What does mindfulness accomplish?

Via http://bit.ly/1OxQNXK.
Via http://bit.ly/1OxQNXK.

A few weeks ago, my therapist suggested I begin practicing mindfulness exercises to deal with depression and attention deficits. Any meditative practice I undertake will be administered in concert with more conventional CBT.

I welcome the excuse to begin mindfulness; I crave discipline for its own sake, and wish to explore the various states of consciousness which meditation can facilitate (e.g. the experience of no-self, the oceanic feeling, and tulpa apparitions).

However, character-building and psychonautics aside, will mindfulness work? That is, will it alleviate my depressive and inattentive symptoms?

Serendipitously, just as the question became relevant to me, Adam Frank of 13.7 Cosmos and Culture wrote about a recent meta-analysis of therapeutic mindfulness. Frank—himself a meditator—reports that while not negligible, the clinical effects of meditation are not as life-changing as their most enthusiastic proponents claim:

There have been many studies showing the effectiveness of meditation for different conditions (particularly those related to stress). But a meta-review of these studies by the Association for Health and Research Quality showed only moderate evidence for the effectiveness of mindfulness meditation. This overarching review study didn’t necessarily say the effects were not there. Instead, it told us that, taken together, the quality of the studies (based on sample sizes, research protocols, etc.) were not strong enough to support the strong conclusions many mindfulness advocates hope for.

The recognition that more is being made of mindfulness research than the research can support has led some scientists in the field to call for a kind of “time out.” For example, in an article in Tricycle magazine, Brown University professor Catherine Kerr points to news outlets like the The Huffington Post and calls foul:

“The Huffington Post features mindfulness a lot and tends to represent only the positive findings (and in the most positive light imaginable) rather than offering a balanced reading of the science. They use that approach to justify the idea that every person who has any mental abilities should be doing mindfulness meditation. I don’t think the science supports that. The Huffington Post has really done mindfulness a disservice by framing it in that way.”

Of course, The Huffington Post is not alone in hyping mindfulness. For Kerr, who runs the Contemplative Studies Initiative and leads a mindfulness research program at Providence’s Miriam Hospital, the issue becomes how the public receives the hype and what it means.

As she says, “The message [these stories] deliver becomes a ubiquitous, circulating meme that people put up on their Facebook pages and that becomes “true” through repetition alone.” But, according to Kerr, the claims are of the kind even the scientists doing the research wouldn’t support. As she put it:

“Scientists are, for the most part, circumspect about making claims for cures attributed to mindfulness. The science doesn’t support that. Scientists know from looking at meditation trials that not every person benefits from mindfulness therapies, but this is something non-scientists seem to have difficulty with. Individuals should not make clinically based decisions based only on neuroscientific studies because the sample sizes are too small.”

Pointing to specifics of stress and depression she adds:

“The clinical trial data on mindfulness for depression relapse, for example, is not a slam-dunk. The results are really not better than those for antidepressants[1]. In general, mindfulness is not orders of magnitude stronger than other things that people are doing right now to help manage stress and mood disorders. So you have to look at mindfulness in the context of a range of options.”

In other words, the research is still too incomplete to support the strongest claims for scientifically grounded benefits from mindfulness. It doesn’t mean they aren’t there or that there aren’t effects, it just means we don’t really know yet.

Though it compares the effects of mindfulness to antidepressants, Frank’s piece says nothing about the efficacy of mindfulness combined with those drugs, which will be the regimen I’ll be undertaking.  It appears I will have to find out on my own.

[1] On some analyses, antidepressants barely perform better than placebos.

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