覺察減壓（MindfulnessBased Stress Reduction 簡稱 MBSR 、以 Mindfulness 為基礎之壓力減低，是一個為期八週、有實證基礎的課程計畫，可提供非宗教性、密集的覺察訓練，以幫助有壓力者、焦慮者、憂鬱者和疼痛者。覺察減壓由喬卡巴金（Jon KabatZinn）教授於 1970 年代在麻塞諸塞州大學的醫學中心開發此課程，它結合了覺察冥想、身體意識、瑜伽來對行為、思維、感覺和行動方式進行探索。覺察可以理解為對當前經驗的非判斷性接受和當下經驗，包括身體覺知、內在心智狀態、思想、情緒、衝動和記憶，目的是減少壓抑或苦惱，並增加幸福感。覺察冥想是一種培養注意力、發展情緒調控、和減少沉思和憂慮的方法。過去的幾十年中，覺察冥想一直是可控的臨床研究主題，有增進心智健康 、和促進身體健康的潛在效果。雖然覺察減壓源自於精神式的引導，但該課程與宗教是無關的 。覺察減壓課程在覺察減壓在 1990 年發表的著作 Full Catastrophe Living 譯：災難生存法則 中有詳細描述。 歷史 1979 年，喬卡巴金在成立了覺察減壓診所，二十年後他在麻州大學醫學院成立醫學、健康照護、和社會覺察中心。這兩個機構使覺察減壓在全球的醫院得到長遠的發展和實際運用。卡巴金在他 1990 年最暢銷的著作 譯：災難生存法則；臺灣目前翻譯此書名為正念療癒力胡君梅、黃小萍（譯）。正念療癒力：八週找回平靜、自信與智慧的自己（卡巴金博士二十年經典增訂版）。新北市：野人，2013 年。（原著 KabatZinn J，2013 年）。 中詳細描述了 MBSR 計劃課程，該書於 2013 年以修訂版重新發行。1993 年，Bill Moyer 在其 Healing from Within 譯：從內在開始治療 一書中推廣卡巴金的 MBSR 課程。到了 2015 年時，全美有將近 80 的醫學院都提供了覺察訓練的元素 Buchholz Laura Oct 2015 Exploring the Promise of Mindfulness as Medicine JAMA 314 13 13271329 doi101001jama20157023 PMID 26441167，使得以覺察為主的研究和教育中心的數量越來越多。 課程 覺察減壓是一種團體課程，著重於以漸進方式獲得有關覺察的注意覺知。覺察減壓是一個為期八週的工作坊課程，由經認證的培訓師講授，內容包括每週 25 小時的團體會議、在第六週和第七週中的一日靜修 含 7 小時的覺察訓練、每天 45 分鐘的在家練習作業、和三種正式技術的指導：覺察冥想、身體掃描及簡單的瑜伽姿勢。課程的重點透過團體討論和探索而獲得覺察的練習經驗和生活應用。前四週的課程重點在於身體掃描，此為正式的覺察技術，它需要安靜地坐著或躺著，並有系統地將注意力集中在身體的各個部位，即注意力從腳趾頭開始，然後慢慢向上移動到頭頂。覺察減壓基本上是無評斷、不費力、接受、放下、初學者心態、耐心、信任、和非自我中心 Frewen P A Evans EM Maraj N Dozois D J Partridge K 2008 Letting go Mindfulness and negative automatic thinking Cognitive Therapy and Research 32 6 758774 doi101007s1060800791421。 喬卡巴金認為覺察減壓的基礎是覺察，他對「覺察」的定義是「當下、無評斷的覺知 momenttomoment nonjudgmental awareness」。課程中，參加者需在日常生活中練習覺察、併入覺察。專注於當下，可以增加對環境的敏感度和反應能力，進而強化自我管理和因應能力。覺察亦提供沉思過去和擔心未來的出口，並打破適應不量的認知過程 Hayes Steven C Villatte Matthieu Levin Michael Hildebrandt Mikaela 20110101 Open Aware and Active Contextual Approaches as an Emerging Trend in the Behavioral and Cognitive Therapies Annual Review of Clinical Psychology 7 1 141168 doi101146annurevclinpsy032210104449 PMID 21219193。 羅伯特薩波斯基在其專書「為什麼斑馬不會得到潰瘍？」Why Zebras Dont Get UlcersSapolsky Robert 2004 Why Zebras Dont Get Ulcers USA Holt paperbacks p 560 ISBN 9780805073690 中為非專業的讀者進行探究，可提供減壓效果和壓力起源的科學實證 Sapolsky Robert 1982 The endocrine stressresponse and social status in the wild baboon Hormones and Behavior 16 3 279292 doi1010160018506X 82 900277 PMID 6890939。覺察冥想可顯著地降低心理壓力 Sharma M Rush SE October 2014 Mindfulnessbased stress reduction as a stress management intervention for healthy individuals a systematic review Journal of EvidenceBased Complementary Alternative Medicine 19 4 27186 doi1011772156587214543143 PMID 25053754Hofmann SG Sawyer AT Witt AA Oh D April 2010 The effect of mindfulnessbased therapy on anxiety and depression A metaanalytic review Journal of Consulting and Clinical Psychology 78 2 16983 doi101037a0018555 PMC 2848393 PMID 20350028，亦可防止因心理壓力而導致的相關生理變化和生物學臨床表現。 覺察練習之推廣 根據《時代》雜誌 2014 年的一篇文章，覺察冥想在平常不會冥想的人們中越來越流行 Pickert K February 2014 The art of being mindful Finding peace in a stressedout digitally dependent culture may just be a matter of thinking differently Time 183 4 406 PMID 24640415。喬卡巴金在麻州大學醫學中心開設的課程已經培養了將近 1000 名獲得覺察減壓認證的講師，這些講師遍佈美國每個州和 30 多個國家。例如 General Mills 公司已為其員工提供冥想的空間；民主黨國會議員提姆瑞安則在 2012 年出版了一本名為「覺察國家 A Mindful Nation」之專書，他在國會山莊協助並組織了定期的團體冥想活動 Rojas Warren January 8 2014 A Meditation on the Quiet Time Caucus Roll Call Archived from the original on January 9 2014 Retrieved April 4 2014。 覺察練習之方法 醫院、靜修中心和各種瑜伽場館都已提供覺察減壓的課程。這些課程都很注重以下的教學內容： 以身心覺知來減輕生理壓力、疼痛或疾病。 實際體驗壓力和苦惱以減少情緒反應。 以鎮定來面對人類生活中自然發生的變化和損失。 日常生活中的無評斷覺知。 隨時保持寧靜和清明。 體驗更快樂的生活並獲得內在療癒能量。 覺察冥想。 效果評估 相關研究成果 覺察方法有益於健康的成年人 Vonderlin Ruben Biermann Miriam Bohus Martin Lyssenko Lisa 2 March 2020 MindfulnessBased Programs in the Workplace a MetaAnalysis of Randomized Controlled Trials Mindfulness doi101007s12671020013283Dawson AF Brown WW Anderson J Datta B Donald JN Hong K et al November 2019 MindfulnessBased Interventions for University Students A Systematic Review and MetaAnalysis of Randomised Controlled Trials Applied Psychology Health and WellBeing aphw12188 doi101111aphw12188 PMID 31743957、青少年和兒童 Zenner C HerrnlebenKurz S Walach H 2014 Mindfulnessbased interventions in schoolsa systematic review and metaanalysis Frontiers in Psychology 5 603 doi103389fpsyg201400603 PMC 4075476 PMID 25071620Dunning DL Griffiths K Kuyken W Crane C Foulkes L Parker J Dalgleish T March 2019 Research Review The effects of mindfulnessbased interventions on cognition and mental health in children and adolescents a metaanalysis of randomized controlled trials Journal of Child Psychology and Psychiatry and Allied Disciplines 60 3 244258 doi101111jcpp12980 PMC 6546608 PMID 30345511，並可改善如飲食失調 Sala Margarita Shankar Ram Shruti Vanzhula Irina A Levinson Cheri A 25 February 2020 Mindfulness and eating disorder psychopathology A metaanalysis International Journal of Eating Disorders doi101002eat23247 PMID 32100320Carrière K Khoury B Günak M M Knäuper B February 2018 Mindfulnessbased interventions for weight loss a systematic review and metaanalysis Obesity Reviews 19 2 164177 doi101111obr12623 PMID 29076610Rogers JM Ferrari M Mosely K Lang CP Brennan L January 2017 Mindfulnessbased interventions for adults who are overweight or obese a metaanalysis of physical and psychological health outcomes Obesity Reviews 18 1 5167 doi101111obr12461 hdl10072393029 PMID 27862826、精神疾病 Xue Jiaming Zhang Yun Huang Ying June 2019 A metaanalytic investigation of the impact of mindfulnessbased interventions on ADHD symptoms Medicine 98 23 e15957 doi101097MD0000000000015957 PMC 6571280 PMID 31169722Cavicchioli Marco Movalli Mariagrazia Maffei Cesare 2018 The Clinical Efficacy of MindfulnessBased Treatments for Alcohol and Drugs Use Disorders A MetaAnalytic Review of Randomized and Nonrandomized Controlled Trials European Addiction Research 24 3 137162 doi101159000490762 PMID 30016796Spijkerman MPJ Pots WTM Bohlmeijer ET April 2016 Effectiveness of online mindfulnessbased interventions in improving mental health A review and metaanalysis of randomised controlled trials Clinical Psychology Review 45 102114 doi101016jcpr201603009 PMID 27111302Hofmann Stefan G Sawyer Alice T Witt Ashley A Oh Diana 2010 The effect of mindfulnessbased therapy on anxiety and depression A metaanalytic review Journal of Consulting and Clinical Psychology 78 2 169183 doi101037a0018555 ISSN 19392117 PMC 2848393 PMID 20350028、疼痛管理 Hilton Lara Hempel Susanne Ewing Brett A Apaydin Eric Xenakis Lea Newberry Sydne Colaiaco Ben Maher Alicia Ruelaz Shanman Roberta M Sorbero Melony E Maglione Margaret A 22 September 2016 Mindfulness Meditation for Chronic Pain Systematic Review and Metaanalysis Annals of Behavioral Medicine 51 2 199213 doi101007s1216001698442 PMC 5368208 PMID 27658913Zeidan F Martucci KT Kraft RA Gordon NS McHaffie JG Coghill RC April 2011 Brain mechanisms supporting the modulation of pain by mindfulness meditation The Journal of Neuroscience 31 14 55408 doi101523JNEUROSCI5791102011 PMC 3090218 PMID 21471390、睡眠障礙 Wang YuanYuan Wang Fei Zheng Wei Zhang Ling Ng Chee H Ungvari Gabor S Xiang YuTao 2020 MindfulnessBased Interventions for Insomnia A MetaAnalysis of Randomized Controlled Trials Behavioral Sleep Medicine 18 1 19 doi1010801540200220181518228 PMID 30380915Kanen Jonathan Nazir Racha Sedky Karim Pradhan Basant 30 April 2015 The Effects of MindfulnessBased Interventions on Sleep Disturbance A MetaAnalysis Adolescent Psychiatry 5 2 105115 doi1021742210676605666150311222928、癌症照護 Xunlin NG Lau Ying KlaininYobas Piyanee 2020 The effectiveness of mindfulnessbased interventions among cancer patients and survivors a systematic review and metaanalysis Supportive Care in Cancer 28 4 15631578 doi101007s00520019052199 PMID 31834518Xie Congyan Dong Bei Wang Lihong Jing Xiuchen Wu Yin Lin Lu Tian Li March 2020 Mindfulnessbased stress reduction can alleviate cancer related fatigue A metaanalysis Journal of Psychosomatic Research 130 109916 doi101016jjpsychores2019109916 PMID 31927347、心理壓力等的各種健康問題 DiRenzo Dana CrespoBosque Monica Gould Neda Finan Patrick Nanavati Julie Bingham Clifton O 18 October 2018 Systematic Review and Metaanalysis MindfulnessBased Interventions for Rheumatoid Arthritis Current Rheumatology Reports 20 12 doi101007s1192601807874 PMC 6233984 PMID 30338418Simpson Robert Simpson Sharon Ramparsad Nitish Lawrence Maggie Booth Jo Mercer Stewart W February 2020 Effects of Mindfulnessbased interventions on physical symptoms in people with multiple sclerosis a systematic review and metaanalysis Multiple Sclerosis and Related Disorders 38 101493 doi101016jmsard2019101493 PMID 31835209Guo Jia Wang Hongjuan Luo Jiaxin Guo Yi Xie Yun Lei Beimei Wiley James Whittemore Robin 11 December 2019 Factors influencing the effect of mindfulnessbased interventions on diabetes distress a metaanalysis BMJ Open Diabetes Research Care 7 1 e000757 doi101136bmjdrc2019000757 PMID 31908794Demarzo M M P MonteroMarin J Cuijpers P ZabaletadelOlmo E Mahtani K R Vellinga A Vicens C LopezdelHoyo Y GarciaCampayo J 9 November 2015 The Efficacy of MindfulnessBased Interventions in Primary Care A MetaAnalytic Review The Annals of Family Medicine 13 6 573582 doi101370afm1863 PMID 26553897。覺察議題已經逐漸成為研究顯學，學術機構在 2003 年發表了 52 篇論文，到了 2012 年已增加到 477 篇論文。2014 年初則已經發表了近 100 篇隨機對照實驗的實證研究論文 Hurley Dan January 14 2014 Breathing In vs Spacing Out New York Times Magazine Retrieved April 9 2014。 研究證實，覺察減壓方法可使大專學生減輕心理壓力 此年齡常見心理壓力。有研究指出 8 週覺察減壓 MBSR 的效果可多延長兩個月 Felver Joshua C Morton Melissa L Clawson Adam J 2018 MindfulnessBased Stress Reduction Reduces Psychological Distress in College Students College Student Journal 52 3 291298 ISSN 01463934。 覺察減壓技術可對飲食失調者有幫助，亦會改善人們對自己身體的看法 Khoshkerdar Parya Raeisi Zohreh March 2020 The effect of mindfulnessbased stress reduction on body image concerns of adolescent girls with dysfunctional eating attitudes Australian Journal of Psychology 72 1 1119 doi101111ajpy12265 ISSN 00049530。MBSR 注重有效的因應技巧，可透過自我同情來改善人際關係、正向影響一個人的身體形象、和增進幸福感。 研究證實，覺察訓練可增進壓力下的聚焦能力、注意力和工作能力 Lazar SW Kerr CE Wasserman RH et al November 2005 Meditation experience is associated with increased cortical thickness NeuroReport 16 17 18937 doi10109701wnr00001865986624319 PMC 1361002 PMID 16272874Cloud John 20100806 Losing Focus Studies Say Meditation May Help TimeKrompinger J Baime M J 2007 Mindfulness training modifies subsystems of attention Cognitive Affective Behavioral Neuroscience 7 2 109119 doi103758CABN72109 PMID 17672382，覺察也對心血管健康有潛在益處 Levine Glenn N Lange Richard A BaireyMerz C Noel Davidson Richard J Jamerson Kenneth Mehta Puja K Michos Erin D Norris Keith Ray Indranill Basu Saban Karen L Shah Tina Stein Richard Smith Sidney C 11 October 2017 Meditation and Cardiovascular Risk Reduction Journal of the American Heart Association 6 10 doi101161JAHA117002218 PMC 5721815 PMID 28963100Grierson AB Hickie IB Naismith SL Scott J 2016 The role of rumination in illness trajectories in youth linking transdiagnostic processes with clinical staging models Psychol Med 46 12 24672484 doi101017S0033291716001392 PMID 27352637Pascoe Michaela C Thompson David R Jenkins Zoe M Ski Chantal F December 2017 Mindfulness mediates the physiological markers of stress Systematic review and metaanalysis Journal of Psychiatric Research 95 156178 doi101016jjpsychires201708004 PMID 28863392。有證據顯示，覺察冥想有益於抑制藥物濫用 Sancho M De Gracia M Rodríguez RC MallorquíBagué N SánchezGonzález J Trujols J Sánchez I JiménezMurcia S and Menchón JM 2018 MindfulnessBased Interventions for the Treatment of Substance and Behavioral Addictions A Systematic Review Front Psychiatry 9 95 doi103389fpsyt201800095 PMID 29651257Chiesa A Serretti A April 2014 Are mindfulnessbased interventions effective for substance use disorders A systematic review of the evidence Substance Use Misuse 49 5 492512 doi103109108260842013770027 PMID 23461667Garland EL Froeliger B Howard MO January 2014 Mindfulness training targets neurocognitive mechanisms of addiction at the attentionappraisalemotion interface Frontiers in Psychiatry 4 173 doi103389fpsyt201300173 PMC 3887509 PMID 24454293 和改善全身肌肉無力 AdlerNeal Adrienne L Zeidan Fadel 27 July 2017 Mindfulness Meditation for Fibromyalgia Mechanistic and Clinical Considerations Current Rheumatology Reports 19 9 59 doi101007s1192601706860 PMC 5693231 PMID 28752493Henke Miriam ChurHansen Anna 5 June 2014 The effectiveness of mindfulnessbased programs on physical symptoms and psychological distress in patients with fibromyalgia A systematic review International Journal of Wellbeing 4 1 2845 doi105502ijwv4i12Lauche Romy Cramer Holger Dobos Gustav Langhorst Jost Schmidt Stefan December 2013 A systematic review and metaanalysis of mindfulnessbased stress reduction for the fibromyalgia syndrome Journal of Psychosomatic Research 75 6 500510 doi101016jjpsychores201310010 PMID 24290038。 此外，最近的研究顯示，覺察減壓會增進照護者 尤其是母親、抵抗藥物濫用的年輕人之自我同情心和幸福感 Smith Jacqueline M Bright Katherine S Mader Joel Smith Jennifer Afzal Arfan Raheen Patterson Charmaine Dimitropolous Gina Crowder Rachael April 2020 A pilot of a mindfulness based stress reduction intervention for female caregivers of youth who are experiencing substance use disorders Addictive Behaviors 103 106223 doi101016jaddbeh2019106223 PMID 31838440。覺察介入會使母親的壓力有所減輕，學會與自己相處，進而改善人際關係。 覺察減壓不只影響獨自奮鬥者和其相關的人，也會正面影響健康的族群。2019 年，Roca 等人 Roca Pablo Diez Gustavo G Castellanos Nazareth Vazquez Carmelo 20190718 SendiñaNadal Irene ed Does mindfulness change the mind A novel psychonectome perspective based on Network Analysis PLOS One 14 7 e0219793 Bibcode2019PLoSO1419793R doi101371journalpone0219793 ISSN 19326203 PMC 6638953 PMID 31318929 研究參與 8 週覺察減壓課程的健康族群，結果將 MBSR 分成五個面向：覺察、同情、心理幸福感、心理苦惱、和情緒認知控制，並以問卷方式觀察包含這五個面向的心理功能。整體來說，覺察和幸福感是最重要的測量變項。 覺察介入及其影響是非常流行的，尤其覺察已是學術上的顯學。在訪談平均年齡為 11 歲的兒童之後，可發現覺察有助於他們調節情緒，且兒童們認為，如果學校和老師可介紹和融入越多的覺察，他們便能購更容易地應用覺察的原理原則 Hutchinson Julia K Huws Jaci C Dorjee Dusana December 2018 Exploring experiences of children in applying a schoolbased mindfulness programme to their lives Journal of Child and Family Studies 27 12 39353951 doi101007s1082601812212 ISSN 10621024。 如前所述，覺察可增加同情心，而高度的自我同情心則會大幅度地減低壓力 Sevel Landrew S Finn Micheal TM Smith Rachel M Ryden Anna M McKernan Lindsey C February 2020 Selfcompassion in mindfulnessbased stress reduction An examination of prediction and mediation of intervention effects Stress and Health 36 1 8896 doi101002smi2917 ISSN 15323005 PMID 31874122 和增進自我覺知能力，這些狀況會發生在課程當中或課程之後。由此可知，覺察減壓可以直接地或間接地提高自我同情心。 在華人相關學術領域中，2020 年出版學術性的文獻探討及探索性因素分析之實證研究，Mindfulness 中譯釐正為覺察之佛學與科學實證檢驗：覺察與正念判準量表之研發 汪珮渲與賴世烱 2020。Mindfulness 中譯釐正為覺察之佛學與科學實證檢驗：覺察與正念判準量表之研發。佛學與科學，第 21 卷，第 1 期，1029。，探討覺察與正念的關係，研究者指出：Mindfulness 之中文翻譯為覺察，佛學專有用語之「正念」確實有評斷正確、正當的正向積極之意，覺察與正念有關，正念可包含覺察，但覺察卻無法包含並代表正念，兩者不能混為一談。該研究中並發展覺察與正念判準量表，用以明確區分覺察與正念為兩個不同面向。 參考文獻 Category 心理學 Category 運動心理學 Category 身心療法 Category 替代醫學 Category 佛教 Category 修行法