Meditation-induced bliss viewed as release from conditioned neural (thought) patterns that block reward signals in the brain pleasure center

The nucleus accumbens orchestrates processes related to reward and pleasure, including the addictive consequences of repeated reward (e.g., drug addiction and compulsive gambling) and the accompanying feelings of craving and anhedonia. The neurotransmitters dopamine and endogenous opiates play interactive roles in these processes. They are released by natural rewards (i.e., food, water, sex, money, play, etc.) and are released or mimicked by drugs of abuse. Repeated drug use induces conditioned down-regulation of these neurotransmitters, thus causing painful suppression of everyday pleasure. As with many spiritual traditions, Buddhism provides strong advice against the pursuit of worldly pleasures to attain the ‘‘good life.’’ In contrast, many forms of meditation give rise to an immense and abiding joy. Most of these practices involve ‘‘stilling the mind,’’ whereby all content-laden thought (e.g., fantasies, daydreams, plans) ceases, and the mind enters a state of openness, formlessness, clarity, and bliss. This can be explained by the Buddhist suggestion that almost all of our everyday thoughts are a form of addiction. It follows that if we turn off this internal ‘‘gossip of ego,’’ we will find relief from the biochemical dopamine/opiate down-regulation, which is, perhaps, the perpetual concomitant of our daily rumination

New Strategies for Combining Mindfulness with Integrative Cognitive Behavioral Therapy for the Treatment of Generalized Anxiety Disorder

Generalized anxiety disorder (GAD) severely impacts social functioning, distress levels, and utilization of medical care compared with that of other major psychiatric disorders. Neither pharmacological nor psychotherapy interventions have adequately controlled cardinal symptoms of GAD: pervasive excessive anxiety and uncontrollable worry. Research has established cognitive behavioral therapy (CBT) as the most effective psychotherapy for controlling GAD; however, outcomes remain at only 50% reduction, with high relapse rates. Mindfulness has been integrated with CBT to treat people suffering from numerous psychiatric disorders, with mindfulness based stress reduction (MBSR) being the most researched. Preliminary evidence supports MBSR’s potential for controlling GAD symptoms and key researchers suggest mindfulness practices possess key elements for treating GAD. Classical mindfulness (CM) differs significantly from MBSR and possesses unique potentials for directly targeting process and state GAD symptoms inadequately treated by CBT. This article introduces the theory and practice of CM, its differences from MBSR, and a critical review of MBSR and CBT treatments for GAD. CM strategies designed to complement CBT targeting cardinal GAD symptoms are outlined with a case study illustrating its use