User:Ppoulin
Hi Everyone!
I'm Patricia Poulin, a 3rd year Ph.D. student in the Counselling Psychology for Psychology Specialist program in the Adult Education and Counselling Psychology department.
Mindfulness-based clinical care really interests me, including research (quantitative and phenomenological), clinical applications, and personal experiences. I'm also doing work in the area of the integration of traditional healing with psychotherapy.
Some of my hobbies: taking care of alley cats, gardening, martial arts...
Link to wikibook for History and Systems of Psychology: http://en.wikibooks.org/wiki/Applied_History_of_Psychology
Link to wikibook for Trauma: http://en.wikibooks.org/wiki/Perspectives_on_Psychological_Trauma
Our team (Amberly, Lisa and I) will focus on trauma.
Nice Intro Patricia! --Abuxton 23:52, 8 May 2007 (UTC)
Some stuff for our project:
The Trauma Centre: http://www.traumacenter.org/
Sensorimotor Psychotherapy Institute: http://www.sensorimotorpsychotherapy.org/faculty.html
---
In the last thirty years, mindfulness-based interventions have gained tremendous popularity in the fields of behavioral medicine and clinical psychology (Kabat-Zinn, 2003). The impressive body of research literature examining the efficacy of interventions focusing specifically on the development of mindfulness practices and skills continues to grow (Baer, 2003; Grossman, Niemann, Schmidt, & Walach, 2004). In addition, mindfulness practices are now being integrated within conventional clinical approaches such as process-experiential (Dalziel, 2007) and cognitive behavioral therapies (Segal, Williams, & Teasdale, 2002). This paper discuses the roots of this practice and the history of its integration within clinical practice. The first section acknowledge the place of mindfulness within Buddhism and indigenous knowledges. The second section focuses on the history of the development and empirical validation of the first structured mindfulness-based intervention to be scientifically appraised. The third section focuses on recent advances in the field. Acknowledging the multiple roots of mindfulness Mindfulness is presented within psychology and behavioral medicine as a secular practice with Buddhist roots (Kabat-Zinn, 2003). What are thought to be the earliest surviving records of the teachings of the Buddha are contained in the Pali Cannon (Tipitaka). These were first passed down orally until around 100BCE, when they were committed to text (Robinson, Johnson, & Bhikkhu, 2005). By 250 BCE, the text was organised in three sets of teachings: The Vinyana consists of the precepts and directions for living for the monks and nuns; the Suttas consists of the discourses given by the Buddha; and the Abhidhamma consists of seven volumes about the working of the mind and consciousness. Many traditions of Buddhism emerged as a result of differing interpretations of the Buddha’s teachings. The two most commonly known schools are the Theravada or The Way of the Elders and Mahayana or The Greater Vehicle. The first teaching of the Buddha consists in the Four Noble Truths, which focus on human experience and the liberation from suffering through awakening. 1) There is dukkha (suffering), 2) The cause of dukkha is craving, 3) To cease suffering, one relinquishes that craving, 4) The path towards cessation of suffering is the Noble Eighfold path of right view, right resolve, right speech, right action, right livelihood, right effort, right mindfulness and right concentration. It is said that the Buddha based the following 45 years of teaching upon this foundation. There are many forms of meditation practices in Buddhism. Mindfulness meditation refers to the cultivation of moment-to-moment awareness. Cultivating mindfulness allows for a recognition of the transitory nature of all experience (e.g., thoughts, emotions, sensations) and for the development of a different relationship to these experiences (e.g., instead of tensing up in response to painful sensations leading to exacerbation of pain, allowing oneself to explore these sensations). The roots of mindfulness practice are not limited to Buddhism. It is interesting to note that there are descriptions of spiritual practices that seem very similar to mindfulness practice throughout other cultures and religions. For instance, Maori Elder Miriam-Rose Ungunmerr-Baumann (2002) speaks of Dadirri in the following ways: What I want to talk about is a special quality of my people. I believe it is the most important. It is our most unique gift. It is perhaps the greatest gift we can give to our fellow Australians. In our language this quality is called Dadirri. Dadirri is an inner, deep listening and quiet, still awareness. Dadirri recognises the deep spring that is inside us. We call on it and it calls to us. This is the gift that Australia is thirsting for. It is something like what you call ‘contemplation’. A big part of Dadirri is listening (cited in Atkinson, 2002).
Practices similar to mindfulness are also part of the many ceremonies of indigenous people on the North American continent (Carbone, 2000, personal communication). Integration of mindfulness within clinical practice Theoretical discussions of the integration of mindfulness into psychotherapy can be found as early as the 1960s, with the well-known works Psychotherapy East and West (Watts, 1960) and Psychoanalysis and Zen Buddhism (Suzuki, Fromm & DeMarino, 1960). The earliest clinical application discussed in the research literature is found in an article by Gary Deatherage (1975) who described five cases in which mindfulness meditation as an adjunct to psychotherapy had been beneficial. In is only in the late 1970s however, that a structured mindfulness-based intervention appeared thanks to the work of Jon Kabat-Zinn (1982; 1990). Don Ferren reported a personal communication with F. Urbanowski regarding the ground-breaking work of Jon Kabat-Zinn (Ferren, 2003) Urbanowski stated that in the late 1970s, Kabat-Zinn used to practice meditation and yoga in the faculty conference room of the University of Massachusetts Medical Centre, where he worked. After a while, a number of doctors asked Kabat-Zinn to teach them. Their personal experience led them to believe that a number of their patients might benefit from these practices. In response, Kabat-Zinn developed a structured ten week mindfulness based stress reduction program (MBSR now refined to an 8-week program) and started evaluating its effectiveness. His first published study focused primarily with groups of patients with intractable chronic pain (1982). The traditional MBSR program involves 8 weekly 2-hour group sessions as well as a full day silent retreat. During the training, participants learn formal mindfulness exercises and are expected to set aside time for practice, 45 minutes a day, 6 days a week. The exercises are designed to help participants augment their awareness of moment-to-moment experience, including sensations, feelings, thoughts, while cultivating compassion and love. In addition to the mindfulness exercises, participants are invited by the group leader to reflect on deepening and integrating one’s mindfulness practice in daily life, so it transforms one’s way of life, can support choices that are healthier and life-enhancing. According to the Center for Mindfulness in Medicine, Health Care and Society, founded in 1995 at the University of Massachusetts Medical Center to organize the growth of MBSR program around the world, over 17000 individuals have already taken part in this intervention (CFM, 2007). MBSR continued to be the most well-researched mindfulness-based intervention. A meta-analytic review of the MBSR research literature found a moderate effect size of training for studies using pre-post single group or between group designs (Baer, 2003). Individuals diagnosed with cancer who participate in MBSR experience a decrease in their level of mood disturbances and stress-related symptoms (Speka, Carlson, Goodey, & Angen, 2000), an improvement in the quality of their sleep (Shapiro, S.L., Bootzin, R.R., Figueredo, A.J., Lopez, A.M., & Schwartz, G.E., 2003) as well as an increase in their quality of life (Carlson, Speca, Patel, & Goddey, 2003). Individuals experiencing chronic pain (Kabat-Zinn, 1982) and fibromyalgia (Kaplan, Goldenberg, & Gavlin-Nadeau, 1993) also experience significant long-lasting physical and mental health benefits (Kabat-Zinn, Lipworth, Burney, & Sellers, 1987). With regard to specific mental health issues, individuals with anxiety disorders (e.g., panic disorder with agoraphobia, panic disorder without agoraphobia, and generalized anxiety disorder) find considerable relief from anxiety and depressive symptoms from participating in the program (Kabat-Zinn, Massion, Kristeller, Peterson, Fletcher, Pbert, 1992). They also report that the improvement in their condition is maintained at three-year follow-up (Miller, Fletcher, & Kabat-Zinn, 1995). The MBSR program has also been offered to individuals with binge eating disorder resulting in decreased binges frequency as well as improvements in depressive and anxious symptomatology (Kabat-Zinn, Massion, Kristeller, Peterson, Fletcher, Pbert, L., et al., 1992; Kristeller, & Hallet, 1999) Recent development in mindfulness-based interventions Mindfulness-Based Cognitive Therapy. Segal, Williams, and Teasdale (2000) adapted the traditional MBSR training to group cognitive therapy to reduce relapse risk of individuals diagnosed with major depression. Their program, MBCT, is structured in much the same way as MBSR. However, while both MBSR and MBCT involve didactic components focusing on the nature and impact of stress and various aspects of mindfulness practice, the MBCT program goes further and includes discussions of themes that have direct relevance to cognitive therapy (e.g., tendency towards judgment and consequences of judgment; emotions are the consequences of the pairing of situation and interpretation). MBCT has been shown to be an effective way to prevent depressive relapse in individuals who have had multiple major depressive episodes (Ma, & Teasdale, 2004; Teasdale, Moore, Hayhurst, Pope, Williams, & Segal, 2002; Teasdale, Segal, Williams, Ridgeway, Soulsby, & Lau, 2000). Mindfulness-based wellness education. The MBSR and MBCT programs were designed for clinical populations. The latest structured mindfulness-based intervention, Mindfulness-Based Wellness Education was designed by Mackenzie, Soloway and Poulin (2006) for non-clinical populations, in particular, individuals working in human services professions. These professions are known for their high rates of burnout and staff turnover. Its short-term effectiveness has been demonstrated with a group of teachers in training and its longer term benefits are currently being examined (Poulin, in progress).
References Atkinson, J. (2002). Trauma trails : Recreating song lines. The effects of transgenerational trauma in indigenous Australia. Melbourne: Spinifex Press. Baer, R. A. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice, 10(2), 125-143. Carlson. L. E., Speca, M., Kamala, D., & Goodey, E. (2003). Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress, and immune parameters in breast and prostate cancer outpatients. Psychosomatic Medicine, 65(4), 571-581. Centre for mindfulness in medicine, health care and society (2007). Retrieved May 24, 2007 from http://www.umassmed.edu/cfm/index.aspx. Ferren, D. (2003). The clinical use of mindfulness meditation within an intensive psychotherapy program for clients diagnosed with a personality disorder. University of Toronto). Dissertation Abstracts International, 64 (5214) Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). Mindfulness-based stress reduction and health benefits: A meta-analysis. Journal of psychosomatic research, 57(1), 35-43. Kabat-Zinn, J. (1982). An outpatient program in behavioral medecine for chronic pain patients based in the practice of mindfulness meditation. General Hospital Psychiatry, 4, 33-47. Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: Past, present and future. Clinical Psychology: Science and Practice, 10(2), 144-156. Kabat-Zinn, J., Lipworth, L., Burney, R., & Sellers, W. (1987). A four-year follow-up of a meditation-based program for the self-regulation of chronic pain: Treatment outcomes and compliance. Journal of Behavioral Medicine, 8(2), 162-190. Kabat-Zinn, J., Massion, A.O., Kristeller, J. L., Peterson, L. G., Fletcher, K. E., Pbert, L., et al. (1992). Effectiveness of a meditation-based stress reductoin program in the treatment of anxiety disorders. American Journal of Psychiatry, 149(7), 936-943. Kaplan, K.H., Goldenberg, D.L., & Gavlin-Nadeau, M. (1993). The impact of a meditation-based stress reduction program on fibromialgia. General Hospital Psychiatry, 15(5), 284-289. Kristeller, J.L., & Hallet, C.B. (1999). An exploratory journey of meditation-based intervention for binge eatine disorder. Journal of Health Psychology, 4(3), 357-363. Ma, H., & Teasdale, J.D. (2004). Mindfulness based cognitive therapy for depression: Replication and exploration of differential relapse prevention effects. Journal of Consulting and Clinical Psychology, 72(1), 31-40. Mackenzie, C.S., Soloway, G., & Poulin, P. A. (May, 2006). Evaluation of mindfulness-based wellness education: Reducing stress and fostering resilience and well-being among beginning teachers. Paper presented at the Ministry of Education/Faculties of Education Forum, Toronto, ON, Canada. Miller, J.J., Fletcher, K., & Kabat-Zinn, J. (1995). Three-year follow up and clinical inplications of a mindfulness meditation-based stress reduction intervention in the treatment of anxiety disorders. General Hospital Psychiatry, 17, 192-200. Robinson, R. H., & Johnson, W. L., and Thanissaro Bhikkhu. (2005). Buddhist religions: A historical introduction (fifth edition) . Belmont, California: Wadsworth, 2005. Segal, Z.V., Williams, J.M.G., & Teasdale, J.D. (2002). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. New York: Guillford Press. Shapiro, S.L., Bootzin, R.R., Figueredo, A.J., Lopez, A.M., & Schwartz, G.E. (2003). The efficacy of mindfulness-based stress reduction in the treatment of sleep distrubance in women with breast cancer. Journal of Psychosomatic Research, 54, 85-91. Speka, M., Carlson, L., Goodey, E., & Angen, M. (2000). A randomized wait-list controlled trial: The effects of a mindfulness-based stress reduction program on mood and symptoms of stress in cancer outpatients. Psychosomatic Medicine, 62, 613-622. Suzuki, D. R., Fromm, E., DeMarino, R. (1960). Psychoanalysis and Zen Buddhism. New York: Basic Books. Teasdale, J.D., Moore, R.G., Hayhurst, H., Pope, M., Williams, S., & Segal, Z.V. (2002). Metacognitive awareness and prevention of relapse in depression: Empirical evidence. Journal of Consulting and Clinical Psychology, 70(2), 275-287. Teasdale, J.D., Segal, Z.V., Williams, J.M., Ridgeway, V.A., Soulsby, J.M., & Lau, M.A. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy.68(4), 615-623. Ungunmerr-Baumann, M. R. (2002). Inner deep listening and quiet awareness. Retrieved from http://liturgyplanningcom.ozhosting.com/liturgies/50.pdf, May 24, 2007. Watts, A. (1961). Psychotherapy East and West. New York: Bantam Books.