Mindful Meditation and Depression: Some Lotus Therapy

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Has your therapist recommended mindful meditation?

If she hasn't already, she very well might try to integrate it into your cognitive behavioral therapy by the time you graduate from counseling.

The New York Times ran an interesting piece about the movement of mindful meditation among psychologists, counselors, and (I shall add) life coaches. The research is inconclusive. The article chronicles success stories but also includes studies showing that, in some cases, mindful meditation can be damaging.

My take on this is that mindful meditation and all meditative practices (tai chi, transcendental meditation, and yoga) are very positive and constructive techniques to augment your treatment. However, when suicidal or severely depressed, they can be damaging to recovery. Can be. Not always. Some severely depressed people are helped. But I, for one, was a case where my attempts worsened my depression, because I failed miserably at mastering my thoughts, and that failure in turn made me feel more depressed.

Here are some excerpts of the article. To read the entire piece click here.

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 is 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. "The interest in this has just taken off," said Zindel Segal, a psychologist at the Center of Addiction and Mental Health in Toronto, where the above group therapy session was taped. "And I think a big part of it is that more and more therapists are practicing some form of contemplation themselves and want to bring that into therapy."

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 3 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.

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 T.M., Zen and mindfulness practice, for a wide variety of physical and mental problems. The study found that over all, the research was too sketchy to draw conclusions.

A recent review by Canadian researchers, focusing specifically on mindfulness meditation, concluded that it did "not have a reliable effect on depression and anxiety."

Therapists who incorporate mindfulness practices do not agree when the meditation is most useful, either. Some say Buddhist meditation is most useful for patients with moderate emotional problems. Others, like Dr. Linehan, insist that patients in severe mental distress are the best candidates for mindfulness.

A case in point is mindfulness-based therapy to prevent a relapse into depression. The treatment significantly reduced the risk of relapse in people who have had three or more episodes of depression. But it may have had the opposite effect on people who had one or two previous episodes, two studies suggest.

The mindfulness treatment "may be contraindicated for this group of patients," S. Helen Ma and Dr. Teasdale of the Medical Research Council concluded in a 2004 study of the therapy.

Since mindfulness meditation may have different effects on different mental struggles, the challenge for its proponents will be to specify where it is most effective -- and soon, given how popular the practice is becoming.

The question, said Linda Barnes, an associate professor of family medicine and pediatrics at the Boston University School of Medicine, is not whether mindfulness meditation will become a sophisticated therapeutic technique or lapse into self-help cliché.

"The answer to that question is yes to both," Dr. Barnes said.
The real issue, most researchers agree, is whether the science will keep pace and help people distinguish the mindful variety from the mindless.


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