Mindfulness Skills Useful in Addressing ADHD
Mindfulness meditation for people with ADHD? It may seem like a stretch, since difficulty with mindfulness is the very challenge for those with attention deficit hyperactivity disorder. And yet recent research shows that mindfulness training can be adapted for this condition and that it can improve concentration. Various clinicians and educators are already teaching mindfulness to people with ADHD as well as to overly stressed school children.
Scientists have been trying for several decades to understand how attention works. Recent studies on mindfulness and attention have demonstrated that with a little work, participants can develop greater ability to focus and self-regulate.
Lidia Zylowska, M.D, a psychiatrist and founding member of the Mindful Awareness Research Center (MARC), Susan Smalley, Ph.D, professor of psychiatry and director of MARC, and colleagues at the University of California-Los Angeles have investigated the effects of the Mindful Awareness Practices for ADHD (MAP) program with 25 adults and 8 adolescents. (Eighteen adults and seven adolescents finished the program). Self-report and other measurements demonstrated “that it is feasible to teach people with ADHD mindfulness. On the surface it looks like a contradiction, but if you look at it, if you look at the nature of self-regulation, it’s not,” says Zylowska.
How the MAPs for ADHD Program Works
The team at UCLA MARC tailored a mindfulness program to make it more gradual and flexible for people with ADHD. Participants started meditating for just five minutes at a time and increased slowly to 20 minutes. If they found it too difficult to sit, they could choose to do mindful walking instead.
The MAPs for ADHD program uses visual aids because people with ADHD tend to be visual learners. For example, the trainers used the picture of the blue sky to explain what mindful awareness is. The blue sky represents the space of awareness, and the clouds represent all the thoughts, feelings, and sensations that pass by. The participants learn to observe their inner experience from a witnessing and nonjudgmental stance. In addition, the educational component of the program addresses some of the self-esteem issues of people with ADHD. It emphasizes observing negative emotional states without identifying with them and with practicing positive emotions. The later was done by a common mindfulness practice called “lovingkindness meditation,” which involves wishing well to self and others.
“Mindfulness starts with attention, and that skill is applied to increase awareness of thoughts, emotions and behaviors. In this way mindfulness also leads to increased choice,” says Zylowska. At the heart of training are two steps:
- focusing on the present moment;
- having an attitude of openness, curiosity and acceptance (i.e., being nonjudgmental).
These two steps are practiced during meditation and throughout the day. In this way, students of mindfulness learn to pay attention to patterns and to subtle changes that happen moment to moment. For example, says Zylowska, a person might notice they interrupt a lot when they are talking with someone. Once they have become more aware of their urge to interrupt, they may choose not to do it the next time the impulse arises.
The majority of participants in the MARC study rated the training highly and reported improvement in attention and hyperactivity. A battery of tests given before and after to measure cognitive impairment and attention showed improvement in conflict attention and some of the inhibition-implying measures, though working memory wasn’t strongly affected. The “conflict” aspect of attention—the ability to stay focused despite distractions– showed the biggest improvement, said Zylowska. These initial findings are encouraging, she says, but the pilot study focused on program development and feasibility outcomes and did not have a control group. More research is needed to validate these initial findings in a controlled study.