Mindfulness (Still) Works

We all know by now about the mindfulness research. Thousands of studies. Top-tier journals. Exemplary findings. Mindfulness, it seems, is an effective treatment for everything from hypertension to depression, from ADHD to PTSD, from racial intolerance to everyday anxiety.

But recently some researchers have begun to push back. Wait a minute! they seem to say over their cold cups of coffee in their windowless labs. Nothing can be this good.

And so, over the past year or so, we have seen a few publications that would like to throw a wet towel on the mindfulness fever that has overtaken America's schools, hospitals, corporations, and media publications.

So let's look at two of these naysayers, shall we?

Earlier this year Coronado-Montoya et al. published a statistical analysis of 124 mindfulness studies. In it, they claimed that, low and behold, the effects of the intervention had likely been exaggerated. Why? Because 88 percent of the trials reported positive results. Put simply, that’s just not possible. Even if mindfulness is effective (which it is), that number is 1.6 times higher than what would be statistically reasonable.

Does this mean mindfulness doesn't work? Absolutely not.

It’s called “selective publication,” and it is rampant, not just in the mindfulness literature, but in all psychological research, and in most medical research besides. Put simply, selective publication takes place when researchers publish positive outcomes and don’t publish negative outcomes. The dynamic is exacerbated by the refusal of most journals to publish most null findings.

The result? It's likely (though not certainly) true that the effect sizes for mindfulness interventions are less robust than initially reported. It does not follow, however, that you should quit your morning meditation and just binge watch Netflix before work.

In another study intended to reset our expectations for mindfulness, Kuyken et al. published the most hard-nosed, nitty-gritty, no-holds-barred randomized controlled trial that anyone is ever likely to conduct. They published it in the Lancet, often considered the world’s premier medical journal.

In the study, they divided 424 chronically depressed patients into two groups: one received medication, the other mindfulness. After five separate follow-ups over a period of 24 months, the investigators crunched their numbers and concluded . . . what?

First, that there is no evidence that mindfulness is superior to antidepressants. Second, that both treatments produce “enduring positive outcomes.”

Stop the bus. Let's repeat that.

Mindfulness is only as effective as SSRIs. Does anyone remember the epic hullabaloo when SSRIs hit the market 20 years ago? Did anyone read Listening to Prozac? Aren't SSRIs, to this day, considered the first line of defense against mild to medium depression and relapse by medical professionals everywhere?

So, friends, if some of the supposed pushback against mindfulness has got you reconsidering your daily commitment to sitting still, if you wondered whether it's really worth it to count your breaths or scan your attention slowly through your appendages on a Sunday morning, you can rest assured.

Yes, mindfulness is a craze right now. Yes, there are adjustments to be made in the research literature. Yes, your girlfriend should stop badgering you to wash the dishes more mindfully.

But one thing is, at this point, beyond contention: mindfulness works.

Craig Hase