Complementary Alternative Cardiovascular Medicine
Complementary Alternative Cardiovascular Medicine
Complementary Alternative Cardiovascular Medicine
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Chapter 8 / Meditation and CVD 125<br />
setts Medical Center is now offering professional training programs for<br />
clinicians who are interested in using such interventions with their<br />
patients (23,24).<br />
When Kabat-Zinn trains his health care professionals, he cautions<br />
them to remember that MM has in both its techniques and its objectives<br />
a “non-doing orientation” (24, p. 768). There is no objective other than<br />
simple awareness of the present moment, which might include pleasant<br />
states of relaxation but may also include unpleasant feeling states. Both<br />
are to be observed with the same attitude of acceptance and nonjudgment.<br />
The goals and attitudes that professionals and patients might have<br />
related to the practice and its ability to generate relaxation or relief from<br />
suffering are intentionally observed as a part of the practice itself and are<br />
also to be regarded with an attitude of nonattachment. Kabat-Zinn highlights<br />
that MM in the medical setting contains a paradoxical element.<br />
Patients are often referred for mindfulness training for specific reasons<br />
and with hopes of achieving specific health related goals, yet, paradoxically,<br />
patients are told early in their mindfulness training that “the best<br />
way to get somewhere is to try not to get anywhere at all but to simply<br />
be where they are already, with awareness” (24, p. 769). Kabat-Zinn<br />
suggests that progress in MM is best measured by the level of acceptance<br />
of the mindfulness process itself and in the patient’s increasing ability to<br />
face his or her life experience (24).<br />
RESEARCH ON MEDITATION PRACTICE<br />
The scientific research on meditation is extensive. However, much of<br />
the research conducted to date has methodological limitations. There are<br />
few controlled studies, and, overall, sample sizes have been small. In<br />
addition, there is a lack of standardization of what constitutes meditation<br />
practice. The lack of clear operational definitions of the various types of<br />
meditation leads to ambiguity and difficulty comparing studies. There is<br />
often confusion between TM, MM, and relaxation. The ambiguity and<br />
overlap of these interventions has made it difficult to isolate the mechanism<br />
of change in these practices. Finally, there is a lack of consensus of<br />
the training requirements for practitioners delivering the interventions.<br />
None of the studies to date has included information about the training<br />
of the clinicians, nor does it use clinical adherence or competence measures.<br />
Despite these methodological weaknesses, there is mounting evidence<br />
to support the use of meditative practice in a medical setting. What<br />
is clear is that further, more rigorous research is required. What follows<br />
is an overall review of the research in this area. Studies of both TM and<br />
MM are included in this review.