Benefits of Mindfulness Meditation in a Corrections Setting. Benefits of Mindfulness Meditation in a Corrections Setting. James M.

Transcription

1 Benefits of Mindfulness Meditation in a Corrections Setting James M. Dunn Upaya Chaplaincy Program March 6,

2 Abstract In the last several decades an increasing number of empirical studies have offered strong evidence that meditative and contemplative practices have great value in health-care and mental health as well as improving well-being in general. This paper reviews this literature with special emphasis on the benefits of these practices in a correctional setting and explores the benefits of meditation and contemplative practices as they might apply to restorative justice. After reviewing several methods of meditation practice and how they work, the paper explores the benefits of meditation in general and then focuses more specifically on the benefits of meditation in a prison environment. Some of the key benefits noted are enhanced sense of well-being, improved health with a reduction of medical problems such as high blood pressure, increased self-esteem, lower substance abuse issues, greater anger management skills, significant reduction in aggressive behavior, fewer prison rule infractions and an overall positive change in behavior. Also, better adaptive responses to the stresses of life in general including those encountered in the correctional system. The paper also develops the relationship between meditative practice and restorative justice. The primary point is that as meditative practices develop, self-awareness grows and the inmates capacity to accept responsibility for their actions also grows. This capacity for responsible participation is a critical factor in successful restorative justice programs Table of Contents: I. INTRODUCTION II. Introduction to Meditation, Mindfulness and Contemplative Practices A. Buddhist bases for meditation B. What is Mindfulness? C. How Meditation Works III. Clinical Applications A. MBSR B. Other Mindfulness Based Therapies C. Cultivating Mindfulness IV. Empirical Evidence for Mindfulness Awareness Practices in Correctional Settings V. Mindfulness and Restorative Justice 2

3 VI. Discussion A. Meditation: Religious or Secular? B. References I. INTRODUCTION Over the last several decades, there have been several promising developments in our approach to the challenges of crime and criminal justice. This paper will focus on two of these developments: contemplative practices (including meditation and mindfulness) within the prison system and restorative justice. It may not be immediately apparent how these two disparate developments apply to the criminal justice system, but it is the intention of this paper to show that these two trends can come together in a way that can be applied in the prison system. I will also discuss the benefits of meditative or contemplative practices, both in general and specifically to the their value in a correctional setting. Meditative and contemplative practices are derived primarily from the Eastern religions, especially Buddhism. Most notable are the mindfulness-based stress reduction (MSBR) programs and mindfulness-based cognitive therapies (MBCT) that have emerged from the work begun by Jon Kabat-Zinn thirty years ago. MBSR programs have demonstrated successes in a variety of areas, especially the medical and behavioral sciences. Additionally, recent findings in the field of neurobiology demonstrate how these programs can actually alter the brain through its capacity for neuroplasticity, the brains ability to develop new connections and neurons. Because the brain has this capacity, meditation practices can actually rewire or alter the brain in ways that literally change the mind and lead to more prosocial behaviors (Siegal, 2007, 2010), thereby offering the possibility of a truly 3

4 transformative corrections program. This paper will explore how these meditative practices might apply within the correctional system. A rapidly growing body of empirical evidence shows the value of meditation in a number of areas related to health-care and mental health. There also is a growing number of studies directly related to meditation in prison, both as way to improve inmate behavior and well-being while incarcerated, as well as a way to reduce recidivism and relapses back into drug and alcohol addictions (Zgierska, 2009; Marlatt 2002). While the number of studies that directly apply to prison are limited, there are a large number relating to behavioral problems often seen in prison populations, including addiction, aggression, depression, post traumatic stress disorder, and health-care issues such as high blood pressure. The potential cost benefits for health-care alone are significant, but the real benefit is the possibility of restoring the human potential typically lost within the correctional system. The other development in criminal justice is the restorative justice movement, which offers new ways of dealing with crime and criminal justice by bringing healing and reconciliation both to the victim and into the community. Restorative justice has its origins first in the indigenous traditions of North America and other parts of the world. Then, working from these principles, a group of Mennonites began trying to apply them in Canada to the criminal justice system. Today, the restorative justice movement is becoming well established as an alternative approach throughout the Canadian criminal justice system and beginning to take root in the United States, New Zealand and other places (Zehr, H., 2002). Section II discusses the meaning of meditation and the various ways that the term is used. The paper will also explore the various practices used in several traditions and the 4

5 theoretical basis for their positive effects on physical and mental well-being in general. Section III will discuss some of the clinical applications, and Section IV reviews empirical studies of the impact of meditative practices on physical and emotional health, with an emphasis on studies of the use of meditation and mindfulness awareness practices in a corrections environment. Section V introduces the concepts of restorative justice and the potential benefits that mindfulness practices might add. Section VI concludes the paper with a discussion of the relevance of the findings of these studies to the challenges and benefits of introducing meditation practices into the correctional system. Section II. Introduction to Meditation, Mindfulness and Contemplative Practices A. Buddhist bases for meditation Contemplative and meditative practices of one type or another have been in use for centuries in all of the major religions and have been generally found to be of value. Although some of the monastic branches of Christianity have maintained a contemplative tradition, the mainstream Western traditions seem to have lost touch with these practices in the scientific era. However, with the growing interest in Eastern thought in the last 50 or so years, various contemplative and meditation practices have become almost mainstream in Western society. Beginning with the Hindu-based practice of Transcendental Meditation (TM) as taught by Maharishi Mahesh Yogi in the 1960s, meditation practices have steadily emerged as an important method for developing well-being, relieving stress and providing some measure of happiness. Since that time, a growing interest in Buddhist practices has brought a wide variety of meditative practices to the West and has inspired the Centering Prayer movement within the Catholic Church (Keating, 1994, 2009). As result of this profusion of forms and 5

6 practices, a discussion of what is meant by meditation and a review several of the major practices seems appropriate. For the purposes of this paper, meditation is the overarching term that will include a variety of meditative practices. (For a full discussion of the issues and concerns in defining the various forms of meditation see Lutz, A., Dunne, J.D., Davidson, R.J. (2007), Lutz, A., Slagter, H., Dunne, J., & Davidson, R. (2008) and Bishop, S. R. et al (2004)). Mindfulness awareness practices (MAPs) (Siegel, 2007) will be used primarily as the general term for those practices based on Eastern thought and especially on Buddhist teachings. These include mindfulness meditation, insight meditation (also called vipassana) and Zen meditation (also called zazen). These will be the major focus of this paper. Contemplation will refer primarily to the Christian practices that include centering prayer, lectio divina and contemplative prayer (Keating, 2009). Although movement meditations such as yoga, tai chi and qigong appear to offer similar benefits, significant research is lacking, and therefore little emphasis is placed on these practices. While all of these practices differ in specific techniques, all types of meditation can be viewed as mental training not unlike physical training. They all share a common goal of developing attention and awareness to become more finely attuned to events and experiences in the present moment in an open, nonjudgmental manner. In traditional Buddhist psychology, meditation is an essential part of the spiritual path if one hopes to advance to any meaningful degree. The central goal of Buddhist practice is the alleviation or cessation of suffering, which is broadly defined as the pervasive unsatisfactoriness of our ordinary life. The underlying root of this suffering is a mistaken or 6

7 defective understanding of the contingent nature of reality and of what is the true source of well-being or happiness. Any remedy to correct this fundamental misapprehension must alter the habitual thought processes that are the source of suffering, and they must do this in a way that will actually uproot these deeply established habitual patterns. This is the intention of the various meditation practices found in all Buddhist traditions (Nyanaponika, 1965; Gunuratana, 2002). Although there is a diversity of practices, they may be viewed as two primary types: concentrative practices or focused attention practices, and receptive or open monitoring practices. Focused attention practices are the most basic and are the usual starting point for new practitioners. The primary technique is to direct attention to an object, most often the breath, and to sustain attention and to return to the object when attention wanders. Open monitoring involves no explicit focus on objects and maintains a nonreactive monitoring of whatever arises in the mind moment-to-moment (Austin, 2009; Lutz, A., Slagter, H., Dunne, J., & Davidson, R., 2008). Open monitoring meditation is also known as bare attention in the Theravadan tradition of Buddhism practiced in Southeast Asia and beginner s mind in the Zen traditions. B. What is Mindfulness? Mindfulness has become the dominate term for meditation in the West and especially in the scientific literature. Jon Kabat-Zinn, the pioneer in applied mindfulness practices in a secular context, defines mindfulness as paying attention on purpose to what is happening in the present moment with an attitude of openness and acceptance, and without adding concepts or elaborations, dropping our emotional reactions to whatever may be occurring. He further 7

8 states that mindfulness involves above all the regular, disciplined practice of moment-tomoment awareness or mindfulness, the complete 'owning' of each moment of your experience, good, bad, or ugly (Kabat-Zinn, 1990). Bishop, et al. (2004) proposed a twocomponent definition of mindfulness. The first component involves the self-regulation of attention so that it is maintained on immediate experience, thereby allowing for increased recognition of mental events in the present moment. The second component involves adopting a particular orientation toward one s experiences in the present moment, an orientation that is characterized by curiosity, openness, and acceptance (Bishop, et al, 2004). Mindfulness, then, can be thought of as a state or mode of awareness that is characterized by an attitude that is non-judgmental and that can be developed by regulating attention intentionally. It can be cultivated by a variety of mindfulness awareness practices which all share common procedures. Sitting-meditation is the most common method taught and will serve as an example of how these approaches work. The meditator sits in an erect posture, either on the floor cross-legged or in a chair, and places attention on the in and out flow of the breath, focusing on either the out breath at the nostrils or on the rise and fall of the abdomen. When attention wanders, the meditator simply notes the distraction and returns to the breath. This is repeated throughout the meditation session. After some stability has been attained, the meditator may let go of the focus on the breath and simply note whatever experience arises with an attitude of openness, acceptance and without making judgments or elaborations on their significance (Kabat-Zinn, 1990; Segal, Williams, & Teasdale, 2002; Bishop, et al, 2004). It should be noted that mindfulness is not the same as relaxation. Although reduced 8

9 tension and feelings of stress may be a desirable outcome of mediating, this is not the primary purpose for practice. Relaxation techniques are usually taught as means of coping with stress and are usually applied at times of stress and are, therefore, serving as goaldirected activities. Mindfulness practices, on the other hand, are intended to cultivate awareness and the ability to maintain non-judgmental presence. This is intended to lead to insight into one's thought processes and to increased well-being. Centering prayer is the method that was developed by the Rev. Thomas Keating, a Roman Catholic priest. Based on The Cloud of Unknowing by an anonymous fourteenthcentury writer and the works of St. John of the Cross, it is intended to bring practitioners into the presence of God, thereby fostering contemplation. In the Catholic tradition this is considered to be a pure gift of the spirit. Father Keating had observed that a number of young people were leaving the church and exploring the Eastern meditative practices and were actually experiencing contemplative states sought but rarely obtained by Catholic monastics. Keating and some of his fellow monastics learned TM, and they also actually sat for several sesshins (a week-long intensive meditation retreat) led by a Zen master. Lectio Divina (a method of contemplation as applied to the reading of scripture) is another meditative technique that also is intended to lead to the gift of contemplation (Keating, 2009). Although there is little research on the benefits of these practices, there is considerable evidence that shows religious practice supports health and longevity (Carmody, et. al. 2008). In practice, centering prayer usually uses a short prayer or a word as the focus of one's attention with a clear intention to consent to God's presence and action within us 9

10 (Keating, 2009, p28). This is said to enable the supplicant to let go of his or her entrenched emotional programs and to begin to move deeper toward the Divine Indwelling that is the source of the divine energy or ground of being (Keating, 2009). C. How Meditation Works Mindfulness can be considered both a trait or mode of awareness and the practice that develops a state of awareness or of being in the present moment. The state of being mindful can be looked at in terms of the underlying physiological mechanisms or in terms of its underlying psychological mechanisms. The body of research examining the physiological mechanisms of consciousness has been burgeoning with the availability of functional Magnetic Resonance Imaging (fmri), EEG and other techniques. These tools to explore the neurological substrates of the brain have allowed for much greater understanding of how MAPs operate in the brain. One of the most important results to emerge from the field of neurobiology is the concept of neuroplasticity, which states that the brain can continue to develop new neurons and new neural connections well into old age. This means the brain continues to develop in response to experience, and trait changes are quite possible (Davidson & Lutz, 2007). Among these new findings is evidence that long-term meditators may actually alter the structure of their brains. These changes include significant growth of neural tissue in the brain and can alter how the brain works as a system. For example, Richard Davidson, a leading researcher in the field, finds that mindfulness practice enables individuals to regulate their emotions in a positive direction and are better able to regulate negative emotional states (Davidson 2004). Neuroplasticity also applies to changes in brain function and in mental experience including feeling and 10

11 mental balance. There are also demonstrated changes in stress response and improved immune function (See Siegel, 2007, 2010 for a complete discussion of mindfulness and neuroplasticity). In another study, Lutz, et al (2008) found that long-term meditators demonstrate increased empathic responses, more so than novice meditators, although novices did show some degree of increased empathic response after limited practice times. K. Rubia (2009) reviewed several studies that emphasized physiological aspects of several different meditation techniques and concluded that there are short-term and long-term effects on functional and structural neuroplasticity. There are also physiological indicators for stress relief and relaxation. Long-term meditators also showed enhanced emotional balance and were better able to maintain focused attention when compared to short-term practitioners. On a psychological level, mindfulness provides an impressive set of skills. The underlying principle of mindfulness awareness is that it develops non-judgmental, presentmoment awareness (Kabat-Zinn, 1994). This attitude of non-elaborative, open acceptance can be developed by mindfulness awareness practice and involves a self-awareness that allows one to witness his or her thought processes without altering them. This is a nonjudgmental attitude of curiosity, openness, acceptance and is a state of mindfulness that is open and receptive to whatever arises in the field of awareness (Siegel, 2007 p. 332). This attitude, which is called bare attention in the Theravadan vipassana tradition, is the condition for clear comprehension and the ability to see things as they are (Nyanaponika, 1965), and all theories of mental health contend that an accurate perception of reality is the hallmark of psychological adjustment (Brown, et al. 2007). In one study, Brown and Ryan (2003) 11

12 argued that mindfulness may facilitate well-being directly, by adding clarity and vividness to current experience. They further state that mindfulness encourages closer, moment-tomoment sensory contact with life, that is, without a dense filtering of experience through discriminatory thought. A mechanism posited by Shapiro (2006) that points to how bare attention operates is reperceiving, which is a shift in perspective whereby the subject of attention becomes the object of attention. Shapiro considers this to be the underlying mechanism of mindfulness that allows one to become a witness to the drama of one's life. Shapiro posits that reperceiving alters the relationship one has to experience and brings about four variables: self-regulation, values clarification, greater cognitive and behavioral flexibility and exposure that leads to the beneficial outcomes of practice. This awareness of awareness is similar to what other writers have called metacognition (Siegel, 2007). This sense of self-awareness or metacognition is also a factor in improved self-regulation (Barnes, Et al., 2006, Shapiro, 2006). Secure or optimal self-esteem has been shown to be associated with reduced aggressive behavior and should be considered as distinct from contingent self-esteem, which is dependent on external factors (Ryan, Brown, 2006; Heppner, et al. 2008). Contingent selfesteem is fragile and unstable. Contingent, or high, inflated self-esteem, is dependent on outside factors such as feeling respected or having social acceptance. This type of selfesteem can easily become threatened by insults or rejection, and these threats can trigger aggressive reactions. A high degree of ego-involvement, which relies on a particular outcome or experience, is also seen to be related to fragile, unstable self-esteem and is vulnerable to 12

13 aggressive reactions in the case of failure or other negative results. Ryan and Brown (2006) argue that the cultivation of awareness, operationalized as mindfulness, is the means to develop optimal self-esteem. Mindfulness, with its aspects of open and accepting awareness, offers a mechanism to reduce the aggressive reactions that are often typical of criminal offenders and therefore can enhance secure self-esteem. A simple standard meditation task involving eating a raisin with complete mindfulness has been shown to bring about a reduction in aggression as measured by a standardized questionnaire. Heppner et al. (2008) suggest that alternative mechanisms involving mindfulness may also play a role. As mentioned, improved self-regulation as been shown to be enhanced by mindfulness practices. Mindfulness seems to be linked with a sense of connectedness with others and feelings of compassion. In another recent study, Borders, et al. (2010) argued that rumination is a significant underlying factor in anger and aggressive actions. This study offered evidence that mindfulness has the potential to decrease rumination and other behavioral components of aggression. The ability to distance oneself from the events of one's life allows for a new way of relating to experience. Tolerance of negative or unpleasant emotions becomes easier, and thus maladaptive, habitual patterns lose their hold, offering a degree of freedom. For example, in many addictive behaviors, the addict turns to alcohol or drugs in response to an emotion or situation perceived to be intolerable. However, as mindfulness is developed, the addicts ability to see the situation as a mental state that is impermanent develops, and he learns that there are other, more skillful means of responding. As one's practice of mindfulness develops, it becomes possible to clarify the 13

14 established set of conditioned values that may never have been examined and to revise one's relationship with the world. This also implies increased flexibility along with the opportunity to become less rigid as one learns to let go of long-held patterns and beliefs. Another mechanism offered by Shapiro is exposure or the ability to tolerate very strong emotional states and even pain with objectivity. In fact Kabat-Zinn's MBSR programs were originally started as a means of aiding with patients suffering from chronic pain. It should be apparent that many of these issues -- contingent or inflated self-esteem, inability to tolerate negative or unpleasant emotions, confused or an ineffective set of values -- often characterize many of those individuals encountered in the criminal justice system. Section III: Clinical Applications A. MBSR Jon Kabat-Zinn's MSBR program is perhaps the best known and most influential source for bringing meditation and mindfulness out of its essentially Buddhist context and applying these techniques to the health-care field. Originally, MBSR was developed in the early 1980s at the University of Massachusetts Medical Center as an attempt to improve the outcomes for cardiac patients and those with other medical issues thought to be stress-related which are not amenable to traditional medical interventions (Kabat-Zinn, 1990). This eight-week program proved to be quite successful in improving the health and well-being of those who applied its techniques. Since that time, there has a rapidly growing body of research supporting MBSR programs and their benefits and a growing interest in developing new areas where mindfulness can be beneficial including health care, education, business and law (Duerr, 2004), and to some extent in the criminal corrections system. MBSR is also being 14

15 offered in non-clinical settings as means of enhancing life skills and well-being. There are seven factors or attitudes that are foundations to mindfulness practices as stated by Kabat-Zinn: 1. Non-judging being an impartial witness to experience; 2. Patience understanding and accepting that sometimes things must unfold in their own time; 3. Beginner s Mind dropping our ideas and beliefs about things and seeing the world as if for the first time; 4. Trust developing confidence in your own feelings and intuitions, your own authority; 5. Non-striving realizing that there is nowhere to go, you are already here; 6. Acceptance seeing things as they actually are in the present; and 7. Letting go releasing thoughts, feelings, and situations that the mind seems to want to hold on to (Kabat- Zinn, 1990). These attitudes, perhaps be condensed into acceptance or equanimity and they can be cultivated with practice and are at heart of all meditative and contemplative practices. In the eight-week MSBR program, participants are given several practices to use. First, they are taught to use a formal meditation practice, which usually done in a sitting position. A body scan and movement meditations in the form of simple yoga techniques and walking meditation are also included. Weekly classes last two to three hours, and all participants are asked to practice 45 minutes each day between classes alternating these practices. They are also encouraged to bring mindfulness to their activities throughout the day. B. Other Mindfulness Based Therapies Since MBSR began about 30 years ago, several mindfulness-based clinical applications have emerged. Mindfulness-Based Cognitive Therapy (MBCT; Segal, Williams, & Teasdale, 2002), Acceptance and Commitment Therapy (ACT; Hayes et al., 1999), Dialectical Behavior Therapy (DBT; Linehan, 1993a), and variants of these approaches have been studied and 15

16 overall found to be beneficial overall in different contexts. MBCT has been most widely used for a variety of mental health issues and demonstrated to be effective in treatment of depression, and especially in prevention of relapse from depression. Mindfulness is a key component of DBT which has been one of only therapies effective in the treatment of border line personality disorder. Although it does explicitly present mindfulness as a practice, ACT uses many of the strategies drawn from MBSR and mindfulness awareness practices has been found beneficial for various clinical problems. Mindfulness has also been demonstrated to be efficacious in preventing relapse for substance abuse problems (Marlatt, 1994). Overall, in a thorough review of the literature concerning mindfulness-based interventions, Baer (2003) found that these techniques are demonstrated to be efficacious to varying degrees, although the research is ongoing and cannot yet be considered definitive. Other reviews of the research of MBSR and mindfulness-based clinical interventions have all been supportive. As the underlying mechanism for the effectiveness is being researched, it is becoming clear that these approaches have value in both treating clinical disorders, as well as improving human well-being. Grossman et al. (2004) concluded that mindfulness training is of value in improving coping with the challenges of everyday life as well as more serious disorders. In a more recent literature review, Santo & Pinto (2009) also conclude that mindfulness-based approaches are of value in the management of a range of mental and physical health issues. Another MBSR approach is mindfulness-based relapse prevention (MBRP) proposed by G. Alan Marlatt (Marlatt, 2002, Bowen, et al., 2009). This approach is based on Buddhist psychology and cognitive-behavioral treatment approaches. The emphasis is on the mind- 16

17 based nature of addictive behaviors and how thoughts and expectations influence addiction. It offers a middle way approach that can allow for continued substance use but with harmreduction training if total abstinence is unacceptable to the client. To date the research is quite supportive of MBRP. Another literature review by Greeson (2008) concludes that the current research on mindfulness has demonstrated its beneficial effects on several aspects of whole-person health, including the mind, the brain, the body and behavior. The growing body of research points to the beneficial effects of mindfulness practices involving shifts in cognition, emotion, physical health and behavior that work together to improve well-being. Mindfulness practice has also been demonstrated to enhance a greater sense of meaning and peacefulness in one's spiritual life and in improved social relationships. Additionally, the developing field of neurobiology with its cutting-edge technologies of brain imaging are providing a solid physiological basis for mindfulness practice (Greeson, 2008; Rubia, 2009). Finally, it seems that research is proving what Buddhists and other meditators have known for centuries that greater attention, openness, acceptance and compassion can bring about more adaptive responses to the stresses of life, which, in turn, can help free us from suffering and realize greater health and well-being. C. Cultivating Mindfulness One question that arises in considering the value of mindfulness practices is the degree to which is mindfulness a personality trait compared to the degree to which mindfulness can be cultivated and what methods are most suitable. In traditional Buddhist teaching, the cultivation of mindfulness is a given. In fact, the Pali the language of the earliest Buddhist 17

18 teachings -- word for meditation is bhavana, which more precisely means mental cultivation and is a meditation practice that develops mindfulness (Gunaratana, 2002). However, as indicated above, with Jon Kabat-Zinn's development of MBSR and the work of many researchers, we now have a large body of evidence supporting the possibility of developing and enhancing mindfulness through a variety of meditation practices that do not need to be a part of a religious tradition. One recent study by Carmody, et al (2009) tested Shapiro's theory discussed above and, with some reservations, found support for the key ideas, especially the benefits of practice. In another study by Carmody and Baer (2009), they also found beneficial results when meditators practice regularly at home. One finding was that the mindful yoga was possibly more beneficial than the sitting meditation. Falkenström (2009), in a study of vipassana meditators on intensive retreat, found that mindfulness clearly enhances wellbeing and that mindfulness practice improves well-being. Also, the development of mindfulness is related to the amount of time spent in meditation and also retreat practice enhances mindfulness. The standard MBSR program is eight-weeks and typically requires two to three hours of instructor-led practice. Participants are asked to practice for 45 minutes per day at home. There is also a six-hour practice day after the sixth week. This can pose a significant obstacle to those who might benefit from MBSR. Klatt, et al. (2008) offered a low-dose variation on the standard MBSR program (MBSR-ld) at a major Midwestern university to determine if a shorter, more available program would be as effective. The low-dose program was offered to faculty and staff who met specified requirements. The MBSR-ld program lasted six weeks with 18

19 a one hour instructor-led session each week, and participants were asked to spend twenty minutes practicing each work day. The results for perceived reduced stress, increased mindfulness and enhanced well-being were fully comparable to the full MBSR program and a clear demonstration that a shorter program is beneficial. While much more research is needed, it is clear that mindfulness can be developed with practice and that meaningful benefits can result from even relatively short-term training. Section IV: Empirical Evidence for Mindfulness Awareness Practices in Correctional Settings It is apparent by now that mindfulness and meditation practices have well documented beneficial effects for overall mental and physical health and enhance well-being in a general population. These benefits will also apply to those who are incarcerated. The current research on meditation and mindfulness directly pertaining to the correctional system is relatively small. However, there are several studies and a significant amount of more anecdotal evidence. In one important study, a modified MBSR program was offered to over 2,000 inmates in the Massachusetts correctional facilities, including one women's prison, four medium security men's prisons and one minimum security/pre-release facility between 1992 and A reported 1,350 inmates completed the program. Results were measured on three widely accepted measures of hostility, self-esteem, and mood disturbance. All three measures indicated significant improvements for all participants, although the women and men in the minimum security facility did better. Opportunities for follow-up were limited from six to eight weeks but the gains were still evident (Samuelson et al. 2007). 19

20 These outcomes were very encouraging, especially with the limitations imposed by prison circumstances requiring shorter class times and program length. Also, available facilities to conduct the program were often less than ideal, and in prison it is often challenging for inmates to find a quiet place and time to practice. Furthermore, the report acknowledges several limitations: first, it was not designed as a research study and lacked a control group and other criteria usually used in formal research. Second, little background data was available for the participants. Finally, there was no opportunity for long-term followup or a measure of recidivism. Other studies involving the use of meditation techniques similarly have demonstrated their value in prisons. A ten-day vipassana meditation retreat was first offered in Tihar jail in India in It was so successful in improving the behavior and attitudes of both the inmates and their jailers who participated in the course that the programs have since become a standard offering in Indian prisons (reported in Bowen, et al., 2006, org). The Indian vipassana retreats are the subject of a powerful documentary movie, Doing Time, Doing Vipassana (Ariel, 1997). Since that time, vipassana retreats have been introduced in several U.S. prison systems including California, Washington and Alabama. Although well-designed research studies have not been conducted for most of these programs, the reports have all been quite positive. However, through a grant from the National Institute of Alcohol Abuse and Alcoholism awarded to G. A. Marlatt, Department of Psychology, University of Washington, Seattle, his department has been able to perform a series of studies at a minimum-security adult jail in Seattle, Washington. 20

21 One of these studies, based on a series of vipassana retreats in the North Rehabilitation Facility (NRF), a minimum-security adult jail in Seattle, by Bowen, et al. (2006) concerned substance use disorder (SUD). This study examined the effectiveness of vipassana meditation as a treatment for substance abuse and looked at questions of improved psychosocial outcomes and reduced recidivism. The results indicated significantly lower use of alcohol, marijuana, and crack cocaine in the three-month post release follow-up studies, as well as fewer alcohol-related incidents. The participants also reported significantly increased optimism and lower levels of psychiatric symptoms. There was some supporting data for reduced recidivism; however, the overall rates were too low to draw meaningful conclusions. There is also concern that the three-month follow-up period was too short. Another study by Simpson, et al. (2007), looked at post traumatic stress disorder (PTSD) symptoms, substance abuse disorder (SUD) and vipassana meditation in incarcerated individuals. As the writers point out, rates of PTSD and substance abuse have been higher among incarcerated individuals than in the general population. Incarcerated men with both PTSD and SUD are more likely to re-offend than those with only SUD, and women are more likely to relapse into substance abuse. The presence of both issues is now viewed as an attempt at self-medication for PTSD. One of the issues with both SUD and PTSD is the need to avoid unpleasant or negative experiences. Mindfulness meditation offers the conditions allowing one to look at painful aspects of experience by fostering non-judgmental acceptance of moment-to-moment experience. It is possible that mindfulness practices may, then, be a useful intervention in treating PTSD. The authors report that earlier studies supported the use of meditation practices, including TM, as one of several strategies in managing PTSD. In this 21

22 study, the key finding for those who were diagnosed with both PTSD and SUD was that there were comparable reductions in drug use and alcohol abuse for those with and without PTSD symptoms. As with many of these studies, the outcomes are encouraging and point to the importance of further research. There have now been several meditation retreats held in prisons. The first vipassana retreat held in a maximum security in a North American prison was at the Donaldson Correctional Facility in Bessemer, Alabama. It is the subject of the documentary film, The Dhamma Brothers, (2008). The outcomes have, again, demonstrated of the ability of meditation to transform lives. The stories of the men who participated in the ten-day retreat are testimony to this transformation. In some cases, this was the first time in their lives that they were able to accept full responsibility for their actions and make peace with themselves. The prison staff, although initially quite skeptical, also found that the men had benefited from the experience and were easier to deal with. However, to date there appears to be no published analysis of the outcomes beyond the favorable testimonials from all parties involved and the decision of the prison to continue the programs. In a study at the Tidewater Detention Center (TDC) in Chesapeake, Va., Sumter offered a seven-week meditation course modeled on Kabat-Zinn's MBSR program. TDC is a residential detention facility for female detainees. Their program maintained a highly supervised, highly structured, paramilitary community environment, which lasted from 20 to 24 weeks. The meditation program was held weekly offering two-and-a-half-hour sessions of meditation practice and instruction. The method taught was based on the meditation practice presented by Herbert Benson in The Relaxation Response. Participants were required to 22

23 maintain silence the rest of the week. No mention was made of encouraging meditation practice outside of the class. The results were overall quite encouraging: reported reduction in sleeping difficulties, greater anger management skills, and reduced stress and anxiety. Also, participants showed improvement by experiencing less guilt and feelings of hopelessness about the future (Sumter, 2007). In an unpublished evaluation of the program sponsored by the Heart Mountain Prison Project at the men's prison in Grants, New Mexico, the writers, Wadsworth, Strong and Brown (2007), found great value to the programming. The program evaluated was held in a special meditation pod with 16 participants who had chosen to live in the pod and who agreed to more restrictive rules than the prison's general population. These rules included daily silent periods set aside for meditation, no television in the common areas and a commitment to spiritual practice. As an interfaith program, several traditions were represented, and there was no requirement to adhere to a specific faith. The results showed that most participants did practice and work at utilizing the skills presented. The inmates also reported less stress and frustration, and they appreciated the opportunity to participate. Objectively, there was a significant reduction in prison infractions and an overall positive change in behavior was noted. The evaluators recommended the program be expanded and otherwise enhanced. Section V: Mindfulness and Restorative Justice Restorative justice, in its modern incarnation, was started in Canada in the early 1970s by Mennonites looking for alternative methods of approaching crime in a primarily Mennonite community. It has since spread extensively and restorative justice practices are being used 23

24 throughout Canada, Europe, North America, New Zealand and Africa (Dhami, et al. 2009). Restorative justice offers a new way of thinking about wrongdoing and criminal and punishment. Howard Zehr (2002) offer a concise introduction to the basic principles summarized here: In its essence, restorative justice has three central concepts or pillars: 1.Restorative justice is concerned mainly with the harm to the victim of the wrongdoing as well as the community. This primacy to the victim's needs and concerns requires repairing the harm done. In considering the harms done to the victim, attention may also be given to the causes of the crime, which will include the offender. The concerns of the community in which the crime occurred are also given attention, with the intent of putting things right. 2.Harm entails obligation. The offender is held accountable and must take responsibility for the harms caused. This may include some type of reparation, community service or even more traditional punishments such as incarceration. The community may also have obligations as well, both to the victim and the offender. Restorative justice has a limited role to play in cases where the offender will not accept responsibility. 3.Engagement is the key element to the restorative justice model. All the stakeholders, the primary parties affected by the crime, are asked to participate in the process in one way or another. There are several methods for doing this, sometimes involving direct dialog or talking circles and at other times indirect exchanges. At times the courts will be heavily involved; at other times the courts may play little or no role at all (Zehr 2002). The overall impetus is toward healing and restoring the community to wholeness. Ideally this also means bringing the offender back into the community as a fully participating member and repairing the harms done to the victim and the community. This emphasis on putting things right is at the heart of the restorative justice movement. This will especially include victims, who have been left out of much of traditional judicial proceedings. Some of the methods used are victim-offender conferences, family group conferences and circles as practiced in the Native American communities of North America. There are a number of variations on how these methods are employed and who participates. Some include only the communities involved; others may include the court and will be a part of more traditional 24

25 legal proceedings. At times, simply acknowledging the victim's need for information and keeping the victim informed as the case progresses will be all that can be done if the perpetrator remains unknown. The role of the offender as a responsible participant is essential for the restorative justice process to be successful. Responsible participation is not always possible because so many offenders either overtly or subtly try to place blame away from themselves. One of the outcomes of meditation and mindfulness practices is an increased self-awareness which may lead to a more willing attitude toward accepting blame. There is also, as has been discussed, an increased ability to accept and face the old memories, painful feelings and personal failures that surface in meditation. It is important to remember that sometimes what the offenders really needs to face are their own woundedness as well as their responsibility for the harms they may have caused others. The accepting, nonjudgmental attitude of mindfulness practice creates a spaciousness, making painful feelings tolerable, thus allowing a sense of personal responsibility to arise. Empathic responses to others have been shown to increase with meditation practice (Lutz, et al. 2008). As Siegel (2007, 2010) suggests, mindfulness skills may actually alter the brain circuitry for compassion and empathy. This change can foster a state of self-empathy and create the capacity to enhance our sense of connectedness to ourselves and to others. This can be the beginning of personal healing as well, which is important to the successful implementation of restorative justice. In several of the studies cited in this paper as well as in the testimonials noted from 25

26 the documentary films cited, mindfulness practices do enable the offender to let go of the anger and self-protective stance that prevents a healthy connectedness to the world. A new sense of connectedness, in turn, will enhance the ability of the offenders to face the painful emotions that arise when they look at their actions, leading to enhanced ability to empathize with the victim. When such a change occurs, there is movement toward healing and restoration. While restorative justice in its fullest sense can only happen if the other stakeholders are interested and willing, allowing offenders the opportunity to find the strength to look honestly at themselves is no small thing, and the possibility of actually using restorative justice methods is now present from one part of the equation. Also, the healing and the actual transformative power of mindfulness practices offer the real possibility that the offender will be able to become a productive member of the community upon release. From the personal experience of teaching meditation and mindfulness practices in prisons both in Ohio and in New Mexico, I have seen inmates transform from being confused or angry, bitter men who seemed to blame anyone or anything for their situation grow toward becoming self-aware, responsible adults. To date, there are few restorative justice programs in prisons, and the ones that are in place are often only partially restorative in their programming (Dhami et al., 2009). However, there are several potential restorative programs that can, with varying degrees of difficulty be implemented within a prison. Van Ness (2007) offers several possibilities beginning with programs to develop awareness and empathy for victims. Other possibilities 26

27 include programming that offer opportunities for reconciliation and making amends to the victims. Prisoners are often alienated from their own families, and programs that facilitate reconciliation with family members will have value. Restorative justice can be applied within prison for conflict resolution between prisoners, staff and between prisoners and staff with the larger goal of creating a culture of peaceful conflict resolution. In all of these potential programs, the transformative effects resulting from meditation practices can play an important role. The role that mindfulness can play in restorative justice programs is significant. Offender accountability is an essential part of any restorative justice program, and developing the ability to accept responsibility for one's actions is a natural outcome of meditation practice. This sense of personal responsibility will apply to both acknowledging accountability for the harms caused by the crime and also to taking one's place as a responsible, contributing member of the community after release. Section VI: Discussion The research into meditation and contemplative practices is still in its infancy but is growing at an exponential rate. The research has strongly supported the value of these ancient practices for treating psychological and health concerns, as well as improving wellbeing in general. The scientific and anecdotal evidence both suggest that these practices are beneficial in the criminal justice system. The health-related benefits of reducing medical costs alone would make them a valuable addition to prison programming. The lower rate of inmate 27

28 frustration and stress would also reduce the problems of potential violence and prison rule violations. The inmates who have participated in the programs appreciate them and tend to follow through with the practices and, in fact, in most of these programs, the inmates volunteered to participate. Meditation programming also seems to carry a less negative image than some of the SUD programs. A. Meditation: Religious or Secular? One question that often arises concerns the status of meditation as a religious practice as opposed to being a secular practice. Because the origins of meditative practices are from religious traditions, this is a reasonable question. In recent times the predominate sources are the Eastern religions, primarily Buddhism but also Hinduism and yoga. There is an on-going question that asks if Buddhism is a religion or a philosophy since it is non-theistic. However, in either case, as Jon Kabat-Zinn has demonstrated, mindfulness practices can be fully effective and beneficial in a secular setting (Kabat-Zinn, 1990) and need not be considered as religious practices. Much can certainly be said in favor of a secular approach that is open to all without the off-putting religiosity that would limit participation. Even so, there is some debate about what is lost when meditative practices are disengaged from their spiritual and cultural origins. One consideration would be the qualifications of the teachers. Because meditation has been taught for centuries by religious practitioners with great depth of experience as meditators themselves, there is some concern that Western therapists may lack the necessary depth of experience. Questions also arise regarding what aspects of the traditional teachings are beneficial in establishing the benefits 28