It is a supposedly transformative discipline with a 2500-year history. It started in the shade of a tree in India, in the fifth century BC, where Siddhartha is said to have reached enlightenment. Until recently, mindfulness was a term confined to Buddhist texts and meditation retreats. Recently, for the increasing burdens of stress, depression, and anxiety, mindfulness has morphed into a healthcare intervention. It is based on the belief that paying more attention to the present moment – your own thoughts and feelings, and to the world around you – can improve your mental wellbeing.

Apps and web courses on mindfulness proliferate. Dr Jon Kabat-Zinn, in 1979, started a medication-based program for stress and chronic pain at the University of Massachusetts Medical School. It was a widely used 8-week intervention with techniques such as mindfulness of breathing and walking meditation. This has led to Mindfulness-Based Cognitive Therapy for depression and Mindfulness-Based Relapse Prevention for addictive behaviors.

Mindfulness is not a single entity but rather several practices leading to a mental state. But does it really work? Many studies have been done, and none are convincing. Scientific knowledge is scant. Its goal is to help people to “decenter” from disruptive inner experiences and to see thinking as thinking rather than something that drives behavior. When the gap between stimulus and reaction is extended, people can become more in control of how and if they do react.

Jack Florin, MD

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