OSBORNE * BHUGRA has become less of a quintessentially Eastern phenomenon in recent years. As such it has fewer religious and ideological overtones — increasing acceptability in the West. (6) The neurophysiology of meditation is becoming a field of empirical research. This may one day unravel the biological processes which underpin the ability of meditation to cultivate feelings of well- being and self-worth, even in the midst of suffering. of mediation were also maintained in this those suffering from the often devastating group. It should be noted, however, that impact of chronic pain, and terminal illness. the samples used in this research were too small to permit definitive conclusions (n=22). MINDFULNESS IN CHRONIC The results are however promising, and A N D TERMINAL ILLNESS indicate the need for more thorough investigation - with a view to a potential integration of Buddhist techniques into Data have indicated that mindfulness western therapeutics. mediation can deliver effective long term reductions in both the severity and frequency The possibility of such integration was of chronic pain. Kabat-Zinn et al (1985) first conceived by Mikulas, in a number of took 90 people for whom conventional Similarly promising results have been pioneering papers marrying Buddhism to hospital-based management had failed to reported for the use of mindfulness behavioural techniques (Mikulas, 1978; effectively treat their pain. They were meditation in the management of oncology Mikulas, 1981). An important commonality entered into a ten-week mindfulness-based patients. Speca et al (2000) applied Kabat- of Buddhist psychology and cognitive stress reduction program, and showed Zinn's meditation program to patients with behavioural therapy is that both stress the significant reductions in measures of present- a range of cancer diagnoses, and observed importance of modifying maladaptive/ moment pain, negative body image, inhibition significant reductions in measures of erroneous cognizing of the internal and of activity by pain, physical symptoms, depression, anxiety, anger and confusion. external environment. For example, mood disturbance, and psychological Moreover, the program brought about behavioural techniques which train patients symptomatology, including anxiety and physical benefits of reduced gastrointestinal to objectify behaviour may later be helpful depression. All improvements were and cardiopulmonary symptoms. in training the mind to objectify thoughts maintained at 15 month follow-up, and the during meditation. Similarly, learning to majority of patients continued to use Such 'organic' benefits of meditation relax through behavioural techniques may meditation in their daily lives. Mindfulness may be of particular value to those suffering contribute to self-regulation and the achieved these results by detaching physical from HIV and AIDS. Taylor (1995) cultivation of meditative states for pain from the psychological response to it. investigated the effect of a stress reduction overcoming attachments. An important Mindfulness helps to break down this belief, program (involving mediation) on HIV- addition that Buddhism could make to the to "cause an 'uncoupling' of the sensory dimension positive men, noting that anxiety reduction west is through a more satisfactory of the pain experience from the affective/ evaluative is particularly important since the explanation of the nature of suffering. The alarm reaction, and reduce the experience of immunosuppressive effect of stress is more Buddha taught that suffering is a natural suffering via cognitive reappraisal." (Kabat-Zinn, pronounced in HIV/AIDS. Participants in and normal state of being. Given that the 1982). the treatment group showed improvements mind is a sense organ, all cognitions, good in overall self-esteem, and even in T-cell or bad, have value. As described by Kabat-Zinn et al (1985) outline a number count. A detailed review of mindfulness Toneatto (2002): a unique features which recommend in the treatment of HIV/AIDS is given by "(Buddhist psychology teaches that] mindfulness as an intervention for chronic Logsdon-Conradsen (2002). She cites a unpleasant cognitive states serve the same function, pain. (1) In the current climate cost preliminary study (Kelly, 1989) showing that psychologically, as does pain for our physical effectiveness, meditation is much less mindfulness was able to reduce psychological wellbeing. Physical pain, while undeniably expensive than complex behaviour stress, enhance positive outlook and promote unpleasant, is a harmless hut potent motivator to modification programs. It can be taught in a sense of control in HIV-positive men. seek and resolve source of pain. Similarly, groups of up to thirty individuals, and has However, the sample size was small (n=4), unpleasant cognitive states serve to motivate changes shown good compliance rates long after and as such further research is required. in our behaviour, lifestyle, social relationship, training has ceased. (2) The emphasis Logsdon-Conradsen (2002) also notes that interpersonal behaviours, and so on. All experiences, placed on self observation can help build a host of new long-term problems have desirable or not, have value for increasing self healthier models of disease in the mind of emerged and these include coping with knowledge and self understanding]' the patient, and give insight into maladaptive medication side-effects, disclosing diagnosis, behaviour patterns resulting from the illness. changes in social relationships, survivor Mindfulness goes above and beyond (3) Insight into the nature of consciousness guilt, re-entering the workforce and financial cognitive therapy - doing much more than can be generalised to other behavioural worries, to name only a few. This highlights simply seeking out and modifying contexts, outside the arena of pain that the Western approach to tackling such maladaptive behaviours. It is a *way of management. (4) Meditation can help reduce devastating illnesses as HIV or cancer is thinking', a paradigm shift which provides secondary psychopathologies such as largely through a detailed understanding of a new way of relating to suffering. As such, depression, and help patients to develop on only organic pathology. This understanding mindfulness has been recruited by some to a personal level (see 'Buddhist Psychology of bow illness occurs has been enormously help develop effective coping strategies in and Psychotherapy' below). (5) Meditation (144)