Improve Resilience with Mindfulness


By John M. de Castro, Ph.D.


“The emotional soup that follows a stressful event can whip up negative stories about yourself or others that goes on and on, beyond being useful. Mindfulness reduces this rumination and, if practiced regularly, changes your brain so that you’re more resilient to future stressful events.” – Richard Davidson


Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations, like healthcare, burnout is all too prevalent. It is estimated that over 45% of healthcare workers experience burnout. Currently, over a third of healthcare workers report that they are looking for a new job. Nearly half plan to look for a new job over the next two years and 80% expressed interest in a new position if they came across the right opportunity.


Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion. Sleep disruption is an important consequence of the stress. “Poor or inadequate sleep can contribute to poor personal health and burnout and adversely affect the quality of care” (Kemper et al. 2016).

Burnout it is a threat to the healthcare providers and their patients. In fact, it is a threat to the entire healthcare system as it contributes to the shortage of doctors and nurses.


Preventing burnout has to be a priority. But, it is beyond the ability of the individual to change the environment to reduce stress and prevent burnout, so it is important that methods be found to reduce the individual’s responses to stress; to make the individual more resilient when high levels of stress occur. Contemplative practices including yoga practice have been shown to reduce the psychological and physiological responses to stress. Indeed, mindfulness has been shown to be helpful in treating and preventing burnoutincreasing resilience, and improving sleep.


So, it makes sense to investigate how mindfulness training during healthcare education may promote resilience and lower the likelihood of future burnout in healthcare workers. In today’s Research News article “Dispositional mindfulness and employment status as predictors of resilience in third year nursing students: a quantitative study.” See:

or see summary below or view the full text of the study at:

Chamberlain and colleagues recruited third-year nursing students and had them complete measures of mindfulness, resilience, compassion, and burnout. They found that for these nursing students the single best predictor of resilience was mindfulness, particularly acceptance; accepting without judging things just as they are. The next most powerful predictor was expectancy for a successful next career step. High levels of mindfulness were also associated with increased compassion and reduced fatigue in compassion.


The results are encouraging, but must be interpreted with caution. The study was correlational and nothing was manipulated, so causation cannot be determined. But the results suggest that mindfulness is very important for resilience. In particular the ability to take what comes and accept it without judgement helps to maintain the individual’s resilience. Since resilience is important for being able to cope with and bounce back from the stress of the occupation, mindfulness may be important for preventing burnout. In addition, the results suggest that mindfulness is associated with persistence of compassion, an important capacity for nurses.


These results need to be followed up with a randomized controlled trial in which these nursing students are trained in mindfulness, to determine if mindfulness is causally responsible for these important benefits. If this was confirmed it would strongly suggest that mindfulness training be included in the nursing curriculum; improving resilience and compassion, making them better nurses who are less likely to burn out.


So, improve resilience with mindfulness.


“The findings provide support for universities to develop strategies that promote mindfulness. Mindfulness training could provide a practical means of enhancing resilience, and personality characteristics like optimism, zest, and patience.” – Badri Bajaj


CMCS – Center for Mindfulness and Contemplative Studies


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Study Summary

Chamberlain, D., Williams, A., Stanley, D., Mellor, P., Cross, W., & Siegloff, L. (2016). Dispositional mindfulness and employment status as predictors of resilience in third year nursing students: a quantitative study. Nursing Open,3(4), 212–221.



Background: Nursing students will graduate into stressful workplace environments and resilience is an essential acquired ability for surviving the workplace. Few studies have explored the relationship between resilience and the degree of innate dispositional mindfulness, compassion, compassion fatigue and burnout in nursing students, including those who find themselves in the position of needing to work in addition to their academic responsibilities.

Aim: This paper investigates the predictors of resilience, including dispositional mindfulness and employment status of third year nursing students from three Australian universities.

Design: Participants were 240 undergraduate, third year, nursing students. Participants completed a resilience measure (Connor–Davidson Resilience Scale, CD‐RISC), measures of dispositional mindfulness (Cognitive and Affective Mindfulness Scale Revised, CAMS‐R) and professional quality of life (The Professional Quality of Life Scale version 5, PROQOL5), such as compassion satisfaction, compassion fatigue and burnout.

Method: An observational quantitative successive independent samples survey design was employed. A stepwise linear regression was used to evaluate the extent to which predictive variables were related each to resilience.

Results: The predictive model explained 57% of the variance in resilience. Dispositional mindfulness subset acceptance made the strongest contribution, followed by the expectation of a graduate nurse transition programme acceptance, with dispositional mindfulness total score and employment greater than 20 hours per week making the smallest contribution. This was a resilient group of nursing students who rated high with dispositional mindfulness and exhibited hopeful and positive aspirations for obtaining a position in a competitive graduate nurse transition programme after graduation.


Get More Attentive with Meditation


By John M. de Castro, Ph.D.


“We practice meditation in the end not to become great meditators but to have a different life. As we deepen the skills of concentration, mindfulness, and compassion, we find we have less stress, more fulfillment, more insight, and vastly more happiness. We transform our lives.” – Sharon Salzberg


In modern everyday life, we are constantly bombarded with a myriad of stimuli, from music, movies, TV, traffic noise, games, telephone calls, texts, emails, tweets, posts, etc. The generations who have grown up in the midst of this cacophony, claim to have developed multitasking skills, such that they can simultaneously work with multiple tasks and sources of information. At first glance they appear to have developed useful skills that the older generation can only marvel at. But, upon closer inspection of the abilities of the multitaskers, it has been found that they actually have impaired attentional abilities and are more easily distracted from what they’re doing. In other words, the multitasking has damaged their ability to focus on any one thing.


Mindfulness training may be an antidote to the impaired attention and distractibility of the multitaskers. One of the primary effects of meditation training is an improvement in the ability to pay attention to the task at hand and ignore interfering stimuli. This is an important consequence of meditation training and produces improvements in thinking, reasoning, and creativity. Hence it would seem that mindfulness training would strengthen the exact capacities that are weakened by chronic multitasking.


There are, however, a wide variety of meditation techniques and it is not known which work best for improving attention and executive function. In focused attention meditation, the individual practices paying attention to a single meditation object, learns to filter out distracting stimuli, including thoughts, and learns to stay focused on the present moment, filtering out thoughts centered around the past or future. On the other hand, in open monitoring meditation, the individual opens up awareness to everything that’s being experienced regardless of its origin. These include bodily sensations, external stimuli, and even thoughts. The meditator just observes these stimuli and lets them arise and fall away without paying them any further attention.


In today’s Research News article “Attentional orienting and executive control are affected by different types of meditation practice.” See:

or see summary below. Tsai and Chou recruited meditators who practiced focused attention meditation, or who practiced open monitoring meditation, and meditation naive controls. They measured mindfulness and then compared the three groups for their performance on a visual attention task. The task measured three separate components of attention, alerting, orienting, and executive control (filtering irrelevant stimuli). As expected, the two meditation groups had significantly higher levels of mindfulness than the control group. In regards to attention, the meditators demonstrated superior ability to orient and to filter out irrelevant stimuli (executive control). They found that the higher the level of mindfulness, the better the meditators were in executive control. Finally, they found that the open monitoring meditators were significantly superior to the focused meditators in their ability to orient to the attentional stimulus.


In a second experiment Tsai and Chou manipulate meditation practice to see if the practice caused the improvements in attention. They recruited meditation naïve college students who were randomly assigned to receive either 3 months of focused attention meditation training or no training. The students were measured on the attentional task both before and after the 3-month training. They found that the focused attention meditation produced a significant improvement in the ability to filter out irrelevant stimuli (executive control) and the higher the level of mindfulness, the better the meditators were in executive control. Thus they demonstrated that meditation practice causes improvements in the attentional ability to ignore irrelevant stimuli.


The results suggest the obvious that practicing paying attention improves paying attention. But, less obvious, is that the practice improves the abilities to shift attention when needed, orienting, and to not be distracted by things that are not relevant to the task at hand, executive function. This latter ability appears to be better developed by open monitoring meditation than by focused attention meditation. This would seem counter intuitive as one would think that part of practicing focusing would be to learn to ignore non-focal stimuli. In fact, it did in comparison to non-meditators. But, surprisingly, open monitoring meditation was superior. It may be that practicing just allowing things to be as they are without letting them attract attention may be the better way to learn to ignore distractors. Being used to not responding appears to make the individual better at not responding when needed.


So, get more attentive with meditation.


“The practice of insight meditation revolves around the art of meditative attention. Its basic tool is ‘bare’ or primary attention which uncovers or lays bare things as they really are. In this way, a non-reactive, unconditioned awareness is acquired that leads to insight knowledge.” – Ven Pannyavaro


CMCS – Center for Mindfulness and Contemplative Studies


This and other Contemplative Studies posts are also available on Google+


Study Summary

Tsai MH, Chou WL. Attentional orienting and executive control are affected by different types of meditation practice. Conscious Cogn. 2016 Oct 3;46:110-126. doi: 10.1016/j.concog.2016.09.020.



  • We studied the relationship between meditationskills and functions of attention.
  • Focused attention meditation only improved execution control function.
  • Open monitoring meditation improved execution control and orientation functions.


Several studies have demonstrated the beneficial effects of meditation on attention. The present study investigated the relationship between focused attention (FA) and open monitoring (OM) meditation skills and the various functions of attention. In Experiment 1, we executed theattention network test and compared the performance of experts on dandao meditation with that of ordinary people on this test. The results indicated that the experts specializing in OM meditation demonstrated greater attentional orienting ability compared with those specializing in FA meditation and the control group. In addition, both expert groups registered improvements in their executive control abilities compared with the control group. In Experiment 2, we trained beginners in FA meditation for 3months. The results showed that the experimental group exhibited significantly enhanced executive control ability. We infer that FA meditation skills promote executive control function and OM meditation skills promote both executive control and attentional orienting functions.


Improve Sexual Function with Mindfulness


By John M. de Castro, Ph.D.


“A key factor in having better sex is actually being there when you’re having it. Being there not just physically — being fully present, in thought, word and deed. it’s about really showing up and tuning in, to the moment, yourself and your partner.” –  Marsha Lucas


Problems with sex are very common, but, with the exception of male erectile dysfunction, driven by the pharmaceutical industry, it is rarely discussed and there is little research. The Puritanical attitudes toward sex in the U.S., in particular, produce inhibitions toward overt explorations of the issues surrounding sex. But, these problems have a major impact on people’s lives and deserve far more attention. While research suggests that sexual dysfunction is common, it is a topic that many people are hesitant or embarrassed to discuss. Women suffer from sexual dysfunction more than men with 43% of women and 31% of men reporting some degree of difficulty. It is amazing that such an important human behavior is can be problematic for so many people without an outcry for more study and research.


Problems with sex with women can involve reduced sex drive, difficulty becoming aroused, vaginal dryness, lack of orgasm and decreased sexual satisfaction. Sexual function in women involves many different systems in the body, including physical, psychological and hormonal factors. So, although, female sexual dysfunction is often caused by physical/medical problems, it is also frequently due to psychological issues. This implies that it many cases may be treated with activities that are effective in working with psychological problems. Mindfulness trainings have been shown to improve a variety of psychological issues including emotion regulationstress responsestraumafear and worryanxiety, and depression, and self-esteem. So, perhaps mindfulness training could help resolve psychological issues that might be affecting sexual behavior. Hence, it would make sense to investigate the effectiveness of mindfulness training as a treatment for female sexual dysfunction.


In today’s Research News article “A Pilot Study of Eight-Session Mindfulness-Based Cognitive Therapy Adapted for Women’s Sexual Interest/ Arousal Disorder.” See:

or see summary below. Paterson, Handy, and Brotto recruited women who were diagnosed with Sexual Interest/Arousal Disorder (SIAD) and provided for them an 8-week program of group Mindfulness-Based Cognitive Therapy adapted for sexual issues (MBCT-S). This program included mindfulness training, cognitive therapy, and sex therapy. Before and after treatment they were assessed for sexual interest, sex-related distress, overall sexual function, mindfulness, self-compassion, interoceptive awareness, depression, rumination, anxiety, and treatment expectations. They found that following treatment the women had significant improvements in overall sexual function (26%), sexual desire (60%), sex-related distress (20%). There were also significant improvements in mindfulness, interoceptive awareness, depression, rumination, and anxiety. In addition, they found that the improvement in overall sexual function was due, in part, to the treatment producing increased mindfulness and self-compassion, and decreased depression. So, MBCT-S improved the psychological and sexual health of the women.


These are interesting and potentially important preliminary findings. This was a small trial without a control condition, so conclusions need to be tempered with the understanding that the significant differences between before and after treatment may be due to experimental contamination including placebo effects. In addition, it cannot be determined if the effects may have been produced by any kind of therapy and not necessarily MBCT-S. Indeed, before the therapy commenced that participants expressed moderate expectations of treatment success, suggesting significant subject expectancy effects that could make any program appear successful. But, regardless, the outcomes were compelling enough to justify performing a large randomized controlled trial.


Nevertheless, the results may indicate that mindfulness based therapy tailored for sexual dysfunction may be a safe and effective means to treat Sexual Interest/Arousal Disorder (SIAD). Sex is very important in relationships and, to some extent, bonding and holding partners together. It can also be very important for the individual’s mental and physical well-being and feelings of self-worth. So, addressing sexual issues is important for the health of the individual and the family and these results suggest that MBCT-S may be a safe and effective treatment.


So, improve sexual function with mindfulness.


CMCS – Center for Mindfulness and Contemplative Studies


“Sexual health is an integral component of quality of life and sexual dysfunction impacts mood, well-being, relationship satisfaction, and many domains of quality of life. Improvements in sexual functioning can positively impact each of these domains.” – Lori Brotto


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Study Summary

Laurel Q. P. Paterson, Ariel B. Handy & Lori A. Brotto (2016): A Pilot Study of Eight-Session Mindfulness-Based Cognitive Therapy Adapted for Women’s Sexual Interest/ Arousal Disorder, The Journal of Sex Research, DOI: 10.1080/00224499.2016.1208800



While few treatment options exist for low sexual desire and arousal, the most common sexual dysfunction in women, a growing body of research supports the efficacy of mindfulness-based approaches. The mechanisms underlying improvements, and whether they are due to mindfulness practice or other treatment components, are unclear. As a result, we designed and pilot-tested an eight-session group mindfulness-based cognitive therapy for sexuality (MBCT-S) program that includes more extensive practice of mindfulness skills and closely aligns with the evidence-based MBCT program for depression and anxiety. A total of 26 women (mean age 43.9, range 25 to 63) with a diagnosis of sexual interest/arousal disorder participated in eight weekly group sessions, before and after which they completed validated questionnaires. The majority of women attended all sessions and completed the recommended at-home mindfulness exercises. Compared to baseline, women reported significant improvements in sexual desire, overall sexual function, and sex-related distress, regardless of treatment expectations, relationship duration, or low desire duration. Depressed mood and mindfulness also significantly improved and mediated increases in sexual function. These pilot data suggest that eight-session MBCT-S is feasible and significantly improves sexual function, and provide the basis for a larger randomized-controlled trial (RCT) with a longer follow-up period.


Improve Diseased Kidney Function with Yoga


By John M. de Castro, Ph.D.


“Yoga combines both physical and spiritual elements which helps restores the body and revitalizes the mind. Some of the poses in yoga can improve the over health of the kidney and improve kidney function. This is an important step for preventing kidney problems and for slowing the progression of kidney disease.” – National Kidney Foundation


Chronic Kidney Disease (CKD) is a serious and all too common medical problem that involves a gradual loss of kidney function over time. As a result, the body retains fluid and harmful wastes build up. This leads to feelings of fatigue, trouble concentrating, poor appetite, trouble sleeping, muscle cramps, swollen feet and ankles, puffiness around your eyes, dry, itchy skin, and need to urinate more often. It is not unusual for people to not realize that they have chronic kidney disease until their kidney function is down to 25% of normal. CKD can eventually lead to complete kidney failure requiring dialysis, to replace the work of the failed kidneys, or a kidney transplant. It is estimated that CKD is present in more than 26 million Americans. Without effective treatment, CKD can lead to heart disease and reduced longevity. There are, however, no cures for CKD and treatment focuses on slowing the progression of the kidney damage, usually by controlling the underlying cause.


Yoga practice has been found to be effective with treating a number of conditions that can lead to Chronic Kidney Disease (CKD). These include hypertension, diabetes, and artherosclerosis. So, it would seem reasonable to test yoga practice as a treatment for CKD. In today’s Research News article “Effects of 6 months yoga program on renal functions and quality of life in patients suffering from chronic kidney disease.” See:

or see summary below or view the full text of the study at:;year=2017;volume=10;issue=1;spage=3;epage=8;aulast=Pandey

Pandy and colleagues recruited patients with Chronic Kidney Disease (CKD) and randomly assigned them to receive either treatment as usual or 6-months of yoga practice. The practice consisted of 15-20 minutes of poses, 10-15 minutes of breathing exercises, and 20 minutes of relaxation. Before and over the 6-months of treatment they measured the patients’ quality of life, blood pressure, blood urea, sodium, potassium, and creatinine levels. They found that at the end of 6-months of yoga practice there was a significant reduction of blood pressure, nonsignificant reduction in blood urea and serum creatinine, and significant improvement in physical and psychological quality of life in comparison to the treatment as usual group. In addition, there was a reduction in the need for dialysis in the yoga practice group.


These are encouraging results and suggest that yoga practice may be a safe and effective treatment for Chronic Kidney Disease (CKD).  The study, however, examined only a small number of patients and sufficient statistical power was not present to detect many possible effects. So, the study needs to be replicated with a larger sample of CKD patients. Also, it needs to be recognized that the study lacked a group who performed another light exercise over the treatment period. So, it cannot be determined if yoga practice is necessary for the benefits or if any light exercise would produce similar benefits. Regardless, it appears that the practice of yoga can help improve kidney function in patients with Chronic Kidney Disease (CKD).


So, improve diseased kidney function with yoga.


“Yoga has been around for more than two millennia and has helped people everywhere overcome their medical conditions the natural way. While it is an effective method of keeping your kidneys healthy, yoga should not be used as a substitute for any medications that your doctor might have prescribed.” – India Times


CMCS – Center for Mindfulness and Contemplative Studies


This and other Contemplative Studies posts are also available on Google+


Study Summary

Pandey RK, Arya TV, Kumar A, Yadav A. Effects of 6 months yoga program on renal functions and quality of life in patients suffering from chronic kidney disease. Int J Yoga [serial online] 2017 [cited 2016 Nov 23];10:3-8. Available from:



Aim: To study the effect of 6 months yoga program in patients suffering from chronic kidney disease (CKD).
Materials and Methods: Fifty-four patients with CKD were studied and divided into two groups (yoga group and control group) to see the effect of yoga in CKD. Patients in the yoga group were offered yoga therapy along with other conventional treatment modalities, while the control group was only on conventional treatment. Subjects in yoga group were trained to perform specific yogic asanas for at least 5 days a week for 40-60 min a day. Regular monitoring of blood pressure, renal function, requirement of a number of dialysis, and quality of life (QOL) indicators were done. Fifty patients (yoga – 25; control-25) completed 6 months follow-up.
Results: In yoga group, a significant reduction of systolic and diastolic blood pressure, significant reduction in blood urea and serum creatinine levels, and significant improvement in physical and psychological domain of the World Health Organization QOL (as assessed by BREF QOL scores) were seen after 6 months. In control group, rise of blood pressure, deterioration of renal function, and QOL were observed. Poststudy comparison between the two groups showed a statistically significant reduction of blood pressure, nonsignificant reduction in blood urea and serum creatinine, and significant improvement in physical and psychological domain of QOL in yoga group as compared to control group. For subjects in yoga group, the need for dialysis was less when compared to control group although this difference was statistically insignificant. Except for inability of some patients to perform certain yogic asanas no adverse effect was found in the study.
Conclusion: Six months yoga program is safe and effective as an adjuvant therapy in improving renal functions and QOL of CKD patients.;year=2017;volume=10;issue=1;spage=3;epage=8;aulast=Pandey

Get Parents Out of the Dumps with Mindfulness


By John M. de Castro, Ph.D.


“a lot of the work is about learning to make peace with our imperfections. Because we’re going to do things that are going to land our kids in therapy, we’re gonna do things that hurt our kids. We can beat ourselves up. But if, instead, we were able to make peace with our imperfections and begin to regulate our emotional state, we can be calmer and more present for our kids and cultivate some self-compassion.” – Elisha Goldstein


Clinically diagnosed depression is the most common form of mental illness, affecting over 6% of the population. In general, it involves feelings of sadness, emptiness or hopelessness, irritability or frustration, loss of interest or pleasure in most or all normal activities, sleep disturbances, tiredness and lack of energy, anxiety, agitation, feelings of worthlessness or guilt, fixating on past failures or blaming yourself for things that aren’t your responsibility, suicidal thoughts, and suicide attempts or completed suicide. Needless to say individuals with depression are miserable and need help.


Depression does not occur in isolation. When an individual in a family is depressed, it affects all of the members of the family. When it is a parent, it affects how the child is raised and what he/she experiences during the formative years. This can have long-lasting effects on the child. So, it is important to study how depression affects childrearing and the child and what are the factors that might mitigate or eliminate the effects of parental depression on the child. Mindfulness training has been shown to both reduce depression and to improve parenting. Mindfulness-Based Cognitive Therapy (MBCT) was developed specifically to treat depression and has been found to reduce depression alone or in combination with antidepressive drugs.  Hence, it is reasonable to study the effects of MBCT on parents who suffer with depression and their children.


In today’s Research News article “Manual Development and Pilot Randomised Controlled Trial of Mindfulness-Based Cognitive Therapy Versus Usual Care for Parents with a History of Depression.” See:

or see summary below or view the full text of the study at:

Mann and colleagues recruited parents with children who were attending an outpatient depression clinic and randomly assigned them to either continue with treatment as usual or receive a form of Mindfulness-Based Cognitive Therapy that was adapted for parents (MBCT-P). They were measured before therapy and 4 and 9 months after for depression, parental stress, mindfulness, self-compassion, and the children’s behavior. They found that the Mindfulness-Based Cognitive Therapy for parents (MBCT-P) treatment program in comparison to treatment as usual significantly reduced depression and improved mindfulness and self-compassion at 9-months after treatment. They also found that there were significantly fewer behavior problems with the children.


These are very interesting and promising results. They suggest that this newly developed Mindfulness-Based Cognitive Therapy for parents (MBCT-P) program is a safe, effective, and long lasting treatment for parental depression which, in turn, leads to improved behavior in the children. It should be noted that this was a small pilot trial and the results need to be confirmed with a larger number of participants before making firm conclusions. But, the fact that significant results were obtained from such a small sample suggests that the effects of MBCT-P are robust.


That MBCT-P relieved depression and improved mindfulness and self-compassion should be expected given the large array of research demonstrating the effectiveness of Mindfulness-Based Cognitive Therapy for depression. It is an important, but not surprising, consequence of MBCT-P that the children’s behavior was improved. It can be speculated that with the depression relived the parents are better able to engage with their children and be more effective and mindful parents. Future research should investigate precisely what changes occur in parenting behaviors after MBCT-P training and how they affect the children.


So, get parents out of the dumps with mindfulness.


“Mindfulness helps parents emerge from autopilot and end ineffective habits, Bertin said. For instance, instead of getting frustrated and yelling at your child during a homework session – like you might usually do — you’re able to pause and observe your feelings, and act in a calmer, and perhaps more effective way.” – Mark Bertin


CMCS – Center for Mindfulness and Contemplative Studies


This and other Contemplative Studies posts are also available on Google+


Study Summary

Mann, J., Kuyken, W., O’Mahen, H., Ukoumunne, O. C., Evans, A., & Ford, T. (2016). Manual Development and Pilot Randomised Controlled Trial of Mindfulness-Based Cognitive Therapy Versus Usual Care for Parents with a History of Depression. Mindfulness, 7(5), 1024–1033.



Parental depression can adversely affect parenting and children’s development. We adapted mindfulness-based cognitive therapy (MBCT) for parents (MBCT-P) with a history of depression and describe its development, feasibility, acceptability and preliminary estimates of efficacy. Manual development involved interviews with 12 parents who participated in MBCT groups or pilot MBCT-P groups. We subsequently randomised 38 parents of children aged between 2 and 6 years to MBCT-P plus usual care (n = 19) or usual care (n = 19). Parents were interviewed to assess the acceptability of MBCT-P. Preliminary estimates of efficacy in relation to parental depression and children’s behaviour were calculated at 4 and 9 months post-randomisation. Levels of parental stress, mindfulness and self-compassion were measured. Interviews confirmed the acceptability of MBCT-P; 78 % attended at least half the sessions. In the pilot randomised controlled trial (RCT), at 9 months, depressive symptoms in the MBCT-P arm were lower than in the usual care arm (adjusted mean difference = −7.0; 95 % confidence interval (CI) = −12.8 to −1.1; p = 0.02) and 11 participants (58 %) in the MBCT-P arm remained well compared to 6 (32 %) in the usual care arm (mean difference = 26 %; 95 % CI = −4 to 57 %; p = 0.02). Levels of mindfulness (p = 0.01) and self-compassion (p = 0.005) were higher in the MBCT-P arm, with no significant differences in parental stress (p = 0.2) or children’s behaviour (p = 0.2). Children’s behaviour problems were significantly lower in the MBCT-P arm at 4 months (p = 0.03). This study suggests MBCT-P is acceptable and feasible. A definitive trial is needed to test its efficacy and cost effectiveness.


Have a Mindful Thanksgiving


By John M. de Castro, Ph.D.


I am grateful for what I am and have. My thanksgiving is perpetual.– Henry David Thoreau


“The greatest gift one can give is thanksgiving. In giving gifts, we give what we can spare, but in giving thanks we give ourselves.”
Br. David Steindl-Rast


Thanksgiving is a time for gratefulness. Most people, most of the time rue what they want and don’t have. So Thanksgiving is particularly important as a reminder of how lucky we are for all the blessings we have. It is a time to recognize that despite all our negative thoughts we have everything that we really need and probably much, much, more.


At this time of year the fall harvest is in and almost universally there is a celebration of the abundance provided. These crops will sustain us through the cold winter and till new crops can be planted, grow, mature, and are harvested. Hence, thanksgiving is very much a celebration of nature and all that it provides. In a modern world we lose track of all that is entailed in bringing us this food. When we are grateful for the food we need to recognize that we should be also be grateful for the seeds, the sun, the rain, the soil, the insects and birds that pollinate the crops, and even the worms and grubs that prepare the soil. Without any of these the food would not grow. In a sense, if we look carefully, we understand that our gratefulness is not just for the particular food item. It is in fact for the entire universe to which we and the food are intimately connected.


These interconnections extend into society and technology. The steel to build the plow, the engines that move the plow, the trains and trucks that transport the food, the farmers, drivers, and engineers, the fuel for the engine, the oil wells and refineries that produce the fuel, the engineers who designed and built the machinery and factories, the men and women who educated the scientists, engineers, and farmers. I’m sure by now that you’ve got the picture. A little reflection soon reveals the vast network of interconnections, even stretching back in time.


Thanksgiving is also a time to celebrate the people we are closest to, our friends and especially our family. They are our origin and our support through development. They are our connections to the past and future. They are the emotional fuel that sustains us. They give us hope and purpose. Yes, there is dysfunction. That goes with all forms of human interactions. But, should we lose any of them we will quickly realize how important they are to our flourishing and happiness.  Remember, that on the deathbed, one of the biggest regrets is not having spent more time with family and friends. Thanksgiving is a time to recognize these interconnections, to be grateful for these people and their importance to our existence.


Certainly one of the most taken for granted amazing blessings that we have is our own awareness. We’ve always been aware. We’ve never, not been aware. So, it is so easy for it to go unrecognized and unappreciated. But, reflect for a moment what a miracle it is. There is an essence to us that is forever present and unchanging. What we are aware of is constantly changing, but that which is aware is not. Without our awareness we are nothing but biological automatons, robots. With it we are suddenly human and spiritual. We would not be able to be grateful or enjoy Thanksgiving without it. So, do not forget on Thanksgiving to be grateful for this wonder that forms the essence of what we are.


There is a very subtle kind of gratefulness that we should also adopt. It’s what the great sage Thich Nhat Hahn calls our “non-toothache.” He points out that if we had a toothache we would be thinking how grateful we’d be if it ended. But once it does we take it for granted. We need to be thankful not only for what we have but also for many things that we don’t. The health of our bodies is taken for granted, but we should be intensely grateful for our non-disease. We may not be happy in our job, but if we didn’t have one we’d think how grateful we’d be to find one. We may be unhappy for the police officer who gave us a speeding ticket. But, we don’t recognize that our safety on the roads depends upon enforcement of the laws. We should be thankful for our non-accident. We are so fortunate in so many ways that we take for granted like our “non-toothache”. But, at Thanksgiving it is good to reflect upon all of these unnoticed blessings.


Finally, it is illuminating to reflect on whether you’re a source of thanksgiving for others. Specifically, what have you done that would make someone grateful to you. In other words, what have you given. This is important as it is not always what we have or what we get that’s important but what we share, what we do for others, and what we give. This is often the source of genuine happiness. The things that we have are never satisfying in a lasting way, but the things that we give forever bring joy. So, ask yourself on Thanksgiving, have you truly and sincerely given to others without expecting something in return?


It is very useful to reflect upon all of these things at Thanksgiving. The modern world, with its emphasis on self-sufficiency and individuality, produces feelings of independence and isolation. But these thanksgiving reflections soon reveal that this is an illusion. We are inextricably connected to the entire fabric of the universe, the tapestry of our physical, social, and spiritual existence. There is so much to be grateful for that upon reflection we can see that our sufferings are silly and small by comparison. We should revel in the vast interconnected blessings that make up everything about our world and ourselves. We should celebrate the miracle of life and our awareness of it.


So, eat, drink, and be merry on Thanksgiving, enjoy the wonderful celebration, but also invest a few moments in reflecting upon all that we have to be thankful for.


He who thanks but with the lips
Thanks but in part;
The full, the true Thanksgiving
Comes from the heart.

~J.A. Shedd

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CMCS – Center for Mindfulness and Contemplative Studies

Chill Cardiac Patients with Mindfulness


By John M. de Castro, Ph.D.


“For people with cardiovascular disease, meditation provides a technique for reducing stress and focusing on things they can do to be healthier. Meditation is a way of allowing you to come to balance in your life. It can also help you to sleep better, which is a very important restorative part of physical health.” – Richard Stein


Cardiovascular disease is the number one killer, claiming more lives than all forms of cancer combined. “Heart disease is the leading cause of death for both men and women. About 610,000 people die of heart disease in the United States every year–that’s 1 in every 4 deaths. Every year about 735,000 Americans have a heart attack.” (Centers for Disease Control). A myriad of treatments has been developed for heart disease including a variety of surgical procedures and medications. In addition, lifestyle changes have proved to be effective including quitting smoking, weight reduction, improved diet, physical activity, and reducing stresses. Stress reduction is a key lifestyle change in treating heart conditions as stress can lead to increased physiological arousal including increased blood pressure that can exacerbate the patient’s condition


Contemplative practices, such as meditation, tai chi, and yoga, have also been shown to be helpful for heart health. In addition, mindfulness practices have also been shown to be helpful for producing the kinds of other lifestyle changes needed such as smoking cessation and weight reduction. They are particularly helpful for stress reduction, decreasing the psychological and physiological responses to stress. So, it would make sense to investigate the effectiveness of mindfulness practices in the treatment of cardiac patients.


In today’s Research News article “The effects of mindfulness-based stress reduction on cardiac patients’ blood pressure, perceived stress, and anger: a single-blind randomized controlled trial.” See:

or see summary below. Momeni and colleagues recruited cardiac patients who were also hypertensive and randomly assigned them to either receive an 8-week Mindfulness-Based Stress Reduction (MBSR) program or to a wait list control condition. The MBSR program included mindful body scan, sitting meditation, walking meditation, and yoga. All of the patients were also receiving antihypertensive medications. They were measured both before and after treatment for blood pressure, perceived stress, and state and trait anxiety.


They found that MBSR training resulted in a significant decrease (12%) in systolic blood pressure, but not diastolic blood pressure, a 45% decrease in perceived stress, a 47% decrease in state anxiety, and a 31% decrease in trait anxiety. Thus, MBSR training was highly effective in reducing blood pressure, stress, and anxiety levels in cardiac patients. The magnitude of the effects large and clinically significant. Hence, they found that MBSR training was a safe and effective treatment for improving the physical and psychological conditions of cardiac patients. This is very important as it may be life saving.


So, chill cardiac patients with mindfulness.


“People who are more mindful tend to have more awareness of where their mind and bodies are at. By increasing our awareness, we might become more aware of the impact of what we are doing on ourselves.” – Eric Loucks


CMCS – Center for Mindfulness and Contemplative Studies


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Study Summary

Momeni J, Omidi A, Raygan F, Akbari H. The effects of mindfulness-based stress reduction on cardiac patients’ blood pressure, perceived stress, and anger: a single-blind randomized controlled trial. J Am Soc Hypertens. 2016 Aug 4. pii: S1933-1711(16)30448-X. doi: 10.1016/j.jash.2016.07.007.



This study aimed at assessing the effects of mindfulness-based stress reduction (MBSR) on cardiac patients’ blood pressure (BP), perceived stress, and anger. In total, 60 cardiac patients were recruited between April and June 2015 from a specialized private cardiac clinic located in Kashan, Iran. Patients were allocated to the intervention and control groups. Patients in the experimental group received MBSR in eight 2.5-hour sessions, while patients in the control group received no psychological therapy. The main outcomes were BP, perceived stress, and anger. Analysis of covariance revealed a significant difference between the study groups regarding the posttest values of systolic BP, perceived stress, and anger (P < .001). However, the study groups did not differ significantly in terms of diastolic BP (P = .061; P = .17). This study reveals that MBSR is effective in reducing cardiac patients’ systolic BP, perceived stress, and anger.



Interrupt Drinking to Cope with Depression with Mindfulness


By John M. de Castro, Ph.D.


“Mindfulness also helps people learn to relate to discomfort differently. When an uncomfortable feeling like a craving or anxiety arises, people . . . are able to recognize their discomfort, and observe it with presence and compassion, instead of automatically reaching for a drug to make it go away.” – Sarah Bowen


Inappropriate use of alcohol is a major societal problem. In fact, about 25% of US adults have engaged in binge drinking in the last month and 7% have what is termed an alcohol use disorder. Alcohol abuse is very dangerous and frequently fatal. Nearly 88,000 people in the US and 3.3 million globally die from alcohol-related causes annually, making it the third leading preventable cause of death in the United States. Drunk driving accounted for over 10,000 deaths; 31% of all driving fatalities. Excessive alcohol intake has been shown to contribute to over 200 diseases including alcohol dependence, liver cirrhosis, cancers, and injuries. It is estimated that over 5% of the burden of disease and injury worldwide is attributable to alcohol consumption.


Alcohol abuse often develops during adolescence and it on display with college students where about four out of five college students drink alcohol and about half of those consume alcohol through binge drinking. About 25 percent of college students report academic consequences of their drinking including missing class, falling behind, doing poorly on exams or papers, and receiving lower grades overall. More than 150,000 students develop an alcohol-related health problem. This drinking has widespread consequence for not only the students but also the college communities, and families. More than 690,000 students are assaulted by another student who has been drinking. More than 97,000 students are victims of alcohol-related sexual assault or date rape. 599,000 students receive unintentional injuries while under the influence of alcohol. Significantly, 1,825 college students die each year from alcohol-related unintentional injuries and between 1.2 and 1.5 percent of students indicate that they tried to commit suicide within the past year due to drinking or drug use.


These facts clearly highlight the need to explore methods to control excessive alcohol intake. One potential method is mindfulness as it has been shown to assist in the control of alcohol intake and in recovery from alcohol addiction . So it would make sense to further explore the effects of mindfulness on alcohol intake in college students. Many indicate that they drink to cope with problems including depression. In today’s Research News article “Depressive Symptoms and Alcohol-Related Problems Among College Students: A Moderated-Mediated Model of Mindfulness and Drinking to Cope.” See:

or see summary below. Bravo and colleagues recruited college students who had consumed alcohol at least one day in the past month and had them complete a questionnaire measuring mindfulness, depression, alcohol consumption, alcohol related problems, and drinking motives.


They found that the higher the level of the students’ mindfulness, the lower the levels of depression, alcohol related problems, and drinking to cope motives while the higher the levels of depression the greater the drinking to cope motives and alcohol related problems. They also found that the students’ depression levels were associated this drinking to cope which was, in turn, associated with alcohol related problems and this was moderated by mindfulness with this relationship weaker in highly mindful students and stronger in low mindfulness students.


These findings suggest that depression energizes the motivation to find a way to cope with the depression and this, in turn, leads to using alcohol intake for coping problems. This then leads to more problems related to alcohol consumption. But, mindfulness appears to interrupt this process by reducing the motivation to cope, it decreases the number of problems resulting from alcohol consumption. It can be speculated that mindfulness helps with the depression reducing the need to find a way to cope with it. This then produces a healthier relationship with alcohol intake.


These are potentially important findings. That mindfulness reduces depression is well known. But, these results suggest that this reduces the need to use alcohol intake to cope with the student’s negative emotional state. They further suggest that mindfulness training for college students could help to address alcohol intake problems that are so rampant in that population. It will take future studies to assess this speculation.


So, interrupt drinking to cope with depression with mindfulness.


There are a few strategies for drinking mindfully. First, we meditated to set our intentions for drinking. While trying to remain in the present moment, we asked ourselves, “Am I drinking because I want to unwind…Or to drown my sorrows?” “Alcohol in itself is not good or bad. It’s our relationship to it that matters.” – Lodro Rinzler


CMCS – Center for Mindfulness and Contemplative Studies


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Study Summary

Bravo AJ, Pearson MR, Stevens LE, Henson JM. Depressive Symptoms and Alcohol-Related Problems Among College Students: A Moderated-Mediated Model of Mindfulness and Drinking to Cope. J Stud Alcohol Drugs. 2016 Jul;77(4):661-6. DOI:



OBJECTIVE: In college student samples, the association between depressive symptoms and alcohol-related problems has been found to be mediated by drinking-to-cope motives. Mindfulness-based interventions suggest that mindfulness may attenuate the conditioned response of using substances in response to negative emotional states, and trait mindfulness has been shown to be a protective factor associated with experiencing fewer alcohol-related problems. In the present study, we examined trait mindfulness as a moderator of the indirect associations of depressive symptoms on alcohol-related problems via drinking-to-cope motives.

METHOD: Participants were undergraduate students at a large, southeastern university in the United States who drank at least once in the previous month (n = 448). Participants completed an online survey regarding their personal mental health, coping strategies, trait mindfulness, and alcohol use behaviors. The majority of participants were female (n = 302; 67.4%), identified as being either White non-Hispanic (n = 213; 47.5%) or African American (n = 119; 26.6%), and reported a mean age of 22.74 (SD = 6.81) years. Further, 110 (25%) participants reported having a previous and/or current experience with mindfulness mediation.

RESULTS: As hypothesized, the indirect effects from depressive symptoms to alcohol-related problems via drinking-to-cope motives were weaker among individuals reporting higher levels of mindfulness than among individuals reporting lower and average levels of mindfulness.

CONCLUSIONS: The present study suggests a possible mechanism through which mindfulness-based interventions may be efficacious among college students: decoupling the associations between depressive symptoms and drinking-to-cope motives.

Strengthen the Immune System with Mindfulness


By John M. de Castro, Ph.D.


“Stress is immunosuppressive. Research into this pernicious relationship between stress and disease has piqued interest in the ways that contemplative practices might positively influence the immune system. According to a large body of evidence, meditation appears to have profound effects on immune function in health and disease because of its ability to reduce stress.” – David Vago


Contemplative practices have been found to improve the physical and psychological well-being of practitioners and to relieve the symptoms of a large number of mental and physical diseases. How these practices might have such widespread benefits is not precisely known. In fact, there may not be one mechanism but many. One important benefit of mindfulness practices appears to be a strengthening of the immune system, the body’s primary defense against disease. Through a series of steps called the immune response, this system attacks organisms and substances that invade body systems and cause disease. It is important that it be properly tuned as too weak of an immune response can allow diseases to develop while too strong of a response can result in autoimmune diseases.


In today’s Research News article “Mindfulness meditation and the immune system: a systematic review of randomized controlled trials.” See:

or see summary below. Black and Slavich review the published research literature on the effects of mindfulness meditation on immune system function. They found and summarized twenty randomized controlled studies that administered mindfulness meditation and measured objective biomarkers of immune system activity, usually in the blood. All but three of the studies used a Mindfulness Based Stress Reduction (MBSR) or similar programs. MBSR includes a combination of meditation, body scan, and yoga practices. They found the published research reported that mindfulness meditation produced a reduction in biomarkers of inflammation including cellular transcription factor NF-κB and liver-derived C-reactive protein, CRP, and increases in cell-mediated immunity, CD4+ T cell count, and increases in telomerase activity indicating decreased biological aging.


These are remarkable findings suggesting that mindfulness meditation practice improves immune system function and reduces the processes of cellular aging. The reduction in the inflammatory response is significant as the inflammatory response which works quite well for short-term infections and injuries can, if protracted, itself become a threat to health, producing autoimmune diseases. Indeed, chronic inflammation is associated with reduced longevity. The improvements in cellular immunity suggest that meditation practice improves the ability of the body to fend off disease by destroying cells that have been infected, an important protection against the spread of disease through the body. Finally, the findings that mindfulness meditation practices increase telomerase activity is very exciting. The telomere is attached to the ends of the DNA molecule. As we age the telomere shortens, resulting in difficulty with cells reproducing, producing more defective cells. The enzyme telomerase helps to prevent shortening of the telomere and thereby slow the aging process.  It appears that mindfulness meditation increases telomerase activity and thereby slow the aging process.


Hence, accumulating scientific evidence suggests that mindfulness meditation has very positive effects on the immune system which improve health and longevity. It is not known exactly how these practices do this, but it is likely that the ability of mindfulness meditation to reduce the physical and psychological responses to stress is responsible. Chronic stress is known to impair immune system function, so its reduction may be responsible to the improved function of this system. Regardless of the mechanism, it is clear that mindfulness meditation is good for health, improving the systems that help to maintain it.


Strengthen the immune system with mindfulness.


“We still don’t know the precise mechanism by which control of attention or meditation acts this way on the immune system. It’s likely that a more “distant” and serene outlook, which is common during periods of meditation (and also between meditation sessions) gives rise to a weaker secretion of adrenaline and cortisol, and that this allows the immune cells to remain more active.” – David Servan-Schreiber


CMCS – Center for Mindfulness and Contemplative Studies


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Study Summary

Black, D. S. and Slavich, G. M. (2016), Mindfulness meditation and the immune system: a systematic review of randomized controlled trials. Ann. N.Y. Acad. Sci., 1373: 13–24.



Mindfulness meditation represents a mental training framework for cultivating the state of mindful awareness in daily life. Recently, there has been a surge of interest in how mindfulness meditation improves human health and well-being. Although studies have shown that mindfulness meditation can improve self-reported measures of disease symptomatology, the effect that mindfulness meditation has on biological mechanisms underlying human aging and disease is less clear. To address this issue, we conducted the first comprehensive review of randomized controlled trials examining the effects of mindfulness meditation on immune system parameters, with a specific focus on five outcomes: (1) circulating and stimulated inflammatory proteins, (2) cellular transcription factors and gene expression, (3) immune cell count, (4) immune cell aging, and (5) antibody response. This analysis revealed substantial heterogeneity across studies with respect to patient population, study design, and assay procedures. The findings suggest possible effects of mindfulness meditation on specific markers of inflammation, cell-mediated immunity, and biological aging, but these results are tentative and require further replication. On the basis of this analysis, we describe the limitations of existing work and suggest possible avenues for future research. Mindfulness meditation may be salutogenic for immune system dynamics, but additional work is needed to examine these effects.

Reduce Depression with Mindfulness and Spirituality


By John M. de Castro, Ph.D.


“If you have unproductive worries you can train yourself to experience those thoughts completely differently. You might think ‘I’m late, I might lose my job if I don’t get there on time, and it will be a disaster!’ Mindfulness teaches you to recognize, ‘Oh, there’s that thought again. I’ve been here before. But it’s just that—a thought, and not a part of my core self,’” – Elizabeth Hoge.


Clinically diagnosed depression is the most common form of mental illness, affecting over 6% of the population. It is difficult to treat and is generally treated with antidepressant medications. But, drugs often have troubling side effects and can lose effectiveness over time. In addition, many patients who achieve remission have relapses and recurrences. Hence, it is important to develop alternatives to drug treatment to help relieve the misery of depression.


Mindfulness training has been shown to be effective for depression alone or in combination with drug therapy. A commonly used form of mindfulness training Mindfulness-Based Stress Reduction (MBSR) has been found to be effective for a myriad of physical and psychological problems including depression. MBSR contains meditation, yoga, and body scan. These are ancient practices that were used primarily as spiritual practices. MBSR, however, was developed as a secular practice, divorced from its spiritual roots, to help improve physical and mental health. It is possible that MBSR, even as a secular practice, has spiritual consequences and these may, in turn, affect depression. Indeed, spirituality has been shown to be associated with reduced depression.


In today’s Research News article “Decreased Symptoms of Depression After Mindfulness-Based Stress Reduction: Potential Moderating Effects of Religiosity, Spirituality, Trait Mindfulness, Sex, and Age.” See: see summary below or view the full text of the study at:

Greeson and colleagues investigate whether the effectiveness of Mindfulness-Based Stress Reduction (MBSR) for depression might be mediated by increased spirituality. They recruited MBSR participants and had them complete measures, both before and after training of mindfulness, anxiety, depression, spirituality, and religiosity.


They found, as have numerous other studies, that MBSR training resulted in a clinically significant (25%) decrease in depression scores. Additionally, they found that the greater the increases in mindfulness and in spirituality the greater the decreases in depression. A sophisticated statistical mediation modelling technique was applied to these data and revealed that the effectiveness of MBSR in reducing depression occurred as a result of the increased mindfulness and spirituality produced by MBSR. Hence, they found that MBSR reduces depression by increasing mindfulness and spirituality.


These are interesting results that suggest that even though MBSR was developed as a secular practice, divorced from its spiritual roots, it still produces increased spirituality. They further suggest that these increases in spirituality are as influential as the increases in mindfulness in reducing depression. This suggests that perhaps MBSR may be even more effective for depression if its spiritual aspects were reinserted into the program. It will take future research to test this speculation.


So, reduce depression with mindfulness and spirituality.


“Mindfulness helps to train individuals in bringing back the attention time and time again when it has wandered. And it is precisely through helping individuals to not get carried away by their thoughts that mindfulness has been shown to be so effective for conditions like anxiety and depression.” – Carolyn Gregoire


CMCS – Center for Mindfulness and Contemplative Studies


This and other Contemplative Studies posts are also available on Google+


Study Summary

Greeson, J. M., Smoski, M. J., Suarez, E. C., Brantley, J. G., Ekblad, A. G., Lynch, T. R., & Wolever, R. Q. (2015). Decreased Symptoms of Depression After Mindfulness-Based Stress Reduction: Potential Moderating Effects of Religiosity, Spirituality, Trait Mindfulness, Sex, and Age. Journal of Alternative and Complementary Medicine, 21(3), 166–174.



Objective: Mindfulness-based stress reduction (MBSR) is a secular meditation training program that reduces depressive symptoms. Little is known, however, about the degree to which a participant’s spiritual and religious background, or other demographic characteristics associated with risk for depression, may affect the effectiveness of MBSR. Therefore, this study tested whether individual differences in religiosity, spirituality, motivation for spiritual growth, trait mindfulness, sex, and age affect MBSR effectiveness.

Methods: As part of an open trial, multiple regression was used to analyze variation in depressive symptom outcomes among 322 adults who enrolled in an 8-week, community-based MBSR program.

Results: As hypothesized, depressive symptom severity decreased significantly in the full study sample (d=0.57; p<0.01). After adjustment for baseline symptom severity, moderation analyses revealed no significant differences in the change in depressive symptoms following MBSR as a function of spirituality, religiosity, trait mindfulness, or demographic variables. Paired t tests found consistent, statistically significant (p<0.01) reductions in depressive symptoms across all subgroups by religious affiliation, intention for spiritual growth, sex, and baseline symptom severity. After adjustment for baseline symptom scores, age, sex, and religious affiliation, a significant proportion of variance in post-MBSR depressive symptoms was uniquely explained by changes in both spirituality (β=−0.15; p=0.006) and mindfulness (β=−0.17; p<0.001).

Conclusions: These findings suggest that MBSR, a secular meditation training program, is associated with improved depressive symptoms regardless of affiliation with a religion, sense of spirituality, trait level of mindfulness before MBSR training, sex, or age. Increases in both mindfulness and daily spiritual experiences uniquely explained improvement in depressive symptoms.