The Business Case for Mindfulness Training

This article comprises the Introduction to Michael Chaskalson’s excellent book:

The Mindful Workplace: Developing Resilient Individuals and Resonant Organizations with MBSR

(John Wiley & Sons)

In a conference room on the edge of London 15 employees of one of the world’s largest online retailers sit in a circle. The room is normally used for PowerPoint presentations of strategy options or market-research data, but today is different. One of the company’s legal counsellors is here, as are the mangers of various divisions. There are strategists present, HR people and a small cluster of people concerned with new-business development. It’s not been an easy time for the firm. They have had their world more or less to themselves for almost a decade, but rival companies have recently been eating away at their market share. A series of high-profile litigation cases have begun to affect crucial public perceptions of a company once thought of as hip, radical and somehow friendly. Some think their approach is beginning to look a little tired. And the market is beginning to turn – it seems we may be on the brink of a deep recession.

It is the final session of an eight-week mindfulness course that the company has laid on for anyone who wants to attend. The participants are discussing what they have learned. ‘It’s been life-changing for me’, the legal counsellor tells the group.

You all know what’s been going on in my corner of this world these past weeks. The stress levels have been immense but the work we’ve been doing in the mindfulness group has made such a difference. Not just at work … I’ve been, I guess, somehow more human at home too. Not so snappy, more available. Of course it’s impossible to evaluate how I’d have been if I’d not done it, but my sense is that I’ve been sharper, more creative, and certainly less difficult to be around.

It’s not been easy for the group to follow this programme. Among other things, it has involved a daily meditation practice of 20 minutes or more at a stretch. Some participants were new to meditation and all of them have very full lives. Their work, family and social lives make huge demands on their time and, prior to the course, their minds were constantly and very actively preoccupied. Just fitting in the taught, group-based part of the course for two hours a week over eight weeks was a challenge, to say nothing of the home-practice requirement. Yet attendance on the course was voluntary and each person had a sense, from the introductory taster session they attended, that there were real benefits on offer. Having persisted with the programme they are now reporting the benefits.

The Mindfulness-Based Stress Reduction (MBSR) programme they have been attending has its origins at the Stress Reduction Clinic that was founded by Dr Jon Kabat-Zinn and his colleagues at the University of Massachusetts Medical School in 1979. The term ‘mindfulness’ points to an idea or approach that is said to have first been described by the Buddha over 2,500 years ago. It is a form of sustained present-moment awareness – of yourself, others and the world around you. The UK Mental Health Foundation’s 2010 Mindfulness Report describes mindfulness in the clinical context as:

an integrative, mind-body based approach that helps people change the way they think and feel about their experiences, especially stressful experiences. It involves paying attention to our thoughts and feelings so we become more aware of them, less enmeshed in them, and better able to manage them.1 (p.6)

Since its inception, the eight-week MBSR programme that Kabat-Zinn and his colleagues developed – as well as variants upon it – has been subject to considerable research. There have been thousands of peer-reviewed papersi published that speak of its effectiveness in a wide variety of applications. Comparative studies of some of the primary peer-reviewed empirical literature about the course have judged the programme and its variants to be effective.2-4 Based on a review of this literature, the Mental Health Foundation’s report suggests that evidence coming from mindfulness and well-being research shows that mindfulness confers significant benefits on health, well-being and quality of life in general. Each of the benefits that the report draws attention to has significant implications for people’s performance in the workplace – either in terms of their levels of stress and productivity or in terms of their interpersonal relationships, as leaders or team members. According to the report:

  • People who are more mindful are less likely to experience psychological distress, including depression and anxiety. They are less neurotic, more extroverted and report greater well-being and life satisfaction.
  • People who are more mindful have greater awareness, understanding and acceptance of their emotions, and recover from bad moods more quickly.
  • People who are more mindful have less frequent negative thoughts and are more able to let them go when they arise.
  • People who are more mindful have higher, more stable self-esteem that is less dependent on external factors.
  • People who are more mindful enjoy more satisfying relationships, are better at communicating and are less troubled by relationship conflict, as well as less likely to think negatively of their partners as a result of conflict.
  • Mindfulness is correlated with emotional intelligence which itself has been associated with good social skills, ability to cooperate and ability to see another person’s perspective.
  • People who are mindful are also less likely to react defensively or aggressively when they feel threatened. Mindfulness seems to increase self-awareness, and is associated with greater vitality.
  • Being more mindful is linked with higher success in reaching academic and personal goals.
  • Practising meditation has repeatedly been shown to improve people’s attention, as well as improve job performance, productivity and satisfaction, and to enable better relationships with colleagues, resulting in a reduction of work-related stress.
  • People who are mindful feel more in control of their behaviour and are more able to override or change internal thoughts and feelings and resist acting on impulse.
  • Meditation practices more generally have been shown to increase blood flow, reduce blood pressure and protect people at risk of developing hypertension; they have also been shown to reduce the risk of developing and dying from cardiovascular disease when it does arises.
  • People who meditate have fewer hospital admissions for heart disease, cancer and infectious diseases, and visit their doctor half as often as people who don’t meditate.
  • Mindfulness can reduce addictive behaviour, and meditation practices generally have been found to help reduce use of illegal drugs, prescribed medication, alcohol and caffeine.1

This list alone might stand as a good case for the introduction of workplace mindfulness training. The case extends well beyond this, however, as later chapters will show. For now, it is worth just touching on the issue of stress and its costs. As we will see, mindfulness training enhances interpersonal relationships; it develops emotional intelligence, increases resilience, enhances innovation and creativity, and extends one’s attention span. All of these have significant workplace benefits. But it is as a stress-reduction intervention that mindfulness training has so far been most widely known.

In the United Kingdom, stress in the workplace is running at epidemic levels. The Labour Force Survey conducted by the UK Office for National Statistics in 2007/2008 estimated that 442,000 individuals in Britain who worked in the last year believed that they were experiencing work-related stress at a level that was making them ill.5 Around 13.6% of all working individuals in the United Kingdom in 2007 thought their job was very or extremely stressful.6 An estimated 237,000 people who worked in 2007/2008 became aware of work-related stress, depression or anxiety, giving an annual incidence rate of 780 cases per 100,000 workers; in the same year, stress, depression and anxiety accounted for an estimated 13.5 million lost working days.5 Commenting on the cost of stress to business, Ben Wilmott, employee-relations adviser at the UK Chartered Institute of Personnel Development, estimates that the direct and indirect costs of employee absence to UK businesses is around £1,800 per employee per year.7 There is a powerful economic case for helping individuals deal with stress.

In a study carried out with 141 employees of West Virginia University8 between 1994 and 1996 – 44% of whom perceived themselves to be in a constant state of high stress prior to the programme – participants reported a 31% decrease in the mean number of medical symptoms, a 17% decrease in the mean impact of daily hassles and a 30.7% decrease in psychological distress. These improvements were actually greater at the three-month follow-up. Participants showed significant improvement in all 21 categories on the stress-map inventory that was used in the study and reported a number of positive changes in their attitudes and behaviour as a result of participating in the programme. By the end of the programme 92% of them were still meditating.

A mindfulness-based programme offered to workers at Transport for London resulted in major changes to the level of health-related absenteeism. Days taken off due to stress, depression and anxiety fell by over 70% in the following three years (absences for all health conditions were halved). Those who took the course also reported significant improvements in their quality of life – 80% said their relationships had improved, 79% said they were more able to relax and 53% said they were happier in their jobs.1

In another MBSR workplace study9, carried out with 48 employees of a biotech company in Madison, Wisconsin, subjects were evaluated for brain and immune function. These were compared with a wait-list control group. At the end of the programme those who had participated in the MBSR course had significantly greater activation in their brain’s left prefrontal cortex (LPFC). LPFC activation – as we shall see in more detail in a later chapter – corresponds to more ‘positive’ emotional processing and is thought to reflect more adaptive responses to stress. The MBSR group also showed a stronger antibody response to a flu vaccine when compared with the control group, and the magnitude of this was positively associated with the increased LPFC activation. The broader significance of these changes, and their implications for issues such as interpersonal relationships, creativity and innovation, will be discussed in more detail in a later chapter. For now, though, it is worth noting their impact on levels of stress. As marked by the changes in question, participants began the course with higher stress levels and completed it with their stress levels reduced.

Depression is another public-health matter with cost implications for the workplace. A study carried out in the United States, for example, suggests that the per-capita annual cost of depression is significantly more than that of hypertension or back problems and is comparable to that of diabetes or heart disease.10 People with depression also have more sick days than people suffering from other conditions,11 and depression in the major industrial countries is running at epidemic levels. At any one time, 10% of people have experienced clinical depression in the past year, and between 20% and 25% of women and 7% and 12% of men will suffer from it at some point in their lives, people who have experienced two or more major episodes of depression have a greater than 70% risk of depressive relapse.12

The good news is that mindfulness training can make a huge difference. The National Institute for Health and Clinical Excellence (NICE), the body that recommends treatment practice to the NHS, recommends an eight-week course in mindfulness as a front-line treatment for relapsing depression.13 The basis of this recommendation is the accumulated evidence from four large-scale randomised control trials. The last of these, conducted by Kuyken and colleagues in 200814 showed that an eight-week mindfulness-training intervention – Mindfulness-Based Cognitive Therapy (MBCT), which is based upon, and is very similar in its content to, Kabat-Zinn’s MBSR programme – was more effective than maintenance doses of anti-depressants in helping people stay well after significant depression. So in relation to stress and to depression, which are often related conditions, mindfulness training can have a significant impact, and there is a strong economic case that could be made for the use of such training in maintaining workplace health.

The benefits of mindfulness training, however, as we will see, extend far beyond the domain of occupational health. Richard Boyatzis, professor of organisational behaviour at the Weatherhead School of Management , speaks of mindfulness as ‘the capacity to be fully aware of all that one experiences inside the self – body, mind, heart, spirit – and to pay full attention to what is happening around us – people, the natural world, our surroundings and events’ (original emphasis).15 For Boyatzis, mindfulness is a key management competency. Mindfulness, he says, starts with self-awareness. This self-knowledge enables you to choose how best to respond to people and situations. It allows you to be consistent, presenting yourself simply as you are. We trust – and follow – people who are authentic and whose behaviour, beliefs and values are aligned: people whom we do not have to constantly second-guess. Mindfulness skills, he says, enable us to make better choices because we can recognise and deal with our own thoughts, feelings and physical sensations. This helps us to make better sense of people and of the situations around us. Our perceptions are then clearer, less clouded by our usual filters and biases. Through the purposeful, conscious direction of our attention, we see things that would normally pass us by and gain access to deeper insight and wisdom. As a result, we make better choices.16 This all makes for effective team management. It also makes for more effective teams.

Boyatzis and McKee15 coined the term ‘resonant leadership’ to describe the way in which great leaders attune to their people and draw out and amplify what is best in them. The same can be said of teams. A resonant team is one whose members are attuned to each other, cooperative and mutually supportive. A dissonant team, by contrast, is inharmonious. The neural integration that mindfulness training brings about17(p290) can significantly increase our capacity for attunement. Mindfulness makes for more effective teams and leaders.

Enabling us to become more aware of ourselves, others and the world around us, mindfulness training helps us to deal more effectively with issues of stress. It also enables us better to handle the welter of information and complexity that marks our working lives.

Participants in mindfulness courses learn to work more consciously and effectively with their minds and mental states. This is a form of training that we all ought to have learned at school (and it is a wonderful fact that, in places like the United Kingdom, there are projects afoot to bring mindfulness training to school pupils).ii It is never too late to learn these skills, however, and workplace organisations have a key role to play.

As I hope this book will show, a more mindful workplace should experience higher overall levels of employee well-being and resilience. Characteristics of such a workplace would be:

  • lower levels of stress and illness-related absenteeism;
  • more employee engagement;
  • greater productivity;
  • less conflict;
  • higher levels of job satisfaction;
  • lower levels of employee turnover;
  • higher levels of creativity and innovation.

All in all, given the relatively low cost of mounting such trainings, the potential return on investment is considerable.

Notes

i              See www.mindfulexperience.org for a list of current papers.

ii             See, for example, http://mindfulnessinschools.org/.

 References

  • Mental Health Foundation (2010) Mindfulness Report, London. Executive summary available from http://www.bemindful.co.uk/media/downloads/Executive%20Summary.pdf (accessed 28 February 2011).
  • Grossman, P., Niemann, L., Schmidt, S., and Walach, H. (2004) Mindfulness-based stress reduction and health benefits: A meta-analysis. Journal of Psychosomatic Research, 57, 35-43.
  • Baer, R.A. (2003) Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice, 10 (2), 125-143.
  • Chiesa, A., and Serretti, A. (2010) A systematic review of neurobiological and clinical features of mindfulness meditations. Psychological Medicine, 40, 1239-1252.
  • Health and Safety Executive (2007/2008) Stress-related and psychological disorders, http://www.hse.gov.uk/statistics/causdis/stress/ (accessed 28 February 2011).
  • Webster, S., Buckley, P., and Rose, I. (2007) Psychosocial working conditions in Britain in 2007, http://www.hse.gov.uk/statistics/pdf/pwc2007.pdf (accessed 3 March 2011).
  • Government Business (n.d.) The fine line between pressure and stress, http://www.governmentbusiness.co.uk/content/view/551/52/ (accessed 8 March 2011).
  • Williams, K. (2006) Mindfulness-Based Stress Reduction (MBSR) in a Worksite Wellness program, in Mindfulness-Based Treatment Approaches: Clinician’s Guide to Evidence Base and Applications (ed. R.A. Baer), Academic Press, Burlington, MA, pp.361-376.
  • Davidson, R.J., Kabat-Zinn, J., Schumacher, J., et al. (2003) Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine, 65, 564-570.
  • Sullivan, J. (2005) Promoting health and productivity for depressed patients in the workplace. Journal of Managed Care Pharmacy, 11 (3), S12-15.
  • Druss, B.G., Rosenheck, R.A., and Sledge, W. (2000) Health and disability costs of depressive illness in a major U.S. corporation. American Journal of Psychiatry, 157 (8), 1274-1278.
  • Segal, Z.V., Williams, J.M.G., and Teasdale, J.D. (2002) Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse, Guilford Press, London.
  • NICE (2004) Depression: Management of Depression in Primary and Secondary Care. Clinical Guideline 23 (December).
  • Kuyken, W., Byford, S., Taylor, R.S., et al. (2008) Mindfulness-based cognitive therapy to prevent relapse in recurrent depression. Journal of Consulting and Clinical Psychology, 76, 966-978.
  • Boyatzis, R., and McKee, A. (2005) Resonant Leadership, Harvard Business School, Boston.
  • Boyatzis, R., and McKee, A. (2005) In a bad spot? Try mindfulness, http://hbswk.hbs.edu/archive/5069.html (accessed 3 March 2011).
  • Siegel, D.J. (2007) The Mindful Brain: Reflection and Attunement in the Cultivation of Well-Being, W.W. Norton & Company, New York.
This entry was posted in Uncategorized. Bookmark the permalink.