The Role of Mindfulness in Times of Crisis
Written By thewakingbear

The world is currently experiencing an unprecedented time of crisis concerning the 2020 global pandemic. This initial crisis of physical health, which at present has claimed the lives of over 600,000 individuals worldwide (Johns Hopkins, 2020), has also given way to a secondary crisis; the mass deterioration of mental health; “45 percent of adults say the pandemic has affected their mental health, and 19 percent say it has had a “major impact.” (Achenbach, 2020)” This paper looks to explore how Mindfulness and its associated practices could provide an invaluable mental levy against the rising levels of global psychological illness.

To investigate this, the discernable benefits of mindfulness will be contrasted with the symptoms of those suffering from quarantine-related mental illness. This examination will determine whether mindfulness itself could be used as an an aid in addressing these arising conditions.

As evinced by the proliferation of psychological disorders either created or exacerbated by the acute onset stress of the COVID-19 pandemic and resultant quarantine, individuals are, on balance, both enormously susceptible to conditions precipitated by protracted periods of isolation and inherently unfit to manage them: “Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. (Brooks et al, 2020)”

While reported levels of mental illness continue to rise, job loss and economic downturn create the inability to afford access to mental healthcare: “In the reviewed studies, the financial loss as a result of quarantine created serious socioeconomic distress24and was found to be a risk factor for symptoms of psychological disorders22 and both anger and anxiety several months after quarantine. (Brooks et al, 2020)”. As such, it has become increasingly incumbent upon individuals to provide themselves assistance in the management of burgeoning psychological affliction; mindfulness practice could contribute to this endeavor.

 Mindfulness as a concept is the simple moment-to-moment awareness of the present. This skill can be seen inadvertently displayed through activities ranging from tennis to chess, wherein an individual must maintain targeted focus on an activity in order to perform said task with proficiency. The therapeutic benefits of this concept were first harnessed in ancient India by Siddhartha Gautama, the historical Buddha, with the development of mindfulness meditation.

Mindfulness Meditation is the practice of placing one’s concentration on a single source of stimuli, such as the breath, as a means of anchoring oneself to the present. Whatever thoughts arise while concentrating on said stimuli the practitioner simply observes compassionately and without judgement. Returning to the anchor of their breath, individuals slowly learn to regulate reactivity to emotional response. “As commonly described, mindfulness-the thing mindfulness meditation aims to cultivate- isn’t very deep or exotic. To live mindfully is to pay attention to, to be “mindful of” what’s happening in the here and now and to experience it in a clear, direct way, unclouded by various mental obfuscations. (Robert Wright, 2017)”

 In order to explore how the mental clarity achieved through sustained mindfulness practice may work to alleviate conditions of quarantine fatigue, first we must define what these various conditions are. To narrow the scope of our investigation we will isolate the hallmark conditions associated with COVID-19 quarantine. For the purpose of this study these conditions will be limited to anxiety, depression, and stress. Each condition will be individually defined by its symptoms and then contrasted with the benefits of mindfulness to determine whether mindfulness itself can be plausibly used to counter them.

The first quarantine-condition that will be examined regarding the concept of mindfulness as a means of treatment is anxiety. Anxiety, or more specifically General Anxiety Disorder (GAD) is defined by the DSM-5, or The Diagnostic and Statistical Manual for Mental Disorders, as the manifestation of the following symptoms:

  1. The presence of excessive anxiety and worry about a variety of topics, events, or activities. Worry occurs more often than not for at least 6 months and is clearly excessive.
  2. The worry is experienced as very challenging to control. The worry in both adults and children may easily shift from one topic to another.
  3. The anxiety and worry are accompanied with at least three of the following physical or cognitive symptoms (In children, only one symptom is necessary for a diagnosis of GAD):
  1. Edginess or restlessness
  2. Tiring easily; more fatigued than usual
  3. Impaired concentration or feeling as though the mind goes blank
  4. Irritability (which may or may not be observable to others)
  5. Increased muscle aches or soreness
  6. Difficulty sleeping (due to trouble falling asleep or staying asleep, restlessness at
    night, or unsatisfying sleep)

These criteria used for the diagnoses of GAD share in common a single thread; the
inability to properly identify and manage the presence of a perceived emotional or physical threat. This disparity between misbelief and reality creates a desperation within the affected individual to rationalize their experience. Individuals will develop a hyper-observational disposition in an effort to find a source for their persistent levels of worry. “Generally, anxious individuals scan the environment for threat-related information and interpret ambiguous information as threatening (Bögels & Mansell, 2004; Hunt, Keogh, & French, 2006). In addition, people with severe anxiety disorders suffer from chronic over arousal, increasing the likelihood of misinterpreting ambiguous environmental information as threatening (Barlow, 1991). (Schreiner & Malcolm, 2008)”

It is through this obsessive observation itself that mindfulness meditation can help to provide relief. Mindfulness is intended to be a practice of observation, not an investigation of anything in particular- as in the case of an anxious individual searching for the root of their anxiety- but a simple, base awareness of one’s self and surrounding stimuli. “People in meditation-based intervention programs for anxiety are trained to nonjudgmentally ‘observe’ their thoughts and physical sensations. The key component here is accepting and objectively examining physiological symptoms. (Schreiner & Malcolm, 2008)”

This practice of observation without judgement can help anxious individuals to witness their environment more objectively; to release themselves from an anxiety-driven narrative and enter the reality of the present moment. With the added component of mental spaciousness afforded by mindfulness, individuals can begin to regulate their own hyper-vigilant observations by acknowledging them plainly as passing sensory phenomena. This nonjudgmental detachment from observations, originally experienced as a solid and factual, allows practitioners of mindfulness the room necessary to disentangle from their identification with the condition.

The perspective gained through this process of disidentification provides individuals the emotional clarity necessary to quell their anxiety and its hold over their consciousness. “Increased awareness of cognitive and emotional states is at the core of reducing distress (Baer, 2003). By accepting thoughts, emotions, and sensations as they occur, people reduce their roles in maintaining various affective disorders and improve self-management abilities (Roth & Robbins, 2004; Teasdale et al., 1995). Hence, the first step to reduce affective symptoms through meditation practice is awareness, followed by acceptance and the development of nonjudgmental attitudes. (Schreiner & Malcolm, 2008)”

Mindfulness can empower an individual to re-contextualize their perspective on anxiety and develop their own process of coping. While COVID-19 quarantine remains in effect, especially because it can be practiced without the assistance of a professional, mindfulness should be regarded as a powerful tool in one’s emotional support arsenal.

The next quarantine-condition that will be measured against the therapeutic benefits of mindfulness is that of depression. As characterized by the DSM-5, the criteria determining depression, or more specifically, Major Depressive Disorder (MDD) are:

  • Depressed mood or a loss of interest or pleasure in daily activities for more than two weeks.

  • Mood represents a change from the person’s baseline.

  • Impaired function: social, occupational, educational.

  • Specific symptoms, at least 5 of these 9, present nearly every day:

1. Depressed mood or irritable most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful).
2. Decreased interest or pleasure in most activities, most of each day
3. Significant weight change (5%) or change in appetite
4. Change in sleep: Insomnia or hypersomnia
5. Change in activity: Psychomotor agitation or retardation
6. Fatigue or loss of energy
7. Guilt/worthlessness: Feelings of worthlessness or excessive or inappropriate
guilt
8. Concentration: diminished ability to think or concentrate, or more
indecisiveness
9. Suicidality: Thoughts of death or suicide, or has suicide plan

The majority of symptoms associated with MDD can be attributed to a significant change in perception of experience. Individuals suffering from said symptoms struggle to maintain what was once their baseline emotional disposition. Those affected will compulsively review their depressive emotions, entering a period of mental stagnation wherein the awareness of depressive symptoms feeds the depression itself. This cyclical process of thought is referred to as rumination.

“Dysfunctional attitudes and negative self-referent thoughts may be viewed as the content of the mind (Beck & Clark, 1988), whereas rumination refers to the processes of the mind or how individuals relate to the content (Hayes & Kelly, 2003; Nolen-Hoeksema, 1991; Nolen- Hoeksema, 2000). When depression prone individuals engage in rumination they engage in a process that ‘recycles’ the negative thought content and consequently increase the chances of relapse and the severity of the depressive episode (Nolen-Hoeksema, 1991). (Schreiner & Malcolm, 2008)”

It is within this process of rumination that mindfulness practice can be used as a powerful emotional resource. One of the ways mindfulness meditation teaches practitioners to remain present is the use of “mindful anchors.” A “mindful anchor” is a source of stimuli that can be consistently used as the object of one’s focus. Though this can vary from the awareness of ones’ breath to sensations associated with a specific body part, the underlying concept is the availability of a constant to where one can return their attention. “By also teaching clients to return the focus of attention to a neutral stimuli (e.g., breathing), they learn to regulate attention on a moment to moment basis, undisturbed by maladaptive thought processes. (Schreiner & Malcolm, 2008)”

This provides a method of grounding oneself in the moment. Should a meditator’s attention be swept away by a distracting thought or sensation, the simple instruction is to return one’s attention to this anchor and thereby the present. “It is like doing a repetitive exercise to develop muscular strength. You keep doing it and the body gets stronger. Coming back to the primary object is mental exercise. We come back to the breath, again and again, and slowly the mind grows stronger and more stable. (Goldstein, 2003)”

The strengthening of this muscle of presence is perfectly designed to interrupt the cyclical nature of ruminative thought. Should an individual suffering from depression experience a period of intense fixation, by incorporating mindfulness meditation, they are given the means of returning to the present moment and thereby disrupting the recycled ponderance of their negative thoughts. “The success of using meditation practice to aid the treatment of depression is achieved by reducing ruminative tendencies and simultaneously increasing attentional control (Ramel, Philippe, Carmona, & McQuaid, 2004). (Schreiner & Malcolm, 2008)”

Though depression can develop or intensify due to the pressures of quarantine, there is also the possibility of depressive symptoms enduring even after quarantine has been lifted; this is especially true for first responders whose exposure to the threat of disease was greater than that
of civilians: “Another study19 of hospital staff examined symptoms of depression 3 years after quarantine and found that 9% (48 of 549) of the whole sample reported high depressive symptoms. In the group with high depressive symptoms, nearly 60% (29 of 48) had been quarantined but only 15% (63 of 424) of the group with low depressive symptoms had been quarantined. (Brooks et al, 2020)”

The practice of mindfulness meditation has no associated cost nor timeline, as is such, mindfulness can be seen as an invaluable means of providing a self-sufficient approach to managing depression and its symptoms, not only during the acute period of quarantine, but in its aftermath as well.

The third and final quarantine-condition to be contrasted with the remedial qualities of mindfulness practice is stress. Stress-based conditions can vary widely, however, due to the continuous and ongoing nature of the COVID pandemic and associated quarantine, this study will be focused primarily on Acute Stress Disorder (ASD).

According to the International Classification of Diseases, the diagnostic guide published by the World Health Organization, ASD, hereto referred as Acute Stress Reaction, is defined as such:

“Acute Stress Reaction refers to the development of transient emotional, cognitive and behavioural symptoms in response to an exceptional stressor such as an overwhelming traumatic experience involving serious threat to the security or physical integrity of the individual or of a loved person(s) (e.g. natural catastrophe, accident, battle, criminal assault, rape), or an unusually sudden and threatening change in the social position and/or network of the individual, such as the loss of one’s family in a natural disaster. The symptoms are considered to be within the normal range of reactions given the extreme severity of the stressor. The symptoms usually appear within hours to days of the impact of the stressful stimulus or event, and typically begin to subside within a week after the event or following removal from the threatening situation. (ICD- 10)”

As it relates to quarantine, rather than a singular traumatic event, ASD can be attributed most commonly to the secondary criteria provided above; “an unusually sudden and threatening change in the social position and/or network of the individual. (ICD-10)” This drastic social adjustment- associated with the isolative nature of quarantine- can be regarded as the overwhelming root of growing levels of acute stress worldwide. “Boredom and isolation will cause distress; people who are quarantined should be advised about what they can do to stave off boredom and provided with practical advice on coping and stress management techniques. (Brooks et al, 2020)” Mindfulness practice is poised to be among the most effective techniques available to manage stress.

One of the most essential elements of practicing mindfulness mediation is acceptance. All sensation, be it emotional or physical, is to be accepted equally and without judgement; it is through this instruction that mindfulness may be best used to address symptoms of ASD. A major characteristic of ASD is the shifting way in which it’s symptoms manifest: “The symptoms show a typically mixed and changing picture and include an initial state of “daze” with some constriction of the field of consciousness and narrowing of attention, inability to comprehend stimuli, and disorientation. (Schreiner & Malcolm, 2008)”

In an effort to pinpoint these symptoms, individuals will scrutinize the root of said stress, which, often, only works to further exacerbate the overwhelming nature of the condition. “Stress as a construct can refer to various physiological and cognitive states, including irritability, excessive worry, or over-arousal (Lovibond & Lovibond, 1995). (Schreiner & Malcolm, 2008)” The unfiltered acceptance associated with mindfulness can be used as a counterbalance to the frantic, agenda-driven mind of an individual suffering from ASD. “Judgmental thoughts, such as those about the source of stress, are observed as long as they are present, then attention is directed back to the present (Kabat-Zinn, 1990; Kristeller and Hallet, 1999). (Schreiner & Malcolm, 2008)

While practitioners use a “mindful anchor” to ground their focus, an array of thoughts will arise and interfere with their targeted attention. By accepting each thought as it arises and returning to their anchor, meditators methodically learn to regard all thoughts as equal, irrespective to their association with stress or otherwise. Sitting through the discomfort of all sensation removes attachment to the intensity of a specific sensation, such as stress. “The meditative journey is not about always feeling good. Many times we may feel terrible. That’s fine. What we want is to open to the entire range of what this mind and body are about. (Goldstein, 2003)”

This repeated process works to both decrease the impact of stressful thoughts while increasing one’s ability to identify the onset of stress inducing triggers. “Since mindfulness training promotes the awareness of all emotional and cognitive events as they occur in the present, individuals can recognise the warning signs of tension build up. Once they have acquired these skills of ‘metacognitive insight’, controlling previously difficult safety behaviours and cognitions become more manageable (Kristeller and Hallet, 1999). (Schreiner & Malcolm, 2008)”

 ‘Metacognitive Insight’ refers to one’s ability to observe not only the contents of their thoughts but their process of thought itself. By gaining neutral understanding into how one’s full spectrum of emotions manifest, individuals suffering from ASD are better able to contextualize their symptoms and therefore diminish their psychological toll.

The emotional discernment enabled by the consistent practice of mindfulness meditation once again demonstrates its value as a psychological aid, especially in times of crisis when stress management options are needed on a grand scale.

Taken as a whole, the concept of using Mindfulness Meditation as a means of combating the examined quarantine-conditions is both promising and effective. As measured against the symptoms of the disorders assessed above, the clarity, stability and fortitude developed through mindfulness practice proves to be a highly plausible means of psychological self-care.

 Through providing anxious individuals a higher level of observational acuity, mindfulness assists in the assessment of threat and the mitigation of anxiety-based response. Through affording depressed individuals the skills to consistently return their focus to the present, mindfulness practice serves to disrupt ruminative thought and thereby weaken the root of depression itself. And through imparting the practice of accepting uncomfortable emotional states, mindfulness aids those suffering from ASD in contextualizing their stressful experiences and identifying the origin and presence of stressors themselves.

In summation, the regular practice of mindfulness meditation works to create greater mental agency in the face of psychological adversity; a resource desperately needed at present. “If quarantine is essential, then our results suggest that officials should take every measure to ensure that this experience is as tolerable as possible for people. (Brooks et al, 2020)”

Though the efficacy of this method remains dependent on an individuals’ consistency of practice, this study concludes that the role of mindfulness in times of crises can be regarded as theoretically integral.

References

 

  • Achenbach, J. (2020, February 4). Coronavirus is harming the mental health of tens of millions of people in U.S., new poll finds. Washington Post. https://www.washingtonpost.com/health/coronavirus-is-harming-the-mental-health-of- tens-of-millions-of-people-in-us-new-poll-finds/2020/04/02/565e6744-74ee-11ea-85cb- 8670579b863d_story.html?_gl=1*1cwanfi*_ga*SWV5OFYyTmdhdVdUWnRBV0UzQ2 puNUF2V3VxLVktZkZ4NDRzTk5GR3k2U04xd1pWb0FMeW5UMGpMdzVPeEJsaw..
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  • COVID-19 Map. (2020). Johns Hopkins Coronavirus Resource Center. https://coronavirus.jhu.edu/map.html
  • Goldstein, J. (2003). Insight Meditation: The Practice of Freedom (Later Printing Used ed.). Shambhala.
  • Schreiner, I., & Malcolm, J. P. (2008). The Benefits of Mindfulness Meditation: Changes in Emotional States of Depression, Anxiety, and Stress. Behaviour Change, 25(3), 156–168. https://doi.org/10.1375/bech.25.3.156
  • World Health Organization. (1992). The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines (1st ed.). World Health Organization.
  • Wright, R. (2017). Why Buddhism is True: The Science and Philosophy of Meditation and Enlightenment (Reprint ed.). Simon & Schuster.

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