychological approaches and for treatment of a variety of problems.

Studies have found that therapists who engage themselves in mindfulness become better therapists.  They tend to develop a more positive attitude toward their clients or patients, growing more understanding of them.  It has been said as well to prevent burnout.  Aside from the professional role, mindfulness has also increased their life satisfaction.

Mindfulness has had considerable positive results in treatment of anxiety, stress, and depression.  It has been employed with some success as well in treating binge eating and with over-activity and impulsivity.  As well as its impact on intrapsychic functioning, mindfulness has been employed on relationship issues, such as parent-child relationships.  It has also had positive results in the treatment of more serious mental health problems.

Sultan gave a case example of the treatment of a woman with schizophrenia.  In responding to a mindfulness intervention, she continued to be very sick, but some of her symptoms improved.  She became less paranoid and less upset.

Proficiency in mindfulness can be developed through deliberate practice.  A key element is in improving the ability to control attention.

How does mindfulness become effective?  Engaging in mindfulness produces actual changes in the structure of parts of the brain. In his talk he illustrated some of these changes with maps of the brain.

Following Dr. Sultan's lecture, you reflect on the writings of the Muslim Sufi masters whose teachings included how to connect to the Almighty through extra prayers day and night, during the working hours up to the time you go to sleep. They recommend using the spoken word Zikr; mindfulness with aid of invoking the names of Almighty and reciting the Quran. In doing so you become indifferent to this life with its pains and sadness. Although they wrote many books on the subject, some are more than 1000 years old and still in circulation including those by Imam Al-Ghazali, they highly recommend that you learn these exercises in person by joining a genuine Sufi group, who are now in most countries including Canada.