CEPA eprint 4098

The meaning of mindfulness: A second-order cybernetics of stress, metacognition, and coping

Garland E. L. (2007) The meaning of mindfulness: A second-order cybernetics of stress, metacognition, and coping. Complementary Health Practice Review 12(1): 15. Available at http://cepa.info/4098
Table of Contents
Introduction
The biopsychosocial consequences of stress
The transactional model of stress, appraisal and coping: a mid-range, substantive theory
Appraisal
Commitments
Beliefs
Situational Factors
Coping Efforts
Mindfulness and positive reappraisal
Mindfulness and dysfunctional coping strategies
Mindfulness and self-transcendence
The second-order cybernetic model of stress, metacognition, and coping
Discussion
Conclusion
References
Stress-related illness presents an ever-increasing burden to society, and thus has become the target of numerous complementary and integrative medicine interventions. One such clinical intervention, mindfulness meditation, has gained eminence for its demonstrated efficacy in reducing stress and improving health outcomes. Despite its prominence, little is known about the mechanics through which it exerts its treatment effects. This article details the therapeutic mechanisms of mindfulness with a novel causal model of stress, metacognition, and coping. Mindfulness is hypothesized to bolster coping processes by augmenting positive reappraisal, mitigating catastrophizing, and engendering self-transcendence. Reviews of stress and mindfulness are then framed by the perspective of second-order cybernetics, a transdisciplinary conceptual framework which builds on extant theory by highlighting the recursion between the individual and their environment.
Key words: mindfulness; stress; coping; second-order cybernetics; metacognition
Introduction
Life, with all its majestic synchrony and perfect balance, is a dynamic process. Human life then, by definition, is also dynamic and thus involves stress; the homeokinesis between person and environment requires continual calibration as the individual grows and adapts to the demands of living. As the organism is subject to a ceaseless array of forces that impinge on it from the external world, concomitant psychophysiological reactions are set into motion that enable the individual to meet the strain of the environment. Humans experience this process as stress when they attribute symbolic meaning to events deemed exigent to well-being (Rosmond, 2005).
Modern society places demands on the individual that require one to cope with increasing levels of stress. In the face of war, economic recession, and ecological crisis, individuals and communities bear the brunt of societal and global catastrophes, compounded by the daily hassles of living. Vulnerable populations who are less able to cope because of a lack of social, economic, or cognitive-emotional resources evidence the adverse consequences of stress through mental and physical illness (de Groot, Auslander, Williams, Sherraden, & Haire-Joshu, 2003). Persons confronted with the inequities of poverty and oppression, who are already taxed by the load of multiple economic, health, and social disparities, are especially susceptible to the cumulative effect of stress; the compounding of stressors presents a very real danger that may initiate sequelae deleterious to mind and body (Rosmond, 2005). Hence, stress-induced pathology presents a serious problem for a society increasingly subjected to both global and local strains, especially so for its most vulnerable members.
Because of the magnitude of this issue, a number of complementary therapies have been integrated into the treatment of stress-related disorders. Among them, mindfulness meditation has gained eminence as a clinical intervention for its ability to enable individuals to cope with adversity. Mindfulness training has been shown to be an effective, evidencedbased practice for reducing stress and improving health outcomes across diverse populations (Astin, 1997; Baer, 2003; Grossman, Niemann, Schmidt, & Walach, 2004; Kabat-Zinn et al., 1998; Shapiro, Schwartz, & Bonner, 1998; Speca, Carlson, Goodey, & Angen, 2000; Teasdale et al., 2002). Although coping strategies have been researched extensively (Folkman, 1997; Folkman & Moskowitz, 2000), little is known about the underlying mechanisms through which mindfulness leverages coping responses. This article first provides a theoretical model of the stress process that builds on the work of Lazarus and Folkman (1984) by highlighting a heretofore unidentified linchpin in the mechanics of coping: metacognition, the state of awareness associated with mindfulness meditation. Second, this model is grounded in a discussion that frames the study of stress and coping within the broader conceptual framework of second-order cybernetics.
The biopsychosocial consequences of stress
There is a robust body of literature describing the deleterious consequences of stress. Much of this research details the biological pathways that mediate between stress and the development of severe, chronic diseases. In brief, perception of threat in the environment coupled with an appraisal that one lacks the resources and coping options necessary to meet this threat results in a stress response, initiating a cascade of psychophysiological processes. One biological stress pathway involves the stimulation of the hypothalamic pituitary axis leading to elevated secretion of cortisol (Chrousos & Gold, 1992; Rosmond, 2005). In turn, unchecked cortisol levels interfere with insulin action, leading to metabolic disturbances. Concomitantly, excess cortisol inhibits protein synthesis in peripheral tissues and leads to dysfunctional lipid metabolism. These deleterious effects may lead to visceral obesity, which increases ones vulnerability to cardiovascular disorders. Compounding this cardiovascular risk, stress activates the sympathetic nervous system and HPA axis, leading to cortisol and catecholamine-induced cardiac pathophysiology. Thus, HPA axis activation is associated with a disruption in the homeostasis of multiple body systems through the cortisol-mediated stress response, which in turn is a significant regulatory factor for disease-generating events (Rosmond, 2005). For instance, diabetes, which has reached epidemic proportions in the United States of America (National Institute of Diabetes and Digestive and Kidney Diseases, 2005), has been tied to increases in hormones stemming from stress-related activation of the HPA axis (Surwit & Schneider, 1993).
Coextensive with the physiological reactions as outlined above, specific emotional reactions result from the cognitive process of stress (Lazarus & Folkman, 1984). For instance, depression is theorized to occur in response to a sense of hopelessness and helplessness following the acute or chronic stress of a significant loss (Lazarus, 1999). Learned helplessness, a phenomenon originally observed in experimental animal models but later applied to causal models of depression in humans, is a state in which the individual expects to be unable to meet future challenges and subsequently adopts a depressed, passive, or withdrawn posture (Abramson, Seligman, & Teasdale, 1978). Learned helplessness effects include, among others, impaired ability to initiate defensive action, and enhanced sensitivity to punishment, enhanced memory for prior stressors, enhanced ruminations about the trauma, and enhanced vulnerabilities to a number of physical disorders (Overmier & Murison, 2005). Stemming from situations of chronic stress, learned helplessness is a behavioral and physiological manifestation of depression that may result in the development of chronic diseases (Kopp & Réthelyi, 2004). Coping is inhibited by learned helplessness, and inhibited coping leads to the hopelessness of depression.
Depression may occur when an individual first appraises an event as involving a loss and then struggles to accept that loss. In so doing, by resisting the conditions of his or her existence, emotions of sadness, anxiety, anger, guilt, and shame result. According to Lazarus’s cognitive-motivational-relational theory, erroneous judgments, conclusions, and beliefs drive the depressive emotional state (1999). Such cognitions, when experienced over time, may stabilize into depressogenic cognitive sets, or schema, that maintain the depressive emotional state and encourage relapse into depression (Teasdale, Segal, & Williams, 1995). These negative cognitive templates involve themes of self-denigration and personal inadequacy, and affect the encoding and processing of information. Consequently, depressogenic schema and their concomitant cognitive styles may result in increased sensitization to aversive experience such as pain, as is the case with psychosomatic diseases such as irritable bowel syndrome (Lackner, Quigley, & Blanchard, 2004). In sum, stress-related disorders, like depression and diabetes, exact tremendous personal and financial costs on society.
The transactional model of stress, appraisal and coping: a mid-range, substantive theory
Theory is needed to elucidate the mechanisms that result in the stress process and its consequences. The biopsychosocial phenomenon of stress arises from the ontologically inevitable, dynamic transaction between organism and environment. Humans experience stress when they become aware of an incongruity between the characteristics of the environment and the needs and resources of the individual (Lazarus & Folkman, 1984). The process of matching demands to resources involves the perception of environmental stimuli, which leads to their subsequent appraisal as irrelevant, benign, or stressful. Stressful stimuli initiate a “fight-or-flight” reaction in the body, activating the endocrine system to secrete hormones that marshal physical strength and endurance for the purpose of selfdefense (Cannon, 1939). When a given event is appraised as exigent to well-being, persons experience the sequences of cognitive, emotional, and behavioral responses that have come to be labeled stress and coping.
The relationship between stress, coping, and biopsychosocial pathology in humans is complex. This relationship is mediated by the process of appraisal and may be moderated by cognitive-emotional states (Folkman & Moskowitz, 2000; Lazarus & Folkman, 1984). A demanding encounter with the environment in and of itself does not carry any particular valence, and takes on positive or negative connotations only after its relevance for one’s well-being has been appraised. Although many taxing events may harm or threaten harm to the individual, other stimuli present a challenge that involves the possibility of growth or benefit to the person. For instance, running subjects human physiology to stress, yet a person’s experience of that stress differs whether they are running from a grizzly bear or running toward the finish line at a marathon. Whereas in the former case, the organism is under definite threat, in the latter case the person will be rewarded for overcoming the challenge. Thus, the experience of stress is contextual; humans interpret context and subsequently appraise stimuli according to that context for their significance. The following domains are pertinent to the study of stress and coping.
Appraisal
According to Lazarus and Folkman (1984), the stress process initiates with a primary appraisal of an event for its threat value. Physiological arousal co-occurs with psychosocial distress when a given event is appraised as threatening, harmful, or challenging. Subsequently, a secondary appraisal of one’s resources and coping options then leads to the determination of whether one can meet the demands of the actual or impending threat. If, during this complex evaluative process, the demand of the stressor stimulus is appraised to exceed extant resources (whether personal, familial, or collective) a biopsychosocial stress reaction will result. Lastly, feedback from one’s behavioral reactions to the stressor coupled with novel data about the changes in the environment may engage a reappraisal process, through which the initial appraisal is modified as a result of new information. Thus, an event that was once viewed as a threat may now be considered benign; conversely, what was once viewed as benign may be seen as threatening. Such reappraisals moderate or intensify the physiological, psychological, or social concomitants of the stress reaction.
Commitments
Central to this theory of stress and cognitive appraisal is the notion of commitments. Commitments are those factors that are meaningful to the individual or group that “determine what is at stake in a specific stressful encounter” (Lazarus & Folkman, 1984, p. 56). They motivate the individual to enter into potentially stressful situation, to seek a given outcome. Commitments also influence cue-sensitivity, in that whichever factors are of greater salience to the individual or group will be attended to with more weight. There is a positive relationship between commitment and stress: the more committed a person is to a given factor, the more stress they will experience if that factor is under threat of harm or loss. Correspondingly, the greater one’s commitment to that factor, the more intensely one will strive to overcome the threat. Hence commitments impel action and account for one’s vulnerability to stress, as well as for the intensity with which one attempts to cope with it.
Beliefs
Beliefs are also pivotal to appraisal, as they shape one’s interpretation of the “facts” of lived reality. Beliefs are conceptual sets that frame stimuli with meaning. They operate both on conscious and unconscious levels to shape appraisal processes. Implicit beliefs stabilize into schema, models that describe the interrelationships between generic features of self and world; these models frame recurrent experiential regularities in the form of themes (Teasdale et al., 1995). Schema may have any emotional valence and may be oriented toward self: “I am a helpless victim who will never amount to anything”; or toward world: “The events in my life occur to make me a stronger person.” Dramatic change, which often involves intense stress, drives individuals to consciously access their schemata to make sense of the happenings in their world. Lazarus and Folkman emphasize that schematic beliefs about personal control and existential beliefs are integral to the appraisal process. Spiritual and religious beliefs enable one to infuse daily life with meaning, facilitating positive reappraisals of stressful situations (Folkman, 1997; Folkman & Moskowitz, 2000). For example, such existential beliefs can help one to find redeeming value and motivation in the face of a terrible loss and provide motivation, such as when a loved one dies from an illness and this tragedy impels a person to pursue research to find the cure for the disease.
Situational Factors
The appraisal of a given situation as threatening or challenging is also conditioned by situational factors. The more familiar, predictable, and comprehensible a given event, the more likely one is to appraise that event as challenging, whereas the more impending, inconveniently timed, and protracted, the more likely the event will be conceptualized as threatening (Lazarus, 1999). However, oftentimes it is difficult to make such evaluations because of incomplete information; in those cases, the situation may be characterized by ambiguity, and when there is ambiguity, individual characteristics, schemas, and tendencies shape appraisal processes (Lazarus & Folkman, 1984). Thus situational factors interact with personal factors to affect the stress response.
Coping Efforts
Once an event is appraised as stressful, the individual may utilize either problemor emotional-focused coping efforts to deal with the stressor (Lazarus & Folkman, 1984). Problem-focused coping is a strategic attempt to manage or resolve the stressful event by using procedures for gathering information, making decisions, and resolving conflict. When one views the conditions of the stressor to be unalterable, emotional-focused coping manages the distress itself through procedures linked to cognitive-emotional regulation. Positive emotion is generated when, as a result of successful coping efforts, the stressor event is resolved favorably; however, biopsychosocial distress intensifies when coping attempts are unsuccessful and the stressor cannot be resolved (Lazarus & Folkman, 1984). Such distress may in turn magnify subsequent threat appraisals of the situation. Alternatively, lack of a favorable resolution may engage meaning-based coping efforts such as positive reappraisal, a cognitive strategy that enables emotional-focused coping with the event (Folkman, 1997). Positive reappraisals attenuate destructive emotions through a process of reconstruing stressor events as benign or beneficial. Despite evidence that positive reappraisals have been empirically associated with improved health outcomes (Folkman & Moskowitz, 2000), little is known about the mechanisms by which they operate.
Mindfulness and positive reappraisal
The shift from threat appraisals grounded in cognitive schema to positive reappraisals may involve metacognition, a naturalistic state wherein consciousness transcends its content to rest on the dynamics of its own processes. This form of awareness is associated with the term mindfulness in the Buddhist teachings of Asia. Although there are slight variations in definition across the Buddhist traditions, mindfulness, or satipattha-na (translated literally as the “establishment of mindfulness”) in Pali, refers to both the name of a practice as well as the innate mental function it is designed to enhance (Kalupahana, 1987). The practice of intentionally regulating attention in an open, nonjudgmental manner cultivates the mode of mindfulness (Kabat-Zinn, 2003). Thus mindfulness is the skillful exercise of a metacognitive faculty that can be developed with training (Bishop et al., 2004).
One traditional metaphor used to describe this state of awareness is the mind as a sky in which the contents of consciousness arise, abide, and cease like the passage of clouds. In the mode of mindfulness, thoughts, emotions, and sensations are experienced as transitory phenomena, as part of a cycle of interdependent co-arising, termed pratityasamutpada in Sanskrit (Kalupahana, 1987; Varela, Thompson, & Rosch, 1991). By exercising mindful awareness, judgments, desires, aversions, and other habitual psychological events are seen as momentary, neurodynamic response tendencies, eigenbehaviors (Rudrauf, Lutz, Cosmelli, Lachaux, & Le Van Quyen, 2003) that maintain the individual’s internal coherence in their adaptation to the environment (Depraz, Vermersch, & Varela, 2002; Varela et al., 1991). Mindfulness reveals that these cognitive responses to environmental stimuli have no inherent, semantic meaning other than what is ascribed to them.
Mindfulness meditation may enhance meaning-based coping processes through the process of decentering from cognitive sets (Teasdale et al., 1995). Once an individual has shifted into a metacognitive perspective from which they can stand outside of their own thought content, they are then empowered to make new appraisals of stressor events. In this manner, decentering may facilitate positive reappraisal, a coping strategy that has been found to be so central to adaptive functioning in the face of chronic stress (Folkman & Moskowitz, 2000). This hypothesized relationship between mindfulness and positive reappraisal has been supported through a study that found a statistically significant, positive correlation between these constructs (Fresco et al., in press).
Mindfulness and dysfunctional coping strategies
Not only may mindfulness alleviate the deleterious consequences of stress by facilitating positive appraisal, it may also ease stress-related problems by inhibiting the use of maladaptive coping strategies. Dysfunctional cognitive coping styles such as catastrophizing have been significantly correlated with increased susceptibility to affective disorders (Garnefski & Kraaij, 2006). Although the causal direction is unclear, stress-related emotional problems may simultaneously maintain and be maintained by such adverse coping processes.
Catastrophizing, the cognitive-affective coping style in which one exaggerates threat and devalues one’s ability to manage that threat, has been shown to be a mediator in a number of stressand pain-related reactions (Garnefski & Kraaij, 2006; Lackner et al., 2004; Sullivan, Rouse, Bishop, & Johnston, 1997; Sullivan et al., 2001). Studies of persons with stress-related chronic conditions such as back pain have linked catastrophizing with fearavoidant coping beliefs and withdrawal from activities of daily living (Buer & Linton, 2002; Woby, Watson, Roach, & Urmston, 2004). Thus, in addition to overestimating the threat value of a given event, catastrophizing may also lead one to avoid engaging in problembased coping efforts, which then may exacerbate stress by preventing a resolution of the stressful event.
Such dysfunctional coping strategies may be allayed by mindful awareness. If mindfulness, as theorists propose, is a state of prereflexive receptivity in which one attends to the present rather than worry about the future or brood about the past (Bishop, 2002; Bishop et al., 2004), then the cultivation of mindful awareness would free the individual from maladaptive, cognitive-behavioral habits (Brown & Ryan, 2003; Varela et al., 1991). Mindfulness may unhinge dysfunctional reactions such as catastrophizing, through a decentering from depressogenic schemata characterized by helplessness and hopelessness. This hypothesis is supported by a study by Fresco et al. (in press), who found statistically significant correlations (r = .25, p Save Selection
Mindfulness is also conceptualized as an awareness of stimuli without distortions and reactivity related to emotional valence (Bishop et al., 2004). These distortions and reactions, which often result in fear-based avoidant coping and increased stress, are caused by a cognitive process of evaluating present conditions as undesirable in comparison with preferred conditions (Hayes & Wilson, 2003). Such reactive patterns result in feeling aversion to what is deemed undesirable and feeling craving for what is deemed desirable (Chen, 2006). This process may become pathological, such as in the case of catastrophizing, which involves an overemphasis on the aversive qualities of experience. Pathological cognitive-emotional processes distort stimuli perception through the imposition of depressogenic schemata (Teasdale et al., 1995). These schemata are regenerated through selfperpetuating information processes, where the output of a depressogenic schema is more depressogenic content. This content is then fed back into the cognitive loop, to maintain the catastrophic view of self and world.
Mindfulness consciousness attenuates emotional distortions of stimuli perception by encouraging nonevaluative contact with the world (Chen, 2006; Hayes & Wilson, 2003); hence, the development of the mindfulness state should disrupt pathological schemata and reduce one’s tendency to catastrophize during both primary and secondary appraisal. In this regard, mindfulness may be conceptualized as a self-regulatory feedback mechanism, through which the individual’s cognitive processing is informed by undistorted perceptions, thereby calibrating behavior to function adaptively to present conditions (Shapiro & Schwartz, 2000; Teasdale et al., 1995). Mindfulness may augment coping through this mechanism.
Mindfulness and self-transcendence
Although mindfulness may facilitate positive reappraisal by enabling one to decenter from threat appraisals, and may inhibit the activation of maladaptive coping strategies, these conceptualizations of its therapeutic effects are Westernized and could be considered ethnocentric (Wong & Wong, 2006). From the Buddhist perspective, mindfulness would not be used to make positive reappraisals, nor would it be used to reduce or prevent negative experiences. According to the philosophical foundations of Buddhism, good and evil are an inseparable complementarity, two sides of the same coin (Watts, 1957) that define one another through the logic of dichotomy. Hence, one can only know good in contrast to evil, and vice versa. By striving to obtain and possess what is considered pleasant or beneficial, one inevitably experiences negative feelings, as the passage of time leads to change and the loss of what one clung to (Watts, 1957). This loss impels one to attempt to better one’s circumstances, which inevitably leads to the same frustration. A vicious circle results, where the seeker is trapped by the double-bind of his seeking (Bateson, 1972; Watts, 1957). Mindfulness affords a way out of the recursive trap of dichotomous thinking.
Hence, in Buddhism, mindfulness is in and of itself considered to be liberating (Varela et al., 1991). “Pure” awareness beyond the habit of discrimination and judgment leads to an experience of transcendence that can have profound therapeutic effects on stress (Chen, 2006). The liberation that comes from mindfulness is the result of a process of personal transformation, which involves a fundamental shift in one’s worldview and values (Wong & Wong, 2006). Rather than using problem-based coping efforts or even changing the meaning one ascribes to the situation, according to mindfulness traditions, liberation from suffering occurs when one transcends cravings and attachments to fully embrace experience.
It is no coincidence that Lazarus and Folkman found a connection between what they termed “commitment” and stress. Commitments express what is valued to a person, what a person is driven toward obtaining and possessing. The more committed one is to a given object or outcome, the more stress one may experience when that object or outcome is challenged or threatened (Lazarus & Folkman, 1984). This construal of commitment is reminiscent of the Buddhist term “attachment,” and as the Buddha observed thousands of years ago, attachment is the root of suffering (Kalupahana, 1987). Suffering stems from the attachment to what is deemed pleasant, and the aversion to what is deemed unpleasant. In Buddhist psychology, attachment leads to the fundamental ignorance of the true nature of human existence: the impermanent, ever-changing quality of phenomenal experience. All sensations, perceptions, cognitions, and emotions are transitory. By resisting or denying the ephemeral quality of existence, one suffers and experiences increased stress (Chen, 2006).
According to Buddhism, the most deeply rooted attachment is the attachment to the concept of a permanent self (Kalupahana, 1987). However, as all experience is in continual flux, so too is one’s experience of self. The body changes over time, experiences sickness, disability, and ultimately death. It is the nature of biological organisms to continually adapt to the environment and ultimately experience dissolution; despite this fact, humans tend to cling to fixed self-concepts (Varela et al., 1991). This clinging or attachment to a sense of an unchanging self inevitably leads to stress, as life events alter aspects of self that had been previously held as one’s identity. For example, one may identify oneself as a committed partner, and in the next moment, find himself bereft and grieving the loss of his loved one. If, as tradition asserts, mindfulness enables an awareness of the cycle of interdependent co-arising, then it may through amplification of feedback processes lead to the discovery of the systemic, integrated nature of reality (Shapiro & Schwartz, 2000).
When we are no longer identified with the idea of ourselves, the entire relationship between subject and object … becomes a real relationship, a mutuality in which the subject creates the object just as much as the object creates the subject. The knower no longer feels himself to be independent from the known; the experiencer no longer feels himself to stand apart from the experience. Consequently the whole notion of getting something “out” of life, of seeking something from experience, becomes absurd … it becomes vividly clear that in concrete fact I have no other self than the totality of things of which I am aware. (Watts, 1957, p. 121)
Mindfulness may relieve stress by evoking such self-transcendence. In so doing, it may liberate the individual from suffering when one experientially realizes that ultimately, life and death, gain and loss are part of an integrated whole, a web of interdependence, the unified, dynamic system that is the foundation of life.
The second-order cybernetic model of stress, metacognition, and coping
The following causal model is offered as a depiction of the various pathways through which mindfulness meditation augments coping processes and reduces stress. Our conceptualization of these mechanisms is informed by the second-order cybernetics of Maturana and Varela (1987) and parallels insights gleaned from Buddhist psychology. Please refer to Figure 1, the Second-Order Cybernetic Model of Stress, Metacognition, and Coping, for a visual representation of this framework. Hereafter each step in the concept map will be referred to with a corresponding number.
As an expansion on the work of Lazarus and Folkman (1984), Folkman (1997), and Lazarus (1999), stress may result from a process that initiates with a primary appraisal of stimuli (1) for their inherent threat value. When a given stimulus is appraised (2) as challenging, harmful, or threatening (3a, b, c), an activation of physiological systems (4a) involved in the stress response co-occurs with a subjective experience of distress (4b). Subsequently, a cognitive process of secondary appraisal (5) occurs in which one’s resources (6a) and coping options (6b) are evaluated (7) to determine whether in fact they are sufficient to meet the demands (6c) of the actual or potential harm. If, during this complex assessment, one deems the available resources (whether individual, familial, or communal) insufficient to resolve the situation (8b) presented by the threatening stimulus, one may then experience the biopsychosocial consequences of stress.
Figure 1: The Second-Order Cybernetic Model of Stress, Metacognition, and Coping
In addition, repeated instances of defeat lead to learned helplessness (9a), which is compounded by catastrophizing (9b). Ultimately, these factors inhibit one’s adoption and implementation of adaptive behaviors, leading to attempts to cope through avoidance (10). Thus, although a person at-risk for illness may be armed with a number of coping strategies, they may still not employ those new behaviors because of an expectation of failure or an exaggeration of the threat. Failure to adopt adaptive coping behaviors compounds stress-activated physiology and emotional distress, and ultimately leads to the development of stress-induced mental and physical illness (11).
Mindfulness may affect this process at several points to alleviate the stress response. First, mindfulness may directly influence primary appraisal processes by attenuating threat appraisals via self-transcendece (12) and indirectly through reductions in catastrophizing (13). Second, mindfulness may reduce catastrophizing indirectly by affecting secondary appraisal processes, thereby enabling one to more accurately appraise their ability to meet the demands of the stressor (14). Lastly, mindfulness may directly facilitate positive reappraisals by enabling one to decenter from prior appraisals of stressor stimuli (15).
The decidedly second-order cybernetic element of this model relates to the influence of the observer in determining the effect of the stressor stimulus. According to the perspective of second-order cybernetics, individuals are connected to the environment but remain operationally closed via their self-perpetuating organization, or autopoiesis (Maturana & Varela, 1987). As Maturana and Varela assert, because of this property of closure, a stressor event may only stimulate the individual to shift into one of its own, inherent response patterns. Hence, the stimulus does not determine the response; instead, a response to a given event is determined by the individual’s own self-organization or cognitive process. Seen through this light, mindfulness alleviates stress by modifying the phenomenology of one’s homeokinetic adaptation with the environment; one becomes free to “re-perceive” (Shapiro, Carlson, Astin, & Freeman, 2006) the event by constructing one’s own coherent reality out of the encounter (Maturana & Varela, 1987).
Discussion
The complex sequelae of the stress response involve an element of perceptual interpretation and meaning-making, thus making the process subject to cognitive coping mechanisms and of significance to our study of complementary and integrative medicine interventions such as mindfulness meditation. The Second-Order Cybernetic Model of Stress, Coping, and Metacognition elucidates heretofore unelaborated mechanisms by which individuals may become more resilient to adversity. It makes a conceptual leap beyond the sociocognitive theory of Lazarus and Folkman’s transactional model of stress and coping.
The transactional model of stress and coping is founded in positivism, in that it assumes the possibility of an observer separate from the observed, a subject who can appraise the environment objectively. In his description of salutogenesis and the sense of coherence, the great medical sociologist Aaron Antonovsky (1987) hinted at the need to adapt the current theoretical models of the stress process to the emerging paradigm of modern science. This new paradigm accounts for the forces of entropy, the trend of closed systems toward chaotic disorganization and disintegration over time, with theories about the dynamic nature of the universe seen through the lens of the observer (Antonovsky, 1987; Sampson, 1985). With the advent of modern physics, the notion of the observer became paramount. In 1927 Werner Heisenberg discovered his uncertainty principle, the realization that observer affects the observed in the very act of observation (Wilber, 1985). Although this finding did not completely negate the notion of objectivity, it brought into clear focus the fact that the observer can only observe symbolic approximations of reality. The notion of the observer is central to our discussion of mindfulness meditation and its role in coping.
Gregory Bateson, one of the progenitors of cybernetics, asserted that ordinary awareness could not usually perceive the systemic interconnection between the observer and the observed because intentionality and desire organize the contents of consciousness in a linear, cause-effect fashion (1972). According to Bateson, when individuals intend to alter their circumstances by changing a given variable, their
… conscious sampling of data will not disclose whole circuits but only arcs of circuits cut off from their matrix by [their] selective attention… the attempt to achieve a change in a given variable … is likely to be undertaken without comprehension of the homeostatic network surrounding that variable. (1972, p. 444)
Without such a systemic comprehension, stress is conceived and experienced as both the process and product of a mismatch between person and environment. This mismatch is by necessity conceptual; seen through a second-order cybernetic lens, all fit is appropriate to the context, in that the organism-environment boundary is always in a state of flux, mutually informed and structured by feedback processes (Maturana & Varela, 1987). This perspective, which grew out of the work of Bateson, Norbert Wiener, Ross Ashby, and the other giants of cybernetics, was revolutionized by Humberto Maturana, Francisco Varela, and Heinz von Forester, among others. The second-order cybernetic revolution transcended the view of systems in terms of objectively observable inputs and outputs, and attempted to encompass both the black box and its observer in one overarching, recursive system (Becvar & Becvar, 2000).
At this greater level of abstraction, the observer interacts with the observed because of the self-referential nature of observation itself. When the environment exerts strain on the organism, the biopsychosocial individual is altered at all levels. Although this change can be seen as positive feedback from a first-order cybernetic perspective, from the lens of second-order cybernetics, positive feedback is only a “partial arc or sequence of a more encompassing negative feedback process” (Keeney, 1983, p. 72). We see positive feedback only by drawing a conceptual distinction around a limited, bounded segment of the larger, holistic process of negative feedback. As the individual changes and adapts, the environment undergoes a reciprocal transformation, and thus, through this mutual calibration homeokinesis is continually maintained.
This iterative process entails the reciprocal adaptation of person and environment. Through a systemic frame, the person and environment adapt to one another because “the boundary of the organism is the boundary of the environment and thus its movements can be ascribed to the environment as well.” (Watts, 1961, p. 122). Materials and flows of energy transfer across this boundary, and without such transaction, the organism would die. Transactional change is ubiquitous and incessant; thus, both the individual and the environment participate in a continual homeokinetic flux.
Maturana and Varela call this homeokinetic, reciprocal process structural coupling, and they argue that
… when one dimension of the system is changed, the whole organism undergoes corrective changes in many directions at the same time. But obviously, such correlative changes as seem to us related to changes in the environment do not emerge because of them, but emerge in the structural drift that takes place in the encounters between organism and environment which are operationally independent. As we do not see all the factors involved in this encounter, structural drift seems to be a process that is haphazard. (1987, p. 116)
Structural coupling and structural drift may be analogous to the Buddhist concept of interdependent co-arising. Whatever its terminology, this apparently haphazard process is what Antonovsky strained to encompass within his sense of coherence construct.
Thus, an organism’s experience of order or chaos in its encounter with the environment is conditioned by perception, and human perception is shaped by language. Concomitantly, phenomenological reality is shaped by one’s linguistic domain, as the categories that we can name and articulate are the very same that we can conceive. “It could be reasonably argued that there are no natural categories, but we construct them to make sense of what we see” (Lazarus, 1999). What we see, that is, what our sensory organs register, is a world that “has the structure of ever-receding levels of detail that blend into a nonspecific background” (Varela et al., 1991, p. 147). Objects do not have discrete boundaries, for at the sub-atomic level, the universe is an interpenetrating field of energy, the interaction of electromagnetic and quantum fields of force (Wilber, 1985). According to modern physics, the substratum of reality is an unbroken wholeness (Schäfer, 2006).
Seen through this lens, our narrative-conceptual distinctions, or punctuations, create and delimit our experience (Keeney, 1983). We make such linguistic distinctions to describe objects and delineate them from the unbroken wholeness of the environment. For instance, a therapist can choose to punctuate the unit of treatment and analysis at the level of the individual, the family, or at the level of the two as an interrelated amalgam. Similarly, a philosopher can observe the behavior of the physical universe and conclude that everything is predetermined, or conversely, that things are unpredictable because of the influence of free will. A caregiver can see their life as cursed with suffering and burden to have to care for a dying partner, or their life as blessed with the opportunity to experience compassion and give unconditional love. Depending on how the observer orders the components of his or her experience, a different reality is constructed out of the interdependent co-arising of structural drift. This process of delineation is dichotomous; to define object, we must define subject as well.
As we construe the meaning of events, we conserve our own concepts of self and world; we create and maintain our schemas. Certain punctuations of self and world are empowering, such as those afforded through meaning-based coping like positive reappraisals, and others are disempowering, such as those afforded through depressogenic processes such as catastrophizing. What then is the determinant of these punctuations?
Antonovsky, in attempting to understand how persons remain healthy in the face of the stress of life, claimed that one’s ability to construe their circumstances as comprehensible, manageable, and meaningful was a central predictor of health outcomes (1987). He remained puzzled how one could maintain such a sense of coherence amidst the everchanging, chaotic world described by modern science, asking
How, in the face of the constant seeming wild dance of the reality of the stimuli bombarding the system from subsystems and suprasystems, does one separate information from noise, make sense of one’s world? (Antonovsky, 1987, p. 166)
Paradoxically, Antonovsky was answered in the same year that he posited his question. In 1987, Maturana and Varela, in their attempt to explain the biology of cognition, found coherence through the linguistic delineation of self from world. Through the intersubjective network of language, “we maintain an ongoing descriptive recursion which we call the ‘I.’ It enables us to conserve our linguistic operational coherence and our adaptation” (1987, p. 231). They affirm, with examples from ecology, animal behavior, and neurobiology, that recursive self-reference is a fundamental condition of living systems. Through self-reference, all biological systems are structured to create and maintain physiological coherence.
Humans, like all organisms, systems, or suprasystems, are by nature self-referential. Our experience reflects our own qualities. This recursiveness involves linguistic explanation. Language shapes the meaning and domain of what is possible. Thus, our conceptual punctuations of experience determine their existence. In the interdependent, dynamic systems of life where change is integral to the structural drift of the unified whole, a stressor is only a stressor if it is punctuated as such. Alternatively, it may be seen as an opportunity for growth, or even as a way of finding meaning in life. The gift of mindfulness lies in its power to render life “as it is,” facilitating coping by freeing the individual to construct meaning in any circumstance, no matter how adverse.
Conclusion
The aforementioned causal model and its underlying conceptual framework represent the theoretical foundation of a novel research area that has direct application to the field of integrative medicine. Until experimental investigations are conducted to test the variable relationships specified in the model, the connection between stress, metacognition, and coping remains hypothetical, having been substantiated only through some correlational evidence. More data is needed to make causal inferences about the central role of mindfulness in coping responses.
Nevertheless, we have traversed much intellectual ground in moving from the concrete, mundane experience of stress to its abstract foundation in the delineation of self from world, only to return from whence we started. Ultimately, we are concerned with ameliorating the suffering of others. In mindfulness we have found a potential leverage point, a linchpin with which we can unhinge the mental processes that uphold individual and societal ills. Thus, mindfulness is an essential element of resilience. Although threat, harm, and loss are inevitable facts of life, the promise of mindfulness is the actualization of that aspect of humanity which enables us to cope with adversity. In this light, one of the most defining human qualities, our very indeterminacy, is our ability to strive for liberation and security despite the conditions of our lives. This quality is not given; it must be cultivated, and it can be developed through the compassionate guidance of others. Here lies a compass for our ethic and effort as scholars, educators, and clinicians. Although this mission is only dawning now, Albert Einstein alluded to it as long ago as 1954. Perhaps now we are ready to listen:
A human being is a part of the whole, called by us “Universe,” a part limited in time and space. He experiences himself, his thoughts and feelings as something separated from the rest – a kind of optical delusion of his consciousness. This delusion is a kind of prison for us, restricting us to our personal desires and to affection for a few persons nearest to us. Our task must be to free ourselves from this prison by widening our circle of compassion to embrace all living creatures and the whole of nature in its beauty. Nobody is able to achieve this completely, but the striving for such achievement is in itself a part of the liberation and a foundation for inner security. The true value of a human being is determined by the measure and the sense in which they have obtained liberation from the self. We shall require a substantially new manner of thinking if humanity is to survive.
References
Abramson L. Y., Seligman M. E. P. & Teasdale J. P. (1978) Learned helplessness in humans: Critique and reformulation. Journal of Abnormal Psychology 87: 49–74.
Antonovsky A. (1987) Unraveling the mystery of health. San Francisco: Josey Bass.
Astin J. A. (1997) Stress reduction through mindfulness meditation. Effects on psychological symptomatology, sense of control, and spiritual experiences. Psychotherapy and Psychosomatics 66(2): 97–106.
Baer R. A. (2003) Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science & Practice 10: 125–143.
Bateson G. (1972) Steps to an ecology of mind. New York: Ballantine.
Becvar D. S. & Becvar R. J. (2000) Family therapy: A systemic integration (3rd ed.) Boston: Allyn & Bacon.
Bishop S. R. (2002) What do we really know about mindfulness-based stress reduction? Psychosomatic Medicine 64: 71–84.
Bishop S. R., Lau M., Shapiro S., Carlson L., Anderson N. D., Carmody J., et al. (2004) Mindfulness: A proposed operational definition. Clinical Psychology: Science and Practice 11: 230–241.
Brown K. W. & Ryan R. M. (2003) The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology 84: 822–848.
Buer N. & Linton S. J. (2002) Fear-avoidance beliefs and catastrophizing: Occurrence and risk factor in back pain and ADL in the general population. Pain 99: 485–491.
Cannon W. B. (1939) The wisdom of the body (2nd ed.) New York: Norton. (Original work published 1932)
Chen Y. (2006) Coping with suffering: The Buddhist perspective. In: P. T. Wong & L. C. Wong (eds.) Handbook of multicultural perspectives on stress and coping (pp. 7390) New York: Springer.
Chrousos G. P. & Gold P. W. (1992) The concepts of stress and stress system disorders: Overview of physical and behavioral homeostasis. Journal of the American Medical Association 267: 1244–1252.
de Groot M., Auslander W., Williams J. H., Sherraden M., Haire-Joshu D. (2003) Depression and poverty among African American women at risk for type 2 diabetes. Annals of Behavioral Medicine 25(3): 172–181.
Depraz N., Vermersch P. & Varela F. (2002) On becoming aware: A pragmatics of experiencing. Philadelphia: John Benjamins Publishing Company.
Einstein A. (1954) Ideas and opinions. New York: Crown Publishers.
Folkman S. (1997) Positive psychological states and coping with severe stress. Social Science & Medicine 45: 1207–1221.
Folkman S. & Moskowitz J. (2000) Positive affect and the other side of coping. American Psychologist 55: 647–654.
Fresco D. M., Moore M. T., Manfred H. M., Segal Z. V., Ma S. H., Teasdale J. D., et al. (in press) Initial psychometric properties of the Experiences Questionnaire: Validation of a self-report measure of decentering. Behavior Therapy.
Garnefski N. & Kraaij V. (2006) Relationships between cognitive emotion regulation strategies and depressive symptoms: A comparative study of five specific samples. Personality and Individual Differences 40: 1659–1669.
Grossman P., Niemann L., Schmidt S. & Walach H. (2004) Mindfulness-based stress reduction and health benefits: A meta-analysis. Journal of Psychosomatic Research 57: 35–43.
Hayes S. C. & Wilson K. G. (2003) Mindfulness: Method and process. Clinical Psychology: Science and Practice 10: 161–165.
Kabat-Zinn J. (2003) Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology: Science and Practice 10: 144–156.
Kabat-Zinn J., Wheeler E., Light T., Skillings A., Scharf M., Cropley T. G., et al. (1998) Influence of a mindfulness-based stress reduction intervention on rates of skin clearing in patients with moderate to severe psoriasis undergoing phototherapy (UVB) and photochemotherapy (PUVA) Psychosomatic Medicine 60: 625–632.
Kalupahana D. J. (1987) The principles of Buddhist psychology. Albany NY: State University of New York Press.
Keeney B. P. (1983) Aesthetics of change. New York: Guilford.
Kopp M. S. & Réthelyi J. (2004) Where psychology meets physiology: Chronic stress and premature mortality – The Central Eastern European health paradox. Brain Research Bulletin 62: 351–367.
Lackner J. M., Quigley B. M. & Blanchard E. B. (2004) Depression and abdominal pain in IBS patients: The mediating role of catastrophizing. Psychosomatic Medicine 66: 435–441.
Lazarus R. S. (1999) Stress and emotion: A new synthesis. New York: Springer.
Lazarus R. S. & Folkman S. (1984) Stress, appraisal, and coping. New York: Springer.
Maturana H. & Varela F. (1987) The tree of knowledge: The biological roots of human understanding. Boston: Shambhala.
National Institute of Diabetes and Digestive and Kidney Diseases. (2005) National Diabetes Statistics fact sheet: General information and national estimates on diabetes in the United States. (2005) Bethesda MD: U. S. Department of Health and Human Services, National Institute of Health.
Overmier J. B. & Murison R. (2005) Trauma and resulting sensitization effects are modulated by psychological factors. Psychoneuroendocrinology 30: 965–973.
Rosmond R. (2005) Role of stress in the pathogenesis of the metabolic syndrome. Psychoneuroendocrinology 30: 1–10.
Rudrauf D., Lutz A., Cosmelli D., Lachaux J. & Le Van Quyen M. (2003) From autopoiesis to neurophenomenology: Francisco Varela’s exploration of the biophysics of being. Biological Research 36: 21–59. http://cepa.info/1140
Sampson E. E. (1985) The decentralization of identity: Toward a revised concept of personal and social order. American Psychologist 38: 279–298.
Schäfer L. (2006) Quantum reality and the consciousness of the universe. Zygon 41: 505–532.
Shapiro S., Carlson L., Astin J. & Freeman B. (2006) Mechanisms of mindfulness. Journal of Clinical Psychology 62: 373–386.
Shapiro S. & Schwartz G. E. (2000) Intentional systemic mindfulness: An integrative model for self-regulation and health. Advances in Mind-Body Medicine 16: 128–134.
Shapiro S. L., Schwartz G. E. & Bonner G. (1998) Effects of mindfulness-based stress reduction on medical and premedical students. Journal of Behavioral Medicine 21: 581–599.
Speca M., Carlson L., Goodey E. & Angen M. (2000) A randomized wait-list control trial: The effects of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients. Psychosomatic Medicine 62: 613–622.
Sullivan M., Rouse D., Bishop S. & Johnston S. (1997) Thought suppression, catastrophizing, and pain. Cognitive Therapy Research 21: 555–568.
Sullivan M. J., Thorn B., Haythornthwaite J. A., Keefe F., Martin M., Bradley L. A., et al. (2001) Theoretical perspectives on the relation between catastrophizing and pain. Clinical Journal of Pain 17: 52–64.
Surwit R. S. & Schneider M. S. (1993) Role of stress in the etiology and treatment of diabetes mellitus. Psychosomatic Medicine 4: 380–393.
Teasdale J. D., Moore R. G., Hayhurst H., Pope M., Williams S. & Segal Z. V. (2002) Metacognitive awareness and prevention of relapse in depression: Empirical evidence. Journal of Consulting and Clinical Psychology 70: 275–287.
Teasdale J. D., Segal Z. V. & Williams M. G. (1995) How does cognitive therapy prevent depressive relapse and why should attentional control (mindfulness) training help? Behavioral Research and Therapy 33: 25–39.
Varela F., Thompson E. & Rosch E. (1991) The embodied mind: Cognitive science and human experience. Cambridge MA: MIT Press.
Watts A. (1957) The way of Zen. New York: Pantheon.
Watts A. (1961) Psychotherapy East and West. New York: Random House.
Wilber K. (1985) Quantum questions. Boston: Shambhala.
Woby S. R., Watson P. J., Roach N. K. & Urmston M. (2004) Are changes in fearavoidance beliefs, catastrophizing, and appraisals of control predictive of changes in chronic low back pain and disability? European Journal of Pain 8: 201–210.
Wong P. T. & Wong L. C. (eds.) (2006) Handbook of multicultural perspectives on stress and coping. New York: Springer.
Found a mistake? Contact corrections/at/cepa.infoDownloaded from http://cepa.info/4098 on 2017-05-02 · Publication curated by Alexander Riegler