Page 104 - Journal of Special Operations Medicine - Spring 2015

most direct contact with reality. Being aware of what is In contrast to unintended thought drifting or haphazard
going on around SOF personnel is what can keep them mind wandering, intentional and purposeful daydream­
and their team members safe. ing or deliberative imagination may be important to
creativity and productivity. 20,35–38 Singer et al. noted in
The term “mindfulness” has been used in many contexts: 1966 that “daydreaming, imagination, and fantasy are
mindfulness meditation, basic meditation, mindfulness­ essential elements of a healthy, satisfying mental life.”
35
based stress reduction, mindfulness training, and mind­ Thus, a clear distinction must be made: mind wandering
fulness­based cognitive therapy, to name a few. 13,14,27,28 during purposeful tasks is viewed as a performance de­
Likewise, it has been defined or characterized differ­ grader, whereas intentional or deliberate daydreaming is
ently by different people. 29–33 Overall, the key concept viewed as important for creativity.
of mindfulness is intentionally being acutely aware of
what is going on internally as well as externally “in­ The Science of Mindfulness
cluding thoughts, emotions, sensations, actions, or sur­
roundings as they exist at any given moment,” without The evidence behind the benefits of mindfulness is quite
20
being outwardly reactive. Intention, the aforementioned extensive and instructive. First and foremost, with re­
awareness, and attention are essential. Table 1 presents gard to personal health, mindfulness­based stress re­
a variety of published definitions of mindfulness. duction (MBSR) training has been shown to improve
sleep, 7,11 and sleep is directly related to performance.
Table 1 Various Definitions of Mindfulness Similarly, mindfulness training (MT) has been and is be­
Study Definition ing used as a treatment for pain, with some excellent re­
39,40
Bishop et al. 29 A process of regulating attention to bring sults. In addition, MBSR training and MT have been
shown to be effective in reducing symptoms of depres­
a quality of nonelaborative awareness 6,7,11 7,8,10,13,19,41
(often termed “nonjudgmental”) to sion and stress in a variety of populations,
7
current experience and a quality of including veterans. Overall, mindfulness practices are
relating to one’s experience within an likely to benefit health and performance.
orientation of curiosity, experiential
openness, and acceptance. However, strategies to optimize performance are more
Shapiro et al. 30 The three axioms of mindfulness— important to SOF personnel than improving health.
intention, attention, and attitude—are Studies have shown that MT is effective for maximiz­
not separate stages. They are interwoven
aspects of a single cyclic process and ing capacity to control focus and attention. Attentional
occur simultaneously. Mindfulness is this control, or the ability to concentrate at will, is critical
moment­to­moment process. for managing continuous and exhaustive intellectual,
Szalavitz 31 The awareness that arises through paying physical, and perceptual demands such as those expe­
42
attention on purpose in the present rienced during high­stress missions. MT also appears
moment, nonjudgmentally. to help mitigate depletion of attentional control capaci­
Brown and A receptive attention to and awareness of ties, which otherwise could contribute to performance
Ryan 32 present events and experiences. failure. 17,42 Morrison et al. showed that only a total
43
Jha et al. 33 Mental mode characterized by full of 7 hours of MT over a period of 7 weeks decreased
attention to present­moment experience mind wandering, which interferes with attentional con­
without judgment, elaboration, or trol. Importantly, mind wandering per se can degrade
emotional reactivity. performance. Thomson et al. demonstrated that in­
44
dividuals who increase the amount of mind wandering
Mindfulness has been characterized as the antithesis of over time, when they are supposed to be focused, had
mind wandering. William James, a famous American decreased accuracy in performing various tasks over
philosopher and psychologist, stated in 1890, “The fac­ time. Furthermore, MT has been shown to improve
44
ulty of voluntarily bringing back a wandering attention, working memory capacity. In particular, MT appears
17
over and over again, is the very root of judgment, char­ to counter decrements in working memory that typically
acter, and will . . . An education which should improve are noted during highly stressful situations. To date, the
this faculty would be the education par excellence.” amount of time spent in training and the frequency of
34
In other words, any educational or training approach MT needed for a positive benefit are open to debate.
that is able to bring one back to the intended focus at Research to identify this minimum training required is
will is the best of its kind. James went on to say, “The ongoing. Figure 1 presents the possible effects of being
immediate effects of attention are to make us: perceive, mindful: if one starts at a baseline of X performance
conceive, distinguish and remember.” These are all units, then, over time, with significant stressors, perfor­
34
conscious actions that SOF personnel want to master, as mance could degrade to Y performance units. Mindful­
the words epitomize Special Operators during missions. ness skills have been shown to mitigate performance

94 Journal of Special Operations Medicine Volume 15, Edition 1/Spring 2015