(Alternative Medicine) Lotus Therapy

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Lotus Therapy

By Benedict Carey

http://www.nytimes.com/2008/05/27/health/research/27budd.html?

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" I was able to be there, present for the pain, " he said, when the

meditation session ended. " To just let it be what it was, without

thinking it through. "

The therapist nodded.

" Acceptance is what it was, " he continued. " Just letting it be. Not

trying to change anything. "

" That's it, " the therapist said. " That's it, and that's big. "

This exercise in focused awareness and mental catch-and-release of

emotions has become perhaps the most popular new psychotherapy

technique of the past decade. Mindfulness meditation, as it is

called, is rooted in the teachings of a fifth-century B.C. Indian

prince, Siddhartha Gautama, later known as the Buddha. It is catching

the attention of talk therapists of all stripes, including academic

researchers, Freudian analysts in private practice and skeptics who

see all the hallmarks of another fad.

For years, psychotherapists have worked to relieve suffering by

reframing the content of patients' thoughts, directly altering

behavior or helping people gain insight into the subconscious sources

of their despair and anxiety. The promise of mindfulness meditation

is that it can help patients endure flash floods of emotion during

the therapeutic process — and ultimately alter reactions to daily

experience at a level that words cannot reach. " The interest in this

has just taken off, " said Zindel Segal, a psychologist at the Center

of Addiction and Mental Health in Toronto, where the above group

therapy session was taped. " And I think a big part of it is that more

and more therapists are practicing some form of contemplation

themselves and want to bring that into therapy. "

At workshops and conferences across the country, students, counselors

and psychologists in private practice throng lectures on mindfulness.

The National Institutes of Health is financing more than 50 studies

testing mindfulness techniques, up from 3 in 2000, to help relieve

stress, soothe addictive cravings, improve attention, lift despair

and reduce hot flashes.

Some proponents say Buddha's arrival in psychotherapy signals a

broader opening in the culture at large — a way to access deeper

healing, a hidden path revealed.

Yet so far, the evidence that mindfulness meditation helps relieve

psychiatric symptoms is thin, and in some cases, it may make people

worse, some studies suggest. Many researchers now worry that the

enthusiasm for Buddhist practice will run so far ahead of the science

that this promising psychological tool could turn into another fad.

" I'm very open to the possibility that this approach could be

effective, and it certainly should be studied, " said

Lilienfeld, a psychology professor at Emory. " What concerns me is the

hype, the talk about changing the world, this allure of the guru that

the field of psychotherapy has a tendency to cultivate. "

Buddhist meditation came to psychotherapy from mainstream academic

medicine. In the 1970s, a graduate student in molecular biology, Jon

Kabat-Zinn, intrigued by Buddhist ideas, adapted a version of its

meditative practice that could be easily learned and studied. It was

by design a secular version, extracted like a gemstone from the many-

layered foundation of Buddhist teaching, which has sprouted a wide

variety of sects and spiritual practices and attracted 350 million

adherents worldwide.

In transcendental meditation and other types of meditation,

practitioners seek to transcend or " lose " themselves. The goal of

mindfulness meditation was different, to foster an awareness of every

sensation as it unfolds in the moment.

Dr. Kabat-Zinn taught the practice to people suffering from chronic

pain at the University of Massachusetts medical school. In the 1980s

he published a series of studies demonstrating that two-hour courses,

given once a week for eight weeks, reduced chronic pain more

effectively than treatment as usual.

Word spread, discreetly at first. " I think that back then, other

researchers had to be very careful when they talked about this,

because they didn't want to be seen as New Age weirdos, " Dr. Kabat-

Zinn, now a professor emeritus of medicine at the University of

Massachusetts, said in an interview. " So they didn't call it

mindfulness or meditation. " After a while, we put enough studies out

there that people became more comfortable with it. "

One person who noticed early on was Marsha Linehan, a psychologist at

the University of Washington who was trying to treat deeply troubled

patients with histories of suicidal behavior. " Trying to treat these

patients with some change-based behavior therapy just made them

worse, not better, " Dr. Linehan said in an interview. " With the

really hard stuff, you need something else, something that allows

people to tolerate these very strong emotions. "

In the 1990s, Dr. Linehan published a series of studies finding that

a therapy that incorporated Zen Buddhist mindfulness, " radical

acceptance, " practiced by therapist and patient significantly cut the

risk of hospitalization and suicide attempts in the high-risk

patients.

Finally, in 2000, a group of researchers including Dr. Segal in

Toronto, J. Mark G. at the University of Wales and D.

Teasdale at the Medical Research Council in England published a study

that found that eight weekly sessions of mindfulness halved the rate

of relapse in people with three or more episodes of depression.

With Dr. Kabat-Zinn, they wrote a popular book, " The Mindful Way

Through Depression. " Psychotherapists' curiosity about mindfulness,

once tentative, turned into " this feeding frenzy, of sorts, that we

have going on now, " Dr. Kabat-Zinn said.

Mindfulness meditation is easy to describe. Sit in a comfortable

position, eyes closed, preferably with the back upright and

unsupported. Relax and take note of body sensations, sounds and

moods. Notice them without judgment. Let the mind settle into the

rhythm of breathing. If it wanders (and it will), gently redirect

attention to the breath. Stay with it for at least 10 minutes.

After mastering control of attention, some therapists say, a person

can turn, mentally, to face a threatening or troubling thought —

about, say, a strained relationship with a parent — and learn simply

to endure the anger or sadness and let it pass, without lapsing into

rumination or trying to change the feeling, a move that often

backfires.

One woman, a doctor who had been in therapy for years to manage bouts

of disabling anxiety, recently began seeing Gaea Logan, a therapist

in Austin, Tex., who incorporates mindfulness meditation into her

practice. This patient had plenty to worry about, including a

mentally ill child, a divorce and what she described as a " harsh

internal voice, " Ms. Logan said.

After practicing mindfulness meditation, she continued to feel

anxious at times but told Ms. Logan, " I can stop and observe my

feelings and thoughts and have compassion for myself. "

, a psychologist at the University of Nevada at Reno, has

developed a talk therapy called Acceptance Commitment Therapy, or

ACT, based on a similar, Buddha-like effort to move beyond language

to change fundamental psychological processes.

" It's a shift from having our mental health defined by the content of

our thoughts, " Dr. said, " to having it defined by our

relationship to that content — and changing that relationship by

sitting with, noticing and becoming disentangled from our definition

of ourselves. "

For all these hopeful signs, the science behind mindfulness is in its

infancy. The Agency for Healthcare Research and Quality, which

researches health practices, last year published a comprehensive

review of meditation studies, including T.M., Zen and mindfulness

practice, for a wide variety of physical and mental problems. The

study found that over all, the research was too sketchy to draw

conclusions.

A recent review by Canadian researchers, focusing specifically on

mindfulness meditation, concluded that it did " not have a reliable

effect on depression and anxiety. "

Therapists who incorporate mindfulness practices do not agree when

the meditation is most useful, either. Some say Buddhist meditation

is most useful for patients with moderate emotional problems. Others,

like Dr. Linehan, insist that patients in severe mental distress are

the best candidates for mindfulness.

A case in point is mindfulness-based therapy to prevent a relapse

into depression. The treatment significantly reduced the risk of

relapse in people who have had three or more episodes of depression.

But it may have had the opposite effect on people who had one or two

previous episodes, two studies suggest.

The mindfulness treatment " may be contraindicated for this group of

patients, " S. Helen Ma and Dr. Teasdale of the Medical Research

Council concluded in a 2004 study of the therapy.

Since mindfulness meditation may have different effects on different

mental struggles, the challenge for its proponents will be to specify

where it is most effective — and soon, given how popular the practice

is becoming.

The question, said , an associate professor of family

medicine and pediatrics at the Boston University School of Medicine,

is not whether mindfulness meditation will become a sophisticated

therapeutic technique or lapse into self-help cliché.

" The answer to that question is yes to both, " Dr. said.

The real issue, most researchers agree, is whether the science will

keep pace and help people distinguish the mindful variety from the

mindless.

A variety of meditative practices have been studied by Western

researchers for their effects on mental and physical health.

Tai Chi

An active exercise, sometimes called moving meditation, involving

extremely slow, continuous movement and extreme concentration. The

movements are to balance the vital energy of the body but have no

religious significance.

Studies are mixed, some finding it can reduce blood pressure in

patients, and others finding no effect. There is some evidence that

it can help elderly people improve balance.

Transcendental Meditation

Meditators sit comfortably, eyes closed, and breathe naturally. They

repeat and concentrate on the mantra, a word or sound chosen by the

instructor to achieve state of deep, transcendent absorption.

Practitioners " lose " themselves, untouched by day-to-day concerns.

Studies suggest it can reduce blood pressure in some patients.

Mindfulness Meditation

Practitioners find a comfortable position, close the eyes and focus

first on breathing, passively observing it. If a stray thought or

emotion enters the mind, they allow it to pass and return attention

to the breath. The aim is to achieve focused awareness on what is

happening moment to moment.

Studies find that it can help manage chronic pain. The findings are

mixed on substance abuse. Two trials suggest that it can cut the rate

of relapse in people who have had three or more bouts of depression.

Yoga

Enhanced awareness through breathing techniques and specific

postures. Schools vary widely, aiming to achieve total absorption in

the present and a release from ordinary thoughts. Studies are mixed,

but evidence shows it can reduce stress.