Improving the Efficacy of Mindfulness in Schools

New research examines factors that make mindfulness interventions in school most effective for adolescent’s mental health outcomes.

Jessica Janze
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A new study, published in Mindfulness, explores moderating factors on the effects of mindfulness interventions for young peoples’ mental health in school settings. The results of the meta-analysis indicate individual differences in student’s ages, teacher’s experiences, and the delivery method may influence the receptivity and effectiveness of school-based mindfulness programs.

“Although mindfulness-based interventions have been shown to be effective for mental health and well-being outcomes, many of the mindfulness-based interventions for youth have been adapted from the programs designed for adults,” the researchers, led by Dana Carsley from the Department of Educational and Counselling Psychology at McGill University, write. “As such, it is likely that further modifications are required to ensure that the interventions are targeted for youth in the school setting.”

Photo Credit: Pixabay

There is a buzz about mindfulness in the current culture as research has demonstrated the benefits of mindfulness practice for psychiatric disorders, resiliency, depression, and burnout.  However, with the majority of research pertaining to adults or college students, more focus is needed to support the adaptation process for school-aged children.

With upward of one in five school-aged children reporting significant mental health concerns, there is a strong argument that can be made for preventative, low-cost, and group-oriented interventions which can be administrated to children in their classrooms. However, ensuring these programs are efficient and effective is essential when considering the time and resource restraints schools often face.

Carsley and her colleagues explain why schools and educational settings may be in a “unique position to support students’ mental health as school services,” as they are “(1) are extremely accessible, (2) can help decrease the stigma associated with mental illness, and (3) can be cost-effective relative to clinical or hospital support.”

In an attempt to distinguish the most efficient approaches for delivering mindfulness-based interventions in schools, the researchers conducted a meta-analysis on 24 studies related to mindfulness-based programs in schools comprising of 3,977 school-aged participants. Among other variables, the researchers examined the outcomes related to the developmental period of children receiving the intervention, type of mindfulness-based intervention used, and the training and type of facilitator (teacher or outsider).

Results of the analysis revealed the greatest effect on mental health and wellness for interventions that were delivered during late adolescents (age 15-18), as compared to middle childhood (age 6-10) or early adolescence (age 11-14). Understanding the age group with the highest outcome levels provides a focus to school administrators when considering adopting mindfulness-based activities for their school.

“Adolescence is considered to be a ‘window of opportunity’, the researchers explain, “specifically, the plasticity in adolescents’ brains and the associated social and cognitive systems essential to development during adolescence are malleable as they co-construct adolescents’ identity.”

A combination intervention including various mindfulness and yoga-based activities was found to be most effective as compared to just mindfulness-based yoga or a pre-designed mindfulness program. This may have been due to the variety of mindfulness training among in-classroom teachers or the flexibility the method provided for student’s needs to be addressed.

The effects of teacher type were mixed, with in-classroom teachers having the best results for mental health outcomes of students and trained mindfulness teachers having more significant effects on mindfulness levels.

“When mental health outcomes and mindfulness outcomes were examined separately in the between-group analyses, the effects on mental health outcomes post-test were only significant when interventions were delivered by a trained teacher; however, the effects on mindfulness posttest were only significant when interventions were delivered by an outside facilitator,” they write.

This study provides a significant contribution to the understanding of effective mindfulness-based interventions in school settings. While mindfulness interventions often demonstrate effectiveness across ages and with varying factors, identifying interventions with the most potent outcomes for student’s mental health is essential for developing evidence-based school programs.

“The mental health of youth, who spend the majority of their day in school, should always be acknowledged in the education system,” the researchers conclude. “Given that mindfulness interventions have become increasingly popular in schools as a way of supporting students’ mental health and overall well-being, it is important for schools to ensure that factors critical to school delivery (e.g., developmental period, type of intervention, and identity of facilitator) are considered when implementing the programs in such a way that students experience optimal benefits of mindfulness interventions.”

 

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Carsley, D., Khoury, B., & Heath, N. L. (2018). Effectiveness of Mindfulness Interventions for Mental Health in Schools: a Comprehensive Meta-analysis. Mindfulness, 9(3), 693-707. (Link)

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Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

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70 COMMENTS

  1. Sigh.
    I practice these regularly, yet I feel extremely uncomfortable about the mindfulness movement, and especially about any environment in which there is the slightest hint of coercion attached to them, (including peer pressure or brownie points), whether it be schools, workplaces or inmate situations. It makes me cringe.

    • I agree. I was horrified to discover that clients were sometimes forced to practice “mindfulness!” It is such an utter contradiction, it’s hard for me to wrap my head around it. “You will be mindful or I will punish you!” Sort of like telling someone they have to have fun or else. Anyone who knows the first thing about true mindfulness meditation would realize that making someone do it is totally destructive to the actual purpose of the activity.

    • I’m not sure how encouraging non-judgement of self and focus on the present is problematic or dangerous. Seems to me that in order to be successful and/or content adults we need to be mindful. If we aren’t in the present, we can’t enjoy what is happening right in front of us! Like a beautiful ocean, reading inspiring poetry, or spending quality time with loved ones.

  2. Unfortunately psychology, is subject to fads. Its been my own experience that mindfulness was created,, because it could be sold to the public where as meditation, could not. Mindfulness was created by those that wanted to use meditation by another name, to enrich themselves financially. Meditation itself, has a long history, with many religious underpinnings. There again, when one looks at what the experts say about meditation, their descriptions of meditation differ from what so called mindfulness instructs us. First of all. Osho, Krishnamurti, and many others have said that meditation, cannot be taught. That is is a “happening”, not a doing and that any lessons, teaching etc,, that purports to teach mediation is in fact its anti thesis. One can learn to experience it that is all. Its been my perception that mindfulness is a form of auto hypnosis, and that those under the influence of its practitioners, exhibit effects similar to being under hypnosis, i.e., they are highly suggestible. That being said, it may seem redundant, to say this but children, who need therapy, need therapy. Mindfulness cannot substitute for therapy, because that’s not what it does.

    • To Prisoners Dilema: Mindfulness is not a fad and it was not “created to be sold.”
      Also, mindfulness is a type of meditation. All meditation practices can be divided into two main categories. One is ‘focused attention meditation’ and this meditation practice is mainly used to calm the mind (note that the mind has the habit of constantly roaming to all types of thoughts: this attribute is sometimes referred to as the “monkey mind”). The other type of meditation is ‘open monitoring meditation,’ where one is attentive moment by moment to anything that occurs in experience – this meditation is used to develop wisdom.
      The following article describes the differences between these two practices:
      Lutz, A., Slagter, H. A., Dunne, J. D., & Davidson, R. J. (2008). Attention regulation and monitoring in meditation. Trends in Cognitive Science, 12, 163-169.

      Also, although meditation is ultimately about subjective experience, it can be taught in a general way – if you read my comment about children watching ‘floats’ that I posted just now, you will understand how it can be taught.

      One can also envision that just like physical activity is healthy for the body, meditation and mindfulness practices are highly beneficial for the mind.

      • Your comments are a good indication, of whats wrong with mindfulness. Its definitely not meditation. Meditation is about getting rid of the mind, not becoming more entrenched in ideas. Its mindlessness, mind is the obstacle. And as was mentioned before its a happening not a doing, not a business, not a training, not a study. A happening…You simply don’t understand, the bigger the degree, the less likely there will be meditation happening, because education strengthens the mind.. It doesn’t get rid of it.. Go ask, Buddha, Osho, Krishnamurti…

        • Prisoners Dilema: I feel that you don’t understand what mindfulness is – perhaps you can start by reading the Wikipedia page (on mindfulness).

          I agree however that it is not a ‘doing but a happening’ – but, if you simply say that to someone, they are going to be highly confused on how to practice it. This is why it is good to give some guidance to people on how to carry out mindfulness meditation (such as how the ‘mind’ works, etc.).

          By the way, your statement “Meditation is about getting rid of the mind” is your own personal definition – it is not a standard definition. I suggest that you read the reference I suggested as well (Lutz, 2008).

      • And Buddhism is not a religion since it has no god and does not worry about things like how Creation happened. Buddha taught that he was not a god at all and in fact all of us contain a sleeping Buddha. This is why Buddhists have statues of the Buddha (in many forms others than just the historical Buddha); they are there to remind us that we are the Buddha. It is not a faith as such. Technically, Buddhism is a practice for living. Mindfulness is not about religion or faith or any other thing other than being in touch with what is happening in your life right here right now in this very moment. It is a matter of being aware and awake in that sense. There is nothing dangerous about mindfulness.

  3. I have to laugh at some of the criticisms of mindfulness. Mindfulness is about trying to adopt a nonjudgemental attitude towards self. To notice our thoughts, notice being distracted, redirect our focus onto the present moment, and to try and do one thing at a time. Our current world doesn’t support mindfulness, as we have constant distractions in modern life. It’s a nonpathologizing view of the human experience. The fact that anyone would get offended by such concepts is to me quite confusing. All children should be taught to practice mindfulness, as it helps someone develop self compassion and focus to be present in one’s life. Not sure how this is controversial.

        • Why on earth would I practice it if I concluded it was BS, Shaun?

          I wasn’t talking about my own experience (and for the record, I find it wonderful), I was talking about the mindfulness movement, about how it is being taught, for what reasons, and by whom, and it being applied in particular settings with people not freely choosing to do it because they like it, about the philosophy and ethics involved.

          • If you find it wonderful, not sure why you would protest? Like I’ve said before, mindfulness isn’t pathologizing. It’s a life skill. Being mindful of one’s thoughts and feelings is just as integral to life as any other subject taught in school. It’s pure hyperbole if anyone is suggesting that people are being forced to practice mindfulness and being punished for not practicing it. Where is this happening? DBT is the only modality in counseling (and community MH centers) which heavily focuses on mindfulness, and only a small minority of clients attend these classes (voluntarily, mind you).

            What is more oppressive is the current education system in America, which focuses on standardized testing and removing many “electives” like art and music.

            Mindfulness isn’t about telling people what to think. Mindfulness is encouraging self-compassion and non-judgement of self. If that is controversial, then we are really screwed. You might as well protest math, science, art, and gym being taught in schools if you think mindfulness is problematic.

          • It is exactly in DBT where I have heard of “mindfulness” being required. And if you really think that DBT is always voluntary, you need to look around closer at the world of “mental health treatment.” DBT is often a requirement of courts to get kids back from child protective services, it is sometimes ordered in criminal cases, and of course, there are those who manage to escape psych “hospitalization” by agreeing to “participate in services,” and whether it is overtly stated or not, the fear of re-hospitalization can make it feel very much like “I’d better do what they tell me or I’m gonna get in trouble again.” There are also housing programs that require “participation in services,” and again, whether correctly or not, people perceive that noncompliance with “treatment” can get them tossed out onto the street.

            I am not at all against offering mindfulness meditation to anyone who wants to learn it. However, I do think you’d do well to listen more carefully to those who are expressing concern with HOW it is presented to them. The power differentials in “mental health services” are VERY real, and a lot of things that seem “voluntary” to you seem anything but to those who have to deal with the consequences of “noncompliance.”

      • There are different types of judgement. Many people are their own worst critics, making negative comments about themselves that aren’t really based in fact. The negative judgments I’m talking about are distorted and usually messages people received in childhood. You are right that some judgments are fair and based on the facts, but I would say that this isn’t the same thing as saying “I’m stupid”, “I’m unworthy”, “I’m a bad person because I’ve made mistakes”, “I’m unloveable”. These judgements are detrimental to one’s one view of self and make it very likely that the person will suffer more.

        • I started writing a long reply and lost it, but realise I can’t be bothered. It’s good to discuss things but mind-sapping to have someone not listen but argue against straw-men.

          For the record, oldhead immediately picked out a problem with the imposition of this kind of doctrine, simple logic really. This is not as simple as you imgine, Shaun.

          • Out,

            Mindfulness is not some sort of doctrine or dogma. Mindfulness is one of the least controversial concepts in the mental health world. Albeit it is difficult to practice, it has immense value to the human psyche and daily life. In one form or another it has been practiced for thousands of years by humans. I hope one day it will be taught to every human on the planet. Our world is the opposite of mindful much of the time, with constant distraction, judgement, attempts at multitasking (which rarely work), and the like.

            Do you think math or science is unfairly “imposed” on students? Should that not be the case? Maybe we should let kids play on the jungle gym all day? Heck, I would have loved that as a child. I didn’t want to learn anything at the time, but I’m glad adults imposed learning into my life. Mindfulness is just one more form of learning. Especially considering the insidious nature of technology in our lives, mindfulness becomes evermore important. Both kids and adults are less happy because of social media and it’s impact on feeling “not good enough”. Mindfulness can help people, all people, to practice letting go of our judgments towards self, just notice them actually, and to be in contact with our inner world and the present moment.

          • Shaun, this is controversial. It is being debated around the world.
            Science is founded on critical thinking. Mindfulness is a faith-based doctrine. Research has shown some benefits (and also some problems) for those practising it, but I’m sure that would be equally true of almost any religious practice. The point is, this is not comparable with teaching maths and science.

            I was surprised when you asked why I would not want something I choose to practice imposed on schoolchildren, on employees, on psychiatric patients…..

          • Out,
            Thanks for your response. I guess we can agree to disagree. The way mindfulness is practiced and taught in the West seems to be secular, so I’m not sure what faith it’s directly connected to?

            And can you clarify what problems arise from mindfulness? I am serious about wanting to understand where you are coming from. The main downside I’ve seen to mindfulness for people is that it requires such a shift in how one relates to oneself and the world, and this is very challenging. Many clients tell me that they are uncomfortable with the idea of taking a nonjudgemental stance towards themselves, as they have been taught for their entire lives that they are worthless. So these messages have been internalized. We also tend to judge certain emotional states as good or bad, and mindfulness is difficult because it teaches something radically different–that emotions are neither good nor bad. They are just temporary states of feeling.

          • I think mindfulness can also be misunderstood by practitioners who don’t practice it themselves. There are a lot of different forms of meditation, for one thing. Some people have a very hard time sitting still and closing their eyes, as it may bring up flashbacks or anxious feelings. There are moving meditation forms like Tai Chi that can be employed for people who find the sitting forms difficult. There are also often arbitrary timeframes attached, rather than allowing each person to figure out how it works best for them personally. I also find it diminishes the power of mindfulness meditation when it is only recommended as a “treatment” for “symptoms of mental illness.” It can be and should be MUCH more than that. It is an opportunity to get in touch with deeper personal truths, and it can require a sensitive leader to make it safe for such truths to find the light of day. It’s not just a “skill” like deep breathing, but it is often taught that way, in my observation.

            I’d love to see mindfulness presented in the full context of Buddhism and an Eastern philosophical world view. Of course, the Eastern worldview completely conflicts with and threatens the Western psychiatric theories of the primacy of the body and the brain, so it is unlikely that we will see this kind of shift any time soon.

          • Oldhead, what is primary in this interchange then?

            Ideally, MIA is about sharing ideas and perspectives. That is what I am trying to do. I am here because I want to learn, but also to advocate for what I believe (like mindfulness). I’m not here to tell you or anyone else what they want to hear.

          • To ‘Out’: mindfulness is NOT a faith-based belief system. It did originate from Buddhist teachings – however as Kabat-Zinn himself has said, “the Buddha was not a Buddhist.” What the Buddha did was to comprehensively explain and describe the mind (consciousness). If you read some of my earlier comments (that you can access by clicking my username – BTW, I probably have directly addressed you as well! – unless there’s another “out”!), you will be able to understand how ‘scientific’ mindfulness is.

          • Hi Nancy99,

            Where I’m sitting right now I have Kabatt-Zinn’s “Full catastrophe Living” on my bookshelf a couple of feet away from me.

            I feel very weary of this debate. Kabatt-Zinn, doesn’t describe himself as Buddhist, but his reasoning comes down to semanatics and I find it disingenuous. This is a powerful worldwide movement and i have a lot of reservations about it.

            As to the “science”, yes there is evidence of benefit, but the claims go way beyond the evidence, and the data coming in, especially from those with no ‘horse in the race’ is more mixed.

            I’m glad you find benefit. I do too.

          • Out: Can you give me a few specific examples of things that Kabatt-Zinn says that has led you to conclude “his reasoning comes down to semanatics and I find it disingenuous”? You can give me page numbers from the “Full catastrophe Living” book, since I have this book with me too.

            Regarding the “science” of mindfulness – the evidence does not have to come through outcomes of interventions, because several factors (such as the skills of teachers, mode of delivery) can play a role in the effectiveness of interventions. You need to remember that science is also about developing theory, and refining theory. When considering mindfulness practices, we know that our minds naturally tend ruminate a lot (about fears, worries, regrets, etc., along with repetitive thoughts – and this is something that can be directly observed), and mindfulness practices are extremely beneficial to gradually overcome this habit.

            This is especially important considering that many studies have shown rumination is a transdiagnostic risk factor (i.e., having the same underlying mechanism) for the development of various mental health issues. Studies have also shown that mindfulness practices are capable of reducing rumination, and cultivating mindfulness also appears to bring about beneficial structural changes in the brain. All this is additional scientific evidence.

          • Hi Nancy 99.
            Kabatt Zinn lives the buddhist faith, he just eshews the label and instead calls it ‘science’.

            To give you a bit of context that might help you understand where I’m coming from – I used to be a member of a Buddhist faith community. as far as I’m aware, ony the Roshi called himself a Buddhist. Faithful pracitioners who followed the Dharma and every aspect of the faith had a strange insistence on saying that they were not Buddhist. This included health professionals, including some who were deriving income from utilising aspects of that faith as ‘medicine’ – effectively selling it as medicine or ‘science’.

            I found this, as with Kabatt-Zinn, uncomortably dishonest. I don’t have a problem with anyone practising a faith, but there are aspects of the ‘movement’ which I find disingenous and troubling.

          • Out: this might surprize you, but Buddhism is a “science” – it is the science of the mind (consciousness). I also attend a Buddhist meditation centre (Western) and I have often wondered where the “religion” is in Buddhism. Of course there are rituals like offering flowers and incense (all of which by the way have reflective meaning), but don’t forget that even in modern society, various rituals (i.e., established, ceremonial acts or features) are often carried out for example at weddings, graduation ceremonies, funerals, etc., (that help create community and mutual support). Even shaking hands and saluting are rituals.

            Regarding Kabat-Zinn, I have often felt that he is very honest. So, if you think he is dishonest, you would need to show me some good evidence! In a recent youtube video that I watched, he says he doesn’t call himself Buddhist because different people interpret the term “Buddhist” differently and some people may feel offended if he uses this label.

            In that youtube video, he also says that ‘the Buddha was not a Buddhist,’ which makes a lot of sense to me. The Buddha explained consciousness, without making the assumption that the brain has to be included in all explanations of consciousness, which as we know seem to be an obsession that almost all scientists have nowadays.

          • Oldhead, what is primary in this interchange then?

            Since I have been asked an unsolicited direct question I suppose it’s ok to answer.

            The secret word is Ego.

    • I don’t think anyone’s offended by the concept of mindfulness. I think some may be offended by efforts to “monetize” mindfulness as part of a manualized program of “treatment,” rather than seeing it as a spiritual practice emerging from an Eastern philosophical view that would be very inconsistent with both the Western “mental health” system and with the profit motive.

    • Go ahead laugh, and stay there for a moment, free of the chains of ideas.. And If you have really changed then you can drop it… Just drop it for awhile…And if you have really changed,it won’t matter …But if it does your ideas are just drugs…As buddha said, thought coverings…nothing is harder to take than a naked mind free of ideas….But that is real meditation.

  4. This is surely coming, here in the 21st-century paradigm shift, away from living in our heads. I suspect that soon enough, the realization will dawn in education systems around the globe, that filling young mind’s with more and more knowledge is not enough.

    And that teaching the revelations of New Testament Neuroscience Revelations on the Human Condition, is very important, especially in that period when people experience the second major growth spurt in brain growth, after the first three years of life.

    Do they, somewhere teach mindfulness of one’s infant sixth sense, I wonder. Or, as most practice in the West, do they teach a pseudo form of mindfulness that keeps the individual trapped in thought, unable to answer the Sage question:

    Where are You, between two thoughts?

    Please consider this excerpt from a paper on Yoga, Wisdom and How to Feel the Inner qualities of Being Human:

    Yoga Therapy and Polyvagal Theory: The Convergence of Traditional Wisdom and Contemporary Neuroscience for Self-Regulation and Resilience.

    Yoga therapy is a newly emerging, self-regulating complementary and integrative healthcare (CIH) practice. It is growing in its professionalization, recognition, and utilization with a demonstrated commitment to setting practice standards, educational and accreditation standards, and promoting research to support its efficacy for various populations and conditions.

    However, heterogeneity of practice, poor reporting standards, and lack of a broadly accepted understanding of the neurophysiological mechanisms involved in yoga therapy limits the structuring of testable hypotheses and clinical applications.

    Current proposed frameworks of yoga-based practices focus on the integration of bottom-up neurophysiological and top-down neurocognitive mechanisms. In addition, it has been proposed that phenomenology and first person ethical inquiry can provide a lens through which yoga therapy is viewed as a process that contributes towards eudaimonic well-being in the experience of pain, illness or disability. In this article we build on these frameworks, and propose a model of yoga therapy that converges with Polyvagal Theory (PVT).

    PVT links the evolution of the autonomic nervous system to the emergence of prosocial behaviors and posits that the neural platforms supporting social behavior are involved in maintaining health, growth and restoration. This explanatory model which connects neurophysiological patterns of autonomic regulation and expression of emotional and social behavior, is increasingly utilized as a framework for understanding human behavior, stress and illness.

    Specifically, we describe how PVT can be conceptualized as a neurophysiological counterpart to the yogic concept of the gunas, or qualities of nature.

    Apologies to the choir for going off script and introducing something new.

    But honestly, the only thing I’m trying to sell you here is the inner nature of you.

    • Thank you for sharing your insights. PVT is integral to my use of EMDR with clients. Many of us are in a constant state of increased arousal due to trauma. I personally think mindfulness is one tool that people can use to tap into their parasympathetic nervous system, which is key for social engagement and increasing positive emotions.

      • Hi Shaun, PVT was key to my increased self-awareness that l am my mind, as Tolle puts it. Mindfulness in my experience of meditation in Buddhist tradition, is a confusing term that deflects from the felt sense intention of this body oriented exercise that has traditionally been a self-inquiry into the nature of Mind, as the Dali Lama suggests.

        My own practice is better defined as a mind-less focus on the muscular tensions and vascular pressures that help energize my thoughts, my mind.

        Through this perspective of my mind as a form of energy, l shift my sense of self away from my mind as a product of memory and the notion that l know myself because l know words & numbers.

        Socrates was suspicious that words imprison self-knowledge by creating static impressions of our own reality. My brain, my heart, my lungs, etc. And the conceptual sense of our experience of experience, is trapped in an analogous use of terms that don’t actually fit our inner reality.

        Terms that are mostly mechanistic, like the image of brain as composed of machine cogs. While the recent turn to cybernetics as a self portrait analogy, seems to suggest we modular in constitution, with the brain being compared to a computer CPU.

        No wonder Laing said we are bemused and crazed creatures, strangers to ourselves and each other. And that he nailed the normal self-deception by saying we all in a post-hypnotic trance induced in early infancy.

        Stuck inside our heads, assuming we perceive reality because we can name & number it.

  5. Apologies to Jessica too for not mentioning her efforts in this wonderful article on the importance of adolescence, and that age which is described as a time when summer nigh, in the New Testament parable of the human condition.

    I’m sure she is familiar with The Polyvagal Theory and its impact on trauma-informed care for people suffering a subconscious nervous response to life’s most difficult experiences. To clarify, for those who care to take the time to read and digest, meditating upon such knowledge in a visceral way. Please consider an excerpt from an academic paper, now a chapter in a book:

    The Infant’s Sixth Sense: Awareness and Regulation of Bodily Processes

    Life is a sensory experience. During every moment of our lives, we experience the world through our varied sensory systems. Sensory experiences drive our behavior and contribute to the organization of our thoughts and emotions. Immediately after birth, the infant is bombarded with a variety of new sensory stimuli. These provide important information about the characteristics and potential demands of the baby’s new environment. The infant must immediately detect, discriminate, and adapt to this information. Successful adaptation to the rapidly changing environment and the ability to cope with changing demands depend on the infant’s ability to detect and interpret sensory information. Thus, when we study infant behavioral patterns, vocalizations, and physiological reactivity, we attempt to understand how the young infant uses sensory systems to detect information from the environment and to integrate this information into motor, affective, and cognitive schema to successfully interact and adapt to a changing environment.

    We have learned that humans have five primary sense modalities: smell, vision, hearing, taste, and touch. We know that even a newborn can respond to these sensory modalities. These responses are obvious to the parent and clinician (although only a few decades ago, scientists were unaware of the sensory capacities of young infants). However, this traditional method of categorizing sensory information does not account for the vast amount of sensory information being conveyed to the brain from the numerous sensors located inside our body. Even current clinical models of infant regulation (e.g., Ayres, 1972; Greenspan, 1991) that emphasize the importance of sensory processing in the emotional and cognitive development of the infant, and individual differences among infants in the ease with which they detect and interpret sensory information, focus primarily on three sense modalities that describe the external environment— that is, touch, vision, and hearing. These models do not deal with internal sensations that provide information about the physiological regulation.

    Although neurophysiologists and neuroanatomists describe sensory systems that regulate our internal organs, this research has had little influence on either our common language or the clinical terminology we use to describe bodily processes. At present, there are only a few easily understood descriptors that characterize internal senses and states— for example, pain, nausea, and arousal. Yet in spite of this linguistic handicap, our experiences provide us with an awareness of bodily sensations and an appreciation of how these sensations can contribute to mood state and psychological feelings.

    Missing from our language and our science is the ability to describe internal states. In our day-to-day interactions we choose vague terms, such as “feelings,” to describe the psychological consequences of bodily changes. Behavioral scientists often attempt to objectify these terms by operationalizing concepts such as state, mood, and emotion with verbal reports and elaborate coding systems. Clinical practitioners infer these feelings and use terms descriptive of emotional tone. However, whether we are talking about feelings, emotions, states, or moods, we are always attempting to describe the internal states that are continuously being monitored and regulated by the nervous system. The goal of this chapter is to introduce an additional sense modality that monitors bodily processes. A variety of terms may be used to describe this sensory system. Classic physiology describes this sensory system as interoception. Interoception is a global concept which includes both our conscious feelings of and unconscious monitoring of bodily processes, Interoception, like other sensory systems, has four components:

    1. Sensors located in various internal organs to “sense” internal conditions;
    2. Sensory pathways that convey information to the brain regarding the internal conditions;
    3. Brain structures to interpret sensory information and organize systems to respond to the changing internal conditions; and
    4. Motor pathways that communicate from the brain back to the internal organs that contain the sensors to change directly the state of the internal organ. Brain structures evaluate interoceptive information, categorize it, associate it with other sensory information, and store the associations in memory.

    Best wishes to all, and I apologize again for appearing to be off topic and off script.

    Although, I do feel its important to try and value-add comments and not just opine.

  6. I’m just going to throw this in here.
    I’m guilty of causing tangles with this, but is there a way we could sort out the threading problem in the comment threads? It can be really hard to follow discusssions. Is there a solution I’m not seeing?

    It seems to be easier to follow conversations via the email feed because even though it’s not clear what comment someone is responding to, threading by time alone seems more coherent when conversations get complicated.

  7. I agree with your comments shaun f. I think anyone can either directly benefit from mindfulness practices, or if they learn the techniques, that can benefit them sometime in the future. Also I am not sure why people are talking about ‘coercion’ in the comments – the article doesn’t even mention that children are being forced to practice (or perhaps I missed something). Usually kids are encouraged to do these practices in a fun-filled way – I had extracted the following sometime back:
    “Children may be told that thoughts pass through the mind like floats pass by in a parade; some of the floats (thoughts) may grab their attention more than others, but just as they would not jump onto a float at a parade, they can simply observe their thoughts as they occur.”

    Reference: Zelazo, P. D., & Lyons, K. E. (2012). The potential benefits of mindfulness training in early childhood: A developmental social cognitive neuroscience perspective. Child Development Perspectives, 6(2), 154-160.

    • I was not referring to the article, but to comments I’ve heard from system users/survivors, who have been told that they “need to practice mindfulness” as a part of their program (usually DBT). I was pointing out the ironic fallacy of such an approach, not downing mindfulness in general. Mindfulness meditation is very powerful and something I have practiced over many decades. I fully encourage anyone to explore it, but only from a self-determined position. One person I know was totally turned off to the concept of mindfulness and meditation in general by being forced to do it as part of a program. I find this kind of outcome very sad, as I know the benefits when it is allowed to unfold properly instead of dealt with by force or manipulation.

      • Thank you for the clarification, Steve McCrea. Regarding your other comment (relating to Eastern worldviews conflicting with Western body/brain views) – this issue boils down to two very different epistemologies (ways of knowing). In other words, these two views do not conflict, but represent two very different ways of understanding ourselves and the world.

        • I think that’s a good way of putting it. Unfortunately, it is a very common human attribute to consider one’s own worldview to be the “right” way. It’s encouraging that mindfulness has spread as a practice to help folks survive better in their lives, and I fully support that effort. However, I do think a great deal is lost when the practice is divorced from its roots in observations on the nature of the ‘self’ and the ephemeral nature of physical reality.

          And I most definitely object to it becoming a “required curriculum” for those who have not chosen to explore it, though I suspect we are on the same page on that point.

          • I agree Steve McCrea. Also, I think people who offer mindfulness programs should perhaps also offer yoga and tai chi classes for those who feel that they are not yet ready for mindfulness. Even exercises done mindfully appear to be quite effective (as suggested by recent studies). As people engage in these other practices, people need to be told that they are welcome to engage in mindfulness practices whenever they feel ready to do so.

            Buddhist teachings also offer various entry points to meditation as discussed in the ‘four foundations of mindfulness.’ I also think loving-kindness meditation can also go a long way to gradually make someone receptive to standard mindfulness practices. Studies also show that loving-kindness meditation by itself can also be quite powerful (I think they can be especially beneficial for children).

    • Thank you Nancy for adding your thoughts to the conversation. You articulately pointed out why I think mindfulness can be useful.

      Steve, the clients who volunteer for the DBT programs at my clinic are never told “you need to do your mindfulness.” While I’m sure this message gets conveyed elsewhere, it is ridiculous to demand anyone do anything. It is certainly counter-therapeutic and doesn’t actually increase the likelihood that the “skill” will be practiced more regularly. The truth is that for mindfulness to be effective for anyone, they probably need to practice this for years if not decades. DBT superficially addresses mindfulness in the sense that coming to a group once a week isn’t likely going to lead to substantial change for the individual in this regard.

      • It appears we would agree on this point. I was actually quite shocked to hear the first time that any kind of enforcement was applied to mindfulness, but since hearing this the first time, have heard from others who verified that it happened to them as well. I think it comes from not really understanding what mindfulness meditation is all about. It is, indeed, a practice that takes a lifetime to fully develop, and I can’t claim to be much more than an amateur, despite years of practice. I’ve just never put in the length of time daily to accomplish the fuller benefits. But it is still a go-to place when I get to feeling crappy about something, about anything, really. It’s a lot more than a “coping skill” to me.

        • Anything can be reified however, or turned into a dogma. What some might call “mindfulness” others may do without even thinking about it as something special, just part of how they relate to the universe. Sort of in the sense that zen is a principle or way of living, and has little to do with archery or flower arranging per se.

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