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"Informed by the maxim that you can't study what you can't see, Baer's book provedes the necessary psychometric underpinning to further our understanding of core change processes in mindfulness-based interventions."---Zindel V. Segal, Ph.D., author of The Mindful Way Through Depression"This kind of attention to the reasons why mindfulness-based intervention may be beneficial will help stimulate informative research in the area and also help clinicians provide therapy that enhances these important skills."---Lizabeth Roemer, Ph.D., coauthor of Mindfulness-and Acceptance-Based Behavioral Therapies in Practice"An excellent resource not only for mindfulness researchers and practitioners, but for amyone interested in what leads to mental health and emotional balance."---Cassandra Vieten, Ph.D., director of research at the Institute of Noetic Sciences and author of Mindful Motherhood"A fascinating journey to the heart of what actually changes in mindfulness and acceptance-based treatment...Highly recommneded for psychotherapists, health care professionals, and anyone seeking the very latest scientific understanding of psychological change."---Christopher K. Germer, Ph.D., author of The Mindful Path to Self-CompassionHow does mindfulness work? Thousands of therapists utilize mindfulness-based treatments and have witnesed firsthand the effectiveness of these approaches on clients suffering from anxiety, depression, and other common mental health issues. But for many clinicians, the psychological processes and brain functions that explain these changes remain a mystery, and effective methodologies for measuring each client's progress are elusive.In Assessing Mindfulness and Acceptance Processes in Clients, Ruth Baer presents a collection of articles by some of the most respected mindfulness researchers and therapists practicing today. Each contribution assesses the variables that represent potential processes of change, such as mindfulness.acceptance, self-compassion, spirituality, and focus on values, and determines the importance of each of these processes to enhanced psychological functioning and quality of life. Clinicians learn to accurately measure each process in individual clients, an invaluable skill for any practicing therapist. A seminal contribution to the existing professional literature on mindfulnessbased treatments, this book is also an essential resource for any mental health professional seeking to illuminate the processes at work behind any mindfulness and acceptance-based therapy.

Context  Primary care physicians report high levels of distress, which is linked to burnout, attrition, and poorer quality of care. Programs to reduce burnout before it results in impairment are rare; data on these programs are scarce.Objective  To determine whether an intensive educational program in mindfulness, communication, and self-awareness is associated with improvement in primary care physicians' well-being, psychological distress, burnout, and capacity for relating to patients.Design, Setting, and Participants  Before-and-after study of 70 primary care physicians in Rochester, New York, in a continuing medical education (CME) course in 2007-2008. The course included mindfulness meditation, self-awareness exercises, narratives about meaningful clinical experiences, appreciative interviews, didactic material, and discussion. An 8-week intensive phase (2.5 h/wk, 7-hour retreat) was followed by a 10-month maintenance phase (2.5 h/mo).Main Outcome Measures  Mindfulness (2 subscales), burnout (3 subscales), empathy (3 subscales), psychosocial orientation, personality (5 factors), and mood (6 subscales) measured at baseline and at 2, 12, and 15 months.Results  Over the course of the program and follow-up, participants demonstrated improvements in mindfulness (raw score, 45.2 to 54.1; raw score change [Δ], 8.9; 95% confidence interval [CI], 7.0 to 10.8); burnout (emotional exhaustion, 26.8 to 20.0; Δ = −6.8; 95% CI, −4.8 to −8.8; depersonalization, 8.4 to 5.9; Δ = −2.5; 95% CI, −1.4 to −3.6; and personal accomplishment, 40.2 to 42.6; Δ = 2.4; 95% CI, 1.2 to 3.6); empathy (116.6 to 121.2; Δ = 4.6; 95% CI, 2.2 to 7.0); physician belief scale (76.7 to 72.6; Δ = −4.1; 95% CI, −1.8 to −6.4); total mood disturbance (33.2 to 16.1; Δ = −17.1; 95% CI, −11 to −23.2), and personality (conscientiousness, 6.5 to 6.8; Δ = 0.3; 95% CI, 0.1 to 5 and emotional stability, 6.1 to 6.6; Δ = 0.5; 95% CI, 0.3 to 0.7). Improvements in mindfulness were correlated with improvements in total mood disturbance (r = −0.39, P < .001), perspective taking subscale of physician empathy (r = 0.31, P < .001), burnout (emotional exhaustion and personal accomplishment subscales, r = −0.32 and 0.33, respectively; P < .001), and personality factors (conscientiousness and emotional stability, r = 0.29 and 0.25, respectively; P < .001).Conclusions  Participation in a mindful communication program was associated with short-term and sustained improvements in well-being and attitudes associated with patient-centered care. Because before-and-after designs limit inferences about intervention effects, these findings warrant randomized trials involving a variety of practicing physicians.

Aliment Pharmacol Ther 2011; 34: 363–373SummaryBackground Stress perception and GI-specific anxiety play key roles in irritable bowel syndrome (IBS). Mindfulness-based stress reduction (MBSR) is a widely available stress reduction course, which has not been evaluated for IBS.Aim To determine whether participation in MBSR is associated with improvement in bowel symptoms, GI-specific anxiety, and IBS-Quality of Life.Methods This is a prospective study of 93 participants in MBSR. We applied measures of Rome III IBS status, bowel symptoms (IBS-Severity Scoring System, IBS-SSS), IBS-Quality of Life (IBS-QOL), GI-specific anxiety (Visceral Sensitivity Index, VSI), mindfulness (Five Facet Mindfulness Questionnaire-FFMQ), and functional status (SF-8) at baseline and 2 and 6 months after enrolment.Results At 2 months, participation in MBSR was associated with small nonsignificant changes in IBS-SSS, IBS-QOL and VSI: d = −0.25, d = 0.08, d = −0.16, respectively. At 6 months, there was no significant change in IBS-SSS (d = −0.36); whereas for IBS-QOL and VSI there were significant improvements (IBS-QOL: d = 0.33, P = 0.044; VSI: d = −0.40, P = 0.014). For patients meeting Rome III IBS criteria (n = 43), changes in IBS-SSS, IBS-QOL and VSI were not statistically significant, but there was a significant correlation between the change in VSI and the change in FFMQ across the three time periods (r = 0.33).Conclusions Participation in MBSR is associated with improvement IBS-related quality of life and GI-specific anxiety. Randomised controlled trials are warranted to further assess the role of MBSR for IBS symptomatology.

It has long been theorised that there are two temporally distinct forms of self-reference: extended self-reference linking experiences across time, and momentary self-reference centred on the present. To characterise these two aspects of awareness, we used functional magnetic resonance imaging (fMRI) to examine monitoring of enduring traits (’narrative’ focus, NF) or momentary experience (’experiential’ focus, EF) in both novice participants and those having attended an 8 week course in mindfulness meditation, a program that trains individuals to develop focused attention on the present. In novices, EF yielded focal reductions in self-referential cortical midline regions (medial prefrontal cortex, mPFC) associated with NF. In trained participants, EF resulted in more marked and pervasive reductions in the mPFC, and increased engagement of a right lateralised network, comprising the lateral PFC and viscerosomatic areas such as the insula, secondary somatosensory cortex and inferior parietal lobule. Functional connectivity analyses further demonstrated a strong coupling between the right insula and the mPFC in novices that was uncoupled in the mindfulness group. These results suggest a fundamental neural dissociation between two distinct forms of self-awareness that are habitually integrated but can be dissociated through attentional training: the self across time and in the present moment.

In the past two decades, the familiar experience of attention - the emphasis on a particular mental activity so that it "fills the mind" - has been subjected to much scientific inquiry. David LaBerge now provides a systematic view of the attention process as it occurs in everyday perception, thinking, and action. Drawing from a variety of research methods and findings from cognitive psychology, neurobiology, and computer science, he presents a masterful synthesis of what is understood about attentional processing. LaBerge explores how we are able to restrict the input of extraneous and confusing information, or prepare to process a future stimulus, in order to take effective action. As well as describing the pathways in the cortex presumed to be involved in attentional processing, he examines the hypothesis that two subcortical structures, the superior colliculus and the thalamus, contain circuit mechanisms that embody an algorithm of attention. In addition, he takes us through various ways of posing the problem, from an information-processing description of how attention works to a consideration of some of the cognitive and behavioral consequences of the brain's computations, such as desiring, judging, imaging, and remembering. Attentional Processing is a highly sophisticated integration of contributions from several fields of neuroscience. It brings together the latest efforts to solve the puzzle of attention: how it works, how it is modulated, what its benefits are, and how it is expressed in the brain.

Meditation can be conceptualized as a family of complex emotional and attentional regulatory training regimes developed for various ends, including the cultivation of well-being and emotional balance. Among these various practices, there are two styles that are commonly studied. One style, focused attention meditation, entails the voluntary focusing of attention on a chosen object. The other style, open monitoring meditation, involves nonreactive monitoring of the content of experience from moment to moment. The potential regulatory functions of these practices on attention and emotion processes could have a long-term impact on the brain and behavior.

Drawing its main source of inspiration from a naturalized interpretation of Husserlian phenomenology, On Becoming Aware: A Pragmatics of Experiencing attempts to examine closely the nature of experience and how we may become aware of our own mental life. The authors also focus on how this project fits into the larger context of cognitive science, psychology, neurosciences, and philosophy. Additional partners in the effort to better understand experience are the contemplative systems of the world's spiritual or wisdom traditions, including particularly that of Buddhism. The book includes three separate glossaries of technical terms in phenomenology, the cognitive sciences, and Tibetan Buddhism. The book On Becoming Aware seeks a disciplined and practical approach to exploring human experience. While much of the book draws its inspiration from the phenomenological theories of Husserl, other approaches to the direct study of experience are also explored in depth. One of these approaches is embodied by the world's spiritual or wisdom or contemplative traditions such as Sufism, Buddhism, the Philokalia tradition, and others. Collectively, these traditions have come upon a variety of their own insights and methods for understanding experience, or, to use words from the phenomenological tradition, has developed its own ways of phenomenological reduction Amongst the various wisdom traditions, the authors focus mainly on Buddhism. The authors give an introduction to Buddhist theory and history, followed by an in-depth discussion of the Buddhist contemplative practices of mindfulness, śamatha, vipaśyanā, tonglen (gtong len), lojong (blo sbyong), dzokchen (rdzogs chen), and mahāmudrā. The authors then relate this discussion to themes from philosophy and phenomenology explored earlier in the book, paricularly Husserl's concept of épochè. (Zach Rowinski 2005-01-17) Publisher's description: This book searches for the sources and means for a disciplined practical approach to exploring human experience. The spirit of this book is pragmatic and relies on a Husserlian phenomenology primarily understood as a method of exploring our experience. The authors do not aim at a neo-Kantian a priori ‘new theory’ of experience but instead they describe a concrete activity: how we examine what we live through, how we become aware of our own mental life. The range of experiences of which we can become aware is vast: all the normal dimensions of human life (perception, motion, memory, imagination, speech, everyday social interactions), cognitive events that can be precisely defined as tasks in laboratory experiments (e.g., a protocol for visual attention), but also manifestations of mental life more fraught with meaning (dreaming, intense emotions, social tensions, altered states of consciousness). The central assertion in this work is that this immanent ability is habitually ignored or at best practiced unsystematically, that is to say, blindly. Exploring human experience amounts to developing and cultivating this basic ability through specific training. Only a hands-on, non-dogmatic approach can lead to progress, and that is what animates this book.

Mindfulness is an attribute of consciousness long believed to promote well-being. This research provides a theoretical and empirical examination of the role of mindfulness in psychological well-being. The development and psychometric properties of the dispositional Mindful Attention Awareness Scale (MAAS) are described. Correlational, quasi-experimental, and laboratory studies then show that the MAAS measures a unique quality of consciousness that is related to a variety of well-being constructs, that differentiates mindfulness practitioners from others, and that is associated with enhanced self-awareness. An experience-sampling study shows that both dispositional and state mindfulness predict self-regulated behavior and positive emotional states. Finally, a clinical intervention study with cancer patients demonstrates that increases in mindfulness over time relate to declines in mood disturbance and stress.

The aim of this study was to measure the effects of a bi-weekly Raj yoga program on rheumatoid arthritis (RA) disease activity. Subjects were recruited from among RA patients in Dubai, United Arab Emirates by email invitations of the RA database. Demographic data, disease activity indices, health assessment questionnaire (HAQ), and quality of life (QOL) by SF-36 were documented at enrollment and after completion of 12 sessions of Raj yoga. A total of 47 patients were enrolled: 26 yoga and 21 controls. Baseline demographics were similar in both groups. Patients who underwent yoga had statistically significant improvements in DAS28 and HAQ, but not QOL. Our pilot study of 12 sessions of yoga for RA was able to demonstrate statistically significant improvements in RA disease parameters. We believe that a longer duration of treatment could result in more significant improvements.

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