Clinical and neuroscientific evidence indicates that transdiagnostic processes contribute to the generation and maintenance of psychopathological symptoms and disorders. Rigidity (inflexibility) appears a core feature of most transdiagnostic pathological processes. Decreasing rigidity may prove important to restore and maintain mental health. One of the primary domains in which rigidity and flexibility plays a role concerns the self. We adopt the pattern theory of self (PTS) for a working definition of self. This incorporates the pluralist view on self as constituted by multiple aspects or processes, understood to constitute a self-pattern, i.e. processes organized in non-linear dynamical relations across a number of time scales. The use of mindfulness meditation in the format of Mindfulness Based Interventions (MBIs) has been developed over four decades in Clinical Psychology. MBIs are promising as evidence-based treatments, shown to be equivalent to gold-standard treatments and superior to specific active controls in several randomized controlled trials. Notably, MBIs have been shown to target transdiagnostic symptoms. Given the hypothesized central role of rigid, habitual self-patterns in psychopathology, PTS offers a useful frame to understand how mindfulness may be beneficial in decreasing inflexibility. We discuss the evidence that mindfulness can alter the psychological and behavioral expression of individual aspects of the self-pattern, as well as favour change in the self-pattern as a whole gestalt. We discuss neuroscientific research on how the phenomenology of the self (pattern) is reflected in associated cortical networks and meditation-related alterations in cortical networks. Creating a synergy between these two aspects can increase understanding of psychopathological processes and improve diagnostic and therapeutic options.

Background: During the coronavirus disease 2019 (COVID-19) pandemic, healthcare professionals (HCPs) faced extremely high levels of work-related stress, which negatively affected their mental health, job satisfaction, and patient care. Mindfulness-Based Stress Reduction (MBSR) programs can help mitigate these challenges. Method: A randomised controlled trial design was used to evaluate the effects of an 8-week MBSR intervention on stress-related outcomes among HCPs compared with a control group. The comprehensive assessment included cortisol levels, perceived stress, attention and awareness, emotional fatigue, and job strain. Results: The MBSR intervention significantly reduced cortisol levels in the short term and improved attention and awareness, with sustained benefits during follow-up. Medium to medium–large effect sizes were observed for job strain and emotional fatigue, although statistical significance was not achieved. Similarly, perceived stress showed negligible changes over time. The variability in stress responses highlights the importance of personalised approaches to mindfulness interventions. Discussion: In the context of the COVID-19 pandemic, MBSR is promising for improving attention and awareness and reducing physiological stress markers in HCPs, although its effects on other occupational outcomes remain uncertain. Future research should focus on longer interventions to maximise the benefits of mindfulness practices in healthcare settings.

Objectives This paper aimed to present a conceptual framework that facilitates integrating early Buddhist psychology with contemporary psychotherapy. Method It was conceptual in scope, rooted in the framework of the early Buddhist teachings. While grounded in contemplative and clinical experience, it selectively integrated contemporary scholarship from psychotherapy, contemplative neuroscience, and Buddhist psychology. Results The article addresses critical limitations in the current literature by engaging with contemporary scientific theories providing empirical support for proposed mechanisms, and outlining practical implications for clinicians. Central to this integration is the recognition of a double bypass consisting in two complementary risks: spiritual bypass, wherein transcendent practices are used to avoid necessary psychological work; and psychological bypass, wherein excessive focus on self-consolidation precludes existential and transcendent inquiry. Conclusions A Buddhist-informed psychotherapy, grounded in the personal practice of the therapist, in “right view” and “right effort” particularly, can address both forms of bypass through empirically tractable processes, including nonattachment, decentering, and compassion.