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觉察减压

维基百科，自由的百科全书

觉察减压（Mindfulness-Based Stress Reduction, 简称 MBSR) 、以Mindfulness为基础之压力减低，是一个为期八周、有实证基础的课程计画，可提供非宗教性、密集的觉察训练，以帮助有压力者、焦虑者、忧郁者和疼痛者[1][2][3]。觉察减压由乔·卡巴金（Jon Kabat-Zinn）教授于1970年代在麻塞诸塞州大学的医学中心开发此课程，它结合了觉察冥想、身体意识、瑜伽来对行为、思维、感觉和行动方式进行探索[1][4]。觉察可以理解为对当前经验的非判断性接受和当下经验，包括身体觉知、内在心智状态、思想、情绪、冲动和记忆，目的是减少压抑或苦恼，并增加幸福感[1][5]。觉察冥想是一种培养注意力、发展情绪调控、和减少沉思和忧虑的方法[1][5][6]。过去的几十年中，觉察冥想一直是可控的临床研究主题，有增进心智健康[7][8][9] 、和促进身体健康的潜在效果[10][11][12]。虽然觉察减压源自于精神式的引导，但该课程与宗教是无关的[1] 。觉察减压课程在觉察减压在1990年发表的著作 Full Catastrophe Living (译：灾难生存法则) 中有详细描述[1]。

以觉察为基础的减压诊所的创始人Jon Kabat-Zinn

历史[编辑]

1979年，乔‧卡巴金在麻州大学医学中心（英语：University of Massachusetts Medical School）成立了觉察减压诊所，二十年后他在麻州大学医学院成立医学、健康照护、和社会觉察中心[4]。这两个机构使觉察减压在全球的医院得到长远的发展和实际运用[1]。卡巴金在他1990年最畅销的著作Full Catastrophe Living（英语：Full Catastrophe Living）(译：灾难生存法则；台湾目前翻译此书名为正念疗愈力[13]。) 中详细描述了MBSR计划课程，该书于2013年以修订版重新发行[1]。1993年，Bill Moyer 在其 Healing from Within （页面存档备份，存于互联网档案馆） (译：从内在开始治疗) 一书中推广卡巴金的MBSR课程。到了2015年时，全美有将近80%的医学院都提供了觉察训练的元素[14]，使得以觉察为主的研究和教育中心的数量越来越多。

课程[编辑]

觉察减压是一种团体课程，著重于以渐进方式获得有关觉察的注意觉知[14]。觉察减压是一个为期八周的工作坊课程，由经认证的培训师讲授，内容包括每周2.5小时的团体会议、在第六周和第七周中的一日静修(含7小时的觉察训练)、每天45分钟的在家练习作业、和三种正式技术的指导：觉察冥想、身体扫描及简单的瑜伽姿势[1]。课程的重点透过团体讨论和探索而获得觉察的练习经验和生活应用。前四周的课程重点在于身体扫描，此为正式的觉察技术，它需要安静地坐著或躺著，并有系统地将注意力集中在身体的各个部位，即注意力从脚趾头开始，然后慢慢向上移动到头顶[1][4]。觉察减压基本上是无评断、不费力、接受、放下、初学者心态、耐心、信任、和非自我中心[15][1]。

乔·卡巴金认为觉察减压的基础是觉察，他对“觉察”的定义是“当下、无评断的觉知 (moment-to-moment, non-judgmental awareness)”[1]。课程中，参加者需在日常生活中练习觉察、并入觉察。专注于当下，可以增加对环境的敏感度和反应能力，进而强化自我管理和因应能力[1]。觉察亦提供沉思过去和担心未来的出口，并打破适应不量的认知过程[16]。

罗伯特·萨波斯基在其专书“为什么斑马不会得到溃疡？”(Why Zebras Don't Get Ulcers[17]) 中为非专业的读者进行探究，可提供减压效果和压力起源的科学实证[18]。觉察冥想可显著地降低心理压力[7][19][20]，亦可防止因心理压力而导致的相关生理变化和生物学临床表现[11][12][10]。

觉察练习之推广[编辑]

根据《时代》杂志2014年的一篇文章，觉察冥想在平常不会冥想的人们中越来越流行[21]。乔·卡巴金在麻州大学医学中心开设的课程已经培养了将近1,000名获得觉察减压认证的讲师，这些讲师遍布美国每个州和30多个国家。例如 General Mills 公司已为其员工提供冥想的空间；民主党国会议员提姆·瑞安则在2012年出版了一本名为“觉察国家 (A Mindful Nation)”之专书，他在国会山庄协助并组织了定期的团体冥想活动[21][22]。

觉察练习之方法[编辑]

医院、静修中心和各种瑜伽场馆都已提供觉察减压的课程。这些课程都很注重以下的教学内容：

  1. 以身心觉知来减轻生理压力、疼痛或疾病。
  2. 实际体验压力和苦恼以减少情绪反应。
  3. 以镇定来面对人类生活中自然发生的变化和损失。
  4. 日常生活中的无评断觉知。
  5. 随时保持宁静和清明。
  6. 体验更快乐的生活并获得内在疗愈能量。
  7. 觉察冥想。

效果评估(相关研究成果)[编辑]

觉察方法有益于健康的成年人[7][23][24]、青少年和儿童[25][26]，并可改善如饮食失调[27][28][29]、精神疾病[30][31][32][33]、疼痛管理[34][5][35]、睡眠障碍[36][37]、癌症照护[38][39]、心理压力等的各种健康问题[40][41][42][43]。觉察议题已经逐渐成为研究显学，学术机构在2003年发表了52篇论文，到了2012年已增加到477篇论文[21]。2014年初则已经发表了近100篇随机对照实验的实证研究论文[44]。

研究证实，觉察减压方法可使大专学生减轻心理压力(此年龄常见心理压力)。有研究指出8周觉察减压 (MBSR) 的效果可多延长两个月[45]。

觉察减压技术可对饮食失调者有帮助，亦会改善人们对自己身体的看法[46]。MBSR 注重有效的因应技巧，可透过自我同情来改善人际关系、正向影响一个人的身体形象、和增进幸福感。

研究证实，觉察训练可增进压力下的聚焦能力、注意力和工作能力[47][48][49]，觉察也对心血管健康有潜在益处[50][51][52]。有证据显示，觉察冥想有益于抑制药物滥用[53][54][55]和改善全身肌肉无力[56][57][58]。

此外，最近的研究显示，觉察减压会增进照护者(尤其是母亲)、抵抗药物滥用的年轻人之自我同情心和幸福感[59]。觉察介入会使母亲的压力有所减轻，学会与自己相处，进而改善人际关系。

觉察减压不只影响独自奋斗者和其相关的人，也会正面影响健康的族群。2019年，Roca 等人[60]研究参与8周觉察减压课程的健康族群，结果将 MBSR 分成五个面向：觉察、同情、心理幸福感、心理苦恼、和情绪认知控制，并以问卷方式观察包含这五个面向的心理功能。整体来说，觉察和幸福感是最重要的测量变项。

觉察介入及其影响是非常流行的，尤其觉察已是学术上的显学。在访谈平均年龄为11岁的儿童之后，可发现觉察有助于他们调节情绪，且儿童们认为，如果学校和老师可介绍和融入越多的觉察，他们便能购更容易地应用觉察的原理原则[61]。

如前所述，觉察可增加同情心，而高度的自我同情心则会大幅度地减低压力[62]和增进自我觉知能力[62]，这些状况会发生在课程当中或课程之后。由此可知，觉察减压可以直接地或间接地提高自我同情心。

在华人相关学术领域中，2020年出版学术性的文献探讨及探索性因素分析之实证研究，Mindfulness中译厘正为觉察之佛学与科学实证检验：觉察与正念判准量表之研发 （页面存档备份，存于互联网档案馆）[63]，探讨觉察与正念的关系，研究者指出：Mindfulness 之中文翻译为觉察，佛学专有用语之“正念”确实有评断正确、正当的正向积极之意，觉察与正念有关，正念可包含觉察，但觉察却无法包含并代表正念，两者不能混为一谈。该研究中并发展觉察与正念判准量表，用以明确区分觉察与正念为两个不同面向。

参考文献[编辑]

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