Enhancing Health and Emotion: Mindfulness as a Missing Link Between Cognitive Therapy and Positive Psychology

Abstract

Mindfulness meditation is an increasingly popular intervention for the treatment of physical illnesses and psychological difficulties. Using intervention strategies with mechanisms familiar to cognitive behavioral therapists, the principles and practice of mindfulness meditation offer promise for promoting many of the most basic elements of positive psychology. It is proposed that mindfulness meditation promotes positive adjustment by strengthening metacognitive skills and by changing schemas related to emotion, health, and illness. Additionally, the benefits of yoga as a mindfulness practice are explored. Even though much empirical work is needed to determine the parameters of mindfulness meditation's benefits, and the mechanisms by which it may achieve these benefits, theory and data thus far clearly suggest the promise of mindfulness as a link between positive psychology and cognitive behavioral therapies. Keywords: meditation; cognitive behavior therapy; positive psychology; chronic illness; depression; psychotherapy Recent epidemiological research suggests that a large number of Americans suffer from chronic illnesses. For instance, it is estimated that 24% of Americans suffer from hypertension (Burt et al., 1995), 20% have some form of cardiovascular illness (American Heart Association, 2002), 15% suffer from some form of arthritis (Helmick et al., 1998), and more than 15 million are estimated to have Type II diabetes (Lamendola, 2003). Although there are well-developed medical treatments for many such illnesses and effective therapies to treat those with a comorbid psychological illness such as depression, there are few resources available for helping the chronically ill develop the skills for more positive psychological functioning. One approach that shows promise for both managing the symptoms of depression and enhancing positive functioning is mindfulness meditation. Although similar to cognitive therapies, mindfulness meditation has the advantages of being taught to a heterogeneous patient population and preventing the onset of psychopathology that may result with new medical diagnoses. Mindfulness meditation, also known as insight-oriented meditation or vipassana, is one of several meditations in Buddhist practice (Goleman, 1972; Kabat-Zinn, 1990; Kabat-Zinn, Lipworth, & Burney, 1985). Consistent with the positive psychology goal of promoting resilience, mindfulness includes goals such as enhancing well-being and awareness of the self and environment, along with disciplining the mind and emotions (Hanh, 1975, 1993; Levine, 2000). The principles and practice of mindfulness meditation also offer promise as an intervention that promotes positive psychology processes such as "flow" (Csikszentmihalyi, 1990), forgiveness (McCullough & Pargament, 2000), hope (Snyder, Rand, & Sigmon, 2002), and resilience (Masten, 2001). Along these lines, Kabat-Zinn (1990) has argued that the purpose of mindfulness is not to point out what is wrong, but to help people find what is right. Although rooted in Buddhist traditions, mindfulness meditation was secularized and imported to the West by Kabat-Zinn as the backbone of his Stress Reduction and Relaxation Program at the University of Massachusetts Medical Center (Kabat-Zinn, 1990, 1994). Since that time, Mindfulness Based Stress Reduction (MBSR) has been used to treat a wide variety of physical and psychological maladies. Among healthy adults, MBSR has been effective in reducing symptoms of stress, anxiety, and depression (Astin, 1997; Roth & Greaser, 1997, 2002; Shapiro, Schwartz, & Bonner, 1998). Likewise, MBSR has been used as an adjunctive therapy for patients diagnosed with cancer (Speca, Carlson, Goodey, & Angen, 2000) and psoriasis (Kabat-Zinn et al., 1998). MBSR also has been used as a primary intervention for patients with fibromyalgia (Goldenberg et al, 1994; Kaplan, Goldenberg, & Galvin-Nadeau, 1993), other chronic pain conditions (Kabat-Zinn, 1982; Kabat-Zinn et al. …