News at Tipitaka Network
Meditation no cure, but it helps
by Eleanor Limprecht, The Australian, Saturday, December 13, 2008
WHEN Guy Corrigall was two years in remission from non-Hodgkin's lymphoma, he began meditating.
Not just any form of meditation, but mindfulness meditation, an increasingly popular practice for alleviating stress, depression, anxiety, and pain.
In Corrigall's case, he was hoping to curtail the depression that had crept into his life since the diagnosis. "Not that I wanted to throw myself off a tall building, but I had shut myself off from life ... The meditation was a wonderful safe place where I could just go and be," he says.
The 63-year-old financial planner now meditates for 40 minutes every day, and says it comes as naturally as brushing his teeth. "It's not a cure for the cancer, but it helped me accommodate it. It has been enormously rewarding and valuable."
One might assume Corrigall learned his practice in a Buddhist temple or during a yoga retreat, but it was actually at the Sydney Cancer Centre at Royal Prince Alfred Hospital, in the Sydney suburb of Camperdown.
Clinical psychologist Elizabeth Foley runs the mindfulness clinic at RPA for cancer patients. In the past couple of years she has worked with over 200 such people.
"Because treatments are improving, 90 per cent of the time people are living with cancer. Certainly mindfulness helps people live with cancer, lets it be part of their lives without taking over their lives. It's about quality of life, about coping with the illness and having a really rich, wonderful life in spite of the diagnosis," she says.
Mindfulness meditation isn't new; the practice is derived from Buddhist vipassana meditation, but its acceptance into mainstream medicine is a recent occurrence, particularly in Australia.
In mindfulness meditation, participants are taught to focus their thoughts on their immediate physical sensations -- including ones normally taken for granted, such as breathing in and out -- in a way that helps them cope more easily with physical pain and to minimise any worries or anxieties they might have about the past or future.
The practice was popularised in the west by Jon Kabat-Zinn, emeritus professor of medicine and founding director of the Stress Reduction Clinic and the Centre for Mindfulness in Medicine, Health Care and Society at the University of Massachusetts Medical School. In the 1970s, Kabat-Zinn developed an eight-week course in Mindfulness-Based Stress Reduction (MBSR), in which he used meditation to teach patients the act of "paying attention in a particular way: on purpose, in the present moment, and non-judgementally". Kabat-Zinn also ran clinical trials which found that MBSR resulted in reductions in chronic pain, anxiety disorders and psoriasis.
The form of mindfulness meditation that Foley uses in the Mindfulness Clinic is Mindfulness-Based Cognitive Therapy (MBCT), a modification of MBSR developed at Oxford to target the cognitive processes associated with relapse into depression. A recent randomised controlled trial of MBCT that Foley ran with 115 clinic patients showed significant improvements in depression, anxiety and distress, and a trend for improved quality of life in the treatment group compared to a waitlist control group.
"Many of these patients have found it life-changing," she says. "The main thing clients tend to learn about is kindness. Developing kindness towards themselves rather than being so judgmental."
Corrigall recalls his own participation in the trial fondly. "It was highly structured and very disciplined. And as I'm a mathematician, I found it very well based." But that's not to say it was easy. "It's quite demanding. You have to say 'look, this isn't for fun'. You have to have a very strong purpose. Meditation is a discipline. It's something you have to concentrate on, like daily exercise," he says.
Overseas, studies of mindfulness meditation have been sprouting with increasing frequency since 2000. It has been credited with helping to increase immune functioning and preventing relapse or recurrence in major depression.
Bruno Cayoun, a clinical psychologist and research consultant in mindfulness-based research at the University of Tasmania, says Australia is lagging in its acceptance of mindfulness meditation, but gradually picking it up. "Had it not been called mindfulness or associated with Buddhism, it wouldn't have taken so long to catch on," he says.
But in psychology, according to Cayoun, the results mean everyone is now talking about mindfulness techniques. "It is coming from the floor -- clients are saying I want this because of the results -- and that is almost unheard of in therapy."
In 2009, Cayoun will be running an eight-week course in mindfulness for staff at Hobart's Risdon Prison, who will in turn teach it to inmates. "In America, it has been shown to reduce recidivism by 90 per cent," he says.
"If I train my brain twice a day not to react to sensations, when I have an emotion I'm not going to react. I'm going to feel it, but I'm going to be more tolerant of it and let it go. I'm not going to ruminate on it."
According to Griffith University psychology PhD student Angela Morgan, mindfulness can also be useful for people who suffer from eating disorders. In recently completed research with colleague Michelle Hanisch, Morgan ran a randomised controlled trial of group-based mindfulness intervention for binge-eating related disorders.
In two-hourly sessions over an eight-week period, they used mindfulness meditation to teach 128 women to tolerate and manage emotional experiences without using food.
"The mindfulness treatment resulted in significant improvements in the frequency of binge-eating episodes and compensatory behaviours (vomiting, laxative use, excessive exercise and fasting) per week," Morgan says. "At the end of the treatment the majority of the participants no longer met diagnostic criteria for eating disorders."
Morgan says 62 per cent of participants were no longer binge-eating and 80 per cent were no longer using the compensatory behaviours. The improvements were all maintained at a one month follow-up.
The effects of mindfulness meditation on the elderly are also being examined. In October the Tasmanian branch of Alzheimer's Australia began a risk-reduction program for healthy adults between the ages of 55 and 80 called Active Cognitive Enhancement (ACE) to combat mental decline. The program results will be evaluated as part of a research project at the School of Psychology at the University of Tasmania. During every two-hour session, participants practise cognitive training exercises, listen to educational lectures and engage in a brief period of mindfulness meditation.
Social worker Malcolm Tyler, with the Tasmanian Department of Health and Human Services, says sessions are short, but participants are often picking up the practice at home as well. "People are reporting increased cognitive effects already," Tyler says.
The Royal Australian College of General Practitioners says it recognises the clinical benefits of mindfulness meditation and the growing body of scientific evidence supporting its use in clinical practice.
The college offers Continuing Professional Development (CPD) points to GPs for several mindfulness meditation courses in Australia.
But Sydney GP Gillian Deakin says the medical community has not embraced mindfulness nearly enough. She considers the practice an essential part of good health, but says that puts her in the minority among medical practitioners.
"We tend to be enamoured with the power of the mind and the thinking mind in medicine, whereas meditation is beyond thinking," she says. "Medical training is a total anathema to this. I consider it a gross failing in medical training that they don't train all medical practitioners in the art of mindfulness. For the distress the average GP sees, largely the best form of treatment would be mindfulness training."
Deakin recommends mindfulness meditation to patients, but says she doesn't do so until physical causes are ruled out. She refers patients to Open Ground, a mindfulness-based stress reduction program that consists of weekly 2 1/2-hour group sessions over eight weeks. The program doesn't come cheap at $660, but director Timothea Goddard says there are payment plans and concessions.
Goddard tells of an 84-year-old man who came to the course having been through cancer and a number of bad accidents. "He was on massive amounts of painkillers and over the eight weeks he got off them. He said, 'I have pain, have bad pain every day, but I'm not making the same meaning of it. I'm interrupting the reactivity that says 'why me, I feel so miserable'. The pain is there and I choose to go and have a life'."
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