Making sense of mindfulness

2200 meters above sea level, Chinese yoga teacher Miya demonstrating a sunset yoga position on Laojun Mountain, a sacred Taoist site in Luoyang city, Henan province on Friday, July 7, 2017. [Photo/Chinanews.com]

At a recent reception, we encountered a "mindfulness guru". Yes, that is the job title on his business card-one bearing the logo of a huge multinational software company. His job is to teach the company's stressed-out employees the "art of mindfulness", which has been described as "awareness that arises through paying attention, on purpose, in the present moment, non-judgmentally" and "knowing what is on your mind".

Mindfulness seems to be everywhere nowadays. Companies like Apple, Sony, Ikea and Google now include mindfulness or meditation in their employee benefit packages, in the hope of cultivating a happier, healthier, more productive workforce. Even some hospitals offer mindfulness meditation sessions to patients and employees. And a Google search for the word yields about 67 million hits.

Extravagant claims for mindfulness have been made. Its advocates assert that it can improve a number of conditions, including anxiety depression, stress, and even drug addiction, while boosting productivity. But can mindfulness deliver on its many promises?

To be sure, there is a scientific basis for mindfulness. But the science does not vindicate any particular lifestyle or thought pattern, because the basis is breathing. Located deep within the brainstem is a tiny cluster of neurons, the pre-B?tzinger complex, that links respiration to feelings of relaxation, attention, excitement and anxiety. Called the "pacemaker for breathing", it communicates the activity in the brain's respiratory control center to the structure responsible for generating arousal throughout the brain. Thanks to this region of the brain, slow, smooth, rhythmic breathing can induce a state of calm.

But today's prevailing version of mindfulness extends beyond breathing to guide the way practitioners think. Over the last 30 years, many studies, including meta-analyses, have claimed to show that when this type of mindfulness is practiced regularly, people experience positive changes in their sense of well-being, their relationships, their ability to concentrate, their experience of physical and emotional pain, and their capacity to enjoy life.

Yet many, perhaps even most, of these studies seem to be observational (that is, uncontrolled) or poorly controlled, and they are susceptible to publication bias-the tendency to publish only studies that support the hypothesis, also known as the "file drawer effect". We wonder how, in a randomized controlled study, mindfulness would compare to other stress-reducing interventions, such as adopting a pet, hiking regularly or practicing yoga, which incorporates mindful breathing.

In fact, mindfulness may carry a risk, compared to these other interventions. In some cases, mindfulness has taken on a kind of cult-like status, and some practitioners have reported feelings of depersonalization and detachment and even loss of identity. Others have had more extreme reactions, including psychosis, delusions, confusion, mania or depression. Maybe such outcomes should not be surprising, since the practice of mindfulness encourages exploration of experiences-whether negative, neutral or positive-with a nonjudgmental attitude.

The adoption of mindfulness by so many high-tech companies may be particularly problematic, because it could effectively paper over the real problem: chronically overworked, stressed-out employees. At a time when many companies are implementing cost-cutting measures and pushing employees to boost their productivity, mindfulness and meditation programs are a more management-friendly solution than raising wages or hiring more employees.

But there is more to it than that. Some corporate leaders in Silicon Valley view mindfulness as away to improve employees' "emotional intelligence", which helps people to understand others' motivations, thereby boosting competitiveness. Whether or not mindfulness really is the panacea its proponents claim it to be, there is no question about its appeal. While companies like the idea that mindfulness can improve their bottomline, individuals may be eager for away to escape their quotidian cares.

The past year brought numerous terror attacks, mass shootings, fetal deformities from Zika virus infections, and, last but not least, the US presidential election and its rancorous aftermath. If deep breathing and focusing on the here and now can help to alleviate the burden of some of these memories, sign us up.

Mia Zaharna is a psychiatrist specializing in sleep disorders. And Henry I.Miller, a physician and molecular biologist, is the Robert Wesson fellow in Scientific Philosophy and Public Policy at Stanford University's Hoover Institution. Project Syndicate