In the Matrix movies, there are those who famously opt to take the ‘red-pill’ and discover that they are living inside a computer simulation of the world, while those who take the ‘blue-pill’ continue to live in blissful ignorance. Hollywood hyperbole aside, could the Matrix really contain a glimmer of truth? In recent years, neuroscientists have started to believe that we do indeed live inside a simulation, albeit one created by the brain rather than an alien computer. And this has profound implications for our understanding of the origins of thoughts, feelings and emotions but also for many mental health problems too.
The New Psychology of the Mind: Predictive Processing
It takes an enormous amount of mental energy to become conscious of the present moment. This is because of the vast amount of information flowing in from our senses, all of it needing to be co-ordinated and integrated so that we can become not only conscious of the world but also make decisions and act upon them – in real time – in the present moment. Given the complexity of the task, you would expect this to make everything – from walking along a crowded street to such simple things as catching a ball – extremely difficult. But nature has got around the problem by giving us a brain that predicts the future. It constructs a ‘simplified’ model of the world that is constantly updated and enriched by information from our senses. What we regard as the present moment is actually a stunningly realistic illusion created by the mind. An illusion so compelling that we mistake it for reality. It is called a simulation and the process it relies upon is known as ‘predictive processing’[i].
Predictive processing works by constantly ‘guessing’ what information the senses are about to send to the brain. We do not truly see the world; we see what our minds think the world is about to look like. Nor do we truly hear, but instead experience the sounds that the mind believes are about to hit our ears. And the same is true for our other senses, too. The mind predicts what we are about to taste, feel and smell. And in practice, it is this prediction – or simulation – that we experience, rather than the ‘real’ world.
As you can imagine, this is a fantastically complex process, but a simple analogy helps: if you are talking about politics in the UK and someone mentions the Houses of P . . . you can guess what’s coming next (the word ‘Parliament’). Because you have predicted the word, you don’t need to listen to the word itself. You can instead use that moment to capture the meaning of the whole sentence. Such predictions make perception and responses more fluent because the world is normally predictable. As explained above, we don’t create a prediction for one single sense but for all of them. Simultaneously. We construct a global model that incorporates sights, sounds, smells, tastes and sensations. This model is constantly updated, moment by moment, and incorporates any deviations from the real external ‘reality’; we move through the world creating and updating – predicting and checking – it. And if our checks show that we have made an error (like when we approach a door and pull on the large handle rather than pushing on it), we simply begin to pay more attention to the actual stream of data arriving from our senses. Any necessary corrections are then built into the model.
The brain also stores core experiences ready for re-use in the simulation. Imagine you are walking through your local park on a lovely sunny day. You have been to the park countless times before, and know it in detail. You have seen the sun filtering through the leaves of the trees many times; you know how the grass looks and smells, the sounds made by the children on the swings, the dogs barking and the traffic in the distance. You know everything you need to know about the park in order to reconstruct a highly accurate simulation of it in your mind. And if there are a few gaps – well, the mind is perfectly capable of filling them in and constructing a seamless experience.
States of Distress Are Also Ones of Hope
It’s not just visits to a lovely park that are recalled from memory to prime your simulation. Distressing thoughts, feelings and emotions are, too. In fact, troublesome states of mind are the easiest to recall. This is because the mind tends to store the most salient experiences on a hair-trigger (along with your most potent thoughts, feelings and emotions). So in practice, the things most likely to be re-experienced in your simulation are the most negative ones. Such dark and amorphous emotions as anxiety, stress, anger and unhappiness are held at the front of the queue.
None of this means that your distress is exaggerated or untrue. If you feel sad, then you are sad. If you feel anxious, stressed, exhausted or angry, then you truly are experiencing such distress. Your predictions are true for you. Simulation is reality.
Painful though they are, these states of distress are also ones of hope. For they are not solid, real and unchanging. Your simulation can be ‘re-calibrated’ to better reflect reality. And you can do this using an ancient type of mindfulness known as vedana or feeling tone meditation (See Deeper Mindfulness: The New Way to Rediscover Calm in a Chaotic World). In these meditations, you are asked to still the mind with a simple breath or body meditation and then to focus, in a very specific way, on the feelings and sensations that arise in the moment that the unconscious mind crystallises into the conscious one. In this way, your simulation is progressively recalibrated and brought into closer alignment with reality. So you learn to experience the world as it truly is rather than one recreated from your darkest memories or deepest fears. Feeling Tone meditations progressively release the grip that such distressing states of mind hold over you. You come to realise that yes, sometimes life can be painful, but at other times it is glorious, too. So you come to experience life as an ever-flowing series of pleasant and unpleasant moments. Moments of keen reality. And it is in such moments, that you can genuinely start to live again.
And research is beginning to show that an eight week program based on these feeling tone meditations can be a highly effective treatment for anxiety, stress, and depression while also enhancing overall wellbeing.[ii] It might not be necessary to take a Red Pill to break free of a distressing simulation. Feeling tone meditations may be enough.
[i] For a review of this approach, see Andy Clark, Surfing Uncertainty: Prediction, Action and the Embodied Mind (Oxford University Press, 2016), Lawrence Barsalou (2008), ‘Grounded cognition’, Annual Review of Psychology, 59, pp. 617–45 and Lisa Feldman Barrett, How Emotions Are Made: The Secret Life of the Brain (Pan Books, 2017) and Manjaly, Z. M. & Iglesias, S. (2020), ‘A computational theory of mindfulness based cognitive therapy from the “Bayesian brain” perspective’, Frontiers in Psychiatry, 11, p. 404.
[ii] Williams, J.M.G., Baer, R., Batchelor, M. et al. What Next After MBSR/MBCT? An Open Trial of an 8-Week Follow-on Program Exploring Mindfulness of Feeling Tone (vedanā). Mindfulness13, 1931–1944 (2022). https://doi.org/10.1007/s12671-022-01929-0
This is a little taste of our new book Deeper Mindfulness. It’s the companion to Mindfulness: Finding Peace in a Frantic World (which has now sold two million copies and been translated into 34 languages).
‘This book walks you gently through the beautiful, messy process of being human, and teaches you how and why all can be well’Sir Kenneth Branagh.
Chapter One: That Was My Life … But I Must Have Missed It
Every morning, a man walked his four dogs in the park. Three of them always darted about, barking happily, tails wagging with delight. The fourth seemed happy enough but would only ever run around in tight little circles (albeit covering quite a distance), staying close to the man as he walked. Day after day, the park keeper watched the dog’s strange behaviour. After a while, the keeper plucked up the courage to ask the man why his dog was behaving so oddly.1
‘Ah,’ the man replied. ‘She’s a rescue dog. She was locked up for most of her life. That was the size of her cage.’
How often have you behaved like that dog? Free, but constantly running around in little mental circles. Free to be happy, yet caged by the same dark, repetitive thoughts. Free to be at peace with yourself and the world, while remaining trapped and entangled by anxiety, stress, unhappiness and exhaustion.
Free as a dog in a cage.
So much of life is needlessly marred by little tragedies such as these. Deep down, we all know that we are capable of living happy and fulfilling lives, and yet something always stops us from doing so. Just as life seems to be within our grasp, it slips through our fingers. Although such periods of distress seem to appear from nowhere, they actually arise from deeply buried psychological forces. Neuroscientists have begun to understand how these processes guide our thoughts, feelings and emotions; but more importantly, they have discovered why they occasionally go wrong and leave our lives as shadows of their true potential. These new discoveries also show why mindfulness is so effective at relieving distress, but crucially, they also open the door to subtly different methods that can be even more effective. Mindfulness has not been superseded; rather, it can be expanded to include an extra dimension that transforms it.
Our new book Deeper Mindfulness: The New Way to Rediscover Calm in a Chaotic Worldharnesses these developments. It will help you to step aside from your worries and give you the tools necessary to deal with anxiety, stress, unhappiness, exhaustion and even depression. And when these unpleasant emotions evaporate, you will rediscover a calm space inside from which you can rebuild your life.
We can help you to do this because we – and our colleagues at Oxford University and other institutions around the world – have spent many years developing treatments for anxiety, stress, depression and exhaustion. We co-developed Mindfulness-based Cognitive Therapy (MBCT), which has been clinically proven to be one of the most effective treatments for depression so far developed. Out of this work arose our book Mindfulness: Finding Peace in a Frantic World.That book, and the mindfulness programme within it, has been proven in clinical trials at Cambridge University and elsewhere to be a highly effective treatment for anxiety, stress and depression. So much so, that it is prescribed by doctors and psychiatrists around the world to help people cope with a wide range of mental health conditions, as well as generalised unhappiness and dissatisfaction with life.
But the practices revealed in Mindfulness, and similar skills taught on courses such as Mindfulness-based Stress Reduction (MBSR), are only the first steps on a longer and more fruitful road. Although they form the foundations for a happier and more fulfilling life, and have proven transformative for many, a lot of people have asked us whether there is anything more they could do to enhance their practice and resolve their remaining issues.
The answer is yes. There is a way of taking mindfulness to the next level, of going deeper and unleashing more of your potential, by exploring another frontier of mindfulness known as vedana or feeling tone. And, importantly, you don’t need to have extensive meditation experience to benefit from these practices. Research is showing that novice meditators can gain just as much from them as those who have practised for many years.
Although it is an often overlooked aspect of meditation, feeling tone is, in fact, one of the four original foundations of mindfulness. These are: mindfulness of the body and breath; mindfulness of feelings and sensations (or vedana); mindfulness of the mind or consciousness; and mindfulness of the ever- changing nature of the world and what helps and hinders your journey through it. Each aspect is cultivated using a different set of practices that, together, bring about profoundly different effects on mind and body. Mindfulness courses generally focus on the first layer of each of these four foundations. This book uses new meditations on feeling tone as a gateway into the deeper layers of the same four aspects of mindfulness. These take you closer to the source of your ‘spirit’; closer to any difficulties you may be having; nearer still to their resolution.
There is no satisfactory translation of the ancient Sanskrit word vedana.
It is a quality of awareness that can only be experienced, not pinned down with precision. It is the feeling, almost a background ‘colour’, that tinges our experience of the world – of mindfulness itself. For this reason, vedana is often translated as feeling tone. Although we will use both terms interchangeably, it will always pay to remember that we are referring to a flavour of awareness, and not a rigid concept that can be hedged in by words and definitions. Feeling tone is something that you feel in mind, body and ‘spirit’, but its true quality will always remain slightly ineffable. Sometimes annoyingly so.
A typical feeling tone meditation consists of stilling the mind with a simple breath or body meditation and then paying attention to your experiences in a manner that is subtly different to what other meditations request. It asks you to focus in a very specific way on the feelings and sensations that arise in the moment when the unconscious mind crystallises into the conscious one. Such moments, though fleeting, are often the most important ones in your life. This is because vedana is the balance point in your mind that sets the tone for the sequence of thoughts, feelings and emotions that follow. It is often subtle, but if you pay attention to it, you can feel it in your mind, body and spirit – right through to your bones. The feeling tone is of profound importance because it guides the trajectory of your subsequent thoughts, feelings and emotions. If it is ‘pleasant’, you will tend to feel positive, dynamic and in control of your life (at least for a while). If it is ‘unpleasant’, you will likely feel slightly gloomy, deflated and powerless. Feeling tone meditations teach you to see, or more precisely, to feel the way that your life is pushed and pulled around by forces you are barely conscious of. Sometimes these forces act in your best interests, sometimes not – but the important thing is that they are not under your immediate control. Under their influence, your life is not your own.
To help these ideas settle into your mind, you might like to try this little practice to get a sense of your feeling tones: if it is convenient, take a few moments to look around you; the room, the window, the interior of your train or bus, or perhaps the street, field or forest before you. As your eyes alight on different things, or different sounds come to your ears, see if you can register the subtle sense of whether each one feels pleasant, unpleasant or neutral. If you are at home, your eye might alight on a card, gift or memento from a much-loved friend. You might feel the instant warm glow of a pleasant feeling tone in response. Or you might see a dirty dish that you’ve been meaning to tidy away, or something you’ve borrowed from someone and had intended to return, and then you might notice an unpleasant feeling tone. If you are outside, you may notice the sun streaming through the leaves of a tree, or a piece of dirty plastic rubbish flapping around. If you can catch the moment, you might sense ripples of pleasant or unpleasant feeling tones. But it is not just the external world that has such an impact. You may also become aware of sensations inside your body, such as aches and pains, or perhaps a sense of relaxed calm. These, too, register on the same dimension of pleasant, unpleasant or neutral. And sooner or later, you may notice thoughts or emotions arising and passing away soon after the feeling tones.
You don’t need to know how you know these feeling tones – you just know. Somehow there is a ‘read-out’ in body and mind on the dimension of pleasant to unpleasant. It’s like a gut feeling. It’s not a matter of thinking hard about it, or hunting for it, it’s more like the taste of something; you just know it when you taste it. Like tasting milk that’s gone sour, you know it’s unpleasant without having to think about it.
Feeling tones can be hugely significant. Cast your mind back to the last time you were sitting in a café and suddenly felt unhappy for no apparent reason. If you could rewind the clock and observe what was happening – frame by frame – as your unhappiness arose, you would have noticed that the emotion was preceded by a momentary pause. It was as if your mind was poised on a knife-edge, a moment when it was sensing whether the evolving situation was pleasant, unpleasant or neutral. A moment of vedana.
So vedana is often a tipping point in your mind that affects how you experience the world in the moments that follow. Good, bad, indifferent. But it is what happens next that is of paramount importance – we call it ‘the reactivity pulse’. It works like this: if a pleasant feeling tone arises in the mind, then it is entirely natural to want to grasp it, keep hold of it and be a little fearful that it will fade away or slip through your fingers. If the tone is unpleasant, then it is natural to want to get rid of it, to push it away, fearing that it will stick around for ever and never leave. Neutral sensations often feel boring, so you feel like tuning out and finding something more interesting to do. These feeling tones are primal and can quickly trigger a cascade of reactions in the mind and body. These are felt as emotions and cravings that compel you to try to keep hold of pleasant feeling tones, push away unpleasant ones and distract yourself from neutral ones. So, the reactivity pulse is the mind’s knee-jerk reaction to feeling tone. If a feeling tone sets the scene, then the reactivity pulse casts the actors, selects the costumes and writes the script for what happens next. And it can write a script and direct a scene that can easily ruin your whole day and sometimes far, far, longer.
Virtually all of the emotional difficulties that many of us experience begin with the mind’s reaction to our feeling tones – our reactivity pulse. But it’s not even the pulse itself that is the problem, but our ignorance of its existence and underlying nature. We are often not aware that it has occurred, oblivious of the feeling tone that triggered it and unaware of its tendency to fade away, all by itself, if only we would allow it to do so. All we are aware of is the cascade of thoughts, feelings and emotions that follow in its wake.
Learning to sense the feeling tone – bringing it into the light – teaches you to recognise your underlying state of mind and helps you make allowances for your sensitivities and entirely natural biases and reactions. It gives you the space to respond rather than react. It helps you to compassionately accept that although you might be anxious, stressed, angry or depressed in this moment, this is not the totality of your life with only one depressing future ahead of you. You can change course. Alternative futures are available to you.
And tapping into an alternative future is as simple as sensing the underlying flow of feeling tones. Noticing the reactivity pulses. Realising that the craving for things to be different is the problem. Craving an end to unpleasantness. Craving for pleasantness to remain. Craving an end to boredom. This idea is common to many ancient traditions. And now, neuroscience agrees.
CAN OUR NEW BOOK HELP YOU?
Our previous book, Mindfulness: Finding Peace in a Frantic World, became the ‘go-to’ book for so many people because it helped them find freedom from their emotional and physical suffering. Throughout the book, we were honest about the benefits of mindfulness, and also warned readers that their journey would not be quick or particularly easy. We asked them to be certain that they were at the right moment in their life to begin, and highlighted that they would need to set aside the necessary time each day to actually do the practices. Despite these caveats, hundreds of thousands of people – perhaps millions – completed the programme in the book (or mindfulness courses based upon it). Many of these people became so intrigued by the effects of meditation on their lives that they wanted to broaden and deepen their practice. Perhaps you are one of them. If you, like them, would like to go beyond the eight-week programme taught in Mindfulness, or on your meditation, MBCT or MBSR course, and extend your practice to embed its benefits, this book is a good place for you to begin.
Alternatively, you may have found Mindfulness, or a course, helpful but it did not go far enough to completely dissolve your remaining negative or self-destructive habits. Perhaps you caught a glimpse of freedom but then lost it once again in your rush through life and now want to renew your acquaintance with it. Or, maybe, the mindfulness skills you learned on courses or through books didn’t quite ‘gel’ with you and you now want to try a different approach. If any of these is true for you, then this book will likely help you.
In Deeper Mindfulness, and the accompanying meditation downloads, we reveal the Feeling Tone programme. This is not simply a sequel to our original book, or to other meditation courses and classes; rather, it is one that will take your practice in a new and even more fruitful direction. And if you don’t have any meditation experience, there is no reason to be put off. The programme has been found to be equally helpful for both novice and experienced meditators, especially for those seeking a practice that combines scientific rigour with millennia-old wisdom.
Why cultivate awareness of the feeling tone of your thoughts, memories and emotions?
Your thoughts, feelings, memories and emotions are not the problem, no matter how unpleasantly real and visceral they might feel. As an example, emotions are signals that something important needs our attention:
We feel sad if we’ve lost something or someone important.
We feel fear when a threat appears on the horizon.
We feel angry when a goal is thwarted.
We are preoccupied when a long-term project needs our problem-solving skills.
In many ways, the real problem is the reactivity pulse, triggered by fluctuations in the underlying feeling tone. This creates a narrative so compelling that we can get stuck inside our thoughts, feelings, emotions and memories and can’t escape.
Learning to sense the feeling tone that precedes this reactivity pulse gives you extra information. It signals to you the very moment when your thoughts, feelings, emotions or memories are likely to seize control, become entangled and spiral out of control. This programme teaches you how to recognise these moments so you can step in and dissolve your old, destructive habits. It will help you rediscover the calm, vigour and joy that lie at the core of your being.
1) Adapted from Into the SilentLand by Martin Laird.
Mindfulness is a powerful painkiller that can dramatically enhance quality of life in chronic pain sufferers, suggests new research. The findings add weight to previous studies which discovered that mindfulness can reduce pain severity by around 50 percent.
This new meta-analysis, published in the peer-reviewed journal Evidence Based Mental Health, analysed the evidence from 21 previous studies involving 2,000 chronic pain sufferers. It was designed to assess whether mindfulness was as effective as Cognitive Behavioural Therapy (CBT) for relieving chronic pain and its associated distress. CBT can be effective and has none of the side-effects of traditional painkillers such as lethargy and addiction. But, crucially, not everyone benefits from CBT.
Most of the participants in this new analysis were women aged between 35 and 65 and suffered largely from musculoskeletal pain. In nearly 40 percent of the studies, participants had endured their pain for more than a decade.
This new analysis suggests that mindfulness is just as effective as CBT when it comes to improving ‘physical functioning’. And both mindfulness and CBT were equally good at reducing pain and its associated conditions such as depression.
Dr Wei Cheng, lead researcher on the study carried out at the Ottawa Hospital, Ontario, Canada, said: “While CBT is considered to be the preferred psychological intervention for chronic pain, not all patients experience a clinically significant treatment response.
‘Although a number of recommendations have been proposed to improve CBT for patients with chronic pain, an additional solution may be to offer patients Mindfulness-Based Stress Reduction since it shows promise in improving pain severity and reducing pain interference and psychological distress.’
Previous work has shown that mindfulness meditation is highly effective at directly relieving chronic pain and also reducing the distress it causes. For example, work carried out by Fadel Zeidan at the Wake Forest Baptist Medical Centre in North Carolina discovered that mindfulness can reduce chronic pain by 57 percent. Accomplished meditators can reduce it by over 90 percent.
Dr Zeidan said: ‘Meditation produced a greater reduction in pain than even morphine or other pain-relieving drugs.’
A typical meditation involves focusing on different parts of the body and simply observing with the mind’s eye what you find. This allows you to see your mind and body in action, to observe painful sensations as they rise and fall, and to let go of struggling with them. And when you do this, something remarkable happens: your suffering begins to melt away of its own accord. It also creates a relaxed state of mind that reduces the level of stress hormones in the body. Such deep relaxation enhances healing and boosts mental and physical health.
Imaging studies show that mindfulness soothes the brain patterns underlying pain and, over time, these changes take root and alter the structure of the brain itself, so that patients no longer feel pain with the same intensity. Many say that they barely notice it at all.
For these reasons, hospital pain clinics now prescribe mindfulness meditation to help patients cope with the suffering arising from a wide range of diseases such as cancer (and the side effects of chemotherapy), heart disease, diabetes and arthritis. It is also used for back problems, migraine, fibromyalgia, coeliac disease, chronic fatigue, irritable bowel syndrome and even multiple sclerosis.
You can download free meditations from You Are Not Your Pain/Mindfulness: A Practical Guide to Relieving Pain, Reducing Stress and Restoring Wellbeingfrom here.
Mindfulness training significantly enhances the performance of elite US special forces, a new study has discovered. Even the simplest of mindfulness exercises were shown to enhance working memory, clarity of thought, and the ability to focus under extreme pressure.
‘Previous studies have found that mindfulness protects against the deterioration in cognitive performance during periods of high stress to help special forces sustain their performance and well-being over time,’ said Dr Amishi Jha, a Psychologist at the University of Miami and lead researcher on the study.[i] “Yet here, in a population already known for their peak cognitive ability, we found that mindfulness training may be able to enhance cognition, even under periods of high stress.’
Psychologists have known for many years that mindfulness meditation reduces anxiety, stress and depression. Scientific studies have shown that mindfulness not only prevents depression, but that it also positively affects the brain patterns underlying day-to-day anxiety, stress, depression and irritability so that when they arise, they dissolve away again more easily. Other studies have shown that regular meditators see their doctors less often and spend fewer days in hospital. Memory improves, creativity increases, and reaction times become faster (see https://franticworld.com/what-can-mindfulness-do-for-you/).
It is so effective that mindfulness meditation is now recommended for the treatment of anxiety, stress and depression by the UK’s National Health Service, many US Hospitals, and other healthcare systems around the world. Mindfulness seems to be particularly effective for relieving the worst forms of depression. Indeed, one programme – Mindfulness-Based Cognitive Therapy (MBCT) – is recommended for the most severe forms of depression by the UK’s National Institute for Health and Care Excellence, which evaluates treatments for the NHS.
In recent years, researchers have begun investigating whether mindfulness can also enhance mental performance rather than merely relieving suffering. In this recent study, Dr Jha and her colleagues wanted to see whether mindfulness could enhance the already formidable mental performance and resilience of elite special forces. To this end, the study followed 120 of the US Special Operations Forces for two months to see whether mindfulness training could help improve their working memory and ability to focus under extreme pressure.
The warriors (special forces dislike being called ‘soldiers’) were taught four different mindfulness meditations over either two or four weeks and asked to practice them for 15 minutes a day for eight weeks. Classroom sessions were used to both teach the meditations and explain their underlying logic. The control group received no training. Each session in the course, known as Mindfulness-Based Attention Training (MBAT), introduced a corresponding mindfulness exercise. They were first taught a simple Breathing meditation. In this, participants were asked to focus on their breathing and to return their attention to the breath each time they realised that their mind had wandered (you can listen to a similar one here: https://franticworld.com/aob/ They were then taught a guided Body Scan. This involved paying attention to the sensations in their body without making any value judgements about them by, for example, describing them as ‘painful’ or ‘pleasant’. You can listen to one here: https://franticworld.com/free-meditations-from-mindfulness/ Two other meditations were also taught. The Open Monitoring meditation involved expanding the field of awareness beyond the breath and noticing the rising, changing, and passing away of sensory and mental phenomena (e.g. sounds, body sensations, or thoughts). The final meditation, known as the Connection exercise, asked the warriors to express kindness and feelings of ‘connectedness’ towards themselves and to others.
Before and after the training, the soldiers’ ability to pay attention under pressure was measured using a computer-based task that required them to respond to numbers on a screen. To test working memory, they were presented with complex visual information (e.g., faces) to remember for short intervals while being bombarded by distracting negative images. The researchers then tracked the changes as they progressed through the course.
Jha’s team also wanted to see whether the benefits of mindfulness followed a ‘dose-response’ relationship, that is, more practice conferred a greater benefit than did less. To test this, they delivered two and four week versions of the course.
‘The two-week training was the shortest we have ever offered,’ said Dr Jha. “And we found that two weeks is too short. The bigger benefits come with the four-week MBAT programme, which resulted in significant improvements to both attention and working memory task performance.
‘In addition, we found that just like physical activity, the more time that participants engaged in daily mindfulness exercises, the more their working memory benefitted.’
‘Because these soldiers are required to do the most difficult and cognitively demanding tasks under extreme conditions, we want them to have the maximum amount of attention and working memory to succeed at those tasks,’ said Jha. ‘We found that after four weeks of mindfulness training, they may well be more capable of dealing with the humanitarian, environmental, and security challenges that our country and the world face.’
Mindfulness is garnering increasing support within the US military. Lt. Gen. Eric Shoomaker, M.D., 42nd Army Surgeon General and former commanding general of the U.S. Army Medical Command said: ‘Dr Jha and her colleagues have demonstrated that mindfulness training may provide the best prospect for success in demanding work. As more people are engaged in critical roles and tasks in which attentiveness and working memory play key roles in ensuring safety… mindfulness training is emerging as a powerful tool.’
Dr Jha believes that anyone who needs to perform for sustained periods at the highest of levels will benefit from mindfulness. But it is not just the likes of firefighters, police officers, athletes, trauma surgeons, nurses, and judges who might benefit says Dr Jha.
‘Mindfulness training may also help in stressful everyday moments by strengthening those cognitive capacities that get readily depleted when the mind is hijacked by anger, fear, worry, and rumination.’
i) Mindfulness training as cognitive training in high-demand cohorts: An initial study in elite military service members; Anthony P.Zanesco, Ekaterina, Denkova, Scott L.Rogers, William K.MacNulty, Amishi P.Jha; Progress in Brain Research; https://doi.org/10.1016/bs.pbr.2018.10.001
One in seven people will suffer from tinnitus at some point in their lives and yet its causes are unknown and treatments are only partially effective. A new clinical trial highlights the remarkable promise offered to sufferers by Mindfulness-Based Cognitive Therapy.
If you have ever suffered from tinnitus, you will understand what a surprisingly distressing condition it can be. It can lead to anxiety, stress, depression, insomnia and impaired hearing and concentration. Its medical definition of ‘the sensation of hearing sounds in the absence of any external sound’ barely reflects the impact it has on day to day life.
I suffered from tinnitus for several years and it still returns from time to time. I managed to control the condition using Cognitive Behavioural Therapy (CBT) and mindfulness. I was taught CBT at hospital where it was called Tinnitus Retraining Therapy and I used my own mindfulness sessions to enhance its effect. And I found it surprisingly effective. The tinnitus in my right ear disappeared completely. Some ringing returns to my left ear from time to time, but it no longer bothers me.
Nor is my experience an isolated case. New research shows that mindfulness can have a big impact on tinnitus. Dr Laurence McKenna of University College London Hospitals NHS Foundation Trust and Dr Liz Marks of the Department of Psychology at the University of Bath, have found that Mindfulness-Based Cognitive Therapy (MBCT) can help sufferers far more effectively than the relaxation-based treatments currently taught by many tinnitus clinics.
Dr Marks’ team compared MBCT to relaxation therapy, the normal treatment for people with chronic tinnitus, to determine if MBCT was a better option.
“In total, 75 patients took part in the trial at UCLH’s Royal National Throat, Nose and Ear hospital receiving either MBCT or relaxation therapy. The study found that both treatments led to a reduction in tinnitus severity, psychological distress, anxiety and depression for patients,” said Dr Marks.
“The MBCT treatment led to significantly greater reductions in tinnitus severity, and this improvement lasted for longer. In addition, 182 patients who completed MBCT routinely in our clinic showed a similar level of improvement.”
MBCT teaches patients to pay purposeful, present-moment attention to experiences, rather than trying to suppress them. In the case of tinnitus, patients were encouraged to meditate on sounds, including that of the tinnitus, and to follow how it rose and fell, how its pitch and timbre changed, and also to place it in the context of the wider ‘soundscape’. This cultivated a more helpful way of responding to tinnitus. People learnt how to allow and accept tinnitus rather than trying to fight or suppress it. Even though this mindful approach did not aim to change the nature of the tinnitus, it led to it becoming less intrusive to the point where it was no longer a problem. In many cases, it disappeared completely.
Dr Marks added: “MBCT turns traditional tinnitus treatment on its head – so rather than trying to avoid or mask the noise, it teaches people to stop the battle with tinnitus.
“The mindfulness approach is radically different from what most tinnitus sufferers have tried before, and it may not be right for everyone. We are confident, however, that the growing research base has demonstrated how it can offer an exciting new treatment to people who may have found that traditional treatment has not been able to help them yet. We hope the results of our research will be one of the first steps to MBCT becoming more widely adopted.”
So how does MBCT, and mindfulness in general, have this effect?
To answer this question, its first necessary to understand the true nature of tinnitus. While its cause is unknown, it is clear that tinnitus is not a disease or an illness in the normal sense. Rather, according to the British Tinnitus Association, it results from some type of change that can be either mental or physical and may be unrelated to hearing. It is probably akin to neuropathic pain, except patients hear non-existent sounds rather than feel the sensations of pain.
Neuropathic pain occurs in the nervous system and often normal investigations fail to discover a clear cause. It might result from damage to the nerves, spinal cord, or brain. But sometimes pain is felt even when there is no damage, or when healing seems to have completed at the site of an illness or injury. Such neuropathic pain can also take the form of unusual sensations, such as burning or electric shocks, and can even ‘occur’ in amputated limbs. Or it can take the form of tinnitus.
It is believed that tinnitus arises when background electrical or ‘white noise’ in the sound processing systems of the ear and brain become unduly amplified. The auditory system is highly sensitive and the nervous system is naturally ‘noisy’. Normally, the auditory system screens out this background electrical noise. However, if the background electrical noise rises above this auditory threshold – or the threshold is lowered – then you will hear the hissing sound of white noise, or tinnitus. What happens next is crucial to the progress of the condition. In some people, the noise is perceived as alarming and the body’s fight or flight system is activated. This ensures that the brain begins to actively search for the sounds of tinnitus because they are seen as a threat that needs to be avoided. The brain and nervous system then responds by increasing its capacity to process the noisy tinnitus signals – rather as a computer devotes extra memory and circuits to an important task. So the brain begins to act like an amplifier that’s stuck on ‘high’.
How you then react to tinnitus determines whether it is amplified further or fades away of its own accord. If you learn to accept the condition by paying conscious attention to the sounds by, for example, mindfully following how it rises and falls, and its changes in pitch and timbre, then you begin to accept the background noise. You can begin relaxing into it. The brain then no longer sees the noise as alarming and begins to naturally screen it out once again. Mindfulness also reduces anxiety and stress, which probably reduces the level of ‘white noise’ in the nervous system. In addition, lowering anxiety and stress can take you off a hair-trigger, and, in effect, lowers the brain’s sound amplifiers still further.
The Sounds and Thoughts meditation seems to be particularly effective for tinnitus although the whole MBCT programme reinforces the benefits.
The researchers in London and Bath now hope to extend their research to see whether it can help with tinnitus related insomnia. Given that mindfulness is an effective treatment for insomnia in its own right, the chances for success are high.
You can try some shortened MBCT meditations here. These are taken from my bestselling book Mindfulness: Finding Peace in a Frantic World co-written with Professor Mark Williams, co-developer of MBCT.
You can also try some free meditations from my book Mindfulness for Health (published in US as You Are Not Your Pain)here.
Please seek medical guidance before you try incorporating mindfulness into your own tinnitus treatment.
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