What is mindfulness based stress reduction?  What is MBSR?

Mindfulness based Stress Reduction, also known as MBSR, is an education and training program that helps people with pain, illness, stress, psychological, and emotional problems by teaching Mindfulness, a new way to relate to life’s challenges.  Mindfulness, which will be explained more further down, is a way you can learn to calm your mind and body that centres around the idea of awareness.  The MBSR program was developed in 1979 at the University of Massachusetts Medical Center by Professor Jon Kabat-Zinn.  Dr. Kabat-Zinn developed the MBSR program to help the many patients who were suffering from chronic ailments and falling through cracks in the system.

Through MBSR, many people have been able to successfully manage their pain and/or illnesses.  Even if they were not cured, MBSR tended to reduce their suffering and increase their sense that they had some control over the outcome of their illness — or, specifically, on how it affected them emotionally and their attitudes towards life in general.

Mindfulness based stress reduction is typically taken as an 8 week course, but it is also available as a workbook A Mindfulness-Based Stress Reduction Workbook by Bob Stahl and Elisha Goldstein.  Hazlett-Stevens and Oren recently (2017) did a study which indicates that, for highly motivated people who are willing and able to be disciplined enough to work through a workbook, this MBSR workbook may provide an effective (not to mention cost-efficient) alternative for those who wish to reduce stress.

What is involved in a mindfulness based stress reduction program?

Mindfulness based stress reduction is a very specific program.  There are offshoots of this program to target specific people, but the mindfulness based stress reduction program itself is an eight week group program.  Sessions are once a week and 2.5 hours long,  There is also one full day session between weeks seven and eight.  The content of the sessions is a mixture of providing information about mindfulness and allowing participants to experience mindfulness through exercises.

The three formal techniques involved in mindfulness based stress reduction are:

1. mindfulness meditation
2. body scanning
3. simple yoga postures

You might be interested in reading:

• What is mindfulness in plain English?

How to do mindfulness meditation

According to Shauna Shapiro in The Art and Science of Mindfulness: Integrating Mindfulness Into Psychology and the Helping Professions, although we all have the capacity for mindful awareness, it is often overshadowed by conditioning that we received from our family, education, relationships, and society.  These thinking patterns have become such a part of us that we probably engage in them on autopilot, not even consciously knowing the forces that are pushing and pulling our emotions.  We are not fully awake and alive to the present reality.  The practice of mindfulness meditation is the method whereby we train our minds to be in the present moment and know each experience as it arises and passes.  This ability is honed through practice and particular exercises as we train our minds to pay particular attention in a caring and nonjudgmental manner.

There are many ways to do mindfulness meditation.   The simplest, most basic mindfulness exercise involves paying attention to the breath.  Mindful breathing exercise from The Art and Science of Mindfulness: Integrating Mindfulness Into Psychology and the Helping Professions:

“To begin, find a comfortable place to sit quietly and assume a sitting posture that is relaxed yet upright and alert. Focus your attention on the breath as a primary object of attention, feeling the breathing in and breathing out, the rise and fall of the abdomen, the touch of air at the nostrils. Whenever some other phenomenon arises in the field of awareness, note it, then gently bring the mind back to the breathing. If any reactions occur, such as enjoying what arose in your mind or feeling irritated by it, simply note the enjoyment or irritation with kindness, and again return to the experience of breathing.”

Mindfulness based stress reduction

As mentioned earlier, there are three basic components to the mindfulness based stress reduction program.  They are mindfulness meditation, body scanning, and simple yoga postures.  Also mentioned earlier, mindfulness based stress reduction is typically taken as an 8 week course, but it is also available as a workbook: A Mindfulness-Based Stress Reduction Workbook by Bob Stahl and Elisha Goldstein.

Body scanning is a mindfulness technique taught during the first four weeks of the MBSR program.  It involves lying quietly on your back while carefully focusing your attention on various regions of the body, typically starting with the toes and slowly moving up to the the head.

The following principles are central to MBSR:

• non-judging,
• non-striving,
• acceptance,
• letting go,
• beginner’s mind,
• patience,
• trust,
• acceptance,
• non-centering.

What is mindfulness based cognitive therapy (MBCT)?

Mindfulness based stress reduction has several specializations for different and specific groups.  One of these specializations is known as mindfulness based cognitive therapy (MBCT).  MBCT was developed by Oxford professor Mark Williams in conjunction with Cambridge’s John Teasdale and Toronto’s Zindel Segal.  The purpose of mindfulness-based cognitive therapy is to prevent relapse in depression. MBCT reduces depression relapse as effectively as antidepressant medication in those who have had three or more previous episodes of major depression.

What is the difference between MBSR and MBCT?

• Mindfulness meditation is at the core of each one
• the intended audience is the main difference – while MBSR is geared towards a more general audience, MBCT is aimed at an audience that might be prone to depression relapse
• The book Mindfulness-Based Cognitive Therapy for Depression explains this form of mindfulness based therapy thoroughly.  MBCT revolves around a straightforward form of mindfulness meditation which a few minutes a day. MBCT has been clinically proven at least as effective as drugs for depression.  MBCT is widely recommended by US physicians and the UK’s National Institute for Health and Clinical Excellence.

Recommended books about mindfulness based stress reduction (MBSR):

1. A Mindfulness Based Stress Reduction Workbook by Bob Stahl and Elisha Goldstein with afterword by Saki Santorelli and foreword by Jon Kabat-Zinn. Learn from this well-reviewed mindfulness based stress reduction workbook.  Mindfulness based stress reduction is clinically proven to be effective in alleviating stress, anxiety, panic, depression, chronic pain, and a wide range of medical conditions. This powerful approach shows you how to focus on the present moment in order to permanently change the way you handle stress. As you work through A Mindfulness Based Stress Reduction Workbook, you’ll learn how to replace stress-promoting habits with mindful ones. This groundbreaking program will help relieve the symptoms of stress and identify its causes so that you can start living a healthier, happier life.
   
2. Full Catastrophe Living (Revised Edition): Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness by Jon Kabat-Zinn with a preface by Thich Nhat Hanh.  This is the classic, groundbreaking work from 25 years ago that was based on Jon Kabat-Zinn’s mindfulness based stress reduction program.  This second edition is updated to feature results from recent studies on the science of mindfulness, a new introduction, up-to-date statistics, and an extensively updated reading list.  Stress. It can sap our energy, undermine our health if we let it, even shorten our lives. It makes us more vulnerable to anxiety and depression, disconnection and disease.   This book shows us how to use medically proven mind-body approaches derived from meditation and yoga to counteract stress, establish greater balance of body and mind, and stimulate well-being and healing. By engaging in these mindfulness practices and integrating them into your life from moment to moment and from day to day, you can learn to manage chronic pain, promote optimal healing, reduce anxiety and feelings of panic, and improve your overall quality of life.
   
3. The Mindful Way Workbook: An 8-Week Program to Free Yourself from Depression and Emotional Distress (Paperback + MP3 CD Edition) by John D. Teasdale, J. Mark G. Williams, and Zindel V. Segal PhD, with a foreward by Jon Kabat-Zinn.  By working through this carefully constructed book, you can receive mindfulness based cognitive therapy (MBCT) any time, any place.  The authors, who are all experts in the field, introduce specific mindfulness practices to try each week, plus reflection questions, tools for keeping track of progress, and helpful comments from others going through the program. This book guides you step by step along the path of change.  Guided meditations are provided on the accompanying MP3 CD and are also available as audio downloads.   This book won second place for American Journal of Nursing Book of the Year Award, Consumer Health Category.
   
4. MBSR Every Day: Daily Practices from the Heart of Mindfulness-Based Stress Reduction
   
5. Mindfulness: An Eight-Week Plan for Finding Peace in a Frantic World by Mark Williams and Danny Penman, with a foreword by Jon Kabat-Zinn.  This book is founded on Mindfulness Based Cognitive Therapy (MBCT).  MBCT was developed by the book’s author, Oxford professor Mark Williams, and his colleagues at the Universities of Cambridge and Toronto. By investing just 10 to 20 minutes each day, you can learn the simple mindfulness meditations at the heart of Mindfulness Based Cognitive Therapy and fully reap their benefits. The book includes links to guided audio meditations.
   
6. The Mindful Way Through Depression: Freeing Yourself from Chronic Unhappiness (Book & CD) by  Mark Williams, John Teasdale, Zindel Segal, and Jon Kabat-Zinn.  I highly recommend this book to anyone who is suffering from depression.
   
7. Guided Mindfulness Meditation: A Complete Guided Mindfulness Meditation Program (Audio CD – Audiobook) by Jon Kabat-Zinn.  This is a four-part home training course in which Jon Kabat-Zinn offers listeners mindfulness meditation practice on CD. Although Kabat-Zinn points out that practicing mindfulness is not goal-oriented — and we are therefore not trying to achieve a particular state — by becoming aware of the present moment, often deep relaxation and physical and mental wellbeing occur during mindfulness meditation.  There are three separate series, all of which are well-reviewed:
   
8. The Mindfulness Toolbox: 50 Practical Tips, Tools & Handouts for Anxiety, Depression, Stress & Pain by Donald Altman.  This book features over 40 easy to use, reproducible handouts and expertly crafted, guided scripts such as working with the breath, overcoming depression with here and now pleasantness, calming the anxious mind with sense grounding, expanding a client s strength narrative, the stress pause S-T-O-P technique, and meditations for peace, acceptance, and re-envisioning pain. This book is ideal for clinicians wanting to integrate mindfulness into their work.
   
9. Mindfulness Skills Workbook for Clinicians and Clients: 111 Tools, Techniques, Activities & Worksheets by Debra Burdick.  This is a unique mindfulness based stress reduction resource which combines the latest research and best practices.  It is oriented towards clinical practitioners, but can also be used by clients. This workbook gives the theory behind each tool, step by step directions, and expert guidance on processing results.
   
10. A Clinician’s Guide to Teaching Mindfulness: The Comprehensive Session-by-Session Program for Mental Health Professionals and Health Care Providers by Christiane Wolf and J. Greg Serpa.  This is a book oriented towards mental health professionals (as the title suggests).  This guidebook provides professionals with a comprehensive, session-by-session guide to six weeks of teaching mindfulness, complete with the scripts and training materials needed to teach introductory mindfulness in a wide variety of settings.
    

Mindfulness based stress reduction training for professionals

The Oasis Institute is the current name of the institute founded by Jon Kabat-Zinn himself and is the world’s longest-running, academic-based mindfulness practice, training and research organization.  They offer comprehensive educational opportunities for professionals at many stages throughout their careers including mindfulness based stress reduction certification.

Conclusion

Mindfulness based stress reduction (MBSR) is an education and training program that helps people with a variety of pain, illness, stress, psychological, and emotional conditions by teaching them a new way to relate to life’s challenges: mindfulness.  Mindfulness is seemingly simple.  In fact it seems like it is nothing at all.  However, by practicing mindfulness, many studies have shown that powerful psychological and physical changes can be effected.  Mindfulness is now at the core of many psychological treatments including MBCT, which is a modification of the MBSR program which is geared towards people who suffer from depression and depression relapses.  It has also been used to treat anxiety.  Also, there are elements of mindfulness in other therapies such as dialectical behavioural therapy (DBT).

Mindfulness itself is actually an ancient Eastern religious practice, but it has found its way into Western medicine and psychology because it has been scientifically proven to be remarkably effective in helping people to overcome a wide range of life’s struggles.

References

Hazlett-Stevens, H.,  Oren, Y. (2017) Effectiveness of Mindfulness-Based Stress Reduction Bibliotherapy: A Preliminary Randomized Controlled Trial. Journal Of Clinical Psychology [serial online]. June 2017;73(6):626-637. Available from: Education Research Complete, Ipswich, MA.

Crane, R. S., Brewer, J., Feldman, C., Kabat-Zinn, J., Santorelli, S., Williams, J. G., & Kuyken, W. (2017). What defines mindfulness-based programs? The warp and the weft. Psychological Medicine, 47(6), 990-999. doi:10.1017/S0033291716003317

Also, thank you to Dr. Mark Williams for his advice on writing this article.  Any errors and/or omissions are my own.