Amishi Jha | Building Cognitive Resilience in High Stress Cohorts with Mindfulness Training

Name: Amishi Jha | Building Cognitive Resilience in High Stress Cohorts with Mindfulness Training
Uploaded: 2017-06-19T15:33:10.000Z
Duration: 3 h 6 min 2 s
Description: Lecture by Amishi Jha, Associate Professor of Psychology, University of Miami: Building Cognitive Resilience in High Stress Cohorts with Mindfulness Training Brown University April 10, 2017

Introduction to Contemplative Studies

Welcome and Overview

Harold Roth welcomes attendees, expressing gratitude for their presence on a sunny afternoon.

He highlights the history of the Contemplative Studies program at Brown, mentioning 157 organized events since its inception in 2005.

Dr. Amishi Jha is introduced as a pioneer in cognitive science related to meditation and mindfulness, now an associate professor at the University of Miami.

Growth of Contemplative Studies

The program has evolved into an official undergraduate concentration with 25 concentrators, reflecting significant growth from its early days.

The curriculum includes cultural, historical, philosophical contexts of contemplative experiences alongside scientific evaluations.

Dr. Amishi Jha's Background and Research

Academic Journey

Dr. Jha completed her PhD at UC Davis and has held positions at prestigious institutions like the University of Pennsylvania and University of Miami.

Her lecture was rescheduled multiple times due to weather-related issues but she finally presents today.

Collaboration with Harold Roth

Roth shares his positive experience working with Dr. Jha during the Third International Symposium on Contemplative Studies.

Mindfulness Training and Cognitive Resilience

Introduction by Dr. Amishi Jha

Dr. Jha expresses excitement about presenting her work on building cognitive resilience through mindfulness training in high-stress cohorts.

Research Focus

She emphasizes her long-standing interest in how attention functions within the brain, particularly under stress.

Understanding Attention's Fragility

Mechanisms of Attention

Dr. Jha discusses her formal training as a cognitive neuroscientist focused on attention mechanisms using various research methods including fMRI.

Impact of Stress on Attention

She identifies stress, negative mood, and threat as key factors that diminish attentional capacity.

Mindfulness as a Solution

After recognizing attention's vulnerability under adverse conditions, she explores mindfulness training as a potential method to bolster attentional functioning amidst challenges.

Mindfulness Training and Attention in High-Stress Populations

Introduction to Mindfulness Training

The speaker introduces a low-tech, accessible form of training aimed at strengthening attention systems through regular practice.

Acknowledges the broad field of mindfulness and contemplative studies while emphasizing their specific focus for the presentation.

Expresses gratitude towards collaborators and funders, particularly highlighting support from the Department of Defense for ongoing research.

Research Focus and Objectives

The collaboration involves active duty military personnel interested in mindfulness training to benefit their communities.

The presentation aims to address three main questions regarding stress impacts on attention, potential benefits of mindfulness training, and best practices for high-stress populations.

Key Findings on Stress and Attention

The speaker shares that attention declines during high-stress intervals, with mindfulness training serving as a protective factor against this decline.

Emphasizes that engagement in short-form mindfulness practices is crucial for realizing benefits among stressed individuals.

Understanding Stress Impact

Defines stress as a perceived sense of overwhelm where demands exceed comfort levels, leading to dysphoria and distractibility.

Highlights that many academic communities experience significant stress related to performance pressures.

Yerkes-Dodson Law: Stress vs. Performance

Introduces the Yerkes-Dodson function illustrating how moderate stress can enhance performance (eustress), while excessive stress leads to decreased performance (distress).

Discusses the tipping point where stress becomes detrimental rather than activating, affecting well-being and performance negatively.

Visual Representation of Stress Effects

Shares an artistic photo montage depicting soldiers' emotional states throughout deployment cycles as a representation of stress impact.

Quotes St. Jerome: "The face is the mirror of the mind," suggesting that visible expressions reflect internal psychological states under high-stress conditions.

Understanding Cyclical Stress and Its Impact on Well-Being

The Nature of Cyclical Stress

The speaker discusses the visible effects of stress on individuals, particularly in military personnel who often undergo multiple cycles of deployment and training.

A broad question is posed regarding how to best protect individuals experiencing cyclical stress, emphasizing the need for research into this area.

High-Stress Intervals and Well-Being

The concept of high-stress intervals is introduced, with a comparison between typical civilian life well-being and that of individuals undergoing significant stress.

It is noted that during periods of high stress, there is a predictable decline in well-being rather than a stable state.

Predictable Patterns in Various Groups

Many groups experience predictable cycles of stress; for example, students face increased demands as they approach finals.

Research indicates that student athletes also experience declines in well-being during pre-season training due to academic and physical pressures.

Examples of High-Demand Contexts

Military personnel are highlighted as facing multiple high-demand intervals: pre-deployment, deployment, and post-deployment reintegration.

Other groups affected by cyclical stress include first responders and professionals like CPAs during tax season.

Attention's Role in Performance Under Stress

Attention is identified as a critical factor for performance across various groups—students need it for learning, athletes for performance, and military personnel for survival.

The speaker introduces the concept of selective attention using the metaphor of a flashlight to illustrate how directing focus can enhance processing capabilities.

Understanding Working Memory and Cognitive Resilience

The Role of Working Memory

Working memory is likened to a "mental whiteboard," serving as an internal scratch space for holding and manipulating information temporarily.

It functions like a whiteboard with disappearing ink, emphasizing its time-constrained nature; it can maintain information for only a few seconds.

Examples illustrate working memory in action, such as recalling points during conversations or remembering phone numbers briefly.

Attention and Cognitive Functions

Both attention and working memory are crucial for higher-order cognitive functions including planning, communication, learning, emotional regulation, decision-making, and behavior control.

These systems are described as "workhorse systems" of cognition that significantly impact various aspects of our daily functioning.

Impact of High Stress on Attention

High stress may lead to a decline in attention due to the overuse of cognitive resources during demanding situations.

An example is students facing pressure to meet deadlines; they may exhaust their attentional resources over time.

Defining Cognitive Resilience

Cognitive resilience is defined as the ability to maintain or regain cognitive capacities despite challenges that risk degradation or depletion over extended periods.

This concept emphasizes maintaining attention levels even under prolonged stress rather than succumbing to decline.

Training for Enhanced Attention Under Stress

The goal is to provide training that helps individuals sustain their attention levels during high-stress situations without experiencing significant declines.

There’s potential for mindfulness training not just to prevent deterioration but also possibly enhance performance even amidst stressors.

Mindfulness Training as a Solution

Engaging in mindfulness practices could lead individuals not only to cope with stress but also potentially thrive from it—akin to post-traumatic growth experiences.

Just like physical fitness requires practice beyond mere knowledge, mental training through mindfulness necessitates active engagement for benefits.

Understanding Mindfulness and Its Application

The Essence of Mindfulness

Mindfulness involves fully experiencing the present moment without dwelling on the past or worrying about the future. This non-reactive orientation allows individuals to engage with their lives as they unfold in real-time.

Research Context and Access Challenges

Researchers often need to convince leadership figures (like deans, coaches, or generals) of the value of mindfulness projects before gaining access to their groups for study purposes. This is a reasonable request as they aim to avoid wasting time.

Defining "Does It Work?"

The question "does it work?" regarding mindfulness training is complex and requires clarity on what is meant by "it." Different interpretations exist based on various forms of mindfulness training available today, such as books, workshops, apps, or retreats.

Variability in Mindfulness Programs

Mindfulness programs differ significantly in terms of duration (e.g., 2 weeks vs. 8 weeks), content focus (exercises vs. didactic information), and delivery methods (in-person vs. online). Understanding these differences is crucial when evaluating effectiveness.

Well-Studied Programs: MBSR and MBCT

Two prominent programs are Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT). Both typically last eight weeks with around 40 hours of total instruction, combining practical exercises with theoretical knowledge delivered by experienced trainers. These parameters help define what it means for a program to be effective.

Mindfulness Training and Its Impact

Application of Mindfulness in Physical and Psychological Disorders

Mindfulness training has been applied to a wide range of physical ailments, including rheumatoid arthritis, high blood pressure, and chronic pain, as well as the physical pain associated with cancer treatment.

It also addresses psychological disorders such as anxiety, depression, PTSD, and ADHD. A newer area of research focuses on mindfulness's impact on relationships across various contexts like family dynamics and workplace interactions.

Growth of Research Literature on Mindfulness

There has been an exponential rise in mindfulness literature over the last five to seven years, moving from individual studies to meta-analyses that aggregate findings across multiple studies.

Recent meta-analyses involving 115 randomized trials with over 8,000 patients indicate benefits from mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT), particularly when compared to standard treatments or control groups.

Effectiveness of Mindfulness Training

The Journal of the American Medical Association's meta-analysis concluded that while effects are moderate, they are comparable to those achieved through antidepressants in primary care settings.

This suggests that mindfulness training can be a viable alternative for certain populations seeking mental health support.

Skepticism Towards Current Findings

The speaker encourages skepticism regarding the effectiveness claims surrounding mindfulness training due to potential biases in published research.

The "power of positive thinking" may skew results by creating an overrepresentation of successful outcomes in the literature relative to what is expected for new therapeutic treatments.

Future Directions in Mindfulness Research

While acknowledging preliminary findings suggest some benefits from mindfulness practices, the speaker emphasizes that more rigorous scientific inquiry is needed for conclusive evidence.

As a neuroscientist rather than a clinician, the speaker's focus lies not just on whether mindfulness works but on understanding how it produces its broad range of benefits.

Understanding Mindfulness Training and Its Effects

The Need for Understanding Mindfulness Practices

The speaker expresses curiosity about the fundamental mechanisms behind various beneficial effects of mindfulness training, suggesting a need to explore foundational practices within these programs.

Acknowledges that mindfulness of breathing is a common foundational practice across all mindfulness training programs, emphasizing its role in stillness practices.

Components of Mindfulness of Breathing

Describes the process of focusing attention on the breath as a key aspect of mindfulness practice, which allows predictions about cognitive and intentional functioning changes.

Outlines specific instructions for practicing mindfulness of breathing, including maintaining an upright posture and concentrating on breath sensations.

Highlights the importance of selecting a specific sensation related to breathing to anchor focus during practice, reinforcing the idea that attention should be maintained on this target object.

Mechanisms Behind Attention Training

Discusses how returning focus when the mind wanders is part of developing meta-awareness and control over attention, likening it to circuit training for attention skills.

Predicts that consistent practice will strengthen attention capabilities, leading to improvements in selective attention and working memory.

Evidence Supporting Mindfulness Practice Benefits

The speaker notes an increasing body of literature supporting positive outcomes from mindfulness practices regarding cognitive tasks.

Mentions a recent review published in American Psychologist, indicating encouraging evidence that regular engagement in mindfulness can enhance performance similar to physical training benefits.

Exploring Mind Wandering in Relation to Performance

Points out that mind wandering has not been extensively studied but is crucial due to its potential negative impact on performance under stress.

Emphasizes the importance of addressing mind wandering for individuals facing high-stress situations, such as students needing concentration during lectures or studying.

Understanding Mind Wandering

Definition and Characteristics of Mind Wandering

Mind wandering is defined as having off-task thoughts during an ongoing task, where attention is diverted from the current activity.

This diversion leads to performance errors and increased distractibility, making it difficult to complete tasks effectively.

The phenomenon of perceptual decoupling occurs, diminishing our ability to perceive information clearly due to mind wandering.

This lack of awareness can be detrimental in high-stakes situations like sports or military operations, where situational awareness is crucial.

Impact on Mood and Awareness

Research indicates a correlation between mind wandering and poor mood; unintentional mind wandering often leads to negative emotional states.

Unintentional mind wandering can result in experiences like rereading without comprehension, highlighting its problematic nature.

Constructive Internal Reflection vs. Mind Wandering

A distinction is made between mind wandering and constructive internal reflection (or daydreaming), which involves intentional thought flow that can lead to creativity.

Intentional daydreaming has been linked with positive outcomes such as creative problem-solving and planning for the future.

Stress and Dysfunctional Mental Time Travel

Under stress, individuals may engage in dysfunctional mental time travel—ruminating on past regrets or catastrophizing about the future.

This pattern can trap individuals in negative memories or worries about events that may never occur, exacerbating psychological issues like PTSD.

Mindfulness Training as a Solution

The discussion shifts towards using mindfulness training as a potential intervention for high-stress groups to mitigate unintentional mind wandering.

Assessing mind wandering poses challenges since it typically occurs without awareness; thus, researchers consider inducing boredom as a method to facilitate this state.

Understanding the Sustained Attention Response Task and Mind Wandering

The Nature of Mind Wandering

If content is boring, people tend to mind wander, finding their thoughts more engaging than the material presented. This highlights a challenge in maintaining attention during tasks.

Overview of the Sustained Attention Response Task (SART)

In the SART, participants see digits appear on a screen approximately every half second and must press a button for each digit except when the digit is '3', which requires withholding a response.

Participants often struggle with withholding their response when they mind wander, leading to errors when they accidentally press for '3'. This reaction can be surprisingly intense, even among those who are typically confident.

Measuring Performance and Awareness

The task allows researchers to assess both accuracy (correct responses) and response time variability as indicators of mind wandering.

Participants are periodically asked about their focus during the task to gauge self-awareness regarding their attention levels.

Implications of Mind Wandering

The SART serves as an effective measure for understanding how mind wandering affects performance and whether mindfulness training can mitigate these effects.

Performance on the SART correlates with mental health indicators such as PTSD scores, depression levels, and sleep quality, suggesting its relevance beyond mere academic exercises.

Study Design: Academic Stress vs. Control Group

A study was conducted with students using the SART at two points during an academic semester—midway through and near finals—to observe changes in attention under stress.

Two groups were compared: one experiencing high-stress academic conditions while another control group was tested outside this period during summer without high stress.

Mindfulness Training Implementation

The study aimed to evaluate if mindfulness training could benefit students' attention amidst academic pressures by comparing results from different periods within the semester.

Students participated in brief mindfulness sessions before classes three times a week over seven weeks, focusing on low time demands while integrating practices into their routine.

Guided practices included mindful breathing and body scans designed to enhance focus without requiring significant additional effort from students.

What Happens to Attention and Performance During the Academic Semester?

Impact of Academic Semester on Attention

The initial question explores how attention and performance are affected throughout the academic semester, focusing on accuracy, response time (RT) variability, and probed responses.

A control group tested outside the academic semester showed stable task performance with no significant differences in accuracy scores over two weeks, indicating a reliable measure.

In contrast, a control group tested during the last seven weeks of the semester exhibited a significant decline in attention, aligning with subjective reports of decreased well-being.

This decline was characterized by poor mood, increased stress levels, risky behaviors, and unhealthy habits; all contributing to worse accuracy and higher variability in task performance.

The findings suggest that attention degrades during high-stress periods like an academic semester without intervention.

Effects of Mindfulness Training

Mindfulness training not only stabilized attention but also resulted in improved performance metrics compared to baseline measurements before training began.

Participants reported no increase in mind-wandering or being off-task over time while benefiting from mindfulness training that required minimal time commitment.

Despite promising results, concerns were raised about study limitations such as small sample size and lack of active comparison groups for mindfulness training effectiveness.

Addressing Criticisms Through New Research

Acknowledging criticisms led to further research involving student athletes under high-demand conditions known as the Cane Brain Project.

The project aimed to assess mental conditioning without labeling it explicitly as mindfulness training to engage participants more effectively.

Methodology for Athlete Study

Conducted just before preseason camps—critical for player positioning—this study anticipated declines due to simultaneous academic pressures and physical training demands.

The entire team was encouraged to participate; they were divided into mindfulness and relaxation training groups for comparative analysis based on existing sports psychology practices.

Relaxation techniques were chosen as a control because they are widely accepted within sports psychology as beneficial without risking athletes' careers through ineffective interventions.

Mindfulness and Relaxation Program Insights

Overview of the Program Structure

The program was named "mindfulness and relaxation," leading to some uncertainty among participants regarding its specific focus.

Participants engaged in a mindful cooldown during weight training, listening to guided practices tailored to their respective groups.

Regularity of practice was emphasized; participants reported their engagement levels both during sessions and outside of them.

Predictions on Practice Engagement

The initial prediction suggested that not all participants would engage equally in practice, impacting their overall benefits from the program.

Low engagement was expected to correlate with decreased well-being, while high engagement might maintain or improve well-being levels.

Results on Attention and Well-being

Results from the SART task indicated that low practice led to significant declines in attention for one group, while high practice maintained stability.

Structural equation modeling provided insights into individual practice levels rather than simple median splits.

Comparative Analysis of Mindfulness vs. Relaxation

High mindfulness practitioners showed stable attention levels, whereas those practicing relaxation experienced significant declines.

Both high mindfulness and high relaxation groups reported improved psychological well-being, but only mindfulness training enhanced attention.

Implications for Military Personnel Training

The discussion shifted towards applying these findings within military contexts where stress management is crucial for performance.

Interest in mindfulness training has grown within the military, particularly concerning post-deployment mental health challenges like PTSD.

Pre-Deployment Training and Mindfulness Impact

Overview of Pre-Deployment Training

The pre-deployment training lasts approximately two to three months, during which service members prepare for deployment, often having experienced three to five prior deployments.

This period involves not only operational skill preparation but also emotional readiness as they leave loved ones behind. High demand during this time may compromise attention and well-being.

Findings on Well-Being During Pre-Deployment

Research indicates a significant decline in well-being among service members over the nine-week pre-deployment interval without any intervention, highlighting the need for effective support strategies.

Mindfulness Training Efficacy

Studies show promising results regarding mindfulness training's ability to promote resilience among pre-deployment Marines and Army servicemembers, with ongoing research expanding to include their spouses.

Systematic Approach to Mindfulness Training

The research systematically manipulates various training durations (24 hours vs. 16 hours vs. 8 hours), aiming to identify the minimum effective training time that yields benefits without being a burden.

Results of Shortened Mindfulness Programs

A program called mindfulness-based attention training shows that eight hours of focused training (two hours per week over four weeks) can effectively enhance attention and working memory.

Practical Implementation Insights

The focus is on engaging participants in practice rather than extensive didactic information; practical engagement is key for effectiveness.

Trainer Selection and Effectiveness

Research explores whether trainers with personal mindfulness experience or those trained in military culture are more effective; findings suggest Army sports psychologists trained in mindfulness outperform traditional instructors.

Participant Experience and Transformation

A participant shared his transformative experience post-training, contrasting his previous uncontrolled state during missions with a newfound focus and attentiveness after completing the program.

Broader Implications of Mindfulness Training

The stark contrast between pre-training and post-training states emphasizes the urgent need for widespread implementation of such programs within military contexts to mitigate psychological risks associated with repeated combat exposure.

Responsibility Towards Service Members' Mental Health

There is a collective societal responsibility to provide mental health support for service members facing repeated deployments, aiming to protect them from potential psychological disorders resulting from their experiences.

What Have We Found About Mindfulness Training?

Current Findings and Future Directions

The speaker emphasizes the need for more research on mindfulness training before it can be universally accepted as beneficial. Current findings suggest that mindfulness can improve attention and protect against lapses during high-stress periods.

Mindfulness training has shown positive effects across various groups, including students, athletes, and service members. Shorter training sessions (7-8 hours over 4-7 weeks) may broaden accessibility to its benefits.

Daily practice is crucial for realizing the benefits of mindfulness. A commitment to formal stillness practice enhances outcomes, indicating a need for ongoing investigation into its effectiveness in high-stress environments.

Program Structure and Practices

In response to audience questions, the speaker clarifies that their program includes multiple practices beyond breath awareness. It features foundational breathing exercises, open monitoring introduced in week three, and compassion practices in the final week.

The compassion component is particularly tailored for military personnel, focusing on fostering concern for teammates or "battle buddies." This approach aims to expand empathy beyond immediate connections.

Compassionate Mindfulness in Military Context

The speaker discusses integrating kindness practices within military programs. Emphasis is placed on framing these practices around existing bonds among service members to enhance relatability and effectiveness.

A separate program targeting military spouses incorporates both mindfulness and compassion elements equally, showing promising results thus far.

Reaction Time Variability Insights

An audience member asks about reaction time reliability; the speaker explains that increased variability correlates with self-reported mind wandering. This suggests a link between cognitive performance and attentional focus during tasks.

Higher reaction time variability has been associated with errors in performance, leading researchers to explore this metric as an objective measure of subjective experiences like mind wandering.

Broader Implications of Mindfulness Training

Ongoing studies aim to understand how mindfulness affects perceptual decoupling—how the brain responds during moments of high internal cognitive burden (ICB).

An audience member raises concerns about language used regarding stress levels affecting all individuals. The speaker acknowledges this point while suggesting further exploration of how mindfulness could connect with social justice movements.

Mindfulness and Emotional Expression in Therapy

The Role of Mindfulness in Addressing Trauma

The speaker critiques the mindfulness approach that emphasizes quietude and gentle cultivation of the mind, suggesting it may not be suitable for all situations, particularly those involving PTSD.

Concerns are raised about a potential fear of using emotionally expressive methods in mindfulness practices, advocating for a focus on present-moment awareness without suppressing emotions.

Reactivity vs. Responsiveness

Engaging in mindfulness is framed as promoting responsiveness rather than disengagement; being present can enhance discernment when responding to situations.

Awareness during decision-making is emphasized, contrasting automatic reactions with conscious choices that align with one's ethical standards.

Understanding Individual Differences in Mindfulness Practice

A question arises regarding whether certain individuals are more predisposed to benefit from mindfulness practices based on personality traits or experiences.

Research indicates that openness to new experiences and prior deployments correlate with a higher likelihood of engaging in mindfulness practices among soldiers.

Resistance and Change Over Time

Initial resistance to mindfulness can shift when individuals observe the benefits experienced by others, leading them to reconsider their stance.

Some previously uninterested individuals began practicing mindfulness while deployed after recognizing its positive effects on their peers' well-being.

Macro vs. Micro Perspectives on Well-being

An audience member questions whether specific instances throughout an academic semester contribute to diminishing well-being, prompting discussion about the broader implications of applying mindfulness as a remedy.

Understanding Mindfulness and Its Impact on Problem Solving

The Role of Mindfulness in Workplace Stress

Mindfulness training can enhance problem-solving abilities, particularly in high-stress workplace environments. It helps individuals recognize that their unhappiness may stem from systemic issues rather than personal shortcomings.

Leaders who understand the impact of stress on employees can initiate changes, such as reorganizing academic schedules to alleviate pressure during vulnerable times like finals.

Effective change requires both individual capacity for problem-solving and leadership support to address systemic issues affecting well-being.

Activism and Attention Resources

Engaging in activism (environmental or political) demands attention and mood stability; depletion can hinder effective participation and advocacy.

A shift in operational demands may occur when individuals feel empowered through mindfulness, leading them to advocate for necessary changes within systems.

Age Considerations in Mindfulness Training

Research indicates a growing mindfulness movement in education, with positive outcomes noted across various age groups, including K-12 students facing high stress.

While benefits are observed across ages, the effectiveness of mindfulness programs varies based on how they are structured and the specific needs of different populations (e.g., ADHD).

Misconceptions About Mindfulness Goals

There is a misconception that mindfulness aims to create compliant individuals ("better cogs in the wheel"). Instead, it should foster intentional engagement and social change.

Historical figures like Martin Luther King Jr. exemplified how deep attention and intention can drive significant social movements without being quiet or passive.

Intentionality vs. Expression in Activism

The discussion highlights that loud expressions of activism do not negate intentionality; both can coexist as forms of self-care while addressing societal issues.

Different approaches to activism reflect varying strategies for survival and expression among marginalized communities, emphasizing the need for diverse methods within mindful practices.

Exploring Inner Lives and Behavioral Alignments

The Complexity of Inner Life

Amishi Jha raises a question about Malcolm X's inner life and whether he had a contemplative practice, highlighting the difficulty in assessing anyone's interior life without direct insight.

An audience member notes that while Malcolm X was a Sunni Muslim in his later years, understanding someone's internal experiences remains challenging.

Engaging Loud Groups

Jha discusses her work with groups typically perceived as loud and reactive, such as servicemembers, first responders, and football players, emphasizing their unexpected engagement with contemplative practices.

She mentions activists as another group she aims to work with, indicating a focus on those not traditionally seen as quiet or introspective.

Behavioral Alignment Through Programs

The response from these groups to mindfulness programs shows an improved ability to behave in ways that align with their values rather than becoming quieter.

Jha suggests that the effectiveness of these programs is not about reducing boisterousness but enhancing alignment between behavior and personal values.

Challenging Biases in Behavior Framing

Jha points out biases in how acceptable behavior is framed within society, suggesting this topic warrants further discussion beyond her expertise as an attention researcher.

Despite skepticism about offering mindfulness practices to these groups, results indicate benefits without diminishing their natural expressiveness.