Mindfulness Practices in Mental Health: An Integrative Review

DOI REGISTRATION: 10.5281/zenodo.7474197

Fabricio Luciano Mendes E Silva ¹
Denilson Gomes Silva ²
Ruth Raquel Soares de Farias ³

SUMMARY

The objective of this work was to present the benefits of mindfulness meditation practices on mental health through an integrative review. It aims to demonstrate how meditative practices originating from the East break down barriers beyond monasteries and become accessible to society in general, encompassing the scientific community, healthcare professionals in various situations affecting a person’s health (patient), and with emphasis on psychology professionals working with mindfulness (an area of ​​study within cognitive behavioral therapy) treating various disorders, as well as individuals with little or no experience in meditation and relaxation techniques. This is a bibliographic review of the integrative type, conducted between 2016 and 2022, using the BVS portal and the Pepsic, PubMed, Lilacs, and SciELO databases. In the end, 8 articles were included to constitute the sample for this research. The results demonstrate the importance of understanding the proper management of mindfulness meditation practices so that we can extract the greatest possible benefit from this application, including at the brain level in the functioning of neurotransmitters.

KEYWORDS: mindfulness; full attention; mental health; quality of life; psychological stress.

ABSTRACT

The objective of this work is to present the benefits of mindfulness meditation practices in mental health through an integrative review. And it intends to expose how the meditative practices coming from the East break barriers beyond monasteries and present themselves to society in general, encompassing the scientific axis, health professionals in various situations that are affecting the health of the person (patient), and with emphasis on psychology professionals who work with mindfulness (an area of ​​study of cognitive behavioral therapy) treating various disorders and for normal people with little or no experience in meditation and relaxation techniques. bibliographic review of the integrative type, took place from 2016 to 2022, in the VHL portal, in the Pepsic, PubMed, Lilacs, and SciELO databases. In the end, 8 articles were included to constitute the sample of this research. The results demonstrate the importance of understanding the proper management of mindfulness meditative practices so that we can extract the greatest possible benefit from this application, including brain levels in the functioning of neurotransmitters.

KEYWORDS: mindfulness; full attention; mental health; quality of life; psychological stress.

1 INTRODUCTION

In the contemporary context, the deluge of tasks we carry on our shoulders is so enormous that there are times when we are simply acting on what is called “autopilot.” This recklessness can manifest as physical pain and harm to our physical health, and consequently, our psychological health as well. Mental health, which is so precious, is now a priority and no longer a luxury. Going to a clinic to see a psychologist, therapist, or analyst—whichever professional we identify with—is important. 

With so many changes in our routines, increasingly challenging, long-distance relationships, and heightened emotions, the time has come to reflect on our conduct and lifestyle habits if we want to maintain well-being, and undoubtedly, mental health is the focus; routine, of course, will not be forgotten. As many people are working from home, a healthy, welcoming work environment is certainly necessary so that we can produce good work and contribute to society. Proposing practices, exercises, and activities that provide us with this balance, well-being, and concentration leads us to the “practice called mindfulness ” (DEMARZO; CAMPAYO, 2017). 

Mindfulness training was initially introduced by Kabat-Zinn (1982) as a treatment for chronic pain, but it has proven effective for other problems, such as various anxiety disorders (VANDENBERGER; ASSUNÇÃO, 2009). 

Mindfulness is an ancient body of knowledge that aims to allow “full attention” to the present moment, a mental state achieved through meditative practices. When we reach this state of awareness and self-regulation of attention, we are likely to perceive emotions, anxieties, and sensations as they arise, without suppressing them, thus creating a more flexible posture and conduct in the face of setbacks or situations that bother us (WILBERT et al., 2019). 

Therefore, mindfulness will function as self-regulation and self-centering (inner balance and peace), so that the person observes and reflects on their emotions and can seek the most positive internal resources to deal with unpleasant situations in their daily life (BRANDÃO, 2021).

From the perspective outlined above, the interest in the topic arose from what the researcher experiences and observes around them in situations and with people close to them in their social environment, sometimes resulting in incongruities in reasoning due to their absence from what we are doing, even acting in a reactive manner. 

This topic is relevant to Psychology because it highlights not only a tool available for people to practice and train mindfulness, but also how effective it has proven to be in addressing the various nuances of busy, everyday life, involving psychological issues, breaking cultural paradigms, and enriching social values. After all, the person gains a greater understanding of themselves.

The objective of this work was to present the benefits of mindfulness meditation practices on mental health through an integrative review. It aims to demonstrate how meditative practices originating from the East break down barriers beyond monasteries and become accessible to society in general, encompassing the scientific community, healthcare professionals in various situations affecting a person’s (patient’s) health, and with emphasis on psychology professionals working with mindfulness (an area of ​​study within cognitive behavioral therapy) treating various disorders, as well as ordinary people with little or no experience in meditation and relaxation techniques.

2 METHODOLOGY

The research was bibliographic in nature, of the integrative review type, working with both theoretical and empirical elements. Souza, Silva, and Carvalho (2010) clarify that an integrative review is a method that provides conditions for synthesizing both what is incorporated and the significant knowledge in the practical application of the results obtained.

Integrative bibliographic research allows for a connection between disparate elements, grouping them for a better dialogical understanding, encompassing much information available for a research topic that can be delimited, separating findings from ideas from scientific contributions (MENDE, SILVEIRA, GALVÃO, 2008).

 The review was conducted using the following steps: presenting the theme, selecting the research question, establishing inclusion and exclusion criteria for data collection, and presenting the studies that were included in the integrative review.

Data collection was conducted virtually using scientific research sources: the Virtual Health Library (VHL) access portal and databases such as the Scientific Electronic Library Online (SCIELO), PubMed, Latin American and Caribbean Literature in Health Sciences (LILACS), and Electronic Journals in Psychology (PEPSIC). The descriptors used were: mindfulness, mental health, and quality of life.

For this research, digital literature was included that was relevant to the selected topic, specifically articles published in Portuguese, with abstracts available in the selected databases and access to the full text. The period from 2016 to 2022 included published articles whose methodology yielded significant evidence on procedures, interventions, or guidelines in the selected area of ​​study. 

Articles published before 2016 in languages ​​other than Portuguese, articles that did not fit the theme, or that were duplicates, were excluded. Books, chapters, reviews, news articles, monographs, master’s dissertations, and doctoral theses were also excluded. The exclusion of these types of publications is justified because, unlike articles, they do not always undergo a rigorous peer-review process.

The methodological approach involved gathering articles in a logical sequence of evaluation based on title, abstract, and full text, using the aforementioned descriptors, individually or in combination, along with Boolean keywords. Subsequently, the selected articles were cataloged to organize the data into the following categories: author, year of publication, and title; type of study; and main outcomes. Based on this organization, a further reading of the material was conducted to delineate the most significant points of each article and construct axes for integrative analysis.

3. RESULTS AND DISCUSSION

To obtain the results, 20 articles were found in the LILACS database, 34 in SCIELO, 30 in Pepsic, and 16 in PubMed, resulting in a final sample of 8 articles. After exhaustive readings, the information regarding the selected articles was systematized, as shown in Table 1.

Table 1: Selected scientific articles

In the practice of self-care for mental health, meditation and its various techniques constitute an exercise that increases concentration levels, consequently increasing self-awareness and improving relationships with oneself and others.

Mindfulness, as a stress reduction technique, suggests emotional recalibration because it is not the presence of stressful stimuli that determines how a person responds, but the organism’s need for adaptation. With this hypothesis, mindfulness emerges as a clinical strategy focused on emotion regulation, which helps to improve it and restore full attention to the present moment (FLEURY et al., 2019).

Training to be in control and present involves being aware of what is happening beneath our skin—our thoughts, feelings, emotions, and memories. At this moment, people turn to their most immediate needs and understand their place in the world, which leads them to pay attention to the stressful moment they are experiencing (PEIXOTO et al., 2020).

Thus, Pinho et al. (2020) explain that depression is a disorder characterized by loss of pleasure (anhedonia) in daily activities, such as apathy, cognitive changes, and decreased ability to reason correctly, concentrate, or make decisions. It is an emotional disorder that has accompanied humanity throughout history. Many chronic clinical pathologies, when associated with depression, end up leading to a worse evolution and adherence to recommended treatments, resulting in a poorer quality of life and greater overall morbidity (PINHO et al., 2020).

In this sense, based on Peixoto et al. (2020), depression can be viewed and treated in various ways; it can manifest as unipolar or bipolar, chronic or episodic, mild to severe, and can even exist alone or in combination with other disorders. At the first symptoms, one should always seek a psychiatrist who can provide an accurate diagnosis and make the necessary interventions for each individual.

Fortes et al. (2019) explain that depression has different manifestations: depression, atypical depression, bipolar depression, postpartum depression, seasonal affective disorder, and dysthymia. Depression has several causes and risk factors, such as loneliness, lack of social support, recent stressful life experiences, family history of depression, relationship or marital problems, financial stress, childhood trauma or abuse, drug use, unemployment or underemployment, health problems, chronic conditions, or pain.

Understanding the cause of depression is the first step to overcoming it and seeking treatment based on healthy lifestyle changes, including yoga, relaxation, dance, healthy eating, medication, psychotherapy, electroconvulsive therapy, repetitive transcranial magnetic stimulation, dietary supplements, physical activity, and mindfulness (PINHO et al., 2020).

In this vein, Fleury et al. (2019) clarify that Mindfulness is a type of psychotherapeutic work that emerged as a support pattern in psychology based on developing the ability to be expansively and receptively present in the experience of the moment, even when that experience is difficult and complex for the individual. It seeks a psychological balance that accompanies psychological qualities such as flexibility, resilience, authenticity, patience, connection, kindness, compassion, and wisdom.

In this context, Fortes et al. (2019) elucidate that the practice of mindfulness is increasingly used in clinical training, where intervention techniques are employed in specific disorders to reduce stress, anxiety, depression, and other psychiatric disordersto minimizeg illness and even promote recovery. According to the author, this technology can help improve well-being.

Mindfulness has been associated with different mental health approaches and integrated into psychology, such as cognitive-behavioral therapy (CBT), psychodynamic psychotherapy, humanistic/existential psychotherapy, behavioral medicine, and positive psychology (PINHO et al., 2020). The authors note that the practice of mindfulness has been used as a complementary therapy to help improve people’s health. Mindfulness can be used by anyone of any age with few limitations.

Mindfulness, when applied, is related to emotional regulation and self-acceptance, helping the individual to reduce their tendency towards negative thoughts and ruminations that rob them of happiness and generate more emotional suffering. The purpose of mindfulness meditation is to free the individual from automatic reaction patterns, resulting in greater attention and awareness of the habits that determine how a person behaves and relates to the world (FLEURY et al., 2019).

Peixoto et al. (2020) state that a meditation practice allows one to create relationships between thoughts, emotions, and perspectives more flexibly and rationally. Training in mindful attention allows a person to use specific techniques to stay focused and concentrated, thus becoming aware that thoughts, emotions, and bodily responses are often activated unconsciously, seeking to control this integration as flexibly and rationally as possible.

In terms of health, the practice helps in the treatment of clinical and psychiatric illnesses, as well as preventing stress. In the field of education, there have been improvements in areas such as concentration, academic performance, and relationships. In business, maintaining this mentally disciplined routine can help reduce and prevent stress at work and increase job satisfaction (FLEURY et al., 2019).

Mindfulness is the best tool to reduce stress, anxiety, depression, and other factors that contribute to patient imbalance. It allows people to have better access to their own thoughts and emotions, enabling them to assess their lifestyle and the current moment they are living in (SILVEIRA et al., 2021).

Mindfulness is a skill that allows us to pay conscious and non-judgmental attention to our experiences in the moment, to be open and accept things as they are, and give them their due importance (FORTES et al., 2019).

It is therefore understandable that mindfulness constitutes a possible self-care practice to address the repercussions associated with social conflict in contemporary society. Through mindfulness techniques, the entire organism enters a more harmonious state, and the individual develops more neuronal synapses, forming behavioral changes that last longer and begin to occur more rapidly, as neurons make new connections and alter the structure of the body/brain.

Fortes et al. (2019) explain that neuroscientists call this activity neuroplasticity. It is unclear how this entire process works, but the results can be observed in the formation of memories. The technique is a multifaceted and heterogeneous task that involves focusing attention in a focused manner, such as opening up sensory experiences, emotions, and thoughts. Mindfulness therapy helps individuals break down negative conditioning mechanisms and provides new tools to reduce mental vulnerability.

From a psychological point of view, mindfulness appears to prevent potentially dysfunctional forms of thought processing, such as rumination and reactions to negative emotions. And the norm is configured as a tool that can reduce vulnerability to mental illness. (FLEURY et al., 2019).

Mindfulness has broad applicability to a wide range of physical and psychological imbalances, and emerges as a therapeutic process that can help people improve their symptoms, not directly in their treatment, but in the psyche, which has a direct impact on the mechanisms of well-being of a person’s emotional and mental health, as well as physical health, assisting and alleviating symptoms and rebalancing current conditions.

In this sense, Azevedo, Xavier and Menezes (2022) explain that when stress levels in the body are controlled, allowing tools to maintain balance in the face of external challenges that are part of everyday life, physical health is immediately improved, corticosteroid levels are reduced in the body, leading to increased immunity and restoring health that was previously in a state of disarray.

 Mindfulness within the framework of therapeutic approaches functions as a tool to perceive, recognize, and constructively relate to the present moment. By shifting the focus of lived moments, it immediately changes how one experiences them. In other words, it will have different effects on the physical and mental health of practitioners. Mindfulness is a way of consciously discovering each thought at the moment it is experienced, with full awareness, without judgment or criticism, with an inner attitude of acceptance, and without expectations for the next moment (PINHO et al., 2020).

According to Fleury et al. (2019), there are several mental processes associated with the effects of mindfulness, such as attention regulation, body awareness, emotion regulation, and the development of metacognitive insight. By regulating attention, people learn to focus on present-moment experiences because stress is a continuous result of projecting thoughts into the future or reflecting on what happened in the past. Thinking about what still needs to be done or reliving what has already happened creates a contrast between the future and the past, which means missing the opportunity to live the only moment that exists, which is the present moment, when, most of the time, it is free from any stress or nervous stimulation.

However, even when you are overwhelmed with stressful stimuli, you learn to be receptive, curious, and non-judgmental in that experience, accepting each moment as it arises, because this acceptance allows you to act more receptively and more sharply. A balanced approach instead of an impulsive reaction to the situation at hand (FLEURY et al., 2019).

With body awareness, one learns to be conscious of the body in each moment of experience in the present moment. In reality, little attention has been given to the body; however, it indicates how thoughts are reflected in the body, generating imbalances in physical health that are often neglected.

Azevedo, Xavier, and Menezes (2022) elucidated that by developing the ability to recognize the signals, individuals will be better able to manage them constructively, thus restoring balance. For example, if you notice tension in your shoulders while working on the computer, try to relax them, or when you are tense and your hands clench involuntarily, observe and try to relax them.

In this regard, through emotional regulation, a person learns to process emotions by recognizing the emotional experience in each moment of life. When recognizing emotions in the present, one is invited to pay attention to these emotions without repressing them or making them conscious. We engage as if we were in the middle of a constantly spiraling tornado; that is, we learn to create a space between our emotions and our responses to actions in order to reduce impulsivity and rebalance our internal emotional state (WENCESLAU et al., 2022).

Based on Azevedo, Xavier, and Menezes (2022), they state that mindfulness and meditation differ from this view, arguing that the functions of the human mind can be understood and modified. Metacognition describes the knowledge used to understand cognitive processes and the mechanisms that alter them, which can be defined by analyzing the functioning of the mind. These types of therapies believe that what matters is not whether the content of thoughts is positive or negative, but how the person relates to them, whether they believe in them, and how they allow themselves to be affected by them. 

Mindfulness therapy is the best tool for developing emotional intelligence, being aware of the thoughts and emotions that arise in oneself and others, and being able to discern between them in order to make choices that allow one to cultivate ideals instead of focusing on the undesirable (SILVEIRA et al. 2021).

Research on therapies demonstrates their use in improving performance and productivity at work, often through attention, focus, and resilience, and in the development of emotional intelligence, thus improving the quality of interpersonal relationships and leadership (PINHO et al., 2020).

Based on Fortes et al. (2019), all therapies have contraindications and precautions for use, and a clinical evaluation should be performed before participating in a treatment group. The first preventive measure is intended for healthy individuals with low motivation, critical or antagonistic attitudes, and the second preventive measure is intended for ill individuals, that is, those in the acute phase of any illness, such as major depression, bipolar disorder, or psychosis, in dissociative states of crisis, post-traumatic stress,s and personality disorders.

Peixoto et al. (2020) clarified that, about treatment adherence, patients with chronic pain drop out more frequently than those with other conditions, such as stress, insomnia, anxiety, and hypertension, etc. Men are more likely than women to abandon their jobs.

In this sense, Fortes et al. (2019) explained that mindfulness therapy can help individuals regain autonomy and focus at work, maintain full attention in daily life, learn to breathe properly, and improve the quality of life for themselves, their families, and those around them.

Mindfulness is associated with more powerful brain patterns that act on the limbic system and manifest as more adaptive psychophysiological responses; that is, from a psychological point of view, it prevents dysfunctional thoughts such as rumination, negative reactions, and emotions.

Mindfulness therapy helps individuals break negative conditioning mechanisms and provides new tools to reduce mental vulnerability (FORTES et al., 2019). As such, mindfulness has been proposed by several authors as a therapeutic intervention for mental disorders, promoting mental training of emotions, feelings, etc. (FLEURY et al., 2019).

4. FINAL CONSIDERATIONS

Based on this research, one can understand the relevance of mindfulness meditation practice, both in terms of scientific research and in the rehabilitation or restructuring of cognitions.

It is important to emphasize how much neuroscience has been studying the benefits of this rebalancing of the body’s vital functions for its practitioners, and even for those who are not diligent in the art of meditation or even self-relaxation, these benefits are extremely relevant. It helps coordinate mental organization and cope with adverse situations around us.

In this sense, we seek to synthesize and reflect on the main concepts, taxonomy, and applicability of mindfulness as a tool for reducing barriers to the development of self-care practices.

It is also related that this meditation technique can be used as a healing practice. Even when associated with therapy, it can be a powerful addition because it can help individuals develop a positive attitude to deal with everyday problems. We emphasize that, unlike other therapies that use long-term therapeutic talk, this technique helps combat negativity, promotes personal responsibility, and provides quick, goal-oriented solutions.

It was concluded that mindfulness is a technique used in psychology to improve quality of life due to its role in assisting mental processes, including combating stress, anxiety, and depression, but without negating the need for monitoring by an interprofessional team composed of doctors, nutritionists, etc.

Thus, the more one understands the self-knowledge that this tool provides for prevention and treatment, the more acutely one can observe its potential for the health of the population, accelerating the self-healing process that exists in every human being.

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