Mindfulness-based interventions for veterans with posttraumatic stress disorder

The wars in Afghanistan and Iraq heighten the need for effective psychological treatment for veterans returning from combat who are suffering from Posttraumatic Stress Disorder (PTSD; see American Psychiatric Association, DSM-5, 2014). Approximately 25.5% of returning veterans from Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) present to the Veterans Health Administration (VHA) for mental health services related to trauma exposure and PTSD (Vujanovic et al., 2013). Also, according to Price et al. (2013), OEF/ OIF veterans are at greater risk for PTSD because of increased combat exposure when compared with veterans of past military operations. Veterans with trauma exposure and PTSD often experience co-occurring affective disorders including anxiety and depression (Owens et al., 2012). This paper examines the efficacy of mindfulness meditation in the treatment of veterans who are suffering from PTSD. The benefits of meditation as a modality and future directions are explored * What is mindfulness meditation? Meditation may be broadly classified as concentrative or non-concentrative (e.g., mindfulness meditation), depending on the manner in which mental attention is trained. Concentrative techniques include intense focus on a particular object (e.g., a candle flame or the sensation of breathing); focus is repeatedly brought back to the object if attention falters. In contrast, in non-concentrative techniques like mindfulness meditation, individuals cultivate awareness and acceptance of all mental events. The goal is to observe moment-to-moment shifts in internal experiences without judging their content (Strauss et al., 2011). The roots of mindfulness meditation can be traced to Tibetan Buddhism practices, which were designed to evoke a new way of perceiving. Mindfulness is a 2,500-year-old tradition devoted to mental training. Mindfulness is grounded in human attention and awareness mindfulness involves intentionally placing attention on the present moment with an awareness that is non-evaluative (Bishop et al., 2004; Shapiro et al., 2006); this makes it possible to systematically explore and refine one's awareness. Understanding one's mind through awareness cultivates kindness and compassion toward oneself, which then extends to others (Bruce et al., 2010; Siegel, 2007b). Greeson's (2009) review of mindfulness research and theory supports the claim that mindfulness meditation increases compassion. Further, Siegel (2007a) suggested that mindfulness practice helps individuals accept and embrace their minds with kindness and compassion. An appropriate operational definition of mindfulness focuses on the elements of cognitive processes (Bishop et al., 2004). These elements involve "self-regulation of attention," "the recognition of mental events occurring in the moment," and "adopting a particular orientation toward one's experiences in the present moment that is characterized by curiosity, openness, and acceptance" (Bishop et al., 2004, p. 232). Mindfulness practice can be used with other therapeutic skills such as with mindfulness communicating and listening. Furthermore, learning mindfulness provides the ability to attune with others during healing and facilitates the development of empathy. * History of mindfulness meditation MBIS spawned from mindfulness-based stress reduction MBSR, which began in 1979 at the University of Massachusetts Medical Center. Brown et al. (2007) stated, "MBSR is most clearly rooted in eastern philosophy and psychology, which emphasizes the importance of experiential, meditative practice as a primary vehicle for personal development and transformation" (p. 219). As a student of Yoga, Vipassana (seeing clearly) meditation, and Zen, Jon Kabat-Zinn (founder of MBSR) included a range of informal and formal practices to cultivate mindfulness. Vipassana is a Buddhist tradition that works well in mainstream settings because it provides specific and direct instructions for sustaining attention and awareness. …