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-Adele Krusche and J. Mark G. Willaims, Oxford Mindfulness Centre, University of Oxford
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-Computing is not about computers any more. It is about living.
-<cite>—Nicholas Negroponte, Being Digital</cite>
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+====== 9 Mindfulness ======
+<blockquote>The faculty of voluntarily bringing back a wandering attention, over and over again, is the very root of judgment, character, and will. … An education which should improve this faculty would be the education par excellence. <cite> William James, Psychology (1892)</cite>
 </blockquote>
-At the Oxford Mindfulness Centre, we teach people the skills to be able to let go of unwanted thoughts, to sit still and to pay attention to what is going on right here and now. Within Oxford University’s Department of Psychiatry, we work with partners around the world to prevent depression and enhance human potential through the therapeutic use of mindfulness. The benefits of mindfulness in preventing serious depression and emotional distress have been demonstrated by clinical trials, and work continues to explore the implications of this relationship and to extend the approach to other disorders, using brain-imaging techniques together with experimental cognitive science to learn how mindfulness has its effects and which practices are best for whom.
-The society we live in and mindfulness therapy seem to be poles apart. A simple concept such as staying still and noticing seems, to many, very alien now, and perhaps that means we need to remember it. Mindfulness courses delivered in person have been shown to be effective for many people experiencing a variety of problems.
+You get dressed, spill some coffee, put the cereal away in the fridge, pretend you're listening to your kids, and leave without the car keys. It's a typical day in the world of the modern Homo sapiens -- a species that has largely lost its natural state of present awareness. We live on autopilot, lost in plans and reruns. Our attention flies off like a coven of witches to all the things we have to do, reliving the conversations we've had or rehearsing the ones we haven't. How many of us are mentally "at work" when we're eating dinner, lying in bed, or even on vacation? Worst of all, our digital devices seem to conspire against us. Picture this: it's the end of a long day, and you're finally unwinding -- just beginning to pay real attention to what your spouse was saying as you settle back into the reality of the present. Suddenly, the vibrating beep attacks, you fail to resist, and it's an email message that flings you back to work, with a dose of stress for the ride.
-The problem comes when we have classes on mindfulness running a few miles from home, starting perhaps while we are at work or picking the kids up from school; maybe disability or cost gets in the way. This is where online mindfulness comes in. It offers the opportunity for people to learn the skills in their own homes, in their own comfortable chair, without the need to rush or arrange childcare. These skills can then be used in the very surroundings they might need most.
+The antidote or opposite state to all this "mind wandering" and "absent-mindedness" is mindfulness. Mindfulness, a kind of broad and nonjudgmental present-moment awareness, is not only a stress reducer, but also a key to wiser decisions, greater life satisfaction, and overall psychological and physical wellbeing, according to research. In fact, it's a bit of a magic bean; plant it, and a wealth of mental resources will be yours. That's probably why mindfulness practice is common to many religious traditions, especially Buddhism.
-That isn’t to say that this online mindfulness therapy is for everyone. We’re only just starting to explore its effectiveness. Our preliminary research suggests that Internet-based mindfulness training has the potential to reduce stress, anxiety, and depression in people who have chosen to take a course. We don’t yet know much about the people taking the course, but are looking forward to finding out exactly who and who does not benefit from it. If people are getting results from this course equivalent to online CBT or some face-to-face courses, it seems essential to continue the research and to develop online therapies to help the people who choose to take them. The word is starting to spread that these Internet interventions exist, that helpful therapies are available now, and that they might just make you feel better without your having to leave your living room. Being able to steal some time back in the light of your monitor might take some of the frantic out of the day.
+The Buddha was arguably the first person to prescribe a mental health intervention. It was a universal eight-step program he called the Eightfold Path designed to support ultimate wellbeing, and among the steps is mindfulness.1 Buddhist traditions have spent the past 2,500 years cultivating mindfulness through specific training practices (i.e., Vipassana, Zazen, and walking meditation), which is why researchers such as Mark Williams and Jon Kabat-Zinn (2013) have turned to these practices to see how they might be tested empirically and integrated into mindfulness interventions for health care, mental illness, and education.
-For further reading, see Krusche et al. 2012. For mindfulness online, a preliminary evaluation of the feasibility of a web-based mindfulness course and the impact on stress is available at BMJ Open, 2(3).
+Mindfulness practices were first adapted for a Western audience around the 1970s. Most significantly, in 1979 Jon Kabat-Zinn of the University of Massachusetts Medical School introduced the Mindfulness-Based Stress Reduction (MBSR) program. MBSR is an eight-week course that has since helped thousands of people with stress, pain, and depression (Kabat-Zinn, 1990) and that research has consistently shown to have large effect sizes (Grossman, Niemann, Schmidt, & Walach, 2004).
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-Mindfulness Online
-<imgcaption image1|Adele Krusche and J. Mark G. Willaims, Oxford Mindfulness Centre, University of Oxford>{{Adele_Krusche_and_J._Mark_G._Willaims.png|}}</imgcaption>
-Adele Krusche and J. Mark G. Willaims, Oxford Mindfulness Centre, University of Oxford
-<blockquote>
-Computing is not about computers any more. It is about living.
-<cite>—Nicholas Negroponte, Being Digital</cite>
-</blockquote>
-At the Oxford Mindfulness Centre, we teach people the skills to be able to let go of unwanted thoughts, to sit still and to pay attention to what is going on right here and now. Within Oxford University’s Department of Psychiatry, we work with partners around the world to prevent depression and enhance human potential through the therapeutic use of mindfulness. The benefits of mindfulness in preventing serious depression and emotional distress have been demonstrated by clinical trials, and work continues to explore the implications of this relationship and to extend the approach to other disorders, using brain-imaging techniques together with experimental cognitive science to learn how mindfulness has its effects and which practices are best for whom.
-The society we live in and mindfulness therapy seem to be poles apart. A simple concept such as staying still and noticing seems, to many, very alien now, and perhaps that means we need to remember it. Mindfulness courses delivered in person have been shown to be effective for many people experiencing a variety of problems.
+Based on MBSR, researchers Zindel Segal, John Teasdale, and J. Mark Williams, director of the Mindfulness Centre at the University of Oxford (see his sidebar in this chapter) developed the Mindfulness-Based Cognitive Therapy (MBCT) program, an integrated approach (now endorsed by the UK National Institute of Clinical Excellence) that has proven effective in treating depression, preventing relapse, and promoting wellbeing (see Segal, Williams, & Teasdale, 2012).
-The problem comes when we have classes on mindfulness running a few miles from home, starting perhaps while we are at work or picking the kids up from school; maybe disability or cost gets in the way. This is where online mindfulness comes in. It offers the opportunity for people to learn the skills in their own homes, in their own comfortable chair, without the need to rush or arrange childcare. These skills can then be used in the very surroundings they might need most.
+Privy to the findings on its many benefits, human-resources departments are now lining up to include mindfulness training as part of professional development. This increased attention has meant increased examination in the research literature as well, which is reflected in an overwhelming number of peer-reviewed studies each year. (The mindfulness research guide2 has cataloged more than 2,500 papers, which began as a handful in 2000 and grew to almost 500 a year by 2012.)
-That isn’t to say that this online mindfulness therapy is for everyone. We’re only just starting to explore its effectiveness. Our preliminary research suggests that Internet-based mindfulness training has the potential to reduce stress, anxiety, and depression in people who have chosen to take a course. We don’t yet know much about the people taking the course, but are looking forward to finding out exactly who and who does not benefit from it. If people are getting results from this course equivalent to online CBT or some face-to-face courses, it seems essential to continue the research and to develop online therapies to help the people who choose to take them. The word is starting to spread that these Internet interventions exist, that helpful therapies are available now, and that they might just make you feel better without your having to leave your living room. Being able to steal some time back in the light of your monitor might take some of the frantic out of the day.
+The scientific evidence for the positive impact of mindfulness on wellbeing has been accumulating within neuroscience as well as within psychology and psychiatry. In this chapter, we look at some of the literature in each of these fields and present examples of the kinds of traditional and technology-based strategies already in place for developing mindfulness. We also look at some of the latest technologies emerging to support mindfulness practice. But, first, the requisite foray into the workings of the mind or how, from our thoughts to our brainwaves, we change measurably as a result of sustained mindful attention.
-For further reading, see Krusche et al. 2012. For mindfulness online, a preliminary evaluation of the feasibility of a web-based mindfulness course and the impact on stress is available at BMJ Open, 2(3).
+===== The Psychology of Mindfulness =====
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+==== Awareness and Attention ====
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+Prominent Zen teacher and author Thich Nhat Hanh (2008) describes mindfulness as "keeping one's consciousness alive to the present reality." It is in fact two elements of consciousness -- attention and awareness -- that are at the core of mindfulness practice. Father of Western psychology William James (1892) conceived of mindfulness as the state of being attentive and aware of what is happening at the present moment. Likewise, Kirk Brown and Richard Ryan (2003) discuss mindfulness as a naturally occurring characteristic, with attention and awareness as its two components.
+Awareness is the component that continuously monitors the inner and outer world. It is what feeds that which Daniel Kahneman (2013) has called "system 1," the automatic system. Attention refers to the focused attention we place on part of the moment-to-moment experience, which may be our thoughts, feelings, behaviors, or the surrounding environment. So depending on the moment itself, a focus of our awareness might be a flower, a companion, or a current feeling of anxiety. Attention provides a heightened sensitivity to a subset of what we sense. An essential element of this attention in the context of mindfulness is nonjudgment.
+==== Mindfulness as Nonjudgmental Attention ====
+Mindfulness is distinct from the retrospective reflective processes discussed in the previous chapter in at least two ways. First, rather than being a mental account or an analysis of experience, mindfulness is a nonreflective and nonjudgmental observation of it. Mindfulness practice specifically avoids evaluation, opinion construction, or analytical cognitions. It is attention and awareness stripped bare of the judgments we so often automatically impose upon all that we perceive. Kabat-Zinn (2003) makes this clear and offers the following as an operational definition of mindfulness accordingly: "the awareness that emerges through paying attention on purpose, in the present moment, and nonjudgmentally to the unfolding of experience moment by moment."
+The nonjudgmental, nonreactive aspect of mindfulness training is critical in clinical settings, where it prevents attention from turning to thoughts of comparison and criticism (e.g., "I'm no good at this; I get distracted all the time" or "He's so much better than me"). The nonjudgmental aspect is also sometimes referred to as "detached" awareness (Speca, Carlson, Goodey, & Angen, 2000). Pema Chodron (2007) describes it in terms of unconditional friendliness: "Unconditional friendliness is training in being able to settle down with ourselves, just as we are, without labeling our experience as ‘good' or ‘bad.'"
+This relinquishing of judgment is also a key difference between mindfulness and CBT. CBT encourages the labeling of negative thoughts and feelings, for example, as "unhelpful" or "irrational" and encourages challenging and changing those thoughts. In contrast, mindfulness practice encourages the simple observation and acceptance of them and discourages both rumination and striving for any particular outcome (Hamilton, Kitzman, & Guyotte, 2006). One goal of this nonjudgmental observation is to gain the insight that all thoughts and feelings, regardless of their content, are empty and transient constructions. Nancy Hamilton, Heather Kitzman, and Stephanie Guyotte (2006) note that although these two approaches (CBT labeling versus mindfulness nonlabeling) are diametrically opposite in practice, they can lead to the same outcomes, and the two practices are frequently used in complement, as in MBCT.
+==== Mindfulness: State or Trait? ====
+Brown and Ryan argue that some people may have a disposition (i.e., trait) toward being more mindful, and so they have explored mindfulness as a naturally occurring attribute. Their research has shown that mindfulness as a trait has a positive effect on self-regulated activity and on wellbeing (Brown & Ryan, 2003; Brown, Ryan, & Creswell, 2007). However, they have also studied mindfulness as a state that can occur as a result of training, and their research has found that, independent of disposition, momentary experiences of mindfulness also have a salutary effect on wellbeing.
+Research on mindfulness states, the success of programs such as MBSR, and the ancient history of Buddhist practice give ample evidence that mindfulness can be developed with practice, and therefore we can infer that there is potential for technology to be involved in this practice, be it as direct guidance or as peripheral support. But before we get to that, it is worth peeking into the world of the neuroscientist in order to discover how mindfulness physically changes our brain structures and their activity.
+===== The Neuroscience of Mindfulness =====
+Sitting in the confines of his plastic cave, the monk enters a state of deep, spacious awareness. Ready to detect any change in his brainwaves are the 24 electrodes pasted to his conveniently shaven head, and the fMRI machine -- the cave within which he sits -- is sending data on cerebral blood flow to the group of eager scientists behind the glass. Ancient in its origins, meditation is by far the oldest systematic practice for developing mindfulness that exists. Newfangled as mindfulness practice may sound to some, humans were training in it long before they were writing on paper. The practice has survived 2,000 years of human history, and modern-day Buddhist monks continue to engage in and teach these same practices around the globe. Happily, these same monks are also amenable to satisfying the empirical curiosity of neuroscientists, which is why we find them in unlikely places, such as fMRI machines in Madison, Wisconsin.
+The physiological impacts of long-term meditation practice are surprisingly conspicuous from a neuroscientific point of view. Although early studies with expert meditators using EEG date back to the 1950s and 1960s, it's only during the past decade that we have been able to accumulate a more rigorous collection of neuroscientific evidence for the impacts of mindfulness practice.
+Via EEG studies, mindfulness meditation has been associated with measurable changes to brainwaves, including changes in alpha waves and increases in theta and gamma rhythms (Lutz, Dunne, & Davidson, 2006). Alberto Chiesa and Alessandro Serretti (2010) report that, in addition to significant increases in alpha and theta activity, mindfulness meditation is associated with activation of the prefrontal cortex and anterior cingulate cortex, areas related to attention. Moreover, long-term meditation leads to enhancement of both these areas (specifically, the anterior cingulate cortex and the dorsolateral prefrontal). Less academically speaking, practicing mindfulness pumps up your attention muscles.
+One surprising finding, with implications for those seeking to measure levels of mindfulness physiologically, is that although it seems logical to assume meditation practice will develop interoceptive awareness, which is often measured by a participant's ability to detect his own heartbeat, Sahib Khalsa and his colleagues (2008) have shown that practicing attention to internal body sensations does not actually lead to a better heart beat detection. So how does one go about measuring mindfulness? Well, usually, with a questionnaire …
+===== Measuring Mindfulness =====
+We can now use EEG and even brain imaging to detect and study mindfulness states, but the simplest, most widely used and thoroughly validated ways to measure mindfulness as both a state and trait are self-report instruments and established mindfulness scales developed by various research groups, each with a slightly different focus.
+Brown and Ryan (2003) have provided a theoretical and empirical framework, including a dispositional scale (the Mindful Attention Awareness Scale, or MAAS) that can be used to measure the individual differences in the frequency of mindful states. MAAS consists of 15 statements to which participants assign a score from 1 to 6: for example, "I could be experiencing some emotion and not be conscious about it until some time later" or "I tend to walk quickly to get where I am going without paying attention to what I experience along the way." The questions have been confirmed by a number of studies that have indicated that the MAAS is a valid measure, distinct from other related measures.
+The Freiburg Mindfulness Inventory is another widely used scale (Walach, Buchheld, Buttenmuller, Kleinknecht, & Schmidt, 2006) that was developed for use with experienced meditators but includes a later version adapted for use by nonmeditators. Other scales include the Kentucky Inventory of Mindfulness Skills, the Cognitive and Affective Mindfulness Scale -- Revised, the Southampton Mindfulness Questionnaire, the Five Facet Mindfulness Questionnaire, the Philadelphia Mindfulness Scale, and the Toronto Mindfulness Scale. For more information on these scales, Ruth Baer (2011) provides a summary and evaluation of approaches to measuring mindfulness.
+Fortunately, there is good correlation among scales as well as between scale measures and related psychological measures (and, to a less studied degree, there is correlation between the results of these scales and neurological measures). Nevertheless, researchers agree that available measures are never perfect, and further development to address weaknesses and devise complimentary methods of measurement is ongoing.
+==== Measuring the Impact of Mindfulness on Wellbeing ====
+The end goal for any effort in cultivating mindfulness is to foster wellbeing (whether by reducing the experience of pain, preventing depression, treating anxiety, or something else.) In order to measure the link between mindfulness and wellbeing, Brown & Ryan (2003) have used a combination of scales across several studies, including the CES-D Scale and the Beck Depression Inventory (for depression); the Positive and Negative Affect Scale and a scale of affective tone (for SWB); two scales to measure eudaimonic wellbeing; and two to measure physical wellness.
+These studies showed that mindfulness (as measured by MAAS) was significantly correlated with measures of self-regulation and wellbeing. Furthermore, to address the limitations of retrospective self-reports, Brown and Ryan added another study using experience sampling (sending reminders to subjects via pagers). MAAS was used to assess both trait and state mindfulness, where "trait" referred to measures of intrapersonal differences, while "state mindfulness" measured variability of an individual's states. Both trait and state mindfulness were independent factors, and both had salutary effects.
+Some of the limitations of Brown and Ryan's experience-sampling study (for example, the number of participants, the amount of data collected, the timing of the data collection) were addressed by a more recent study by Matthew Killingsworth and Daniel Gilbert (2010). They also used experience sampling, although thanks to technological advancements in the interim period, they were able to harness the convenience of mobile phones. In order to investigate whether mindfulness was a cause of happiness, they created a mobile phone application (see trackyourhappiness.org) that periodically interrupted participants during the day to ask the following three questions:
+  * How are you feeling right now? (answers were on a sliding 1-100 scale)
+  * What are you doing right now? (with a choice of 22 activities generally used in the day-reconstruction method (Kahneman, Krueger, Schkade, Schwarz, & Stone, 2004)
+  * Are you thinking about something other than what you are doing? (with the following options: "No," "Yes, something pleasant," "Yes, something unpleasant," or "Yes, something neutral")
+The application collected an impressive 2.5 million samples from 5,000 individuals from 83 different countries ages 18 to 88. From among these samples, they analyzed the US-derived data (N = 2,250), and the findings were striking.
+  - Mind-wandering occurred about half the time. Their findings suggest that on average 46.5 percent of the time we are thinking about something other than what we're doing. This happens at least 30 percent of the time for specific activities (with the exception of love making, for which we mind wander -- or admit to it -- only about 10 percent of the time). Interestingly, whether we mind wander is not, as one might expect, related to the nature of the activity we are engaged in.
+  - People were less happy when their minds wandered, regardless of what they were doing at that time. Minds wandered to positive things 42.5 percent of the time, to negative things 26.5 percent of the time, and to neutral things 31 percent of the time. And here's the clincher: people were not happier when their minds wandered to positive thoughts than when they were simply being mindful of the task at hand (whatever it may be). In other words, fantasizing about a tropical island while sitting in dull traffic will not make you happier than mindfully attending to the traffic.
+  - What people were thinking was more important to predicting how they felt than what they were doing. The nature of participant activity explained only 4.6 percent of the variance in happiness, while mind wandering explained 10.8 percent.
+  - Most significantly, the study gave evidence that mind wandering was generally a cause rather than simply a consequence of unhappiness.
+Clearly, mind wandering is a mental activity that sits in opposition to mindfulness in that it describes doing one thing but thinking another. It seems logical then to suspect that multitasking, which refers to the simultaneous execution of multiple tasks, might also reduce mindfulness and consequently wellbeing to some degree. Indeed, research is providing evidence for such a hypothesis.
+In a recent survey of more than 3,000 girls ages 8?12 (Pea et al., 2012), media multitasking was shown to be negatively correlated to wellbeing (media multitasking constituted combinations of watching video, playing videogames, listening to music, texting, and talking over the phone). Specifically, the more participants multitasked, the worse they felt. In contrast, face-to-face social activities, which were also measured by the study, were positively correlated to wellbeing. Another study (Becker, Alzahabi, & Hopwood, 2013) measured 318 college students and found that increased media multitasking was associated with higher symptoms of depression and social anxiety (even after controlling for neuroticism, extraversion, and overall media use).
+Multitasking research is particularly relevant to positive computing because the current design of technology actively facilitates parallel activity. This is probably because most digital devices are considered productivity tools, and multitasking is culturally viewed largely as a positive expression of greater productivity, despite ample evidence that it reduces performance (Wang & Tchernev, 2012).
+Digitally afforded multitasking trains us to be drawn away from what we're experiencing and to be distractible. Whenever we come across a few seconds of pause (e.g., a file download, a line at the grocery store), we have come to react by immediately seeking something to fill in the moment, and mobile phones make this possible anywhere, anytime. Our brains seem addicted to busyness, despite our pleas for rest. Time and again we react to the prospect of present-moment awareness with anxiety, rapidly seeking out new points of attention -- we even look for new thoughts to think (What can I plan? I should check my schedule mentally while I stand here) rather than settling into the moment as it is. Ironically, this is all at the expense of both performance and wellbeing.
+With multiple devices on hand, each of which houses multiple applications displayed in parallel windows, modern devices are multitasking dynamos. It is only recently in response to information overload that some software designs have been switching some of the focus back to well … focus. If multitasking does in fact decrease wellbeing, researchers in positive computing need to investigate how we can support productivity (genuinely) and in ways that don't compromise wellbeing.
+The abundance of research evidence for the wellbeing benefits of mindfulness gives us plenty of reason to support it in the context of positive computing. However, how do we approach supporting users with a factor so subjective and internally experienced? Eight-week programs are unlikely to be the best model when users seldom engage with technology in the way they do with intensive medical interventions. Nevertheless, even longer programs are composed of smaller parts, and interventions in psychology remain an important place to look for guidance.
+===== Strategies and Interventions for Fostering Mindfulness =====
+==== Mindfulness Training and Meditation ====
+Jon Kabat-Zinn's (1990) eight-week intensive MBSR program is based on a combination of meditation, Yoga practices, and inquiry exercises developed in weekly meetings. The meditation practice consists of turning attention, without judgment, to thoughts, feelings, and body sensations. A meta-analysis of 20 independent evaluations of MBSR programs (Grossman et al., 2004) found that all the interventions had similarly large effect sizes of 0.5 (P < 0.0001),3 a track record of success that has placed MBSR programs in more than 200 institutions around the world.
+Mindfulness-based training programs and mindfulness-based CBT programs incorporate multiple strategies, including mindfulness meditation. For mindfulness-based meditation (MBM in the scientific literature), various approaches have been used for guiding practitioners, including using mental practices such as body scans (intentionally observing and relaxing each part of the body) and the use of metaphors ("Simply watch your thoughts as you would watch clouds pass across the sky"). Buddhist teaching commonly employs attention to the breath as a technique for bringing a wandering mind back to the present (e.g., "Whenever you find your thoughts have wandered, simply bring your attention back to your breath, following it as it moves in and out"). The idea is not to encourage deep concentration on the breath, but simply to use the breath as a gentle and ever-available returning point.
+The core of mindfulness meditation involves training the mind to reel itself back in whenever it wanders, as it wanders, over and over again. As Pema Chodron (2007) puts it, "Through meditation, you're training in interrupting the momentum of the wandering mind and going right to the experience itself." As we have come to learn from discoveries on neuroplasticity, the mind can indeed be trained and changed. We can get better at this.
+Although most modern technology trains us in splitting attention, there are a number of initiatives, from the experimental to the commercial, that have already been developed specifically to support mindfulness, either by providing guidance for meditation or by training the wandering mind to return to the present through the use of sound or visual stimuli (we look at those technologies in the later section "Digital Technologies for Mindfulness").
+==== Strategies in Education ====
+Despite the fact that William James had already espoused the value of mindfulness training for education back in the nineteenth century, we are only now beginning to see this training find its way into the curriculum. Politicians, academic administrators, and educators are gradually coming to the conclusion that promoting mindfulness programs in schools is worth serious attention.
+Tim Ryan (2012), a Democratic congressman from Ohio, has shared his views on the ways in which mindfulness can change schooling, the health-care system, the military, and even the nation. His basic tenet is that mindfulness is an important aspect of the socioemotional skill set that leads to good conflict resolution, responsible decision making, better relationships, the setting of goals, and the development of self-discipline. Together with Judy Biggert, then Republican congresswoman from Illinois, Ryan sponsored legislation to introduce socioemotional learning in schools, which included the Academic, Social, and Emotional Learning Act of 2011.
+The Association for Mindfulness in Education, a collection of organizations and individuals promoting the introduction of mindfulness practices in education maintains a list of schools and programs that already include mindfulness in their curriculum.4
+Integrating mindfulness training programs or other mindfulness interventions into people's lives through schooling and workplace training requires the commitment of policymakers and managers who recognize the value of such programs. Seeing that scientists have shown the causal relationship between mindfulness and wellbeing, it seems rational to expect an increasing number of initiatives to emerge over the next decade.
+==== Biofeedback Interventions ====
+As mentioned earlier, there are measurable correlations between mindfulness states and various physiological signals (Chiesa & Serretti, 2010; Lutz et al., 2006), and although these signals are useful for research, some researchers have gone further to ask how they might be used as feedback for mindfulness training. Biofeedback systems record physiological signals and feed them back to the user as sound or visual stimuli in real time. The signals may include a variety of inputs from EEG and electrocardiogram to heart rate or breathing patterns. By receiving this synced real-time feedback, a participant can learn to change a detected physiological factor, for example, via operant conditioning (with a subtle reward system).
+There is some minimal early evidence that biofeedback systems could be helpful in supporting mindfulness or at least some of the characteristics associated with mindfulness, such as stress reduction, emotional awareness, mental clarity, and loss of intention (Plasier, Bulut, & Aarts, 2011; Stinson & Arthur, 2013; Vidyarthi & Riecke, 2013). This early work suggests that biofeedback systems may provide a useful area of future research and development.
+Although the price, size, and accessibility of biofeedback sensors and systems have been plummeting over the past few years, most experimental systems remain fairly intrusive or expensive or both. An alternative approach comprises a challenge to positive computing: How can mindfulness states and training be effectively supported by common digital technologies?
+===== Digital Technology for Mindfulness =====
+From melting into an embodied symphonic experience to following the reassuring guidance of a soft voice recording or even sharing your efforts with friends, the examples of technology-mediated support for mindfulness, though in their early stages, are already surprisingly diverse. Available technologies designed around mindfulness practices can currently be placed into three categories: (1) those focused on guided sessions (lessons, exercises, or meditation sessions); (2) those that include social networking and sharing features; and (3) those focused on embodied experiences, often based on biofeedback approaches. Numerous applications have been designed to promote mindfulness, but we have selected just a few to describe by way of example.
+==== Guided Sessions ====
+Smiling Mind is a collection of mindfulness-training activities delivered over the Internet and via mobile app. Like other audio-instruction-based courses, it provides a series of guided meditation recordings. It differentiates itself, however, by providing these recordings in the context of tailored training curricula. Smiling Mind provides content targeted to various contexts (e.g., a curriculum program aimed at school-age children and a corporate training program for adults). For each of the programs, the focus has been on developing a high-quality curriculum and set of materials.
+Other examples of guided support have specifically targeted stress in the workplace. Mark Williams and his group at the University of Oxford (Krusche, Cyhlarova, King, & Williams, 2012) evaluated a set of modules from the MBSR and MBCT programs delivered over six weeks. The Perceived Stress Scale (Cohen, Kamarck, & Mermelstein, 1983) was used to measure the program's impact, and the study concluded that online mindfulness training can significantly decrease perceived stress (with changes still apparent at a one-month follow-up).
+==== Social Features in Mindfulness Training ====
+Projects such as Mindfulnets5 distinguish themselves by adding social networking features that allow users to share their ongoing experience with others. The user fills out two questionnaires, the Perceived Stress Scale and the Five Facets Mindfulness Questionnaire. Although the responses from the questionnaires are not used to personalize the interaction (which might be an interesting feature in future), they are used to measure the impact of the interventions, which is useful both for the user (as evidence of improvement) and for the organization (as evidence of efficacy).
+An interesting feature of Mindfulnets is its integration with Facebook. Users are able to comment on their progress, and discussions are visible to visitors. Another feature is a page displaying personal statistics and results of the Perceived Stress Scale and the Five Facets Mindfulness Questionnaire. These sharing features could hypothetically have two types of impact. On the one hand, the sharing of experience may increase motivation. On the other hand, users may be more likely to compare themselves to others and judge themselves, which is recognized as a disabling practice for mindfulness. The website intervention was evaluated (Quintana & Rivera, 2012) giving small effect sizes, albeit with a number of disclaimers due to the small and sparse distribution of the subjects' demographics.
+One study (Morledge et al., 2013) evaluated a mindfulness intervention for which a content-centric program was compared to the same intervention but combined with discussion forums. The results reproduced the positive effects of mindfulness intervention shown in other studies, with statistically significant improvements in perceived stress and mindfulness for both the content-based version and the version with social features at 8 and 12 weeks. With regard to the social features, the authors stated, "Some evidence from our study suggested that this component improved some participants' therapeutic experience. These results and feedback from participants suggest that greater benefits may be achieved with a more expansive and integrated social media component."
+More research is currently needed before we can understand if social interaction and sharing are beneficial to mindfulness practice and interventions, which are by nature personal endeavors. If so, we will also need to know what kinds of social features are helpful (and which are harmful), for whom, and in what contexts, and what design features have an impact.
+==== Embodied Experience ====
+Very few have explored embodied experiences for supporting mindfulness, but notable exceptions do exist. At a basic level, the mindfulness breathing exercises at Mindfulnets include very simple embodiment features in that the user clicks the mouse with each breath while a preset timer runs.
+For a more thoroughly embodied experience, we turn to Sonic Cradle. In the Sonic Cradle, you are suspended in a hammock-like "cradle" while straps fastened around your chest detect your breathing patterns. These breathing patterns are then used to shape the ambient sound enveloping you in the dark sound-proof space. Created by HCI designer and musician Jay Vidyarthi, Sonic Cradle is an immersive full-body experience designed to mediate mindfulness meditation, particularly as a way to introduce the practice to novices (Vidyarthi & Riecke, 2013).6 A qualitative investigation found that the experience led participants to experience subjective elements of mindfulness meditation -- in particular, clarity of mind and loss of intention.
+But mindful awareness is by no means restricted to the meditative context and is intended as a way of life. Buddhist monks practice mindful walking, eating, cleaning, and living in general. Mindful eating is gaining popularity in the mainstream, and programs have even found their way into corporate offices (Google recently invited Zen teacher Thich Nhat Hanh to come and give their employees guidance on mindful eating).
+A few technologies already tackle mindfulness support in day-to-day activity. For example, the Breath -- Walk Aware System was designed to support beginning meditators in the practice of walking meditation using a smartphone (Yu, Wu, Lee, & Hung, 2012). Similarly, the Slow Floor employs pressure-sensitive surfaces and sound to promote awareness of bodily movement (Feltham & Loke, 2012).
+The HAPIfork is a commercial product that intervenes at mealtimes by vibrating when you eat too fast. The electronic fork promises to promote mindful eating (and associated weight loss) and is also a data-collection tool that records the time it took you to finish a meal and the speed at which you ate (measured by "fork servings" per minute and intervals between them). It will also connect with apps to correlate your eating data with sleep, meal, and relaxation times. The fork's associated desktop app has coaching advice and provides stats from data collected automatically by the fork and self-reports.
+From light-up floors to shaking forks, we're clearly only seeing the very tip of the iceberg when it comes to how embodiment might be employed to support mindful attention during meditation and daily activity. It will be a while yet before we can come to know what is genuinely effective and what is obstructive or merely superfluous to such endeavors, and we can expect there to be differences across contexts, levels of experience, and possibly cultures. At any rate, embodiment research will be an interesting space to watch (and sample) as future developments arise.
+==== Games for Mindfulness? ====
+Although there are websites eager to suggest that common videogames train us in mindfulness, they are confusing mindfulness with concentration. We can concentrate heavily on a videogame for hours, losing our awareness of what is happening around us. We do this in the context of striving to achieve a specific goal. Concentrated striving is not mindfulness. Mindfulness is frequently described as a method of "nonstriving" (see Williams & Kabat-Zinn, 2013) that facilitates open acceptance and awareness, so goal setting seems decidedly antithetical in this context. This indeed poses challenges for the use of games for mindfulness. Can you have a game without an object or goal? Would it still be a game by definition? For this reason, we may find that games are better suited to training certain skills that are helpful to mindfulness (e.g. returning to the breath) than to inducing a state of mindfulness itself. In fact, this is precisely the route being taken by the earliest experiments in mindfulness games.
+Games+Learning+Society (GLS), a group of researchers and developers based in Madison, Wisconsin, is working on games specifically designed to provide practice in aspects of mindfulness and other wellbeing-related skills. One of these games, called Tenacity, requires the player to tap an iPad once for each breath and twice for each fifth breath through increasing levels of distracting difficulty. Researchers at GLS, who include neuroscientists such as Richard Davidson, study the psychological effects of videogames using a combination of behavioral, structural, and fMRI-based measures -- an approach that is sure to reveal important insights for positive computing designers.
+===== Design Implications =====
+==== Distraction versus Guidance ====
+In Japanese monasteries, the head monk voluntarily provides a generous service to those in his spiritual care -- he walks around the hall quietly until he spots someone whose mind has evidently wandered, at which point he raps the willing student on the shoulder with a stick. Veterans swear by the effectiveness of this practice. Still, some prefer the comparatively gentle awakening provided by the meditation bell or the early-morning gong. Each of these methods, from the stick to the gong, is a form of short and sweet wake-up call designed to bring a wandering mind back to the present moment, and there doesn't seem to be any reason that technology couldn't be employed to provide a similar service. Yet how do we separate the song of the bell from the nag of the beep? A beep is an aggravation if it goes off at the wrong time, and a rap with a stick unsolicited could lead to bursts of profanity. At least part of the answer to striking this balance seems to lie in two things: autonomy (as usual) and that design stalwart, minimalism.
+First, in the case of autonomy, whether the stick is an affront or an invigorating aid has something to do with whether you agreed to it or not. For software design, that means honoring user agency as to when, where, and how help occurs. Moreover, autonomy issues can extend into important details. Can the user set limits, apply variations, or otherwise take part in shaping the support environment or service? After all, it's ultimately a kind of improved autonomy that one is attempting to foster with mindfulness training, in the form of improved self-regulation of attention.
+Second, there is reason to believe that minimalism is critical to design intended to support mindfulness. We have already discussed how modern digital environments, with their continuous provision of distraction, train us in splitting attention. Meditation halls and retreat environments are effective for mind training precisely because they are comparatively distraction free. Therefore, introducing additional distraction is counterproductive to supporting a more conducive environment for practice. As we improve in our capacity for mindfulness we should of course be able to practice it even amidst distraction and difficulty, but few of us start at that level. Of course, a notable exception is when a particular training program introduces distraction deliberately as part of training participants in bringing focus back to the present (as with Tenacity).
+By minimalism we also mean subtlety. You might say the Zen master's stick is hardly subtle, but then it is simple, direct, infrequently applied, and reserved for willing experts. In general, traditional methods such as gongs and bells are applied in a way that is infrequent, gradually increases in volume, and is prefaced and followed by silence. The intention is not to devastatingly startle or distract, but to gently awaken from mind-wandering reverie.
+==== Using Aural and Haptic Feedback ====
+The bell and stick go back centuries as effective tools for supporting mindfulness and meditation. In modern terms, they might be described as tools for aural and haptic feedback. Another form of haptic feedback is seen in a common meditation posture that requires holding the hands in the lap with thumbs almost touching (the "Zen mudra") (Chodron, 2007). This clever feedback mechanism is designed to let you know you're dozing off (as your thumbs collapse) or overdoing it (as they push together).
+Some of the modern examples mentioned previously, such as Sonic Cradle, have successfully employed aural feedback to represent physiological signals. In another example, the Tibetan "singing bowl" inspired an experimental variation: the Electronic Singing Bowl produced by a team at Phillips (Plasier et al., 2011). The bowl produced synthesized gong sounds and monaural beats (sound-frequency combinations that have been shown to trigger states of relaxation). The device was not designed to support mindfulness, but rather to aid relaxation, for which it was shown to be helpful. Even here, however, a design principle of minimalism is advisable as participant feedback from such studies shows that users have an aversion to sounds that are unusual, overly loud, or overly present -- probably because meditation is something generally done in silence.
+==== Supporting Nonjudgment ====
+We have already alluded to the potential pitfalls of applying certain motivational features such as tracking and goal-setting to meditative practice and mindfulness training, although they are highly effective in other contexts. We also highlighted the "nonstriving" aspect of mindfulness that makes goal setting problematic. Tracking and goal setting may also encourage comparison to others ("I will practice mindfulness every day this month" or "I can't believe he meditates more than me").
+Jon Kabat-Zinn (2003) explains that in MBSR clients are encouraged "to let go of their expectations, goals, and aspirations for coming, even though they are very real and valid, to let go -- momentarily, at least … and to simply ‘drop in' on the actuality of their lived experience and then to sustain it as best they can moment by moment, with intentional openhearted presence and suspension of judgment and distraction, to whatever degree possible." Thus, we may find that for supporting mindfulness it may be the relinquishing of goal setting, expectation, and striving that requires the most support.
+Yet how do you reconcile the need for purpose and direction in lifestyle change as well as people's motivations for pursuing practices like mindfulness with the essential attitude of nonstriving? Kabat-Zinn encourages participants to let go "momentarily -- at least." The idea is not to chuck away all your goals in life, but to let go of striving, tallying, and resistance during mindfulness practice. Buddhist and Yogic practices find a balance between goals and nonstriving by encouraging participants to "make aspirations" or "set intentions for the day." In this broader approach, aspirations provide direction but are sufficiently vague and gently applied as to be easily let go. More specifically, they are not quantified.
+In other words, an intention may be "I focus today on returning to the present moment each time I realize my mind has wandered" and less like "I will clock 20 hours of mindfulness meditation this month." Also, individuals set their own intentions; they are not supplied with a prewritten structure of achievement levels by someone else.
+Support for self-compassion may also prove helpful in balancing out our tendency to strive and judge in this context. Kabat-Zinn (2003) suggests the answer to reconciling nonstriving with the reality of valid intentions is rooted in teacher authenticity, which in our case, translates to designer authenticity.
+==== Practicing What You Teach (or Design For) ====
+Although there do not seem to be any downsides to mindfulness (for example, there are no reported negative side effects), Kabat-Zinn has drawn attention to the potential pitfalls that scientists (and, we infer, technologists) are at risk of encountering as interest in mindfulness gains momentum within clinical practice and beyond. In a thorough commentary, Kabat-Zinn (2003) cautions:
+It becomes critically important that those persons coming to the field with professional interest and enthusiasm recognize the unique qualities and characteristics of mindfulness as a meditative practice, with all that implies, so that mindfulness is not simply seized upon as the next promising cognitive behavioral technique or exercise, decontextualized, and "plugged" into a behaviorist paradigm with the aim of driving desirable change, or of fixing what is broken.
+Specifically, he challenges us to practice mindfulness systematically, before we attempt to teach it or support its development in others. He warns us not to ask more of our patients (or users) than we do of ourselves.
+If we fail to practice first, either because we are too busy or not sufficiently interested, Kabat-Zinn (2003) warns that our "attempts at mindfulness-based intervention run the risk of becoming caricatures of mindfulness, missing the radical, transformational essence and becoming caught, perhaps by important but not necessarily fundamental and often only superficial, similarities between mindfulness practices and relaxation strategies, cognitive-behavioral exercises, and self-monitoring tasks."
+In the case of technology, we can just as easily get carried away by enthusiasm, by our desire to fit a mindfulness agenda into a particular technology or vice versa, or by a temptation to compromise critical principles of mindfulness for the sake of quantifiable goals or aesthetic values. The lesson is simple: when it comes to mindfulness, don't just talk about it, don't just design for it, do it, and do it before you design.
+==== Notes ====
+. The eight steps are: Right View, Right Intentions, Right Speech, Right Actions, Right Livelihood, Right Effort, Right Mindfulness, and Right Concentration.
+. The research guide can be found at mindfulexperience.org.
+. This means that the relationship between the intervention (doing MBSR) and wellbeing is considered high.
+. For this promotion, see the website mindfuleducation.org.
+. See the website mindfulnets.co.
+. Although the full experience requires the cradle and a sound-proof room, you can get a taste of it at jayvidyarthi.com.
+==== References ====
+  * Baer, R. A. (2011). Measuring mindfulness. Contemporary Buddhism, 12(1), 241-261.
+  * Becker, M. W., Alzahabi, R., & Hopwood, C. J. (2013). Media multitasking is associated with symptoms of depression and social anxiety. Cyberpsychology, Behavior, and Social Networking, 16(2), 132-135.
+  * Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84(4), 822-848.
+  * Brown, K. W., Ryan, R. M., & Creswell, J. D. (2007). Mindfulness: Theoretical foundations and evidence for its salutary effects. Psychological Inquiry, 18(4), 211-237.
+  * Chiesa, A., & Serretti, A. (2010). A systematic review of neurobiological and clinical features of mindfulness meditations. Psychological Medicine, 40(8), 1239-1252.
+  * Chodron, P. (2007). How to meditate with Pema Chodron: A practical guide to making friends with your mind. Boulder, CO: Sounds True.
+  * Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385-396.
+  * Feltham, F., & Loke, L. (2012). The slow floor: Towards an awareness of bodily movement through interactive walking surfaces. Paper presented at the workshop "The Body in Design," at the 24th Australian Computer-Human Interaction Conference, OzCHI ’12, Melbourne, VIC, Australia, November 26-30.
+  * Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). Mindfulness-based stress reduction and health benefits. A meta-analysis. Journal of Psychosomatic Research, 57(1), 35-43.
+  * Hamilton, N. A., Kitzman, H., & Guyotte, S. (2006). Enhancing health and emotion: Mindfulness as a missing link between cognitive therapy and positive psychology. Journal of Cognitive Psychotherapy, 20(2), 123-134.
+  * Hanh, T. N. (2008). The miracle of mindfulness. New York: Random House.
+  * James, W. (1892). Psychology: A briefer course. New York: Henry Holt.
+  * Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York: Delacourt.
+  * Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology: Science and Practice, 10(2), 144-156.
+  * Kahneman, D. (2013). Thinking, fast and slow (p. 512). New York: Farrar, Straus and Giroux.
+  * Kahneman, D., Krueger, A. B., Schkade, D. A., Schwarz, N. S., & Stone, A. A. (2004). A survey method for characterizing daily life experience: The day reconstruction method. Science, 306(5702), 1776-1780.
+  * Khalsa, S. S., Rudrauf, D., Damasio, A. R., Davidson, R. J., Lutz, A., & Tranel, D. (2008). Interoceptive awareness in experienced meditators. Psychophysiology, 45(4), 671-677.
+  * Killingsworth, M. A., & Gilbert, D. T. (2010). A wandering mind is an unhappy mind. Science, 330(6006), 932.
+  * Krusche, A., Cyhlarova, E., King, S., & Williams, J. M. G. (2012). Mindfulness online: A preliminary evaluation of the feasibility of a web-based mindfulness course and the impact on stress. BMJ Open, 2(3). Retrieved from http://bmjopen.bmj.com/content/2/3/e000803.full.html.
+  * Lutz, A., Dunne, J. D., & Davidson, R. J. (2006). Meditation and the neuroscience of consciousness: An introduction. In P. D. Zelazo, M. Moscovitch, and E. Thompson (Eds.), The Cambridge Handbook of Consciousness (pp. 497-550). Cambridge, UK: Cambridge University Press.
+  * Morledge, T. J., Allexandre, D., Fox, E., Fu, A. Z., Higashi, M. K., Kruzikas, D. T., … Reese, P. R. (2013). Feasibility of an online mindfulness program for stress management: A randomized, controlled trial. Annals of Behavioral Medicine, 46(2):137-148.
+  * Negroponte, N. 1995. Being digital. New York: Vintage.
+  * Pea, R., Nass, C., Meheula, L., Rance, M., Kumar, A., Bamford, H., … Zhou, M. (2012). Media use, face-to-face communication, media multitasking, and social well-being among 8- to 12-year-old girls. Developmental Psychology, 48(2), 327-336.
+  * Plasier, S., Bulut, M., & Aarts, R. (2011). A study of monaural beat effects on brain activity using an electronic singing bowl. Annual Symposium of the IEEE Engineering in Medicine and Biology Society (EMBS). Benelux Chapter, December 2 (Brussels/Leuven, Belgium).
+  * Quintana, M., & Rivera, O. (2012). Mindfulness training online for stress reduction, a global measure. Studies in Health Technology and Informatics, 181, 143-148.
+  * Ryan, T. (2012). A mindful nation. Carlsbad, CA: Hay House.
+  * Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2012). Mindfulness-based cognitive therapy for depression (p. 471). New York: Guilford Press.
+  * Speca, M., Carlson, L. E., Goodey, E., & Angen, M. (2000). A randomized, wait-list controlled clinical trial: The effect of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients. Psychosomatic Medicine, 62(5), 613-622.
+  * Stinson, B., & Arthur, D. (2013). A novel EEG for alpha brain state training, neurobiofeedback, and behavior change. Complementary Therapies in Clinical Practice, 19(3), 114-118.
+  * Vidyarthi, J., & Riecke, B. (2013). Mediated meditation: Cultivating mindfulness with sonic cradle. In CHI13 extended abstracts on human factors in computing systems (pp. 2305-2314). New York: ACM.
+  * Walach, H., Buchheld, N., Buttenmuller, V., Kleinknecht, N., & Schmidt, S. (2006). Measuring mindfulness-the Freiburg Mindfulness Inventory (FMI). Personality and Individual Differences, 40(8), 1543-1555.
+  * Wang, Z., & Tchernev, J. M. (2012). The "myth" of media multitasking: Reciprocal dynamics of media multitasking, personal needs, and gratifications. Journal of Communication, 62(3), 493-513.
+  * Williams, J. M. G., & Kabat-Zinn, J. (Eds.). (2013). Mindfulness: Diverse perspectives on its meaning, origins, and multiple applications at the intersection of science and dharma. New York: Routledge.
+  * Yu, M.-C., Wu, H., Lee, M.-S., & Hung, Y.-P. (2012). Multimedia-assisted breathwalk-aware system. IEEE Transactions on Bio-medical Engineering, 59(12), 3276-3282.
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