Health & Family

Talk therapy's silent partner

The patient sat with his eyes closed, submerged in the rhythm of his own breathing, and after a while noticed that he was thinking about his troubled relationship with his father.

“I was able to be there, present for the pain,” he said, when the meditation session ended. “To just let it be what it was, without thinking it through.”

The therapist nodded.

“Acceptance is what it was,” he continued. “Just letting it be. Not trying to change anything.”

“That's it,” the therapist said. “That's it, and that's big.”

This exercise in focused awareness and mental catch-and-release of emotions has become perhaps the most popular new psychotherapy technique of the past decade. Mindfulness meditation, as it is called, is rooted in the teachings of a fifth-century B.C. Indian prince, Siddhartha Gautama, later known as the Buddha.

It's catching the attention of talk therapists of all stripes, including academic researchers, Freudian analysts in private practice and skeptics who see all the hallmarks of another fad.

For years, psychotherapists have worked to relieve suffering by reframing the content of patients' thoughts, directly altering behavior or helping people gain insight into the subconscious sources of their despair and anxiety. The promise of mindfulness meditation is that it can help patients endure flash floods of emotion during the therapeutic process – and ultimately alter reactions to daily experience at a level that words cannot reach.

At workshops and conferences across the country, students, counselors and psychologists in private practice throng lectures on mindfulness. The National Institutes of Health is financing more than 50 studies testing mindfulness techniques, up from three in 2000, to help relieve stress, soothe addictive cravings, improve attention, lift despair and reduce hot flashes.

Some proponents say Buddha's arrival in psychotherapy signals a broader opening in the culture at large – a way to access deeper healing, a hidden path revealed.

Yet so far, the evidence that mindfulness meditation helps relieve psychiatric symptoms is thin, and in some cases, it may make people worse, some studies suggest. Many researchers now worry that the enthusiasm for Buddhist practice will run so far ahead of the science that this promising psychological tool could turn into another fad.

“I'm very open to the possibility that this approach could be effective, and it certainly should be studied,” said Scott Lilienfeld, a psychology professor at Emory. “What concerns me is the hype, the talk about changing the world, this allure of the guru that the field of psychotherapy has a tendency to cultivate.”

Sit and breathe

Mindfulness meditation is easy to describe. Sit in a comfortable position, eyes closed, preferably with the back upright and unsupported. Relax and take note of body sensations, sounds and moods.

Let the mind settle into the rhythm of breathing. If it wanders (and it will), gently redirect attention to the breath. Stay with it for at least 10 minutes.

After mastering control of attention, some therapists say, a person can turn, mentally, to face a threatening or troubling thought – about, say, a strained relationship with a parent – and learn simply to endure the anger or sadness and let it pass, without lapsing into rumination or trying to change the feeling, a move that often backfires.

One woman, a doctor who had been in therapy for years to manage bouts of disabling anxiety, recently began seeing Gaea Logan, a therapist in Austin, Texas, who incorporates mindfulness meditation into her practice.

This patient had plenty to worry about, including a mentally ill child, a divorce and what she described as a “harsh internal voice,” Logan said.

After practicing mindfulness meditation, she continued to feel anxious at times but told Logan, “I can stop and observe my feelings and thoughts and have compassion for myself.”

Steven Hayes, a psychologist at the University of Nevada at Reno, has developed a talk therapy called Acceptance Commitment Therapy, or ACT, based on a similar, Buddha-like effort to move beyond language to change fundamental psychological processes.

“It's a shift from having our mental health defined by the content of our thoughts,” Hayes said, “to having it defined by our relationship to that content – and changing that relationship by sitting with, noticing and becoming disentangled from our definition of ourselves.”

For all these hopeful signs, the science behind mindfulness is in its infancy.

The Agency for Healthcare Research and Quality, which researches health practices, last year published a comprehensive review of meditation studies, including TM, Zen and mindfulness practice, for a wide variety of physical and mental problems.

The study found that overall, the research was too sketchy to draw conclusions.

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