Mindfulness and Meditation Therapy

Mindfulness and meditation therapy is a non-pharmacological psychological intervention method that has been verified by evidence-based medicine around the world for nearly 40 years and has an effective rate of 60%-80% in clinically improving mild to moderate anxiety disorders, chronic primary pain, and adult sleep disorders. It is neither a "practice method" in the category of metaphysics. , it is not a panacea that can solve all emotional problems. The core logic is to adjust the overreaction mode of the amygdala of the brain to negative stimuli through continuous "active awareness of the present without judgment" training, and help people escape from the state of being "carried away by emotions".

In the four years I have been doing clinical cases, I have seen too many people go to extremes in their understanding of it. An Internet operation client who just finished the intervention last week had been taking anti-anxiety drugs for 8 months because of frequent performance appraisal anxiety. His hands were shaking and his chest was tight every Thursday when the weekly report came. Even three electrocardiograms failed to detect organic problems. The first time I took her to do a 10-minute breath anchoring training, she suddenly cried at the 3rd minute and said, "I just realized that my shoulders had been hunched so much that they almost touched my ears. Before, I always thought that the blockage in my chest was due to a heart problem. It turned out that I had been tense for almost two years without even knowing it."

Many people who have just started to be exposed to mindfulness always feel that "I can't calm down, there are too many distracting thoughts in my mind, I am not suitable for meditation", and they may even feel a strong sense of frustration due to mind wandering. When I participated in Kabat-Zinn's MBSR (Mindfulness-Based Stress Reduction) training before, the old professor who taught the class said something very practical: The core of meditation is never "thinking about nothing during the whole process", but the "pull-back" movement when you find that your mind is wandering, and then bring your attention back to your breathing and the current feelings - just like you have to repeatedly lift dumbbells to practice biceps. This "pull-back" process is to train your brain's muscles to "not be led by emotions and distracting thoughts."

A long-term follow-up study covering 1,200 subjects published in JAMA Psychiatry in 2022 showed that people who persisted in completing 8 weeks of standard MBSR training had an average reduction of 6.1% in gray matter volume in the brain’s amygdala, which is the core of people’s stress reactions such as stress and anxiety. The connection strength between the brain areas, the prefrontal cortex and the amygdala, which are responsible for rational decision-making, has been significantly improved, which means that faced with the same stressful events, trained people are less likely to trigger excessive anxiety reactions. This change at the physiological level has been confirmed by a large number of brain imaging experiments, and it is not simply "psychological comfort."

Of course, the controversy over mindfulness therapy in the industry has never stopped. Traditional Vipassana mindfulness practitioners always feel that the commercialized fast-food meditation courses of "7 days to relieve anxiety" and "10 minutes to cure insomnia" on the market have completely distorted the core of mindfulness and turned it into a tool for harvesting anxiety. ； Many researchers in the field of clinical psychology have also pointed out that self-help meditation without professional guidance not only has little effect on patients with severe anxiety and depression, but may even bring risks. For example, if an unassessed PTSD patient rashly engages in body scanning meditation, it is likely to trigger acute traumatic flashbacks and worsen symptoms. I have met a client who suffered from childhood trauma before. He followed the APP for a week of body scans and had nightmares for three consecutive days. Later, he stopped the self-help training. After the trauma stabilization intervention, he slowly introduced mindfulness exercises, and no discomfort occurred.

In fact, you really don’t need to think too high-level about mindfulness meditation. You have to find a quiet room, light incense, and sit cross-legged for half an hour before you can practice it. When I'm busy with projects, I can't squeeze out a whole block of time, so I use the 30 seconds while waiting for the elevator to focus on the touch of the soles of my feet and the ground, or don't rush to drink the coffee after making it, close your eyes and smell the burnt aroma of the coffee for 3 seconds. These are all mindfulness exercises. To put it bluntly, it is a small tool that helps you get rid of "your mind is full of bad things in the past and worries about the future". If it works well, use it, and if it doesn't work, replace it. There is no need to praise it too highly, and there is no need to deny its value just because you can't "not think about it all the time."

If you always feel emotionally tense recently and want to try it, you might as well start with five minutes of breathing awareness every day. It doesn’t matter if you feel irritable when you sit down. Just stand up and take two steps. There is no need to force yourself to be "effective" - ​​after all, allowing yourself to be "ineffective" is the first step of "non-judgment" in mindfulness.