Stefan Schmidt

University Medical Center Freiburg · Clinic of Psychosomatic Medicine and Psychotherapy

This work synthesizes and updates findings from four previous systematic-reviews and meta-analyses on open-label placebos (OLPs). For the first time, it directly tests whether OLPs have different effects on self-report versus objective outcomes and on clinical versus non-clinical samples. We searched eight data-bases up to November 9, 2023, and inc...

Secular Mindfulness Based Interventions (MBIs) are increasingly being promoted as tools to support proenvironmental behaviour. To facilitate scientific evaluation, they are often based on the well-documented Mindfulness Based Stress Reduction (MBSR) programme or its derivatives, with additional contemplation and practices related to sustainability....

In recent years, there has been a significant amount of literature on design, design thinking, and the design process. Many researchers have conducted studies to describe and explain the essence and mechanisms of the design process, as well as the unique nature of design thinking. However, this research aims to systematically review the literature...

Theoretischer Hintergrund. Die Systemische Therapie ist Teil der psychotherapeutischen Routineversorung für Erwachsene, Kinder und Jugendliche in Deutschland. Jedoch existiert kein standardisiertes Instrumentarium zu ihrer Qualitätssicherung. Fragestellung. Wie kann eine regelmäßige, niedrigschwellige und ökonomische Befragung (Routine Outcome Moni...

The present study investigated the differences in movement synchrony and therapeutic alliance between solution-focused and problem-focused counseling. Thirty-four participants each attended two counseling sessions with different counselors, one with a solution-focus and one with a problem-focus, in randomized order. The sessions consisted of three...

In this conceptual contribution, we argue that experimental investigations of phenomena in the cognitive sciences and consciousness research may benefit from a thorough integration of data acquired from the first-person perspective. We present a line of research from our lab applying this approach to the Libet task on voluntary action. In this well...

Introduction Problematic usage of the internet (PUI) is an umbrella term for a range of uncontrolled, excessive, and potentially harmful online behaviors. Recently, numerous studies have examined the potential of mindfulness programs (MPs) for reducing PUI. We conducted a comprehensive systematic review and meta-analysis in this emerging field. Me...

Floatation-REST (Reduced Environmental Stimulation Therapy) minimizes stimulation of the nervous system by immersing subjects in an environment without sound or light while they effortlessly float in thermoneutral water supersaturated with Epsom salt. Here we investigated the relationship between altered states of consciousness (ASC) and its associ...

Humanity is knowingly heading into a socioecological crisis and science has spent decades trying to understand this paradox of conscious (self-)destruction. In the process of searching for answers, mindfulness practices from the health sector have been applied in the sustainability discourse, hypothesizing they can support sustainable lifestyles. E...

Background The Freiburg Mindfulness Inventory (FMI) in its short form is one of the most frequently used instruments in research to measure self-attributed mindfulness. We sought to calibrate it in a representative German sample and to replicate its psychometric properties. Methods We administered the FMI-14 to a representative German sample. We r...

Floatation-REST (Reduced Environmental Stimulation Therapy) is a sensory isolation technique where subjects are immersed in an environment without sound or light while they float in thermoneutral water that is supersaturated with Epsom salt. Here we investigated the relationship between altered states of consciousness (ASC) and its association with...

The present study investigated the differences in movement synchrony and therapeutic alliance between solution-focused and problem-focused counseling. Thirty-four participants each attended two counseling sessions with different counselors, one with a solution-focus and one with a problem-focus, in randomized order. The sessions consisted of three...

Introduction: Videoconferencing psychotherapy (VCP) delivers treatment to individuals with limited access to face-to-face mental healthcare. VCP's effectiveness has been demonstrated for various disorders and therapeutic interventions. However, there is contradictory evidence regarding the therapeutic alliance in VCP as compared to psychotherapy i...

The use of open-label placebos (OLPs) has shown to be effective in clinical trials. We conducted a systematic review and meta-analysis to examine whether OLPs are effective in experimental studies with non-clinical populations. We searched five databases on April 15, 2021. We conducted separate analyses for self-reported and objective outcomes and...

Eine wachsende Anzahl an Studien zeigt, dass achtsamkeitsbasierte Programme sich als vorteilhaft in der Förderung des psychischen Wohlbefindens von Krankenhausmitarbeitenden erweisen. Bei den gängigen Achtsamkeitskursen werden in der Regel jedoch nur wenige Bemühungen unternommen, den Transfer des Erlernten in den Arbeitsalltag zu gewährleisten. Mi...

Introduction: Internet use disorder (IUD) is on the rise and is associated with detrimental health consequences. Growing evidence suggests that mindfulness-either as a trait or cultivated in mindfulness-based programmes (MBPs)-is promising in preventing and treating IUD. With this systematic review and meta-analysis, we will examine (1) the associ...

Background: The use of open-label placebos (OLPs) has been shown to be effective in clinical trials. We conducted a systematic review and meta-analysis to examine whether OLPs are effective in experimental studies with non-clinical populations. Methods: We searched five electronic databases on April 15, 2021. We conducted separate analyses for self...

This study examined the effects of meditative states in experienced meditators on present-moment awareness, subjective time, and self-awareness while assessing meditation-induced changes in heart-rate variability and breathing rate. A sample of 22 experienced meditators who practiced meditation techniques stressing awareness of the present moment (...

Objectives Medical residency is a challenging phase that puts the mental health of resident physicians at risk. This study explores the effects of a tailored mindfulness-based program on the positive mental health of resident physicians. Methods We conducted a longitudinal randomized controlled trial with an active control group. The intervention...

Objective To estimate the proportion of healthcare interventions tested within Cochrane Reviews that are effective according to high-quality evidence. Study design and setting We selected a random sample of 2428 (35%) of all Cochrane Reviews published between 1 January 2008 and 5 March 2021. We extracted data about interventions within these revie...

Background: The COVID-19 pandemic and the measures to protect the physically vulnerable may disproportionately affect people with mental health vulnerabilities, who receive psychotherapeutic inpatient treatment, as many of these measures impact the (inter)subjective space crucial to psychotherapy. Objective: We investigate how people with pre-ex...

Background Based on promising effects seen in a pilot study evaluating a generic mindfulness-based program for migraine, we developed a migraine-specific adaptation of the Mindfulness-Based Cognitive Therapy (MBCT) program. The aim of this study was to evaluate this program for feasibility and effectiveness in a randomized controlled trial. Method...

In individual psychotherapy verbal communication and movement synchronization are closely interrelated. The microanalysis of timing, rhythm and gestalt of movement has established dynamic movement coordination as a systemic property of the dyadic interaction. Movement synchronization supports and enhances the unfolding of linguistic meaning. In ord...

Background Many resident physicians suffer from distress, which endangers their individual health and the quality of care. Objective To examine the impact of a tailored mindfulness-based program (MBP) for resident physicians on distress and the quality of care. Methods A single-centre, two-armed, longitudinal randomised controlled trial. The inte...

Cognitive–behavioural therapy (CBT) with exposure and response prevention is the recommended standard for the treatment of obsessive–compulsive disorder (OCD). However, a high proportion of patients refuse this treatment, do not respond or relapse shortly after treatment. Growing evidence suggests that mindfulness-based and acceptance-based program...

This chapter focuses on replication and reproducibility. A single observation cannot be trusted. Similarly, findings from a single experimental investigation may reflect some regularity but they may also be due to chance, artefacts, or misinterpretations. Therefore, it is necessary to repeat the respective research procedure in order to validate th...

Background Chronic low back pain is the most frequent medical problem and the condition with the most years lived with disability in Western countries. The objective of this study was to assess a new treatment, Medi-Taping, which aims at reducing complaints by treating pelvic obliquity with a combination of manual treatment of trigger points and ki...

Die Systemische Therapie hat einen langen Weg hinter sich. Inzwischen kann sie als ambulantes Psychotherapieverfahren durchgeführt werden. Einige Fragen sind allerdings noch offen. Über Innovationen, Reibungsflächen und Stolpersteine bei der Integration der Systemischen Therapie in die ambulante GKV-Versorgung.

Open-label placebos (OLPs) are placebos without deception in the sense that patients know that they are receiving a placebo. The objective of our study is to systematically review and analyze the effect of OLPs in comparison to no treatment in clinical trials. A systematic literature search was carried out in February 2020. Randomized controlled tr...

Background and purpose: Diminished well-being is prevalent in resident physicians. This qualitative study explored the effects of a tailored mindfulness-based program (MBP) aimed at increasing resident physicians’ well-being. A second goal was to compare the MBP with an active control group. Materials and methods We conducted interviews with 35 re...

Gegenwartsgesellschaften funktionieren über enorm dynamische Zeitlogiken und eröffnen vielfältige Handlungsräume. Das transdisziplinäre Glossar bietet Einblicke in die vielseitigen Erkenntnisse und Perspektiven zum Thema Zeit im Lebensverlauf. Die einzelnen Stichworte beschreiben Aspekte individueller Zeitlichkeit und sozialer Zeitstrukturen in ihr...

Gegenwartsgesellschaften funktionieren über enorm dynamische Zeitlogiken und eröffnen vielfältige Handlungsräume. Das transdisziplinäre Glossar bietet Einblicke in die vielseitigen Erkenntnisse und Perspektiven zum Thema Zeit im Lebensverlauf. Die einzelnen Stichworte beschreiben Aspekte individueller Zeitlichkeit und sozialer Zeitstrukturen in ihr...

Objectives: The objective of the study was to determine the change in quality of evidence in updates of Cochrane reviews that were initially published between January 1, 2013 and June 30, 2014. We used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system to document evidence quality. Study Design and Setting: We se...

Functional magnetic resonance imaging (fMRI) studies report impaired functional correlates of cognition and emotion in mental disorders. The validity of preexisting studies needs to be confirmed through replication studies, which there is a lack of. So far, most replication studies have been conducted on non-patients (NP) and primarily investigated...

Objectives Many resident physicians suffer from mental distress. This endangers the individual physician as well as the quality of patient care. This study tested the feasibility of a novel 8-week mindfulness program tailored to improve resident physicians’ personal and work-related well-being.Methods Participants were nine resident physicians from...

Do people who are diagnosed with cancer with good chances of recovery still feel close to death? And what does the confrontation with the finitude of life mean for the design of the living environments of these people? The researchers present here parts of the results of their study ‘Perception of time in subjective proximity to death’ and prove pe...

Boredom is an everyday experience during uneventful situations and while waiting. Such situations are typically described as unpleasant since oneself becomes the focus of awareness, and the subjective duration expands. Self-control is an individual trait that helps to cope with unpleasant situations. Hardly any systematic studies exist on real wait...

Background: Chronic lower back pain is the most frequent medical problem and the condition with the most years lived with disability. A pragmatic RCT was performed to assess a new treatment, Medi-Taping, which aims at reducing complaints by treating pelvic obliquity with a combination of manual treatment of trigger points and kinesio taping. Method...

Introduction Residency is a stressful phase associated with high prevalence of mental distress. Besides impaired personal health, mental distress in residents has an impact on the quality of patient care and produces economic costs. Therefore, there is demand for interventions that improve resident physicians’ mental health. The aim of the present...

The minimal neural correlate of the conscious state, regardless of the neural activity correlated with the ever-changing contents of experience, has still not been identified. Different attempts have been made, mainly by comparing the normal waking state to seemingly unconscious states, such as deep sleep or general anesthesia. A more direct approa...

1. Das Experiment von Benjamin Libet Was geschieht im Gehirn, wenn man eine Handlung ausführt? Um dieser Frage, und damit der Frage, ob das menschliche Handeln durch neuro-physiologische Prozesse determiniert ist, nachzugehen, kann man u.a. die elektrischen Aktivitäten der Hirnrinde mittels Elektroenzephalographie (EEG) über dem Schädel ableiten. S...

Objectives Considerable evidence points to stress and health risks among students and teachers in modern schools. In recent years, mindfulness-based interventions have emerged as an answer to this growing strain. The present study implemented and evaluated a dual approach that introduced mindfulness simultaneously to students and teachers in three...

During the observation of an ambiguous figure our perception alternates between mutually exclusive interpretations, although the stimulus itself remains unchanged. The rate of these endogenous reversals has been discussed as reflecting basic aspects of endogenous brain dynamics. Recent evidence indicates that extensive meditation practice evokes lo...

Background Providing compassionate care can be challenging for palliative care practitioners (PCPs). An empirically grounded model describing the factors that contribute to preserve the balance between personal closeness and distance in the professional setting is still lacking. Objective To investigate which are the factors that help to regulat...

Aim: We performed a pilot study in order to evaluate the feasibility and to estimate effect sizes of mindfulness-based stress reduction (MBSR) in a sample of patients suffering from migraine. Method: Migraine patients (n = 62, mean age 44 years, 92% female) were randomly allocated to either MBSR or an active control intervention based on progres...

Self-generated tones elicit smaller brain responses as compared to externally generated tones. This phenomenon known as sensory attenuation has been explained in terms of an internal forward model in which the brain predicts the upcoming events and thereby attenuates the sensory processing. Such prediction processes have been suggested to occur via...

Assistenzärztinnen und Assistenzärzte gehören zu den belastetsten Berufsgruppen im Krankenhaus. Ein neues Kursprogramm, das zurzeit in Freiburg erprobt wird, zielt darauf ab, die Selbstfürsorge der jungen Ärzteschaft zu stärken. Mittels Achtsamkeitspraktiken und dem Zielhorizont der Muße üben sie sich darin, auch unter Zeitdruck nicht aus der Ruhe...

Mind-wandering or daydreaming can be described as spontaneous thoughts that are independent of the task at hand and the current sensory information. Mindfulness, defined as the ability to focus on the present moment with an accepting attitude towards the present experience, is considered to be the opposite of mind-wandering. We aimed at assessing h...

This study is based on the relationship between meditation, the present moment, and psychophysiology. We employed the metronome task to operationalize the extension of the present moment. A pre-post longitudinal study was conducted. The performance in the metronome task was compared before and after the interventions (meditation, story). The aim wa...

Neuronal interactions coupled by phase synchronization have been studied in a wide range of frequency bands, but fluctuations below the delta frequency have often been neglected. In the present study, phase synchrony in slow cortical potentials (SCPs, 0.01–0.1 Hz) was examined during two different mental states; a resting state and a breath-focused...

Mind-wandering or daydreaming can be described as spontaneous thoughts that are independent of the task at hand and the current sensory information. Mindfulness, defined as the ability to focus on the present moment with an accepting attitude towards the present experience, is considered to be the opposite of mind-wandering. We aimed at assessing h...

Background: Distant intention research refers to experiments in which a distant interaction between two persons is assessed that precludes conventional communication. In these experiments the intention of one person is varied systematically while the effect of this variation is assessed in the remote other person. Aims: Our study aimed at improv...

Feldenkrais ‘Functional Integration’ (FI) is a widely used type of body work with a focus on the continuous integration of body sensations and awareness with movement. The method is, amongst others, known for improving balance in aging populations, but also for its ability to relax muscles. With participants treated in the supine position FI is pot...

Objective: Trauma therapists are exposed to high emotional stress. A growing number of studies suggest that compassion-oriented practices can foster resilience in healthcare professionals. This study aimed to explore the effects of a psychodynamic, compassion-oriented, trauma therapy program (PITT) on the resilience of trauma therapists. Methods:...

While the contingent negative variation (CNV) has been the subject of extensive research over the last fifty years, the maximum duration during which such cortical negativity can be maintained has, to the best of our knowledge, never been systematically explored. Participants were presented with the classic S1-S2 paradigm task, where a warning stim...

Background Maintaining a sense of self-care while providing patient centered care, can be difficult for practitioners in palliative medicine. We aimed to pilot an “on the job” mindfulness and compassion-oriented meditation training for interdisciplinary teams designed to reduce distress, foster resilience and strengthen a prosocial motivation in t...

Feldenkrais ‘Functional Integration’ (FI) is a widely used type of body work with a focus on the continuous integration of body sensations and awareness with movement. The method is, amongst others, known for improving balance in aging populations, but also for its ability to relax muscles. With participants treated in the supine position FI is pot...

Background: Maintaining a sense of self-care while providing patient centered care, can be difficult for practitioners in palliative medicine. We aimed to pilot an " on the job " mindfulness and compassion-oriented meditation training for interdisciplinary teams designed to reduce distress, foster resilience and strengthen a prosocial motivation in...

Mindfulness meditators often show greater efficiency in resolving response conflicts than non-meditators. However, the neural mechanisms underlying the improved behavioral efficiency are unclear. Here, we investigated frontal theta dynamics—a neural mechanism involved in cognitive control processes—in long-term mindfulness meditators. The dynamics...

Hintergrund: In dieser Anwendungsbeobachtung wird zum ersten Mal die Behandlung des Reizdarmsyndroms (RDS) mit einem homöopathisch-phytotherapeutischen Komplexpräparat beschrieben. Methodik: Ziel der 6-wöchigen Therapie mit dem Magen-Darm-Entoxin N® war die Reduzierung der RDS-Symptomatik sowie die Verbesserung der Lebensqualität. Zielkriterien war...

The study investigated whether typical psychological, physiological, and neurophysiological changes from a single exercise are affected by one’s beliefs and expectations. Seventy-six participants were randomly assigned to four groups and saw different multimedia presentations suggesting that the subsequent exercise (moderate 30 min cycling) would r...

Background: Research has demonstrated that short meditation training may yield higher pain tolerance in acute experimental pain. Our study aimed at examining underlying mechanisms of this alleged effect. In addition, placebo research has shown that higher pain tolerance is mediated via endogenous neuromodulators: experimental inhibition of opioid r...

In this contribution it is shown that the practice of mindfulness, which becomes more and more popular, and the systemic approach share many similarities. Here a fruitful dialogue between these two worldviews will be presented that might in turn inspire each of the respective fields. Mindfulness is understood as an attitude with orientation towards...

Research in social neuroscience provides increasing evidence that self and other are interconnected, both on a conceptual and on an affective representational level. Moreover, the ability to recognize the other as “like the self” is thought to be essential for social phenomena like empathy and compassion. Meditation practices such as loving-kindnes...

Hintergrund: Erkrankungen der Atemorgane treten mit steigendem Alter öfter auf, nehmen weltweit zu und sind häufige Ursachen für Morbidität und Mortalität. In dieser Pilotstudie wurde der Frage nachgegangen, ob eine einmalige 10-minütige Behandlung mit einer Körpertambura eine signifikante und effektive Verbesserung der Lungenfunktion von Patienten...

The objective of this contribution is to conceptualize self-healing processes in a biosemiotic model. Thereby the main question is how beliefs, expectations, attributions, and meaning creating processes can result in physiological changes. In order to address these issues, we have to go beyond the predominant biophysical model of the medical scienc...

Objectives: Fibromyalgia (FM) is a syndrome characterized by severe pain, fatigue and sleep disturbance. There is evidence of central hyper-responsiveness to sensory stimulation and impaired cardiovascular autonomic control. Laboratory investigations suggest that mindfulness-based stress reduction (MBSR) may improve autonomic functioning in FM. Ho...

Background Cardiovascular diseases are a main cause of mortality worldwide. Spa bathing and immersion in thermoneutral water (ITW) have a long history in the treatment of cardiovascular risk factors. Methods We conducted a three-arm parallel-group, randomized controlled study to investigate the effects of frequent ITW on moderately elevated bloo...