城市急速的生活步伐，常令人迷失方向，容易跌入不快情緒的漩渦中。愈要達到心目中理想境界，愈企圖控制生活中種種不能確定的事物，就愈容易變得沮喪、無助、不安。不知不覺中，很容易被潛藏的恐懼和不安驅使，引發(fā)出無意識的負面行為。即使發(fā)現(xiàn)自己處理事情的方法不奏效，但在壓力下，慣性的機械反應仍然會重復出現(xiàn)。若不正視和處理，久而久之，心境愈來愈困擾，失去尋求滿足和快樂的力量，甚至出現(xiàn)種種身心病癥。
1979年，美國麻省（馬薩諸塞州）大學醫(yī)學院教授喬·卡巴金博士（Jon Kabat-Zinn, Ph.D.）創(chuàng)立靜觀正念減壓（MBSR），結合西方醫(yī)學、心理學研究與東方禪修傳統(tǒng)，協(xié)助參與者以正念內觀處理壓力、疼痛和疾病，多年來西方科學界已發(fā)表數(shù)百篇的研究文獻，證實其為一套有效的訓練方法。靜觀（港譯）正念（臺譯）譯自「mindfulness」，其他譯法包括「內觀」、「專注覺察」等。
2016年6月20日，美國臨床腫瘤學會《臨床腫瘤學雜志》在線發(fā)表奧胡斯大學（丹麥王國第二古老的綜合性大學，僅次于哥本哈根大學，后來因為合并了奧胡斯工程學院，成為該國最大的大學）及其附屬醫(yī)院的隨機對照研究，發(fā)現(xiàn)靜觀正念認知療法（MBCT）可以顯著、穩(wěn)定、持久地改善原發(fā)性乳腺癌女性晚期治療后疼痛。
J Clin Oncol. 2016 Jun 20. [Epub ahead of print]
Efficacy of Mindfulness-Based Cognitive Therapy on Late Post-Treatment Pain in Women Treated for Primary Breast Cancer: A Randomized Controlled Trial.
Maja Johannsen, Maja O’Connor, Mia Skytte O’Toole, Anders Bonde Jensen, Inger Hojris, Robert Zachariae.
Aarhus University Hospital; Aarhus University, Aarhus, Denmark.
PURPOSE: To assess the efficacy of mindfulness-based cognitive therapy (MBCT) for late post-treatment pain in women treated for primary breast cancer.
METHODS: A randomized wait list-controlled trial was conducted with 129 women treated for breast cancer reporting post-treatment pain (score ≥ 3 on pain intensity or pain burden assessed with 10-point numeric rating scales). Participants were randomly assigned to a manualized 8-week MBCT program or a wait-list control group. Pain was the primary outcome and was assessed with the Short Form McGill Pain Questionnaire 2 (SF-MPQ-2), the Present Pain Intensity subscale (the McGill Pain Questionnaire), and perceived pain intensity and pain burden (numeric rating scales). Secondary outcomes were quality of life (World Health Organization-5 Well-Being Index), psychological distress (the Hospital Depression and Anxiety Scale), and self-reported use of pain medication. All outcome measures were assessed at baseline, postintervention, and 3-month and 6-month follow-up. Treatment effects were evaluated with mixed linear models.
RESULTS: Statistically significant time × group interactions were found for pain intensity (d = 0.61; P = .002), the Present Pain Intensity subscale (d = 0.26; P = .026), the SF-MPQ-2 neuropathic pain subscale (d = 0.24; P = .036), and SF-MPQ-2 total scores (d = 0.23; P = .036). Only pain intensity remained statistically significant after correction for multiple comparisons. Statistically significant effects were also observed for quality of life (d = 0.42; P = .028) and nonprescription pain medication use (d = 0.40; P = .038). None of the remaining outcomes reached statistical significance.
CONCLUSION: MBCT showed a statistically significant, robust, and durable effect on pain intensity, indicating that MBCT may be an efficacious pain rehabilitation strategy for women treated for breast cancer. In addition, the effect on neuropathic pain, a pain type reported by women treated for breast cancer, further suggests the potential of MBCT but should be considered preliminary.
Supported by The Danish Cancer Society, Aase & Ejnar Danielsens Fond, Einar Willumsens Mindelegat, and Radiumstationens Forskningsfond.
DOI: 10.1200/JCO.2015.65.0770
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