6 Mindfulness-Based Stress Reduction PAUL G. SALMON, SANDRA E. SEPHTON, AND SAMUEL J. DREEBEN
The unquiet mind Can you be with this one breath, This moment, this now? —Paul Salmon
HISTORICAL CONTEXT AND DESCRIPTION OF THE MODEL Mindfulness-Based Stress Reduction (MBSR) This term denotes a time-limited, group-based behavioral medicine intervention initiated in 1979 by Jon Kabat-Zinn, who founded the Stress Reduction Clinic at the University of Massachusetts Medical Center in Worcester, Massachusetts. Mindfulness has been characterized by Kabat-Zinn (2003) as “. . . the awareness that emerges through paying attention on purpose, in the present moment, and non-judgmentally to the unfolding of experience moment by moment” (p. 145). “Present moment awareness” is fundamental to this definition, a point on which most definitions of mindfulness converge (Brown & Ryan, 2003). The foundation of MBSR rests on the simple but profound idea that much of our distress and suffering results from incessantly wanting things to be different from how they actually are. Wishing to be well; hoping for a cure; regretting past behavior that led to health problems; and trying somehow to recapture one’s youth are all manifestations of this tendency.
Clinical Applications of Mindfulness The tradition of mindfulness is based in Buddhist meditation practices but has been widely applied in Western biomedical settings in the context of the biopsychosocial perspective advocated by Engel (1977). Epstein (1999) noted its compatibility with Western philosophical pragmatism, which emphasizes practical consequences of interactions between behavioral, emotional, and cognitive processes. MBSR programs have proliferated in recent years and are currently offered in several hundred domestic and foreign hospitals and clinics as part of a clear trend toward participatory health care (Salmon, Santorelli, Sephton, & Kabat-Zinn, 2009). Beginning with the publication of Full Catastrophe 132
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