How the Mindfulness-Based Skess Reduction Program
May be Able to Help Some of Your Patients
(data compiled by Jim Carmody of UMass Medical School)
trainingcan be powerfuladjuncts
Publishedresearchhas repeatedlyshownthat meditationand relaxation
the
medicaltreatmentof manydisorders.The StressReductionProgramincorporates
to the conventional
programs
andtakesthe healingprocessan
andmeditation
criticalelementsof all theserelaxation
importantstepfurther. A centralfeatureof the programis the teachingof a gentleyet effectivemethodthat
(momentof mindfulness
levelof inquiryintothe application
the patientto developa profound
encourages
in everydaylife. Patients
copingstrategies
non-judgmental
awareness)
andmindfulness-based
to-moment,
to supporttheirhealth,
in the programaretaughtto becomeawareof, anddevelop,theirownresources
withbetterhealthacrossthe lifespan.
thusbecomingmorestresshardy,a qualitythatis associated
medicine
for
Programhasbeenon the cuttingedgeof mindibody
and integrative
The StressReduction
and integrativemedicineat its best. Over 13,000patients
twentytwo yearsand representsparticipatory
completed
the eight-week
courseand 1,400physicians
havesuccessfully
withall mannerof diagnoses
.PU:ijiishdd
patientsto thTS-p-fogram.
outCbmesresultin$Trom
eVal0ations
of the merJiCal
haveret'erreci
patientparticipation
in the numberof medicalsymptomsanda 40%reduction
haveshowna 35%reduction
1982,1985,1986, 1992,1998,Milleret al
in psychological
symptoms(stableoverfouryears)(Kabat-Zinn
1995,etc.).
Numberof
Medical
Symptoms
Psychological
Distress
(GSr/SCL-e0-R)
(MScL)
Pre
Post
2A02
Pre
Wff
Post
2002
so theseoutcomedataapply
by theirreferraldiagnosis,
Patientscomingto the programare notseparated
thathavebeenreferred.
acrossall the diagnostic
categories
Stressand Patient Presentation
hasestimatedthat up to twothirdsof all officevisitsto family
The AmericanAcademyof FamilyPhysicians
symptoms.Recentresearchhas indicatedthat up to 60%of all HMOvisitsare
doctorsare for stress-related
disorder- the "worriedwell"(Sobel1995)- andthatmanyof these
madeby peoplewithno diagnosable
presenting
symptomsare relatedto the patient'spsychosocialfunctioning
- suchthingsas depression,
1989).At leastonethirdof chestpain
ovenrvork
etc.(Kroenke& Mangelsdorff
anxiety,socialisolation,
patientswithnormalor nearnormalcoronaryarterieshavebeenfoundto be suffering
frompanic
cardiology
disorder(Kushner1989).
these
in addressing
the malaisethatoftenunderlies
Mindfulness
traininghas beenshowneffective
presentations
(Kabat-Zinn
1982,1985,1986,1992,Miller1995,etc.),andfurtherevidenceof thiscanbe
meditation
training(Kabat-Zinn,'1987b,
seenin studiesshowingreducedneedfor clinicalservicesfollowing
1994).
Hellman1990,Caudill199'la,1991b,Tate1994,Orme-Johnson
(continued
on back)
PatientsWho Can Benefit From Taking the StressReduction Program
(data compiled by UMass Medical School)
Stress ReductionProgramand learnedhow to use
Since its inceptionin 1979, more than 13,000 people have completedour eight-weekMindfulness-Based
their innate resourcesand abilitiesto respond more effectivelyto stress, pain, and illness. The centralfocus of the SR Program is intensivetraining in
mindfulnessmediationand its integrationinto the challenges/adventures
of everydaylife.
regimenshas been
The additionof meditation
trainingto standardcardiacrehabilitation
shownto reducemortality(41%decreaseduringthe first two yearsfollowing,and 460/o
reductionin recurrencerates)morbidity,psychological
distress,and some biologicalrisk
factors(plasmalipids,weight,bloodpressure,bloodglucose)(Linden1996,Zammara
practicealonehas beenshownto reduceexercise-induced
myocardial
1996).Meditation
ischemia
in patientswithcoronaryarterydisease(Zammara1996,Ornish1983).
to the
Meditation
traininghas beenshownto reducebloodpressurein amountscomparable
and otherlifestylemodifications
suchas weight
changesthat are producedby medication
loss, sodiumrestriction,
and increasedaerobicexercise(Schneider1995, Linden&
1994,Alexander
1994).
Chambers
StressReduction
A randomized
trial with canceroutoatients
showedMindfulness-Based
(MBSR)was effectivein significantlydecreasingmood disturbance(65%), including
of stress
depression,
anxiety,angerand confusion,
and also in decreasing
the symptoms
such as cardiopulmonary
and gastrointestinal
symptoms(Speca2000). Thesechanges
weresustained
at six rnonthfollowup (Carlson2001). Survivalratesof bothmelanomaand
rnetastaticbreest cancer patlentshave L'eensignificantlylnnprorred
by refaxationand
lessenedin
meditation
distresswas
training(Fawzy1993,Speigal1989)and psychological
womenwithearlybreastcancer(Bridge1988).Anticipatory
nauseaand vomitingdue to
(Green1991).
chemotherapy
is alsoinhibited
Mindfulness
meditationhas been shownto reduceboth the experienceof pain and its
inhibitionof patients'everydayactivities. Further,mood disturbanceand psychological
(includinganxietyand depression)are also reduced.Pain-related
drug
symptomatology
wasdecreased
andactivitylevelsandselfesteemincreased.Thiswas in marked
utilization
group,whichshowedno changeon these
contrastto a traditionalpaincliniccomparison
(Kabat-Zinn
at four-year
dimensions
1982,85). Thesegainswere nearlyall maintained
follow-up(Kabat-Zinn
1987).
in physical
Mindfulness
trainingresulted
in clinically
significant
improvements
condition
and
(Kaplan
1994,Weissbecker
2OO2).
bothpsychologicaland
socialspheres
1993,Goldenberg
type
Meditation
trainingsignificantly
loweredglucoselevelsin patientswithpoorlycontrolled
(McGrady
I diabetes
1991).
Meditation
traininghas beenshownto be effectivein improvingthis condition (Blanchard
1992).
Mindfulness
reducesymptomsof anxiety,psychological
traininghasbeenshownto clinically
(Kabat-Zinn
at 3distressandsecondary
depression
1992).Thesechangesweremaintained
yearfollow-up
(Miller1995).
well-being,functional
Relaxationtraininghas been shownto improvethe psychological
statusand frequencyof attacksof asthmapatientsas well as adherenceto treatment
(Devine1996). lt has also been shownto have a beneficialeffecton dyspneaand
psychotogicaiWell-beihgafronS-eduifilWrth-ob-slructrve
Ttum-onarydis:ase (Devine &
Pearcy,in press).
published
Recently
research
hasshownthatmindfulness
meditation
increases
skinclearing
(Kabatratesfour-fold
whenusedin conjunction
withphototherapy
and photochemotherapy
Zinn1998).
1987).
Meditation
hasbeenshownto decrease
headache
activity(Anastasio
The skills derivedfrom mindfulness
trainingand cognitivetherapyhave been shown
reducingthe recurrence
of majordepressive
episodesin patients
ive in significantly
(Teasdale
2000).
whohavebeentreatedfor depression
improvement
Trainingin mindfulness
of movement
resultedin MS patientsreporting
over
(Mills2000).
broadrangeof symptoms,
including
balance
qualityof life. (functional
MBSRhasbeenshownto significantly
improvehealth-related
physical
psychological
(Reibel2001)
well-being,
reduced
symptoms,
distress)
,