09/03/2009 | DALE W. DINGLEDINE, PHD
Herbert Benson at Harvard Medical School states, “in regard to mainstream healthcare we are overlooking, or neglecting, the powerful component of self-care. That is, what an individual can also do for himself (as a complement to medication). Taking this into consideration, two journals in the past year (Journal of Attention Disorders and Complementary Health Practice Review) published articles on ADHD and Mindfulness Meditation as a method of developing inner abilities for calming oneself, encouraging focused attention, and increasing self-esteem.
While Benson advocates self-care for the general population, children with ADHD are often taken to the doctor for a solution to their impulsive behaviors and extreme moodiness — situations presenting as mild to severe attentional, procedural and/or behavioral difficulties in school and in relationships. While the medical community has powerful medication options, they may actually produce intolerable side effects or be ineffective, or only partially effective and therefore require additional drugs. Compounding this, individuals with ADHD frequently also have psychological issues such as anxiety and/or depression, requiring additional medications.
Mindfulness, a type of meditation which focuses on present moment experience (thoughts, sensations and emotions), is used in a variety of settings, and for a variety of situations. Since its introduction 30 years ago by Jon Kabat-Zinn at the University of Massachusetts Medical Center, more than 240 hospitals and clinics now teach Mindfulness-Based Stress Reduction (MBSR) for chronic pain disorders and disorders influenced by anxiety such as cancer, cardiac conditions, psychiatry, etc. There is now a large of body of evidence-based research supporting the use of mindfulness for well-being. Mindfulness-based therapies are also taught by well-trained individuals in the private sector (See http://www.umassmed.edu/cfm/mbsr/). Mindfulness meditation is used in learning how to respond calmly rather than reactively to situations as they arise in daily life.
Mindfulness and ADHD
Mindfulness meditation allows awareness of sensation, thought, and emotion to arise and return focus, non-judgmentally, to an attentional anchor (such as the breath). This is a practice that accepts the fact that brains are meant to think, but they get carried away. Through the practice of returning again and again to the present moment, thus minimizing the cognitive interference, the brain can become more and more focused. Recent research in neuroscience is showing that mindfulness meditation can modify attentional networks, change neural activity, alter neurotransmitter levels, and increase brain volume in areas related to attention, focus and regulating emotion. Even beginning meditators show increased activation in an area of the brain related to well-being.
In Zylowska’s study, traditional mindfulness meditation was slightly modified specifically for adults and adolescents with ADHD. In this study, ADHD was reframed as an extreme point on a neurobiological continuum of functioning. Other slight modifications included the use of visual aids in explaining mindfulness concepts and allowing “walking medication” during regular seated meditation periods. A “loving-kindness” meditation (acknowledging positive intention and extending wishes for well-being to oneself and others) at the end of each session helped to address the low self-esteem issues which so often accompany individuals with ADHD. Beauchemin also reports overwhelmlingy positive attitudes by high school subjects toward the mindfulness program related to anxiety, social skills, and academic performance. The participants showed significant improvement in demonstrating decreased anxiety, enhanced social skills, and improved academic performance.”
The power of mindfulness meditation is that it is beginning to be recognized as a useful complement in helping those with ADHD. While these articles are at the cutting-edge of ADHD research, they point to a future in which individuals with ADHD become partners with their doctors in their well-being, contributing with a degree of self-regulation of emotions and behaviors by responding rather than reacting. Parents and teachers may also benefit from mindfulness training for themselves as well as in knowing when to encourage mindfulness interventions with children.