#286      31 min 37 sec
Moment’s notice: Enhancing well-being through the practice of mindfulness

Mindfulness researcher Professor Felicia Huppert talks about how evidence-based mindfulness practices can increase well-being in individuals and organisations. Presented by Dr Dyani Lewis.

"If teachers are mindful, they teach in a much kinder, more engaged, more aware way and then the children benefit. Then when the children themselves learn the skills it's an extraordinary combination." -- Prof Felicia Huppert




Prof Felicia Huppert
Prof Felicia Huppert

Professor Felicia Huppert is internationally renowned for her work on the science of well-being and the promotion of human flourishing. Her research examines the causes and consequences of well-being using data from large population samples, longitudinal studies, and intervention programs such as the Mindfulness in Schools Project. Felicia is a Professor of Psychology who spends part of the year in the UK, where she is Director of the Well-being Institute at the University of Cambridge, and part of the year in Sydney, Australia at the Institute for Positive Psychology and Education. She advises the UK Government and international bodies on the measurement of well-being and policies to enhance well-being. In addition to numerous published papers, her edited books include the seminal publication The Science of Well-being (2005), a four-volume set “Major Works in Happiness and Well-being” (2011), and the more recent book Interventions and Policies to Enhance Well-Being (2014).

Credits

Host: Dr Dyani Lewis
Producers: Eric van Bemmel, Kelvin Param, Dyani Lewis
Audio Engineer: Gavin Nebauer
Voiceover: Nerissa Hannink
Series Creators: Kelvin Param & Eric van Bemmel

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VOICEOVER 
This is Up Close, the research talk show from the University of Melbourne, Australia. 

DYANI LEWIS 
Hi, I'm Dyani Lewis, thanks for joining us. We hear a lot about the notion of mindfulness these days. We're told mindfulness is a learnable technique and that regular practice can help us alleviate depression and anxiety or reduce chronic pain and stress. Mindfulness it's said can be beneficial in pretty much most parts of our lives from the workplace to our personal relationships and even when we find ourselves alone. It can enhance our ability to concentrate and even perhaps our capacity to empathise. But can everyone truly benefit from a dose of mindfulness? Can teaching mindfulness to schoolchildren lead to a happier and healthier society? How do we go about empirically testing how effective mindfulness is at improving well-being? I'm joined today by an expert in the science of both well-being and mindfulness. Professor Felicia Huppert is Emeritus Professor of Psychology and Director of the Well-being Institute at Cambridge University. She's also Professor at the Institute for Positive Psychology and Education at the Australian Catholic University. And she's here in Melbourne to speak at the Fourth Australian Positive Psychology and Well-being Conference, organised by the Melbourne Graduate School of Education. Welcome to Up Close, Felicia.

FELICIA HUPPERT
Thank you.

DYANI LEWIS
Felicia, where did mindfulness come from?

FELICIA HUPPERT
It’s a very ancient technique that arose out of Buddhism so it's 2600 years old.

DYANI LEWIS
Given its origin in Buddhism is there a difference between mindfulness and meditation?

FELICIA HUPPERT
It's a very good question. Not all mindfulness involves meditation and not all meditation involves mindfulness. So you can be mindful just in the course of your ordinary life. So let's imagine you are going into a meeting and you look at the agenda and you are very anxious to make your points. But in fact if you just pause and look around and notice how people are, how they are behaving, what is going on inside you and what are your thoughts what are your feelings, what's happening in your body, that's being mindful right then. And it turns out that if you do that then the meeting usually goes a lot better. There is a lot more listening, a lot more respect and perhaps a lot more collaboration.

DYANI LEWIS
So in terms of mindfulness as something you can practice, what would be involved in that practice?

FELICIA HUPPERT
Well there are ways to learn mindfulness and one of the best studied is something called Mindfulness-Based Stress Reduction (MBSR). This was developed in the last 1970s by a scientist at the University of Massachusetts Medical Centre, someone called Jon Kabatt-Zinn. And he's someone who was practicising mindful meditation himself. He suddenly realised well if I am getting all these benefits if my life is just less stressed, more peaceful, there is more clarity in my thinking as a result of doing this, why couldn't I offer it to the patients in the medical centre. He went to see one of the administrators and they said well okay we are willing to give it a try. You can have a room in the basement and we'll only give you our hardest cases. The ones who haven't responded well to surgery or the ones for whom the drugs aren't working, chronic pain and the like. He said, okay I'll try it. And so over the course of decades he developed an eight week program, initially for these patients, with remarkable benefits in terms of their symptoms, in terms of things like pain management. And all of it - because he was a scientist he approached it in a very scientific way and he measured things before and after and was very clear about the outcomes. And that then developed into a technique that is just widely used for people even if they don't have particular problems with physical health or indeed mental health. Just on the subject of mental health, it is now quite widely used in the case of things like anxiety and depression, eating disorders. In the UK we have something called the National Institute for  Clinical Excellence. On the basis of the beautiful science that has been done and the randomised control trials they now recommend mindfulness training for the relief of recurrent depression. It is one of the frontline treatments now.

DYANI LEWIS
These are certainly quite severe conditions that people are dealing with but you look at mindfulness more for general well-being, perhaps as a start we can define what you mean by well-being?

FELICIA HUPPERT
Well-being is a combination of feeling good and functioning effectively. It's not about feeling good all the time because in fact there are periods in our lives where it is entirely appropriate not to feel good to be sad or disappointed or in grief or even sometimes angry. So it's not about feeling good all the time, but it's about how you manage your feelings. And in terms of functioning well. That involves developing our potential, leading a fulfilled and meaningful life and contributing to the well-being of others. Now on all those fronts I think mindfulness has a potential role to play. One of the things it's very good at is teaching us how to manage our emotions. And the fundamental thing with mindfulness in respect of any process is awareness. We first of all need to become aware and if we are aware of what we are feeling let's say we're aware that we're feeling really angry right now, well instead of lashing out and yelling at somebody or hitting someone, we can just sit with that for a moment and think, okay I'm feeling really angry. And now I have a choice of what kind of response I can make. So it's not about automatic reaction it's about considered response.

DYANI LEWIS
So it sounds like it's not necessarily about accepting that someone else's behaviour might not need intervention as well. It's not just accepting blindly?

FELICIA HUPPERT
That's certainly true. There's a part of mindfulness which is around acceptance but it's accepting what's happening to you right now because there is no choice that is what is happening to you right now that's your experience. But it's commonly misunderstood as being accepting bad external conditions, it's certainly not about that. In fact it's recognising that if certain external conditions let's say an abusive relationship or whatever it is, a horrible boss it's recognising that if those things are impacting on you in a certain way you do need to change them.

DYANI LEWIS
As a research scientist if you look at how mindfulness can impact well-being, how do you go about measuring well-being in the first place? Are there objective measures?

FELICIA HUPPERT
Well-being, the kind of well-being that I am looking at is subjective well-being. It's people's experience, therefore by its very nature you can't measure it objectively. There are objective measures of well-being that governments use for instance. People's level of education or the kind of neighbourhood they live in or whether they are married or not. But I'm talking about people's experience and therefore you do have to measure it subjectively. Now that's not to say there aren't brain correlates, of course there are. I mean all our experiences have correlates in the brain. But primarily it's asking people about their experience. It's doing really thoughtfully worded, well worded surveys, questionnaires and the like and then perhaps backing it up with some of the physiology or the brain signs.

DYANI LEWIS
You and your colleagues have done some research looking at how well-being differs across different countries especially in Europe. What kind of factors can contribute to population level well-being?

FELICIA HUPPERT
Well socio-demographics certainly does play a role. It's true that relatively wealthy countries tend to be higher on well-being. But within a country you don't see a strong relationship between wealth and well-being except for the very poor. So right down the bottom end if people are poor then every pound every dollar they have does make a difference to their well-being. But beyond a certain point where basic needs are met there's not a strong relationship to wealth. But some of the other factors that are very important are things like social inequality, so countries where there is little social inequality, where the difference between let's say the top ten per cent and the bottom ten per cent in terms of wealth is rather small they tend to have higher well-being than countries in which there are very large gradients in inequality. Another thing is social trust. In countries where people feel they can trust the people around them, trust their neighbours, trust strangers in the street well-being tends to be much higher than in countries where there isn't that sense of trust.

DYANI LEWIS
What about the sense of a national psyche influencing how I guess generally positive or generally negative a group of people are?

FELICIA HUPPERT
If you think of well-being as just a single thing there may well be national differences and very often well-being is thought of as something like life satisfaction. So people are asked the question, all things considered how satisfied are you with your life as a whole nowadays? You do get very large national differences on a question like that. But that's a very complex thing to work out actually, all things considered. I mean how do you consider all things in just a few seconds. So well-being is actually multi-dimensional. It's not just a single thing and I think it's absolutely crucial that when we do do research, when we do measure well-being we look at a whole range of dimensions that are parts of well-being. Martin Seligman talks about five key parts of well-being and all of these need to be measured and they are, positive emotion, engagement, relationships, meaning – a sense of meaning and accomplishment. So we need to measure all of those things, people's perceptions of those. But that's not the end of the story I think there are other things that are also very important to measure. Things like resilience, optimism, self-esteem I think also a sense of vitality and perhaps also something like autonomy or grit, determination. It's a very new science the science of well-being and in the early stages of a new science I think it's really crucial to be measuring a whole range of variables. Because at the moment we just don't know which of those is going to turn out to be the most important. So I really strongly recommend that anyone who is thinking about doing research in this area takes a genuinely multi-dimensional approach to the measurement of well-being.

DYANI LEWIS
This is Up Close, I'm Dyani Lewis and in this episode we are talking about well-being and mindfulness with psychologist Professor Felicia Huppert. Felicia, mindfulness has been used to treat things like depression and anxiety and eating disorders as you mentioned before. Why would you consider mindfulness for people who aren't actually mentally unwell?

FELICIA HUPPERT
I think that mindfulness is actually the foundation of well-being. And I say that because it teaches us how to be aware, how to pay attention to what's going on around us and what's going on inside us. We can lead a completely mindless automatic life where we just get on with things rushing from on thing to another. Answering phones, answering emails, sending tweets and at the end of the day we can think, well what was I doing that day, what experiences did I have, what kind of a day was it and we just let our life go by. What mindfulness does is allows us to be aware of what's going on in the moment. So walking along a street, looking up and noticing the beautiful clouds or the smile of a child going past, but also noticing what's going on within us. Noticing our emotions or noticing that we're feeling really quite tense right now somewhere down near our stomach and that's giving us important information. So awareness is at the heart of mindfulness training and awareness is absolutely crucial to well-being. But there's another part as well and that is it's awareness with kindness. So we can be aware of things and very annoyed with ourselves. So let's imagine that we have a nasty thought about someone and that leads us to think we're a nasty person. No, it's just a thought and thoughts come and go, thoughts are transient they are like passing clouds. So we need to recognise that it's just a thought, we're not a bad person, we need to be kind to ourselves. Or very commonly, particularly in the West people are very hard on themselves. They often think, oh gosh I'm not going to be able to do this, I can't I'm going to fail and that kind of thinking is very unhelpful. Because what it does if you nurture something, if you continually repeat something it will grow. Now that's true in all of life and it's true in the brain. If we go on thinking of our selves as not being able, possibly going to fail, not wanting to try then the neurological pathways that subserve those thoughts get stronger and stronger and stronger. Every time we're faced with a new challenge we go straight to that kind of negative thinking. Whereas if we are kinder to ourselves and think okay well I'm not the best at this but I'm prepared to try and maybe it won't work out this time but that's okay. If we take that kinder attitude then the neurological pathways which subserve those thoughts get stronger and stronger. The next time we face a challenge or a difficulty then we're likely to actually try it out, be willing to try.

DYANI LEWIS
It sounds like there is quite a bit of potential rewiring that is going on in the brain when we try to change our automatic response of thinking negatively into a more positive framework. Does that take quite a bit of practice and time?

FELICIA HUPPERT
You're absolutely right that rewiring is going on all the time and the more you practice the faster the better the rewiring is going to be. So it's just as important to practice paying attention, being kind as it is to practice any physical activity if we want to excel or do better in a physical sport or exercise.

DYANI LEWIS
So what does that look like? Is it sitting down by yourself for five minutes a day or is it something more continual that you need to be thinking about, continuously throughout your day? What form does practice take?

FELICIA HUPPERT
Where I would like to start is I think it's incredibly helpful to do a course beforehand. It's quite tough to just go into the practice without the background learning. Now there are marvellous courses around the world Mindfulness-Based Stress Reduction, MBSR courses and the quality of those courses you can pretty much guarantee is first rate. They usually take eight weeks and you learn for about an hour and a half or two hours a week. Typically they are group based but there are actually some now online mindfulness-based stress reduction courses that are also very effective. And of course learning about something isn't enough. I mean we could learn about how to swim but if we never actually practice swimming we are not going to get any good at it. So it's the same with mindfulness. Learning about mindfulness is tremendously important particularly from a well-qualified teacher whether face-to-face or online. But then the crucial thing is actually practicing it. And they usually advocate practicing between 20 and 40 minutes a day of actually sitting, focusing on the breath noticing what's happening in our mind, noticing the thoughts coming and going, the feelings coming and going, sounds moving around us and that's a marvellous, marvellous practice. But there is some evidence that even 10 or 12 minutes a day makes a difference both to our cognitive capabilities, our ability to pay attention, our working memory but also to our brains. And of course, it's also the case that you don't have to sit and meditate in order to be mindful. You can just be mindful at any time in the day at any point during the day you can stop and pause and just notice what's happening right now.

DYANI LEWIS
Felicia, you have implemented mindfulness training in schools. Why did you choose schools?

FELICIA HUPPERT
First of all I think it's worth saying that I came to mindfulness entirely through the science. The UK government was doing a very big review on mental capital and well-being a few years ago. And I was asked to do an overarching review on what are the determinants of well-being and what are the interventions that improve well-being. I kept coming across studies of mindfulness I didn’t know what it was but I was very struck by the evidence of its benefits across a wide range of conditions. And then I started to think well if it is having these benefits and most of the studies were in adults, surely we should be offering it to children so that they can have these benefits for the rest of their lives. In 2007 I was at the first meeting on Happiness in Education in the UK and there was a panel discussion. Somebody asked the question if you only had a small amount of money to spend to improve the well-being of pupils in schools what would you do. I said look on the basis of my reading of the science I would teach them mindfulness and if anyone is interested come and see me afterwards and we'll do some research. So a couple of teachers came up to see me afterwards and this was the start of something called the "Mindfulness In Schools" program. These are extraordinarily, brilliant, gifted teachers who were already teaching just to small groups. But they then developed a program, an eight week program for adolescents based on Kabatt-Zinn's mindfulness-based stress reduction program but exquisitely designed for young people to really engage them, lots of video materials, lots of games and challenges, an absolutely beautiful course. So that course has been implemented in a lot of schools now around the UK and actually internationally. We recently published a study the first author was Willem Kuyken, "k-u-y-k-e-n", in Exeter looking at the effects of this in a controlled study. So there were about 12 schools, 537 pupils took part. In half of the schools there were teachers who had learned this particular mindfulness curriculum and half the schools they didn't but they were matched as closely as possible, so they were very similar kinds of schools. Then we measured a whole range of things, well-being, depressive symptoms, aspects of their relationships and so on. We measured it before, at the end of the eight week course and also three months later just before they were about to do exams. It was really encouraging because what we found was there were substantial, statistically significant increases in well-being particularly at the three month period. So three months after they had done their course they had very high levels of well-being just before they were doing their exams. Both immediately after the training and at three months depressive symptoms were lower as well in people who had had the mindfulness.
DYANI LEWIS
And the effect that you find three months later, that must be clearly showing that students have accepted the practice and continued to practice after the course has finished.

FELICIA HUPPERT
I think that's right and in fact in the very first study we did it was published a few years ago now we actually looked at the effects of practice directly and we just divided the students into high, medium and low levels of practice and it was absolutely clear. The more practice the greater the benefit on well-being, on resilience and on mindfulness itself. So we're going on now to do a much, much bigger study and this time the schools will be randomised as to whether they get the mindfulness or not. That's always the top way in science to determine if something works is to do random allocation.

DYANI LEWIS
What would your control situation be?

FELICIA HUPPERT
So what will happen is a large number of schools will be selected and then they will be randomised as to whether teachers in those schools are taught this mindfulness curriculum. The schools take part not knowing whether they are going to be in that first group being offered the mindfulness training or not.

DYANI LEWIS
The schools that don't have the mindfulness training, do they get a placebo mindfulness course?

FELICIA HUPPERT
Oh yes those schools will be offered a form of relaxation training and that's a very interesting thing to compare mindfulness with. Because some people think mindfulness is just about relaxation. Of course, if those schools who just have the relaxation do just as well on the various outcome measures then okay, teach relaxation not mindfulness. But there is also some literature which suggests quite strongly that mindfulness is so much more than relaxation. The thing about relaxation is it can make you sleepy, soporific whereas with mindfulness what you have is  combination of relaxation and alertness and also these skills for how to keep paying attention, how to keep focused. So it's going to be a very interesting comparison that comparison between the mindfulness and the relaxation control group.

DYANI LEWIS
I'm Dyani Lewis and my guest today is psychologist Professor Felicia Huppert. We are talking about improving well-being with mindfulness here on Up Close. Felicia, does mindfulness work for everyone or are there some people, maybe some personality types who just have a lower set point in their well-being?

FELICIA HUPPERT
There are two different questions there, one is does it work for everyone and another is how is it related to set point. I don't think there is any program or any intervention that works for everyone. There's always going to be individuals or types of individuals for whom some things work better than others. But I think that mindfulness is likely to be about as broadly effective as any program can be. I mean sometimes for instance it's compared with Cognitive Behaviour Therapy. Cognitive Behaviour Therapy which has been incredibly effective in alleviating all mental health problems is clearly something that doesn't work for everyone. It's very intellectual, it's a very - well as it suggests a very cognitive approach. Mindfulness is a much easier thing to understand and it just starts with the body, you know our experiences in the body and that's pretty straightforward. The idea of paying attention and constantly coming back to something like the breath is pretty straightforward. So I think mindfulness is likely to work for lots of people but we need to do more research to establish whether there might be certain groups of people for whom it is not very effective.

DYANI LEWIS
I was wondering about people in particular who perhaps distracting themselves from painful thoughts might be a way of coping with traumatic events. So perhaps focusing in on these thoughts might be potentially dangerous?

FELICIA HUPPERT
Yes and it's often thought that that might be the case but in fact the evidence is to the contrary. The evidence is often that if we suppress, bury, reject painful thoughts they end up affecting us in other ways. Whereas if we can sit with those thoughts and have learned the techniques of just breathing, just accepting them just knowing they're thoughts and they can change, they can shift they can disappear even. If we can sit with those difficult thoughts then they tend to get less difficult.

DYANI LEWIS
It sounds like there are very few downsides to mindfulness.

FELICIA HUPPERT
Yes, I would say that broadly speaking that does seem to be the case. It has been suggested though that mindfulness might prevent us from daydreaming and daydreaming is something that is very good for our creativity and maybe for planning our futures. And I think that's a really important misunderstanding that needs to be addressed. The situation is this there are different kinds of daydreaming. One kind is poor attentional control where you are actually trying to do something else you are trying to do your essay at school but your mind keeps wondering off to your friends or your football match or whatever it is. Now in that case mindfulness is very helpful because it's a technique that teaches you the skills of bringing back a wandering mind. Time and again bringing it back to where you want it to be. There's another kind of daydreaming that is about anxiety. You are always worrying about situations that you've either already experienced or you might experience in the future and again that's not helpful. With mindfulness we can learn to how deal with those situations and recognise okay I'm back there, I'm thinking about this anxiety provoking thing, but I don't need to be. It's okay I can let that one go. But there's a third kind of daydreaming which has been called positive, constructive daydreaming which is extremely helpful. And it is volitional, it is under our control and that is something that's completely compatible with mindfulness. And in fact, mindfulness might even help there because what we would do is recognise ah okay I'm having that daydreaming that's really about should I do this next time I go on holidays or should I do that. That's really important and that's really interesting. I'm going to just see what it feels like to have those thoughts and what are the effects on my body. And okay that option makes me feel really, really good and relaxed. That option makes me feel tense so maybe that's giving me important information about which choice to make.

DYANI LEWIS
I did want to ask you about the religious origins of mindfulness. Has the scientific community embraced mindfulness or has it been a bit sceptical because of its origins?

FELICIA HUPPERT
There's always some scepticism within the scientific community, sometimes within the schools and other communities because of its origins. But the beautiful thing is that when John Kabatt-Zinn developed Mindfulness-Based Stress Reduction back in the late 70s, he did it as a purely secular technique. There's nothing about mindfulness training in this form that has any religious connotations at all, it's purely secular. And in fact it sits very well with a notion espoused by the father of modern psychology a brilliant man called William James, way back in the 1890s when he was writing his book the Principles of Psychology. He talked about the problem of the wandering mind and how if there was a form of education which would allow children to be trained in how to focus rather than their mind wandering out of control that would be an education par excellence. And it's amazing that it's taken us 120 years to heed his idea. But there's no doubt at all that this secular form of mindfulness is a wonderful attentional training. A training in attention a training in kindness and certainly something I think that should be taught in schools, but initially to teachers. If teachers are mindful they teach in a much kinder, more engaged more aware way and then the children benefit. Then when the children themselves learn the skills it's an extraordinary combination.

DYANI LEWIS
There are many things in life that are beneficial to our health like regular exercise for example. What about mindfulness - how do you stop it from being another good health resolution that just falls by the wayside?

FELICIA HUPPERT
You're absolutely right that like anything else it's tough to maintain even with the best intentions in the world people sometimes stop the practice or stop it for a period and so on. So the question is what can we do about that. One of the beautiful things about mindfulness training in an organisation such as a school is that you have a kind of community of practice. You have other people around you doing it. The particular mindfulness course that we have developed in the UK the "Mindfulness In Schools" program is called ".b" that's a dot and then the letter B. That was used as a way of children texting each other to remind each other to do the practice. So dot means stop B means breathe. When they got a ".b" message on their mobile phones it was a reminder to do the practice. Now of course some schools don't allow mobile phones but at various points around the school there will be a poster and the poster will just have a dot and a B. When you pass the poster you just stop and breathe, get in touch with the present moment. So that's a lovely way to reinforce the practice. But also sometimes kids themselves will say, teacher please could we do a ".b". Or groups of children will get together spontaneously and say let's do a ".b". The sense that they really need to do it and they do it as a community it's very, very helpful indeed. I think there is also scope for technology to help here. There are definitely apps now that can remind us to do things like that and some people find it very helpful. Some people find it intrusive but I think there are growing numbers of people who find that kind of thing very helpful to be reminded to do the things that they really do want to do.

DYANI LEWIS
Felicia Huppert, thank you for being our guest on Up Close today.

FELICIA HUPPERT
Thank you for inviting me.

DYANI LEWIS
Professor Felicia Huppert is Emeritus Professor of Psychology and Director of the Well-being Institute at Cambridge University. She is also Professor at the Institute for Positive Psychology and Education at the Australian Catholic University. If you would like more information or a transcript of this episode head to the Up Close website. Up Close is a production of the University of Melbourne Australia created by Eric van Bemmel and Kelvin Param. This episode was recorded on 10 February 2014. Producers were Eric van Bemmel, Kelvin Param and myself Dr Dyani Lewis, audio engineering by Gavin Nebauer. Until next time, goodbye.

VOICEOVER 
You have been listening to Up Close. We are also on Twitter and Facebook. For more information visit upclose.unimelb.edu.au. Copyright 2014 The University of Melbourne.


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