For many, it’s almost become automatic to associate the issue of stress with the solution of mindfulness.
The pandemic has also played a role.
In April 2020, mental wellness app downloads neared 10 million, a 24.2 percent increase from that January, according to data from Sensor Tower Store Intelligence.
But it didn’t start with the pandemic.
A 2018 reportTrusted Source from the Centers for Disease Control and Prevention (CDC) noted that the use of meditation among adults more than tripled in 2017, going from 4.1 percent in 2012 to 14.2 percent. Participation in yoga increased from 9.5 percent to 14.3 percent.
Though a buzzy term these days, mindfulness is hardly new. A specific type of mindfulness, known as mindfulness-based stress reduction (MBSR), has been around for more than 40 years.
The 8-week program is designed to help participants “harness inner resources and develop the ability to cope with stress, short and long-term,” says Tony Maciag, a program manager and senior instructional technologist at the birthplace of MBSR, UMass Memorial Health’s Center for Mindfulness.
So, what does the science have to say? Here’s the research and expert input on the history, benefits, and risk factors for MBSR.
What is mindfulness-based stress reduction?
MBSR is an 8-week program developed by Jon Kabat-Zinn, PhD. It’s based on traditional Buddhist practices of mindfulness and meditation.
Kabat-Zinn is professor emeritus of medicine and creator of the Stress Reduction Clinic and the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School.
He created the Stress Reduction and Relaxation Program at the University of Massachusetts Medical Center in 1979. This eventually became the Mindfulness-Based Stress Reduction program.
The program is based on mindfulness practices and Buddhist teachings Kabat-Zinn studied with his teachers, one of whom was Seung Sahn, a Korean Zen master.
Kabat-Zinn incorporated mindful Hatha yoga into his work with patients and noticed repeated reductions in symptoms. He then created a model to replicate those results, and MBSR was born.
“He wanted to create a paradigm shift in the medical system,” says Elana Rosenbaum, MS, MSW, LICSW, who began working with Kabat-Zinn in 1984. “He got inspiration from Buddhism, but wanted to create a program that appealed to all people.”
Maciag agrees.
“Science has long known about the effects of stress on the body and mind, so examining the mitigation of those effects through the practice of present moment awareness and the mind-body connection made sense,” he says.
How it works
Participants practice at home daily for 45 minutes to an hour, using guided audio meditations. They meet once a week online or in-person with a teacher and classmates, complete weekly homework assignments, and participate in a full-day guided silent retreat during the course, typically between weeks six and seven.
“It invites them into informal practice, such as finding moments in their day to pause and bring awareness back to the present moment and coming off ‘autopilot,’ if even for a few moments,” Maciag says.
Mindfulness-Based Stress Reduction benefits
There’s plenty of independent research on MBSR, though evidence is still emerging. Here’s what the experts know (and don’t know) about MBSR.
What the science and research say
Peer-reviews in the last 30 years have indicated that MBSR may help with:
- physical health
- stress
- depression
- anxiety
- emotional exhaustion and burnout
- sleep quality
Physical health
There’s some evidence to show MBSR could support the treatment of chronic conditions and pain.
A 2011 systematic reviewTrusted Source of 18 studies that focused on patients with chronic illness, including cancer, HIV/AIDS, high blood pressure, and skin disorders indicated MBSR could help improve their condition and ability to cope with various clinical issues.
A 2019 randomized-control trialTrusted Source on individuals with osteosarcoma, a type of bone cancer, suggested that MBSR could reduce pain when combined with music therapy.
A 2020 meta-analysis of randomized control trialsTrusted Source indicated that MBSR could reduce blood pressure at a clinician’s office, though it did not show a significant decrease in out-of-office blood pressure.
A 2021 meta-analysisTrusted Source indicated MSBR was a promising intervention that could lower diastolic blood pressure.
Mental health
Recently, studies have emerged that indicate MBSR could improve mental health, though some research has produced mixed results.
A 2021 studyTrusted Source suggested that individuals who underwent MBSR did not have more emotional clarity than those who remained on a waitlist.
A 2019 review of research on MBSR and women with breast cancer suggested that MBSR may slightly reduce anxiety and depression while bettering sleep quality. Still, researchers indicated it likely didn’t make a difference in anxiety and depression up to 2 years after the MBSR intervention.
A 2021 studyTrusted Source of the effects of an 8-week MBSR program on individuals ages 60 to 65 indicated that it was a cost-effective way to prevent stress and maintain a work-life balance in the years before retirement.
A small 2018 studyTrusted Source of 100 psychiatric nurses indicated that MBSR could lower work stress, anxiety, and depression, and it could bolster mental health.
A systematic reviewTrusted Source from the same year suggested that MBSR could enhance psychological functioning in employees. Researchers noticed lower levels of:
- emotional exhaustion
- stress
- psychological distress
- depression
- anxiety
- occupational stress
- sleep disturbance
Another 2018 randomized-control trialTrusted Source indicated that MBSR did not decrease emotional exhaustion in Dutch medical, surgical, and primary care residents. Researchers did note that participants with a high baseline level of emotional exhaustion seemed to benefit from MBSR.
A 2018 systemicTrusted Source review indicated low quality evidence suggesting MBSR could reduce depressive symptoms and anxiety in caregivers of dementia patients, at least in the short term. The authors said higher quality research was needed.
The same 2019 randomized-control trialTrusted Source on patients with osteosarcoma mentioned above suggested that MBSR could lower anxiety and enhance sleep quality for those individuals.
What can it help with?
Anecdotally, Rosenbaum has seen MBSR help with:
- attitude and mindset
- commitment and perseverance
- creating of new patterns of thinking
- behavior and habit changes
- mental clarity
- providing a sense of community
- self-efficacy, or belief in yourself
“People come to [MBSR] because they want to feel better emotionally or physically,” Rosenbaum explains. “There’s a way out of that suffering.”
Rosenbaum says participants also dig into the causes of their suffering, such as holding on to old views.
They “look at how [their] belief systems and habits are conditioning and affecting [them] neurologically,” she says. “By bringing awareness to that, it’s possible to interrupt that pattern, create new patterns, and make change possible.”
Finally, participants can gain a sense of community from going through the program with others.
“It’s a learning experience as you go through a journey with other people, and you learn as much from others as you do from teachers,” Maciag says.
How to do it
MBSR is a specific 8-week program. Still, there are some accessible types of practices used that you can try on your own before signing up.
Techniques and practices
Throughout the 8-week MBSR program, formal practices include:
- body scan meditation
- mindful movement
- sitting meditation
- mindful eating
- mindful breathing
- walking meditation
Body scan meditation involves bringing awareness to a specific body part for a period before moving on to another one. It usually moves in a sequence from head to toe or vice versa.
Mindful movement, such as yoga, asks a person to stay present as they flow through a series of gentle movements and stationary postures.
Sitting meditation is practiced in a seated upright position, either on the floor or a chair, with appropriate cushioning and support for an individual.
Mindful eating involves paying full attention to the food you’re eating, including texture, taste, and each tiny bite.
Mindful breathing asks the practitioner to pay attention to their breathing.
Formal walking meditations often alternate between periods of sitting and walking. While walking, the practitioner will focus on sensations, including the contact of the foot with the ground during each step. They’re encouraged to pause and refocus when the mind wanders.
Step by step
In MBSR, participants have formal practices and ways to apply their learnings to day-to-day life. Here are some examples.
Body scan
Here are the steps Rosenbaum uses at The Center for Mindfulness at UMass Memorial Health:
- Form an intention for the practice.
- Find a comfortable and quiet place where you will feel safe and not be disturbed.
- Before starting, decide how long the practice will last. Set a timer.
- Let go of expectations and judgments.
- The attitude you bring to practice is important. Practice curiosity and an attitude of acceptance and kindness. Remember to be patient and kind as you go through your body.
- Stay in the present moment. When the mind wanders, bring it back to the body.
- When thoughts or feelings arise, note how they affect sensations in the body and vice versa.
- Bring awareness to the body. To do this step, note and feel the whole body and the fact that there is breath. Feel how the breath enters and leaves the body. Let it be. There’s nothing you need to do or change.
- Move through the body side by side and back to front with awareness. Note areas of strong sensations and areas where sensations may not be felt. Go slowly. Take your time. Begin with the foot, up into the ankle, legs, pelvis, back, front, chest and neck. Include arms and hands. Move up into the neck and face, including each sense organ (eyes, ears, nose and mouth).
- If discomfort arises, note it, soften into the sensations and bring loving attention to it. Note thoughts about what is happening. Is it a familiar story? Does it evoke strong feelings? Feel the breath, and breathe into the discomfort or pain. Be compassionate. Move or stop the practice if you have reached the edge of your toleration point. You can begin again when you feel more settled.
- When you have brought attention to the body part by part, you can feel its wholeness.
Mindful eating
The following steps are from Brittany Ferri, PhD, an occupational therapist and founder of Simplicity of Health:
- Check in with your body every time you feel a hunger signal.
- Slow down your movements, and decide whether you’re truly hungry, or if you’re bored, sad, angry or stressed. If you’re hungry, you’ll receive a cue from your stomach. If emotions are driving your hunger, the signal will come from the brain.
- Distract yourself if the cue comes from the brain.
- Check in with yourself again when you feel another hunger cue. Has it changed this time?
- Sit down and eat if your stomach is giving you the cue.
- When you eat, put all other distractions aside and focus only on eating.
- Savor each bite, and eat slowly.
- Take the time to chew your food thoroughly. Drink in between bites.
- Listen to your body when you get to the point of feeling full.
- Don’t overeat just because it’s in front of you. Put your emotions aside, and only eat if you feel it will satisfy your hunger.
- Think about the nutrients and energy each bite gives you.
- Thank your food for what it has given you.
Mindful breathing
These are the steps Ferri uses:
- Drown out everything around you. Focus on your breathing.
- Take one large deep breath in through your nose and blow that air out through your mouth.
- Repeat and do not let any distractions sink in.
Resources
For further learning or to find a course, consider the following resources.
Online courses and resources
- UMass Memorial Health MBSR
- Palouse Mindfulness MBSR
- UMass CFM weekly online guided meditations
- A video overview of MBSR, suggested by Maciag
Books
- Books by Jon Kabat-Zinn (multiple)
- “Heal Thy Self” by Saki Santorelli
- “Being Well (Even When You’re Sick)” by Elana Rosenbaum
- “A Mindfulness-Based Stress Reduction Workbook” by Bob Stahl and Elisha Goldstein
- “A Mindfulness-Based Stress Reduction Workbook for Anxiety” by Bob Stahl, Florence Meleo-Meyer and Lynn Koerbel
Frequently asked questions
Have more questions? Get the FAQs on MBSR below.
What’s the difference between mindfulness and MBSR?
Mindfulness is a broad term that encompasses practices like yoga and meditation.
By contrast, MBSR is a specific, 8-week curriculum that requires a 2.5-hour weekly class commitment and a full-day guided silent retreat at the end of the program.
Participants will also do a daily meditation practice of 45 to 60 minutes for the duration of the program.
What are the practices used in MBSR?
Participants will learn and do several mindfulness practices during the MBSR program, including:
- body scan
- mindful movement
- sitting meditation
- mindful eating
- mindful breathing
- walking meditation
Can MBSR help treat depression and anxiety?
Research indicates MBSR could aid in the treatment of depression and anxiety, though it’s not always clear how much and for how long.
For example, the 2019 research review of women with breast cancer mentioned above indicated that MBSR could slightly lower anxiety and depression in patients from the end of the intervention and 6 months later. But it did not seem to make a difference up to 2 years later.
Other research previously mentioned, such as a small studyTrusted Source of psychiatric nurses and a 2018 systemic reviewTrusted Source, suggest MBSR could reduce depression and anxiety.
Who shouldn’t practice MBSR?
Rosenbaum says individuals who actively hallucinate, take psychiatric drugs, or who are actively coping with substance use disorder should speak with a psychiatrist or healthcare professional before doing MBSR.
She also recommends people with post-traumatic stress disorder (PTSD) speak with their doctor, as they may need additional support.
Takeaway
Mindfulness-Based Stress Reduction is an 8-week program developed by Jon Kabat-Zinn to help improve mental well-being.
Research suggests MBSR may help improve physical and mental conditions, but more research is needed to confirm its effects.
