(MBCT) (MBSR) & ZEN

Mindfulness has been described as a practice of learning to focus attention on moment-by

moment experience with an attitude of curiosity, openness, and acceptance. Mindfulness
practices have become increasingly popular as complementary therapeutic strategies for a
variety of medical and psychiatric conditions. This paper provides an overview of three
mindfulness interventions that have demonstrated effectiveness for psychiatric symptoms
and/or pain. The goal of this review is to provide a synopsis that practicing clinicians can use
as a clinical reference concerning Zen meditation, mindfulness-based stress reduction
(MBSR), and mindfulness-based cognitive therapy (MBCT). All three approaches originated
from Buddhist spiritual practices, but only Zen is an actual Buddhist tradition. MBSR and
MBCT are secular, clinically based methods that employ manuals and standardized
techniques. Studies indicate that MBSR and MBCT have broad-spectrum antidepressant and
antianxiety effects and decrease general psychological distress. MBCT is strongly
recommended as an adjunctive treatment for unipolar depression. The evidence suggests that
both MBSR and MBCT have efficacy as adjunctive interventions for anxiety symptoms.
MBSR is beneficial for general psychological health and stress management in those with
medical and psychiatric illness as well as in healthy individuals. Finally, MBSR and Zen
meditation have a role in pain management.

Mindfulness-based cognitive therapy (MBCT)

is an approach to psychotherapy that was originally created as a relapse-prevention treatment

for depression. Research indicates that it may be particularly effective for individuals with
major depressive disorder (MDD). The focus on MDD and cognitive processes is what
distinguishes MBCT from other mindfulness-based therapies such as mindfulness-based stress
reduction (MBSR), which is applicable to a broad range of disorders, and mindfulness-based
relapse prevention which is used to treat addiction.

MBCT uses cognitive behavioral therapy (CBT) methods in collaboration with Eastern
psychological strategies such as mindfulness meditation. Cognitive methods can include
educating the participant about depression. Mindfulness and mindfulness meditation focus on
becoming aware of all incoming thoughts and feelings and accepting them, but not attaching
or reacting to them. This process is known as "Decentering" and aids in disengaging from self-
criticism, rumination, and dysphoric mood that can arise when reacting to negative thinking
patterns.

Like CBT, MBCT functions on the etiological theory that when individuals who have
historically had depression become distressed, they return to automatic cognitive processes
that can trigger a depressive episode. The goal of MBCT is to interrupt these automatic
processes and teach the participants to focus less on reacting to incoming stimuli, and instead
accepting and observing them without judgment. Like MBSR, this mindfulness practice
encourages the participant to notice when automatic processes are occurring and to alter their
reaction to be more of a reflection. It is theorized that this aspect of MBCT is responsible for
the observed clinical outcomes.

Beyond the use of MBCT to reduce depressive symptoms, research additionally supports the
effectiveness of mindfulness meditation in reducing cravings for individuals with substance
abuse issues. Addiction is known to involve interference with the prefrontal cortex that
ordinarily allows for delaying of immediate gratification for longer term benefits by the limbic
and paralimbic brain regions. The nucleus accumbens, together with the ventral tegmental
area, constitutes the central link in the reward circuit. The nucleus accumbens is also one of
the brain structures that is most closely involved in drug dependency. Mindfulness meditation
of smokers over a two-week period totaling five hours of meditation decreased smoking by
about 60% and reduced their cravings, even for those smokers in the experiment who had no
prior intentions to quit. Neuroimaging of those who practice mindfulness meditation reveals
increased activity in the prefrontal cortex, a sign of greater self-control.

Mindfulness-based stress reduction (MBSR)

is a program that incorporates mindfulness to assist people with pain and a range of conditions
and life issues that were initially difficult to treat in a hospital setting. Developed at the
University of Massachusetts Medical Center in the 1970s by Professor Jon Kabat-Zinn, MBSR
uses a combination of mindfulness meditation, body awareness, and yoga to help people
become more mindful. In recent years, meditation has been the subject of controlled clinical
research. This suggests it may have beneficial effects, including stress reduction, relaxation,
and improvements to quality of life, but that it does not help prevent or cure disease.[4] While
MBSR has its roots in spiritual teachings, the program itself is secular