Mindfulness is not a terminator of stress

Original image was originally posted on Flickr by Al Lemos. Image published under Creative Commons license. Background has been adapted.
Article Originally Published on LinkedIn on January 4, 2020.

On more than one occasion during my work life I have been under pressure and in a stressful situation. Being a self-sufficient and independent person, I never want to burden my colleagues with my shortcomings, as I would see it, regardless of the reason for the pressure.

So, I put my head down and somehow miraculously plough my way through it. The ploughing tends to require me starting work at the crack of dawn, eating lunch and dinner at my desk and working well past midnight, if not through the night.

"The studies on consequences

of overtime work are many and most,

if not all, point in the same direction:

It is bad for your physical and mental health."

This is in no way a healthy behaviour, and I wished that I had realised exactly how much it could cost me, 20 years ago. The studies on consequences of overtime work are many and most, if not all, point in the same direction: It is bad for your physical and mental health.

The research on the topic on how long-term stress affects human health is vast. Findings based on data from the longitudinal Whitehall II study in the UK that followed British civil servants for 30 years have for example shown:

  • being a woman working 55 h / week more than doubles your risk of depression and anxiety compared to if you work 35‒40 h / week,

  • 3–4 h overtime / day increases the risk of coronary heart disease for middle-aged employees by 160% compared with those with no overtime work,

  • for a majority of middle-aged people, working over 55 hours per week affects the cognitive functions of vocabulary and reasoning negatively compared to those working 40 hours per week. (The differences qualify as having clinical significance, however more research is needed in order to confirm this.)

As a business owner or leader you might not feel that you have “the luxury” of caring about your employees’ health. After all it is something that only affects them, isn’t it? This is not the case.

"The presence of workplace

stress negatively affects your

company's bottom line."

According to the European Union (EU) Framework Directive on safety and health at work employers have to manage the psychosocial issues in the workplace and prevent occupational risks. This means that you as an employer can be held liable if you fail to fulfil this responsibility.

The presence of workplace stress also negatively affects your company’s bottom line:

  • The International Labour Organisation states that in Europe the estimated cost of work-related depression for employees is €272 billion a year for absenteeism and presenteeism and the cost in loss of productivity is €242 billion. Put into perspective Portugal had a GDP of €216 billion in 2018 and has the 3rd largest national debt in the world with €232 billion in 2019. Exactly what these sums means for your individual business will depend on the size of the business, the gender split, ages of the employees, social benefits or other factors specific to your business and location.

  • The American Psychiatric Association Foundation has developed a tool for individual businesses to calculate the cost of not helping employees with depression or alcohol or substance abuse. This tool shows that if you have a business in management with 50 employees, three are likely to suffer from depression. From this your company would lose roughly an estimated 94 workdays per year to absenteeism and 84 workdays per year to presenteeism and, on top of that, it would cost your business over $30,700 per year in wages.

In one of my workplaces, HR recognised there were some of us who had a stressful work-life situation. In an effort to help they organised a mindfulness seminar that I attended. The seminar had, apart from a presentation, some practical exercises in it and at the end they recommended a mindfulness app. The purpose of the app was to help you achieve a mindful state that, if you practised regularly, would relieve the stress.

Being a conscientious person, always trying to be a “good employee”, I used the app. I worked really hard to squeeze in the mindfulness practice even after a 20 hour workday. I practised, a lot, and I got more and more stressed. By now I was anxious and slightly panicked over my lack of progress despite trying so hard. What was wrong with me? Why didn’t it help?

I felt really bad about it, as I felt that I didn’t fulfill my obligations to my employer, but eventually I gave up the app.

This company wasn’t the only one believing mindfulness would help their employees through stressful situations. Many companies today offer mindfulness training to their employees or try to have a mindful working environment, in order to help them cope with workplace stress.

However, this might not be the best solution at least not according to several critical reviews of existing research on mindfulness.

These reviews show there is little to no reliable evidence that mindfulness reduces stress. This might sound contradictory to what you have heard or read; there is plenty of research out there supporting the use of mindfulness to reduce stress. Likewise the media is full of reports on such studies, and how fantastic results can be achieved if employees just practice mindfulness in their (work)life.

"The evidence that mindfulness

has any clinical effect as a

stress management tool just

isn’t there yet."

The problem is that the majority of the research done, and reported on, is not yet at a stage where any conclusions on the effect of the use of mindfulness in the general public can be drawn. The evidence that mindfulness has any clinical effect as a stress management tool just isn’t there yet.

One important study on the topic of the effects of mindfulness, has looked at how many of the studies done on the topic of Mindfulness and its effects, that followed and completed all stages of the US National Institutes of Health tool “Stage Model for Behavioral Intervention Development”.

This model is used to ensure that mental health interventions are well researched before being used in the care of the general public and that there is a certain level of scientific rigour behind clinical research. The model has six stages ranging from stage 0 which involves the research done before an intervention is being designed to stage 5, where how to implement an empirically successful intervention in a community is being researched.

Of the research conducted on mindfulness only 1 % passes stage 4 “research examines empirically supported behavioural interventions in community settings, with community-based providers or caregivers […]”. Only if a study passes stage 4, the intervention has proven to be effective, can it be assumed safe to be used publicly.

In another large study, 15 researchers from diverse areas of expertise looked at the evidence for mindfulness and its effects based on behavioral and neuroimaging studies. They point out many areas of concern regarding the research that has been done:

  1. The studies don’t properly define what is meant by mindfulness, meaning it is hard to measure the effects of mindfulness on a test subject. This is concerning in many ways but let’s look at two reasons for concern:

    • One of the fundamentals of scientific research is that its results should be reproducible by independent research projects. Other researchers should be able to do the same test on a different population and see if they get similar results. This becomes impossible if what is meant by “mindfulness” is not defined in the first place.

    • In research it is not uncommon that researchers put data from several research projects together to get a larger population to draw conclusions from in a so called meta-analysis. This is fine when you know that the studies have analysed exactly the same thing. When this is done on mindfulness studies, and this is common as most studies are very small, this is problematic as extremely few actually define what their study means by “mindfulness”. Researchers end up comparing subjects using a random online mindfulness app, with subjects who have undergone Mindfulness Based Stress Reduction training (MBSR1), with people who have been on a three month mindfulness retreat as if they were all one and the same thing. Or as my secondary school maths teacher would have put it: You draw conclusions on what apples taste like based on fruit puree.

  2. Most studies rely on self-reporting questionnaires. These studies are troubled by the participant’s limited understanding of mental states (compared to the study writer) and are often biased as the participants know what is “expected” of them as the experimenters often fail to hide what effect they hope mindfulness will have on the participant.

  3. Many of the characteristics measured as a proof of mindfulness are also personality traits, i.e. what is being measured is not necessarily the state of mindfulness achieved but a mood change in the participant caused by other factors.

  4. Very few of the studies have a systematic way of detecting any adverse effects from the treatment. Mindfulness might sound harmless but in fact it is recommended that MBSR is not undergone by persons who are suicidal or suffer from a current psychiatric disorder. If occurrences of adverse effects are not systematically tracked, the studies can’t assure the method studied is harm-free. They can also not identify which patients it might be harmful for and what characteristics those patients have.

  5. Studies based on structural or functional neuroimaging have issues with a set of unique confounding factors. An example of this is that the recorded brain activity can be affected by heart and respiratory rate.

  6. Another issue affecting studies based on neuroimaging is that the technique is relatively new, so there is not yet a proven way of differentiating between practical significance and clinical importance in the changes being observed.

Instead of offering a mindfulness seminar that recommended a mindfulness app, what could my former employer have done? What can you as a business owner do?

"Consideration of both physical

and mental working conditions

is needed to combat workplace stress"

The International Labour Organisation has, through extensive reviews of stress research, concluded that consideration of both physical and mental working conditions is needed to combat workplace stress.

What does that mean? There are many ways to approach this challenge but a good place to start is to look at how tasks are executed and in what kind of physical and mental environment the work is done. Then you can find ways of improving both.

Examples of preventative measures for stress management may include:

  • your organisation has an open attitude towards stress reporting and that it has positive, rather than negative, effects for employees when stress is reported.

  • your organisation has systems in place for reporting and following up on reported stress as well as detecting unreported stress.

  • your employees knowing how to manage the tools provided to them, such as computer software, to their full capability.

  • automating repetitive tasks done on a computer, e.g. by introducing macros or similar solutions.

  • having clear duty descriptions for all roles.

  • writing all directives, processes, standard operating procedures, duty descriptions etc. with disabled employees in mind, including those with invisible disabilities.

  • utilising the full competence of your employees.

  • that capabilities, resources, or needs of your employees are met and rarely exceeded.

  • making sure your employees feel appreciated for the work they do.

  • having managers that lead by example when it comes to stress management and working long hours.

  • that if you have an employee returning to work after a stress-related illness, you make sure they are not returning to the same stressful environment they had to leave.

To use efficient and well proven methods to tackle workplace stress is crucial for all employers. Despite the fact that googling “How to use mindfulness to reduce stress?” produces 49’700’000 search results, mindfulness is not one of them. If you use mindfulness and find it helpful by all means continue to practice it. However, don’t make the mistake of viewing it as a method that has been proven to be efficient in warding off, or reducing, workplace stress. Mindfulness is not a terminator of workplace stress, not even a baby terminator.

  1. MBSR is an eight-week mindfulness based stress reduction course introduced in the 1990s.