Mindfulness and Meditation Therapy

Mindfulness and meditation therapy are psychological intervention methods that have been verified by evidence-based medicine and can effectively improve anxiety and depression and enhance emotional regulation capabilities. They are neither metaphysical "chicken soup for the soul" nor a "panacea" suitable for everyone. The core of their effectiveness depends on the adaptability and persistence of the practice, rather than a genre gimmick.

This is the most straightforward conclusion I have come to after leading mindfulness intervention groups in university psychology centers and social consultation rooms for 6 years and having contact with nearly 200 clients. I was particularly impressed by a young girl I met in the first half of last year who was taking the postgraduate entrance examination in her junior year. At that time, she had woken up at 3 a.m. for half a month, kept her eyes open until dawn, and her hands were shaking when she was writing two sets of English papers. The hospital tested her and she showed moderate anxiety. The doctor prescribed medicine and recommended psychological intervention. When she first heard about meditating, she shook her head like a rattle. She said that she had tried it, and her mind could run through 800 knowledge points after sitting for five minutes. She couldn't calm down at all, and instead became more annoyed. I didn't ask her to sit cross-legged, but gave her two very simple requirements: chew each bite 20 times while eating, and don't listen to the endorsement audio when walking back to the dormitory. Just focus on stepping on the floor tiles and counting your steps. Three weeks later, she came for a follow-up visit and said that the number of early awakenings had been reduced by more than half. “I used to think that eating and walking were a waste of time, but now I realize that when I slow down, I can breathe more evenly.”

Speaking of which, many people's first impression of mindfulness is that they wear plain meditation clothes, sit cross-legged on a futon, have to clear their minds of all distracting thoughts, and even go to retreat in the mountains to call it "serious practice". In fact, it completely deviates from the original clinical design of this method. The most widely used MBSR (mindfulness-based stress reduction therapy) in the mainstream today is an intervention program that Kabat-Zinn conducted for chronic pain patients at the University of Massachusetts Medical School in 1979. Those patients were in so much pain that they could not sit still. How could they withstand a few hours of meditation? Therefore, the initial exercises are all fragmented and life-oriented. You can practice brushing teeth, washing dishes, and walking. There are not so many thresholds at all. Last time, a visitor from an Internet operation complained to me, saying that he spent 999 to sign up for an "advanced meditation class" that required him to sit with his eyes closed for 40 minutes every day. He worked overtime until 11 o'clock and had to practice hard. After half a month, he didn't learn to meditate, and he got a headache whenever he heard the background music of meditation. I gave him a "brushing mindfulness" method: when brushing his teeth every morning and evening, don't think about today's KPIs that have not been completed or the meetings that will be held later. Just concentrate on feeling the mint flavor of the toothpaste rubbing against the tip of your tongue, the touch of the bristles sweeping over the teeth, and the feeling of foam melting in your mouth. He gave it a try with hesitation, and came back to me for a follow-up visit two months later. He said that now that the product manager is continuously changing the requirements for version 8, he will not be as furious as before. "Anyway, I can still do 3 minutes of breathing exercises when changing the requirements, so I can't make it difficult for myself."

Oh, by the way, last time a friend asked me for the "most authentic" meditation audio, saying that what others recommended to him were "masters teaching lessons" worth several thousand dollars. I directly sent him the 10-minute body scan audio that is free and publicly available on the official website of the University of Massachusetts Medical School. He thought it was too cheap and ineffective, which made me laugh. Most of the practice materials that have been clinically verified are public welfare, so how can there be such a premium.

Of course, mindfulness has always been controversial. Every year I meet three or four clients who feel worse after practicing mindfulness. Practitioners from different schools have quite different views on such issues. Most teachers who practice traditional Vipassana will say, "The ineffectiveness is because you don't have enough time to practice and your heart is not sincere." However, scholars of the evidence-based CBT integrated mindfulness school do not recognize this statement at all: many times it is not the practitioner's fault, but the wrong method. For example, a client with severe dissociative symptoms is already out of touch with his own physical feelings. If you ask him to do a body scan with his eyes closed for half an hour, he will only become more and more distracted as the practice progresses, and may even suffer from a more serious loss of reality. ； There are also patients with PTSD (post-traumatic stress disorder) who have not yet passed the acute stage. If they rashly practice emotional awareness, it is easy to directly trigger traumatic flashbacks and cause secondary damage. In the clinical guidelines updated in 2022 by the American Psychological Association, although mindfulness therapy is included in the first-line intervention plan for generalized anxiety disorder, it is also clearly marked: People with acute psychotic symptoms and an unstable history of trauma are not recommended to use mindfulness exercises alone, and the plan must be adjusted under the supervision of a professional.

I have been practicing mindfulness for almost 7 years. At the beginning, I also suffered from the obsessive-compulsive disorder of "must do enough standard exercises". Sometimes I worked overtime until 11 o'clock, and I was so sleepy that I couldn't open my eyes. I had to sit still for 30 minutes, and the more I sat, the more irritated I became. Later I figured out: mindfulness is supposed to help you get along well with your own feelings. Even "I must do good mindfulness" has become pressure. Isn't it putting the cart before the horse? When I was leading a community group before, I met a retired aunt who said that she had to take care of her grandson and couldn't spare any time to practice. I asked her to push her grandson downstairs for a walk every day. Don't watch short videos and think about your family. Instead, focus on feeling the weight of your feet on the ground, the touch of the wind blowing in your ears, and the scent of the flowers on the roadside. She persisted for three months and said that her chest was so tight when she had a conflict with her daughter-in-law, but now she is relieved without realizing it. "After all, raising a baby is also raising a baby, so I just did the exercises at the same time, and it's not a hassle."

Some time ago, the little girl who was taking the postgraduate entrance exams sent me a pack of Sakura cakes from her school, saying that she had successfully passed the exam for her target major, and she still maintains the habit of chewing 20 times per mouthful. She told me that before, she always felt that she had to run for results all the time. She wanted to endorse books while eating, answer questions while walking, and even counted how many knowledge points she still had to finish while sleeping. Only now did she realize that the sweetness of a good bite of rice, the feel of the wind blowing through your hair, these little things that don't cost anything, are what pull you out of the whirlpool of anxiety.

In fact, there are not so many mysterious things. In the final analysis, mindfulness just teaches you how to live in the present moment - you don't need to become a god, just be a human being.