Current Opinion in Psychology
January 14, 2019
E. Garland, B. Fredrickson
131 citations
The Mindfulness-to-Meaning Theory (MMT) describes how mindfulness promotes health and resilience through positive emotion regulation. This review extends the MMT to show that mindfulness fosters self-transcendence by triggering upward spirals of decentering, attentional broadening, reappraisal, and savoring. Savoring is key for inducing absorptive experiences of oneness between subject and object, amplifying the object's salience and imbuing perception with affective meaning. New evidence indicates that inducing self-transcendent positive emotions and nondual states through mindfulness-based interventions may restructure reward processing, producing therapeutic effects on addictive behavior, such as opioid misuse, and chronic pain syndromes.
Mindfulness
May 24, 2023
E. Garland, Bhanuteja Gullapalli, Kort C. Prince et al.
A randomized controlled pilot trial compared Zoom-based Mindfulness-Oriented Recovery Enhancement plus Just-in-Time Adaptive Intervention prompts triggered by wearable sensors (MORE+JITAI) to a Zoom-based supportive group psychotherapy control among 63 opioid-treated chronic pain patients. Ecological momentary assessments over 90 days showed that MORE+JITAI produced significantly greater reductions in craving, pain, and stress, and greater increases in positive affect over time than the control. JITAI-initiated mindfulness practice was associated with improvements in these outcomes and increases in heart rate variability. Machine learning predicted the effectiveness of JITAI-initiated mindfulness practice with reasonable accuracy. The intervention shows preliminary efficacy for reducing factors implicated in opioid misuse.
Behaviour Research and Therapy
February 28, 2022
Anna Parisi, Adam W. Hanley, E. Garland
Mindfulness-Oriented Recovery Enhancement (MORE) reduces acute opioid craving, pain, and negative affect more than supportive group psychotherapy for chronic pain patients on long-term opioid therapy. In a trial with 50 participants receiving MORE and 45 receiving supportive group therapy, medium-to-large effects favored MORE for session-level improvements in craving, pain, and negative affect. Higher curiosity predicted craving reductions; greater decentering and daily mindfulness practice predicted reduced negative affect. Momentary measures showed significant group-by-time interactions for craving and pain. The findings suggest MORE provides immediate symptom relief on therapeutic targets in daily life.
JAMA Internal Medicine
February 28, 2022
E. Garland, Adam W. Hanley, Y. Nakamura et al.
A mindfulness-based program called Mindfulness-Oriented Recovery Enhancement (MORE) reduced opioid misuse and improved chronic pain more than supportive group psychotherapy in adults with both conditions. After 9 months, 45.0% of participants receiving MORE had stopped misusing opioids, compared with 24.4% receiving supportive therapy. MORE also led to significant improvements in chronic pain symptoms. The program appears to be an effective treatment for opioid misuse among people with chronic pain in primary care.
Journal of Psychosomatic Research
November 1, 2021
R. L. Roberts, K. Ledermann, E. Garland
Mindfulness-Oriented Recovery Enhancement (MORE) improved reappraisal of distress in patients with opioid-treated chronic pain by enhancing interoceptive self-regulation, supporting a key pathway in the Mindfulness-to-Meaning Theory. In a randomized trial, 95 patients (mean age 56.8, 66% female) were assigned to 8 weeks of MORE or a Support Group. MORE led to greater improvements in interoceptive awareness, and this increase mediated the effect of MORE on reappraisal. In turn, increased reappraisal mediated reductions in emotional distress through a 3-month follow-up.
Journal of Substance Abuse Treatment
May 8, 2021
Nina A. Cooperman, Adam W. Hanley, A. Kline et al.
Mindfulness-Oriented Recovery Enhancement (MORE) added to methadone maintenance treatment (MMT) reduced illicit drug use, craving, pain, physical and emotional limitations, depression, and anxiety, while increasing well-being, vitality, and social functioning through 16-week follow-up compared to MMT alone. In this randomized trial of 30 individuals in MMT, those receiving eight weekly two-hour MORE groups plus treatment as usual showed significantly better outcomes than those receiving only treatment as usual. The authors conclude that MORE could be an effective adjunct to MMT and that larger trials are warranted.
Psychology of Consciousness
November 19, 2020
Adam W. Hanley, D. Dorjee, E. Garland
Mindfulness training increased both decentering and self-transcendence in novice practitioners compared with an active listening condition. Greater decentering midway through five training sessions predicted greater self-transcendence at the end, suggesting that becoming better able to non-reactively observe thoughts, feelings, and physical sensations during meditation facilitates self-transcendent experiences. This provides initial empirical evidence that mindfulness can cultivate self-transcendence through decentering.
Drug and Alcohol Dependence
August 5, 2019
E. Garland, Adam W. Hanley, A. Kline et al.
Mindfulness-Oriented Recovery Enhancement (MORE) improved opioid craving, pain unpleasantness, stress, and positive affect more than treatment as usual among individuals with opioid use disorder and chronic pain receiving methadone maintenance therapy. Participants in MORE reported nearly 1.3 times greater self-control over craving. Positive affect was associated with reduced craving, and this link was significantly stronger for those in MORE. The findings suggest MORE may serve as a useful non-pharmacological adjunct for this population.
Journal of Alternative and Complementary Medicine
March 1, 2019
Andrew S. Mcclintock, Shannon M. McCarrick, E. Garland et al.
A systematic review of 20 studies found that brief mindfulness-based interventions (BMBIs, total contact time under 1.5 hours) have limited and inconclusive evidence for managing acute or chronic pain. BMBIs delivered by a provider and lasting more than 5 minutes showed some promise for acute pain, but the authors conclude that more rigorous large-scale studies with pain populations are needed before recommending BMBIs as a first-line treatment.
Annals of Behavioral Medicine
January 22, 2019
E. Garland, M. A. Bryan, Sarah E. Priddy et al.
A mindfulness-based intervention, Mindfulness-Oriented Recovery Enhancement (MORE), improved the ability to inhibit responses when exposed to pain-related emotional distractors in adults with chronic pain and long-term prescription opioid use. In a controlled trial, participants in MORE showed greater reductions in errors of commission on an Emotional Go/NoGo Task with pain-related stimuli compared with a support group. More mindfulness practice and increased nonreactivity predicted better emotional response inhibition. Improvements in emotional response inhibition were linked to later reductions in pain severity at 3-month follow-up. The results provide preliminary evidence that MORE enhances inhibitory control under negative emotional interference.
Personality and Individual Differences
July 1, 2015
Laura G. Kiken, E. Garland, K. Bluth et al.
Individual trajectories of state mindfulness during an eight-week mindfulness-based intervention varied significantly and predicted changes in trait mindfulness and psychological distress. Those whose state mindfulness increased more over repeated meditation sessions also showed greater gains in trait mindfulness and greater reductions in distress. The findings suggest that cultivating state mindfulness through meditation practice may contribute to a more mindful and less distressed disposition, though individual patterns of change differ and require further study.