What Is MBSR and Who Can Benefit from It?

Mindfulness-Based Stress Reduction (MBSR) is taught as an eight-week course of usually two-and-a-half- to three-hour sessions, with a full day of silent mindfulness practice between the sixth and seventh meeting. Dr. Jon Kabat-Zinn developed MBSR at the University of Massachusetts Medical Center in Worcester. Inspired by his own experiences with Vipassana and Zen meditation, as well as yoga, Kabat-Zinn taught the first MBSR course in 1979. MBSR was part of the then-emerging field known today as mind-body, or integrative, medicine.

At its core, MBSR is an intensive training in mindfulness, which Kabat-Zinn has defined as "the awareness that arises by paying attention on purpose, in the present moment and non-judgmentally." The most detailed training and study of mindfulness occur in Buddhist traditions, particularly Vipassana, but mindfulness is expressed in other contemplative traditions as well. Since the 1970s it has been integrated into Western health care, education, and other fields and is seen as a nondenominational, nonreligious training available to everyone, whatever their belief. As Kabat-Zinn notes, mindfulness

is a way of looking deeply into oneself in the spirit of self-inquiry and self-understanding. For this reason it can be learned and practiced, as is done in mindfulness-based programs throughout the world, without appealing to Asian culture or Buddhist authority to enrich it or authenticate it. Mindfulness stands on its own as a powerful vehicle for self-understanding and healing. In fact, one of the major strengths of MBSR and of all other specialized mindfulness-based programs such as mindfulness-based cognitive therapy (MBCT) is that they are not dependent on any belief system or ideology.

Shortly after Kabat-Zinn began teaching MBSR, the Stress Reduction Clinic at the University of Massachusetts Medical Center opened with MBSR as its flagship program. During a one-year trial phase, the clinic held stress-reduction courses with up to thirty participants in each class, many of them chronic-pain patients. The course proved effective in that participants learned to handle their pain in a better way. Their personal suffering diminished, and in some cases their pain levels were reduced in intensity.

From the outset, Kabat-Zinn and his coworkers did research studies. MBSR has been shown to be helpful in reducing symptoms and improving the quality of life for people experiencing a wide range of conditions.

MBSR was the first of what are now known as mindfulness-based interventions or approaches. Programs whose formats (including course length and emphasis on practice at home) are modeled on MBSR include, among others, Mindfulness-Based Cognitive Therapy (MBCT), Mindfulness-Based Eating Awareness Training (MB-EAT), Mindfulness-Based Relapse Prevention (MBRP), and Mindfulness-Based Cancer Care. The main difference between MBSR and these more specialized programs is that the latter generally target people with a specific condition — for example, chronic pain, multiple relapses of depression, substance abuse, cancer, and so on. MBSR courses address participants who have an array of conditions but who are not separated according to their diagnosis or situation.

MBSR is being taught throughout the world by a wide range of professionals, including physicians, psychologists, psychotherapists, schoolteachers, social workers, coaches, physiotherapists, nurses, occupational therapists, chaplains, yoga teachers, and many more people in a wide variety of environments and institutions, including hospitals, psychiatric clinics, universities, private practices, schools, hospices, adult-education institutes, corporations, prisons, counseling centers, medical schools, the armed forces, and many other settings.

MBSR is suitable for people who want to learn to cope with stress using their own resources to improve the quality of their lives. A key element of the course is seeing that it is possible to shift the way we view events or conditions in our lives. In the MBSR course, participants learn that practicing mindfulness can help alleviate their symptoms by creating a wider context for their condition. Rather than focusing on the situation itself, we learn to observe the way we relate to it on emotional, intellectual, and behavioral levels. In the case of relating to pain, for example, some clients in our classes report that the emotional pain (anger, blaming, resignation, a sense of helplessness) they experienced before the course no longer dominates their waking moments. While participating in the course they have practiced being aware of thoughts as thoughts rather than facts, enabling them to create some distance rather than be carried away by them. By practicing the formal MBSR exercises, and particularly the body scan, pain patients can begin to shift their relationship to pain from "I am my pain" to "My body is experiencing pain, but it is not all of me." They may still experience physical pain, but it does not narrow their life choices or dominate their thoughts as much as it did before.

In summing up the relationship between scientific studies and the way we see ourselves, Kabat-Zinn points to the health-enhancing qualities that mindfulness of thoughts and emotions can support:

If we can be aware — especially in our own personal experience, as well as from the evidence from scientific studies — that certain attitudes and ways of seeing ourselves and others are health-enhancing: — that affiliative trust, compassion, kindness, and seeing the basic goodness in others and in ourselves has intrinsic healing power, as does seeing crises and even threats as challenges and opportunities, then we can work mindfully to consciously develop these qualities in ourselves from moment to moment and from day to day. They become new options for us to cultivate. They become new and profoundly satisfying ways of seeing and being in the world.

Alleviating symptoms of illness and stress is an important aspect of an MBSR course and an understandable motivation for many to join, but practicing mindfulness and making it part of our daily lives goes far beyond reducing the symptoms of an illness. Mindfulness is more than a problem-solving technique. It is a fundamental shift in attitude toward ourselves and whatever our condition might be. It helps us tap into our inner resources and capacities and access the potential for healing that we all have. This in turn creates the basis for an inner orientation toward a wholesome way of life. In this sense, mindfulness is a fundamental attitude and way of living.

Developing a kind and compassionate attitude toward ourselves is...