An Extensive Mixed-Methods Analysis: Mindfulness Meditation, Attentional Abilities, Perceived Stress and Emotional Acceptance

A quantitative investigation was conducted testing the effects of mindfulness meditation on attentional abilities, perceived stress and emotional acceptance. Additionally, a qualitative component at post-test was also incorporated. Participants (n = 25) reported an increase in attentional abilities and perceived stress following a three week mindfulness program, however mixed results were obtained on the differences in self-control and emotional acceptance and the mediation of executive control by emotional acceptance. Four major themes emerged: increased self-regulation, individual variations, necessity of; an open attitude, and practice. Results support previous literature postulating the potential of mindfulness to provide succinct suggestions on how its training is a mediator of its effects on mental health. Further implications are deliberated upon in the discussion section. AN EXTENSIVE MIXED-METHODS ANALYSIS: MINDFULNESS MEDITATION, 9 ATTENTIONAL ABILITIES, PERCEIVED STRESS, AND EMOTIONAL ACCEPTANCE Chapter I: Introduction and Literature Review Introduction Mindfulness interventions are a growing means of providing considerable psychosocial benefits to a range of populations, including providing assistance in coping to clinical patients suffering from cancer, chronic pain and somatic issues such as fibromyalgia (Schreiner & Malcolm, 2008), mood disturbances, and sleep problems (Shigaki, Glass, & Schopp, 2006), epilepsy (Deepak, Manchanda & Maheshwari, 1994), individuals with various psychological disorders including bipolar disorder (Williams et al., 2008), depression and anxiety (Hofmann, Sawyer, Witt, & Oh, 2010) and in non-clinical samples and healthcare professionals expressing stress (Baer, Carmody & Hunsinger, 2012), in the form of mindfulness based stress reduction (MBSR) after its breakthrough introduction by KabatZinn (1982) at the University of Massachusetts Medical Centre in 1979. Furthermore, along with this promptness in its clinical uptake, there has been a huge augmentation in research on these interventions, its components and dynamic mechanisms, for instance relaxation and attention that impressively achieve their radical, revolutionary results. A mounting body of evidence also investigates the potential of associating mindfulness with other different types of therapies such as cognitive-behavioural therapy which have in turn sparked developments of new therapies – quite popularly referred to as the ‘third-wave therapies’, adapted from CBT, but mainly endeavour to nurture acceptance in patients through mindfulness i.e. acceptance and commitment therapy. Withal, despite the enthusiasm generated by these advancements, authors have critiqued this integration of two entirely distinct modalities into one interdisciplinary intervention as mindfulness still stands AN EXTENSIVE MIXED-METHODS ANALYSIS: MINDFULNESS MEDITATION, 10 ATTENTIONAL ABILITIES, PERCEIVED STRESS, AND EMOTIONAL ACCEPTANCE as a comparatively new avenue for research and practice, with a substantial number of questions remaining to be answered (Watson, 2008). Thence, the penultimate goal of this study was to incorporate a mixed-methods i.e. quantitative and qualitative inquiry into individuals’ experiences of mindfulness-based exercises, so that further understanding can be acquired on the mechanisms behind this psychosocial phenomenon, its experience and its benefits. Literature Review Digressions on the definition of Mindfulness: Due to its complexity as a phenomenon, numerous definitions have been proposed for mindfulness, with authors delving deeper into its origins to comprehend what it sets out to achieve and how it is applied in therapeutic settings. It is principally defined as purposefully guiding attention to internal and external experiences; cognitive states, emotions, urges and bodily sensations, occurring from moment-to-moment and accepting them with an open attitude, non-judgementally (Schreiner & Malcolm, 2008). Howbeit, it’s essential to denote that the concept of ‘guiding attention’ here is usually considered within an expansive spectrum of the mind and consciousness i.e. an individual engaged in mindfulness is identified as undergoing the “process of focusing conscious awareness, providing heightened sensitivity to a limited range of experience” which is flashing light upon particular things in awareness (Brown and Ryan, 2003). Focusing further, because present day mindfulness meditation finds its roots in a religious concept i.e. Zen and Vipassana meditation traditions which are components of Theravada and Mahayana Buddhism (Mikulas, 2007; as cited by Watson, 2008), Kabat-Zinn (2003) postulates that mindfulness encapsulates an attitude of compassion along with AN EXTENSIVE MIXED-METHODS ANALYSIS: MINDFULNESS MEDITATION, 11 ATTENTIONAL ABILITIES, PERCEIVED STRESS, AND EMOTIONAL ACCEPTANCE attention because in Asian languages, the words for heart and mind are the same. Additionally, mindfulness exists within the context of a broader philosophical system which entails guidelines for ethical behaviour, including how to train the heart-mind with meditation practices in order to reduce one's suffering. So, it can be deduced that the primary aim of mindfulness exercises is to gauge insight, wisdom, and patience in the individual, which arises from the cultivation of a mental state involving a "non-verbal present-mindedness" (Stoyva, 2000; as cited by Watson, 2008). Another analysis provided by Gunaratna (2002) suggests that mindfulness is merely “the application of bare attention.purely noticing what comes up without getting involved” (p. 143). Everyone naturally has these moments of pure awareness before identification or conceptualization of the objects of awareness occurs, hence developing the ability of mindfulness is then only a case of prolonging this initial time of pure awareness before the occurrence of conceptualization. These mindfulness techniques serve that function of developing the skills to stay in pure awareness (Watson, 2008). Bishop (2002) provides a classic illustration of this analysis by describing a mindfulness meditation exercise, in which an individual sits or lies down and learns to keep their attention entirely on their breath. Attention will beyond any doubt wander away from the breath, but the meditator is advised to simply notice it, accept it, let it go, and return their attention to their breathing. Nevertheless, the focus of attention should not be on the content of thoughts, feelings, or sensations, but instead on pure observation of the present moment; a variety of internal or external stimuli. Mindfulness-based Interventions tailored for stress reduction: One of the most prominent treatment modality related to mindfulness training is for stress reduction, which as a concept can refer to a range of physiological and cognitive states, including irritability, excessive worry, or over-arousal. Chronic stress can be associated with AN EXTENSIVE MIXED-METHODS ANALYSIS: MINDFULNESS MEDITATION, 12 ATTENTIONAL ABILITIES, PERCEIVED STRESS, AND EMOTIONAL ACCEPTANCE stressful occupations (Shapiro, Astin, Bishop, & Cordova, 2005), terminal illness (Speca, Carlson, Goodey, & Angen, 2000), or psychological disorders (Bishop, 2002). Delivery of the MBSR program is group-based, usually consisting about 20-30 people and conducted as an 8-10 week course, integrating discussions, instructions on the exercises and active mindfulness training. Clients are made aware of the necessity of commitment, and recommended to diligently participate both in intensive meditation practices inside and outside sessions prior to joining the group in order to gain the maximum benefit out of the program. Other than the long-established mindfulness exercises, such as guided imagery (use of body senses and visualization to allow the body to respond to what is being imagined as if it is real; clients are asked to imagine a safe and comfortable place to achieve a state of relaxation) and progressive muscle relaxation (paying attention to breathing to induce selfawareness and then to guide attention to different muscle groups in the body, thereby facilitating the screening and counteracting of the first signs of muscular tension accompanying stress), MBSR also employs a ‘body scan’, where individuals are trained to direct their attention to body parts and observe the naturally occurring sensation in each area. Attending to physiological symptoms of high stress levels e.g. muscular tension with a nonjudgemental attitude will alleviate these physical responses by increasing awareness of all emotional and cognitive states of the present moment. The individual then develops the ability to recognize the warning signals of tension rising up and can thus, manage stress and control distressful cognitions (Kabat-Zinn, 2003). Overview of Quantitative Research on Fundamental Mechanisms of Mindfulness Mindfulness Meditation and Attentional Abilities. Since attention is one of the cardinal components of mindfulness, accordingly then, it’s also noteworthy that attentional AN EXTENSIVE MIXED-METHODS ANALYSIS: MINDFULNESS MEDITATION, 13 ATTENTIONAL ABILITIES, PERCEIVED STRESS, AND EMOTIONAL ACCEPTANCE training and enhancement are fundamental to meditation practices as they involve a repeated practice of self-regulation of attention (Jensen, Vangkilde, Frojaer & Hasselbalch, 2012). Nevertheless, in spite of the few, experimental studies that have supported the concept of mindfulness meditation related improvements in attention, their mixed results have been ample. For instance, in an extensive review by Ivanovski and Malhi (2007), it was reported that mindfulness meditation increases an ability to both inhibit stimuli that might otherwise distract attention away from the intended target and to sustain attention. Furthermore, with increases in meditative skill, people were more likely to achieve states of "total attention", which was re