I’d like to take more of a skeptic’s orientation toward mindfulness and start with a question I often get asked when I pitch an idea for a research project. I get asked this question about mindfulness training by leaders of all kinds of organizations, and, in fact, I was asked most recently at the U.S. Pentagon, and it’s this: Does it work?
The question sounds simple, but I think what’s being communicated is a little more complex. What I think I’m being asked is: What are the real, known, effective benefits of mindfulness training? So I want to break this down to really explore its parts.
The first thing to examine in “Does it work” is the word “it.” What’s meant by that? Does it mean reading a book, downloading an app, listening to a lecture, or, potentially, signing up for a course that lasts a few weeks or a retreat that lasts several months? There are many forms of what “it” might mean. But when we think about research on mindfulness training, we have to constrain our questions to programs that we call “manual-ize,” meaning they actually follow a manual or a prescription that can be repeated by various individuals, in various labs, to make sure we can repeat the intervention or the training over and over again to find out what the beneficial effects might be.
The most commonly studied and most commonly offered mindfulness training programs that actually check the box for being manual-ized are two programs: one called Mindfulness-Based Stress Reduction, MBSR, which was developed by Dr. Jon Kabat-Zinn at the University of Massachusetts medical school; and Mindfulness-Based Cognitive Therapy (MBCT), which was developed by Dr. Zindel Segal and his colleagues at the University of Toronto. Both of these programs are manual-ized; robust, in terms of how often and in what form they’ve been delivered, by many different people; and the evidence is quite strong for both, regarding their benefits.
Let’s take MBSR first: This is an eight-week program where the participants meet with a skilled trainer and then meet together as a group for about two to two-and-a-half hours a week. They’re also assigned 45 minutes of at-home practice each week, which consists of mindfulness workouts they’re introduced to in class. Most of the studies that have been done so far on MBSR and even MBCT—which is used for recurrent depression—have been compared to no training at all, or something we might call Treatment As Usual—which refers to other things that people might do to address some of the challenges they’re facing.
So this gives us a sense of what I mean by “it” in that question, “Does it work?” We’re talking about manual-ized programs, approximately eight weeks in duration, about 24 or so hours in total, including at-home practice.
Exploring the Effectiveness of Mindfulness
But let’s return back to that question before we talk about the research: so, what do we mean by something “working”? When I consider if something works in this context, I’m asking: Does it reduce suffering? Does it actually reduce our human experience of having challenge? Now, the nature of that challenge can take multiple forms: we can have suffering in the body with chronic ailments; we can have suffering in the mind with psychological disorders; and we can have suffering in our relationships, our interpersonal, most intimate life. Now, the way the mindfulness evidence base has been parsed also follows along those lines: there have been hundreds of studies done to look at the benefits of mindfulness training for the body, and the evidence is growing and quite strong. There are benefits now documented in the case of chronic pain, fibromyalgia, high blood pressure and a whole host of other, what we might call bodily or somatic issues.
There’s also growing literature on mindfulness training for suffering in the mind: for psychological disorders such as depression, anxiety, PTSD, ADHD. And the benefits there are also growing.
And the newest area for mindfulness trainings’ evidence base is really around this topic of mindfulness training in the service of improving the quality of our relationships—whether it’s family dynamics, workplace relationships, leader-subordinate relationships, team cohesion. This is sort of a new frontier in mindfulness research, and it’s one I think is very important.
I think at this point we might want to say yes, absolutely, to the question, “Does mindfulness training work? The evidence base is strong. But let me just put on my researcher hat again for a minute and say that while it may be strong and growing—there are, of course, thousands of studies that have been done, to date, on mindfulness training—we’re nowhere near the 300,000 mark. We are very much in our infancy, and frankly, the mindfulness literature has been scrutinized: we are being shown that we need to have more rigour and replication across multiple laboratories.
I mention all this simply to encourage you to be very responsible consumers of information. If you find that mindfulness-training research is described in some news report as some magic-bullet panacea, it’s probably inaccurate. And do use your judgment when it comes to mindfulness as well.
Here’s How Mindfulness Works
So, given this preamble that mindfulness training is a useful thing and has a lot of promise, I actually want to move now to a related question that is pursued in my own lab: We’re not so much asking does it work. In fact, we’re relying on a strong array of literature from the clinical domain, healthcare settings, even workplace settings that suggest it does hold a lot of promise. The question we’re asking is: How does it work? How is it that engaging in something as simple as paying attention to your breath privately for as little as 12 minutes a day can result in such a host of benefits—from a relief from physical symptoms associated with chronic pain, for example, or reduced suffering from depression, or a better marriage? These results are so broad and so vast, it really does make us wonder what’s going on with regard to mindfulness training and how it’s functioning.
The lens that I apply in my work as an attention researcher, and my interest and understanding, is focused on whether attention can actually be strengthened with mindfulness training. I approach my studies of attention from a cognitive-neuroscience perspective in order to explore how mindfulness training may work. This is just one perspective, of course, but we really want to understand mindfulness from a multitude of perspectives. What I’ll say so far, however, is that the evidence, again, is quite robust—and growing. We now have repeated examples of attention being stronger after as little as eight weeks of mindfulness training. We’ve also seen reductions in mind-wandering, and improvements in other aspects of cognition such as cognitive flexibility or the ability to learn and problem solve.