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)

Published

esearch as repeatedly hown

hat meditation nd relaxationraining an be

powerful

djuncts

to the conventional

edical reatment f

many

disorders.

The

Stress

Reduction

rogramncorporateshe

critical lements

f all hese elaxationnd

meditation

rograms

nd akes he healing

rocess

n

important tep urther.

A

central

eature f the

program

s

the eaching f

a

gentle

yet

effective

method hat

encourages

he

patient

o develop

profound

evelof

nquirynto

heapplication

f mindfulness

moment-

to-moment,

on-judgmentalwareness)nd

mindfulness-basedoping trategies

n

everyday

ife. Patients

in he

program

re

aught o become ware f, anddevelop,

heir

own

esourceso support

heirhealth,

thusbecoming

ore

stress

ardy,

quality

hat

s

associated

ithbetter ealth cross he

ifespan.

The

Stress

Reduction

rogram asbeen n he cutting dgeof

mindibody

nd

ntegrative

edicineor

twenty

wo

years

and represents

articipatory

nd ntegrative edicine t

its

best. Over

13,000

atients

withall

manner

f

diagnoses ave uccessfully

ompletedhe eight-weekourse nd

1,400

hysicians

have et'erreci

atients

o thTS-p-fogram.

PU:ijiishdd

eVal0ationsf

the merJiCalutCbmes

esultin$Trom

patient articipation

ave

shown

35% eduction

n

he

number f medical ymptoms nda

40% eduction

in

psychological

ymptoms

stable

ver our

years) Kabat-Zinn

982, 985 , 986,1992,

998,Miller t al

1995, tc.).

Patientsomingo

the

program

renotseparated y heir

eferral

iagnosis,

o theseoutcome

ataapply

across ll hediagnosticategories

hathavebeen eferred.

Stress

and Patient

Presentation

TheAmerican cademy f

FamilyPhysicians asestimatedhat up o twothirds

of all office

isits

o

family

doctors re

or stress-relatedymptoms.

Recent esearch as ndicatedhat up

o

60%

of all HMO

visitsare

madeby

people

withno diagnosableisorder the

"worried

ell"

Sobel

995) and hat

manyof hese

presenting

ymptoms re

relatedo he

patient's sychosocialfunc tioning

such hings s depression,

anxiety, ocial

solation,venrvorktc .

Kroenke

Mangelsdorff989).

At least

one

hirdof chest

ain

cardiology

atients

ithnormal r nearnormal oronary rteries

avebeen ound o be suffering

rom

panic

disorder

Kushner

989).

Mindfulnessraining asbeen hown ffective

n addressinghe malaisehatoften

underlieshese

presentations

Kabat-Zinn

982, 985,

986,1992,Miller 995 , tc.), nd

urther vidence f hiscanbe

seen n studies howing

educed eed

or

clinical ervices

ollowing editationraining

Kabat-Zinn,'1987b,

Hellman 990,Caudill

99'la, 991b, ate1994,Orme-Johnson

994).

Number f

Medical

Symptoms

(MScL)

Psychological

Distress

(GSr/SCL-e0-R)

Wf

A02

Post 2002

re Post

Pre

(continued

n back)

 

PatientsWho Can

Benefit From Taking

the Stress

Reduction Program

(data

compiled by UMass

Medical School)

Since

ts inception n 1979,more

than

13,000

people

have completed ur eight-weekMindfulness-Based tress ReductionProgramand

learnedhow to use

their

innate resources

and abilities o

respond more effectively o stress,

pain,

and illness. The central ocus of the SR Program

s intensive

raining

n

mindfulnessmediation nd ts ntegrationnto he challenges/adventuresf everyday

ife.

Th e

addition

f meditationrainingo standard ardiac ehabilitation

egimens as been

shown

o

reducemortality

41%

decrease uring he first two

years

ollowing, nd 460/o

reductionn recurrenceates)morbidity,

sychological

istress, nd some biological

isk

factors

plasma

ipids,weight,

lood

pressure,

lood

glucose) Linden

996,Zammara

1996).Meditation

ractice

lonehas beenshown o reduceexercise-induced

yocardial

ischemian

patients

ithcoronary rtery i sease

Zammara

996,Ornish 983).

Meditationraining

as

beenshown o

reduce

lood

pressure

n

amounts

omparableo the

changes

hat

are

produced

y medicationnd other ifestylemodificationsuchas

weight

loss, sodium estriction,nd increased erobicexercise

Schneider

995, Linden&

Chambers

994, lexander994).

A randomizedrial

with

canceroutoatientshowed

Mindfulness-BasedtressReduction

(MBSR)

was effective

n

significantl y ecreasing

mood

disturbance

65%),

ncluding

depression,nxiety, ngerandconfusion,nd also

n

decreasinghe symptoms

f stress

such as cardiopulmonarynd

gastrointestinal

ymptoms

Speca

2000). Thesechanges

weresustainedt six rnonthollow p

(Carlson

001). Survivalates f both

melanoma nd

rnetastatic reest

cancer

patlents

have L'eensignificantlynnprorredy

refaxation

nd

meditation

raining

Fawzy

993, peigal 989) nd

psychological

istresswas

womenwithearlybreast ancer

Bridge

988).Anticipatoryausea nd

vomiting

ue

to

chemotherapys also nhibited

Green

991).

Mindfulness editation as beenshown o reduceboth the experience f

pain

and its

inhibition f

patients'

veryday ctivities. Further,mood disturbance nd

psychological

symptomatology

including

nxiety nd depression) re also reduced.Pain-relatedrug

utilization

as

decreased

ndactivityevels

nd

self

esteem

ncreased. hiswas

n marked

contrasto a traditional

ain

cliniccomparison

roup,

whichshowed

o

changeon these

dimensions

Kabat-Zinn

982,85). These

ains

were

nearly

ll

maintainedt four-year

follow-up

Kabat-Zinn

987).

Mindfulnessrainingesultedn clinicallyignificantmprovements

n

physical

onditionnd

both

sychologicaland

ocialspheres

Kaplan

993,Goldenberg

994,WeissbeckerOO2).

Meditationraining ignificantlyowered

lucose

evels

n

patients

ith

poorly

ontrolled

ype

I diabetes

McGrady

991).

Meditation

raining

as

beenshown o be effective

n improving

his

condition

(Blanchard

1992).

Mindfulness

raining

as

been howno clinically

educe

ymptoms f anxiety,

sychological

distress ndsecondaryepression

Kabat-Zinn

992).

hese

hanges

eremaintainedt 3-

year

ollow-up

Miller

995).

Relaxationraininghas been shown o improve he

psychological

ell-being,unctional

statusand frequency f attacksof asthma

patients

s well as adherenceo treatment

(Devine

1996). lt has also been shown

o

have a beneficial ffecton dyspneaand

psychotogicai

Well-beihg fronS

eduifilWrth-

ob-slructrve

tum-onary

is:ase

(Devine

&

Pearcy,n

press).

Recently

ublished

esearchas

shownha t

mindfulnesseditationncreaseskin learing

rates our-fold hen

used

n

conjunction

ith

phototherapy

nd

photochemotherapy

Kabat-

Zinn

1998).

Meditationasbeen hown o decrease eadache ctivity

Anastasio

987).

The

skills derived

rom mindfulnessrainingand cognitive herapyhave been shown

ive

n

significantly

educing

he

recurrencef majordepressive pisodes

n

patients

whohavebeen reated

or

depression

Teasdale

000).

Trainingn mindfulnessf movementesultedn MS

patients

eporting

mprovement

ver

broad ange f symptoms,ncludingalance

Mills

000).

MBSR as

been hown o significantly

mprove ealth-related

uality

f ife.

(functional

,

well-being,educed

hysical

ymptoms,

sychological

istress)

Reibel

001)