Mindfulness and Cognitive-Behavioral Therapy for Stress

Mindfulness-based stress reduction may be more effective than cognitive-behavioral stress reduction, a new study reports.

Mindfulness is an approach in which attention is focused on a physical sensation (such as breath). When thoughts intrude, the individual returns to the focus. Attention is placed on the present moment, rather than on the future or past. This technique may involve a "body scan," in which one focuses on the body from head to feet, concentrating on areas of pain or illness. This is usually performed while lying down. Regular practice is suggested to enhance self-awareness.

Researchers from New Mexico investigated the effects of mindfulness-based stress reduction and cognitive-behavioral stress reduction in 50 subjects. Participants self-selected into mindfulness-based stress reduction (36 participants) or cognitive-behavioral stress reduction (14 participants) courses taught at different times. There were no initial differences between the mindfulness-based stress reduction and cognitive-behavioral stress reduction subjects among demographics, including age, gender, education and income.

Mindfulness-based stress reduction was an eight-week course using meditation, gentle yoga and body-scanning exercises to increase mindfulness. Cognitive-behavioral stress reduction was an eight-week course using cognitive and behavioral techniques to change thinking and reduce distress.

The researchers analyzed perceived stress, depression, psychological well-being, neuroticism, binge eating, energy, pain and mindfulness before and after each course. Weekly meetings for both courses were held in a large room on a university medical center campus.

The study found that mindfulness-based stress reduction subjects improved in all eight outcomes, with all of the differences being significant. Similarly, cognitive-behavioral stress reduction subjects improved in six of eight outcomes, with significant improvements on well-being, perceived stress and depression.

According to the researchers, mindfulness-based stress reduction subjects had better outcomes across all variables, when compared with the cognitive-behavioral stress reduction subjects; particularly, mindfulness-based stress reduction subjects had better outcomes with regard to mindfulness, energy, pain and a trend for binge eating.

The study authors concluded that while mindfulness-based stress reduction and cognitive-behavioral stress reduction may both be effective in reducing perceived stress and depression, mindfulness-based stress reduction may be more effective in increasing mindfulness and energy and reducing pain. The authors recommended that future studies examine the differential effects of cognitive behavioral and mindfulness-based interventions and attempt to explain the reasons for the differences.

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Comments

[Delany Dean]

Just found your blog through Google Reader. Nice work! I had not seen this New Mexico study before. Interesting design, and it appears to be well-executed. Now, if only someone could figure out how to do a meaningful "placebo" condition!

[Julie]

There are many theories about how meditation might work. It has been suggested that meditation reduces the activity of the sympathetic nervous system (which is responsible for the "fight or flight" response), leading to a slower heart rate, lower blood pressure, slowed breathing and muscle relaxation. Multiple studies of transcendental meditation® have noted decreased metabolism, heart rate, blood pressure, breathing and oxygen consumption. Changes in blood flow to the brain and in brain wave patterns have been reported, as well as alterations in hormone levels. Decreased lactic acid levels have also been reported.

[mo]

“The Power of Now” is a book written by Eckhart Tolle that has a similar focus to the one described here. This book was brought to my attention by a good friend who had successfully used its tenets in his own life. Basically, the book teaches that the only thing that is “real” is now and that individuals can feel more in control of their lives by recognizing things and being able to observe their reactions in the present moment. Once you do this, you find there is less to make you feel stressed, angry, depressed, etc. I think there is something really special about the message in this book. It’s definitely worth a look: http://www.amazon.com/Power-Now-Guide-Spiritual-Enlightenment/dp/1577314808/ref=pd_bbs_sr_1?ie=UTF8&s=books&qid=1210353034&sr=8-1.

[Jess]

I've heard a lot about that book - the Power of Now. I am a firm believer in this approach to life - living in the moment. To comment on the study, however, my friend listens to a meditation and performs a body scan for 45 minutes a day, with the intention of cultivating mindfulness. If we can cultivate the present moment and the NOW, then the depression or other feelings will be seen through - like clouds passing in the sky. Considering the other options for depression and other psychological and behavioral conditions, I would consider meditation as a first line defense because it doesn't cost anything. Of course, this wouldn't bode well for pharmaceutical companies, but the lack of well-designed studies should not deter folks from trying this.

[Leah Cohen]

I agree - in the case of meditation-based therapies, there is overwhelming historical evidence that supports its overall health supporting effects. While meditation may not be a first-line treatment for acute diseases, its use as adjuvant therapy, especially in treatment of long-term chronic diseases, is certainly worthy of inclusion in a patient's treatment plan. Overall, the research suggests positive effects.

[Marsha]

This is a great example of therapy can only provide positive effects. Even if it doesn't work, it's not like it's going to hurt you or worsen your current condition. Why not give it a shot?

So many conditions are aggravated by stress: anxiety, hypertension, asthma, depression, obesity, etc. If we can find ways to decrease our stress levels, we'll be able to live healthier lives.

[Martin]

I agree, Marsha. Stress can really have a negative impact on your health. But many people don't even realize how stressed they actually are. Here's a link to a good online stress test:

http://www.healthcentral.com/sleep-disorders/stress-test-3454-143.html

[Leah Cohen]

Completely agree Marsha. Often times, so much emphasis is placed on potential ineffectiveness of this kind of mind/body-based treatment, and I agree that it is always worth a shot to try at the very least. I would be surprised to hear of significant/relevant negative effects of decreased stress via meditation.

[Samantha]

This is good news. Mindfulness, staying in the moment through meditation and other practices are gentle ways to reduce stress and of be in touch with ourselves in the most basic of ways. I feel the difference when I am meditating regularly and when I let it slide. It is like the contrast of light (mindfulness) and dark (anxiety).