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Mindfulness-Based Approaches in Cultural Populations (pp. 69-86) $100.00
Authors:  (Keisha-Gaye N. O’Garo and Christopher L. Edwards, Womack Army Medical Center, Ft. Bragg, North Carolina, USA, and others)
The basis of medically-useful mindfulness is founded on Buddhist
meditative practices that aim to develop mindfulness, concentration,
supramundane powers, tranquility, and insight (Miller, Fletcher, & Kabat-
Zinn, 1995). Kabat-Zinn the father of modern day mindfulness, defines
mindfulness as ―the awareness that emerges through paying attention, on
purpose, in the present moment, and non-judgmentally to the unfolding
experience moment by moment‖ (Kabat-Zinn, 2003). It is through this process
that one connects with true thoughts and feelings in an open manner, with
compassion and loving-kindness rather than focusing on the interpretations of
one‘s reality that contributes to rumination and worry.
Mindfulness is the cornerstone of several therapeutic practices that are
very popular in modern society. These therapeutic practices can involve bodily
movements such as yoga, tai-chi, and qigong or mindfulness can be woven
into aspects of contemporary psychology as is the case with mindfulness based
cognitive therapy (MBCT), mindfulness based stress reduction (MBSR),
acceptance and commitment therapy (ACT), and dialectical behavior therapy
(DBT). It is through these practices that self-regulation contributes to the
achievement of a transparent mental state that exhibits clarity, calmness,
peace, gratitude, and improved concentration. The word ―mindfulness‖ is
derived from the Pali word ―sati‖ which means having awareness, attention,
and remembering (Bodhi, 2000). Sati is an activity that involves the process of
mindfulness to occur when one does not objectify or conceptualize the
experience, but instead allows the moment to be perceived as pure without
biases. The meditation technique involved in achieving mindfulness is
―vipassana‖, which is insight. The purpose of vipassana is to prolong the
moment of awareness (Gunaratana, 2002).
There is evidence to suggest that mindfulness meditation is neurologically
and physiologically altering. Specifically, studies have shown particular
physiological and neurological patterns that occur from mindfulness. Evidence
indicates that mindfulness meditation develops the skill of self-observation
and neurologically disengages autonomic pathways developed from prior
learning and experiences and enables present moment input to be integrated
into novel, more adaptive responses (Siegel, 2007)
Farb et al. (2010) randomly assigned study participants to an 8-week
MBSR training group and a waitlisted control group. Neural reactivity from
each group was measured by functional magnetic resonance imaging (fMRI)
as well as self-report measures of depression, anxiety, and somatization. The
results indicate that those exposed to MBSR had less neural reactivity and
displayed different neural responses than the control group when exposed to
sad films. Data also showed that MBSR was associated with less depression,
anxiety, and somatization symptomatology as compared to the control group.
Other studies have examined the relationship between mindfulness, neural
activity, and depression noting that mindfulness is associated with decreased
levels of depression via amygdala activity (Way et al., 2010). Similarly, Jha et
al. (2010) found that meditation was associated with positive affect and
enhanced working memory capacity.
Mindfulness has also achieved great recognition in the treatment of
several psychiatric diseases and physical conditions to include depression
(Kaviana, Hatami, & Foroozan, 2012), anxiety (Kaviana, Javaheri, and
Harami, 2011), psychosis (Langer, Cangas, Salcedo, & Fuentes, 2011;
Chadwick, Hughes, Russell, Russell, & Dagnan, 2009), eating disorders
(Wanden-Berghe, Sanz-Valero, Wanden-Berghe, 2011), and chronic pain
(Morone, Greco, & Weiner, 2008; Edwards, Feliu, Johnson, Webster, Bennett,
Bishop, Samios, Ellison-Manuel, Martinez, 2005). McKim (2008) conducted a study on a community sample that experienced chronic pain, anxiety, and/or
depression. After MBSR training, the participants reported diminished
symptoms in ruminations, psychological distress, anxiety, depression, and
pain, as well as increased mindfulness. Langer, Cangas, Salcedo, & Fuentes
(2011) randomly assigned eighteen patients with a diagnosis of psychosis to a
mindfulness-based cognitive therapy (MBCT) and control groups. The MBCT
group demonstrated greater ability to respond mindfully to stressful internal
events than the control group.
It has also been well researched that mindfulness enhances interpersonal
relationships, empathy, and communication skills (Irving, Dobkin, & Park,
2009). Irving, Dobkin, and Park (2009) conducted a review on the potential
benefits of MBSR programs for clinicians who are at increased risk for
burnout and stress. They concluded that clinicians who participate in MBSR
programs are likely to experience decreased ruminations, anxiety, and stress,
as well as experience improvement in compassion, self-awareness, and
mindfulness. They further reported that patients of providers participating in
mindfulness also reported greater symptom reduction and an enhancement in
their therapeutic relationships.
This chapter will discuss the efficacy of four primary mindfulness
interventions in the treatment of diverse psychological issues and medical
concerns. Aspects of this chapter will also address the utility of these
interventions in cultural populations. 

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Mindfulness-Based Approaches in Cultural Populations (pp. 69-86)