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Work-Related Mental Health and Job Performance:
Can Mindfulness Help?
William Van Gordon &Edo Shonin &Masood Zangeneh &
Mark D. Griffiths
#Springer Science+Business Media New York 2014
Abstract Work-related mental health issues such as work-related stress and addiction to work
impose a significant health and economic burden to the employee, the employing organization,
and the country of work more generally. Interventions that can be empirically shown to
improve levels of work-related mental health—especially those with the potential to concur-
rently improve employee levels of work performance—are of particular interest to occupa-
tional stakeholders. One such broad-application interventional approach currently of interest to
occupational stakeholders in this respect is mindfulness-based interventions (MBIs). Follow-
ing a brief explication of the mindfulness construct, this paper critically discusses current
research directions in the utilization of mindfulness in workplace settings and assesses its
suitability for operationalization as an organization-level work-related mental health interven-
tion. By effecting a perceptual-shift in the mode of responding and relating to sensory and
cognitive-affective stimuli, employees that undergo mindfulness training may be able to
transfer the locus of control for stress from external work conditions to internal metacognitive
and attentional resources. Therefore, MBIs may constitute cost-effective organization-level
interventions due to not actually requiring any modifications to human resource management
systems and practises. Based on preliminary empirical findings and on the outcomes of MBI
studies with clinical populations, it is concluded that MBIs appear to be viable interventional
options for organizations wishing to improve the mental health of their employees.
Keywords Work-related stress .Work addiction .Workaholism .Workp la ce w ell be in g .
Occupational stress .Job Performance .Mindfulness .Meditation .Buddhism
Int J Ment Health Addiction
DOI 10.1007/s11469-014-9484-3
W. Van Go rdon :E. Shonin :M. D. Griffiths
Division of Psychology, Nottingham Trent University, Chaucer Building, Burton Street, Nottingham, UK
NG1 4BU
W. Van Go rdon ( *):E. Shonin
Awake to Wisdom Centre for Meditation, Mindfulness, and Psychological Wellbeing, Nottingham, UK
e-mail: william@awaketowisdom.co.uk
W. Van Go rdon :E. Shonin
Bodhayati School of Buddhism, Nottingham, UK
M. Zangeneh
Factor-Inwentash, Faculty of Social Work, University of Toronto, Toronto, ON, Canada
Introduction
Work-related mental health issues can cost the British economy up to £26 Billion per year
(Sainsbury Centre for Mental Health 2007). The most prevalent and empirically researched
complaint is work-related stress (WRS) that accounts for 40 % of all work-related illness in Great
Britain (Health and Safety Executive [HSE] 2012). Approximately 20 % of British adults are
stressed as a result of their work (Houdmont et al. 2011) and 10.4 million working days each year
are lost in Great Britain due to WRS (HSE 2012). A less empirically investigated but equally
consequential work-related mental health issue is work addiction (i.e., ‘workaholism’). The
prevalence of work addiction in Western populations is approximately 10 %, although estimates
vary considerably according to how the construct is defined as most definitions of workaholism
are not based on addiction criteria found in other behavioral addictions (Sussman et al. 2011).
There is growing consensus that work addiction is a bone fide mental health issue that for a
minority of employees meets all of the qualifying criteria for classification as a behavioral
addiction (e.g., Griffiths and Karanika-Murray 2012) (i.e., properties of salience, conflict,
mood modification, tolerance, withdrawal symptoms, and relapse—see Griffiths’(2005)
components model of addiction). Both WRS and work addiction can lead to serious detri-
mental health and socioeconomic consequences including somatic illness, (comorbid) psycho-
pathology, (concurrent) addictive behavior (both chemical and behavioral), work-related
injury, mortality, reduced productivity, absenteeism, presenteeism, high staff turn-over, unsafe
driving, employee compensation claims, burnout, and work-family conflict (e.g., Cox and
Griffiths 2010; Frone et al. 1994; Griffiths and Karanika-Murray 2012; Manocha et al. 2011;
Wu et al. 2012; Shonin et al. 2014a; Sussman 2012).
Mindfulness—a form of meditation that derives from Buddhist practice—involves culti-
vating a full, direct, and active awareness of experienced phenomena that is spiritual in aspect
and that is maintained from one moment to the next. The last two decades have witnessed a
marked increase of empirical investigation into the applications of mindfulness meditation
within public healthcare domains. Indeed, 72 % of UK-based general practitioners believe that
patients can improve their health by practicing mindfulness meditation (Mental Health Foun-
dation 2010). Similarly, certain mindfulness-based interventions (MBIs) have now been
advocated by both the (British) National Institute for Health and Care Excellence (NICE)
and the American Psychiatric Association (APA) for the treatment of specific forms of
depression (APA 2010;NICE2009).
In addition to depression and other mood disorders, MBIs have been shown to be effective
in helping treat a broad range of mental health problems and somatic illnesses including
anxiety disorders (Chiesa and Serretti 2011), problem gambling (de Lisle et al. 2011),
schizophrenia-spectrum disorders (Shonin et al. 2013a,b), anger dysregulation (Singh et al.
2013a), and cancer (Arias et al. 2006). In addition to applications within clinical populations,
MBIs have also been shown to facilitate significant improvements in cognitive function and
task performance in healthy adults (e.g., Chiesa et al. 2011; Eberth and Sedlmeier 2012).
Karanika-Murray and Weyman (2013) have argued that there is scope for transferring
protocols for interventions that are demonstrably efficacious in public healthcare contexts into
occupational and organizational domains. Accordingly, in the last few years there has been
growing scientific interest into the applications of mindfulness in the workplace setting. Of
particular interest and relevance to occupational stakeholders is the potential of MBIs to
concurrently improve work-related mental health and job performance. Following a brief
explication of the mindfulness construct, this paper critically discusses current research
directions in the utilization of mindfulness in workplace settings and assesses its suitability
for operationalization as an organization-level work-related mental health intervention.
Int J Ment Health Addiction
The Mindfulness Construct
According to Buddhist thought, individuals have a tendency to ruminate about the past and/or
rush towards the ‘ungraspable’future (i.e., the future is ‘ungraspable’because it never
materializes—it is always the present) (Shonin et al. 2014b). The Buddhist teachings explicate
that this behavioral trait of ‘not being fully present’can corrupt an individual’sperceptionof
reality, and relative to a realized mindfulness/spiritual practitioner, it reduces their experience
of existence to that of a ‘walking corpse’(Shonin et al. 2014b). Thus, mindfulness is
traditionally viewed as a means of ‘waking-up’from the sleep of ‘corpse-like’unawareness
so that an individual can begin to observe, experience, and consciously participate in the
present moment. Although there is still an absence of consensus in the literature of both
Western medicine and psychology as to what defines the mindfulness construct, there is a
reasonable degree of accord amongst academicians that mindfulness: (i) is fundamentally
concerned with becoming more aware of the present moment, (ii) can (and should) be
practiced during everyday activities and not just when seated in meditation, (iii) is cultivated
more easily by using a ‘meditative anchor’(e.g., observing the breath), (iv) is a practice that
requires deliberate effort and (v) is concerned with observing both sensory and cognitive-
affective processes. Key areas of discord amongst Western psychologists in terms of an
accurate working definition for mindfulness are as follows:
1. Non-judgemental awareness: The most popular delineation of mindfulness employed in
the Western psychological literature is that proposed by Kabat-Zinn who defines mind-
fulness as “paying attention in a particular way: on purpose, in the present moment, and
non-judgmentally”(1994, p.4). Proponents of this definition contend that the term ‘non-
judgemental’is appropriate because it infers that mindfulness involves the acceptance
(i.e., rather than the rejecting or ignoring) of present-moment sensory and cognitive-
affective experiences. However, it might also be argued that the term ‘non-judgemental’is
too ambiguous because it conceivably implies that the mindfulness practitioner is essen-
tially ‘indifferent’and does not seek to discern which cognitive, emotional, and behavioral
responses are conducive to ethically-wholesome conduct (Shonin et al. 2014b).
2. Insight generation: In the Western psychological literature, the terms ‘vipassana medita-
tion’and ‘insight meditation’are often regarded as being synonymous with the term
‘mindfulness meditation’(e.g., Bowen et al. 2006; Chiesa 2010). However, this portrayal
of vipassana meditation (and insight meditation) is not consistent with the traditional
Buddhist perspective (Shonin et al. 2014b). According to the classical Buddhist literature,
vipassana (a Sanskrit word that means ‘superior seeing’) meditation involves the use of
penetrative investigation in order to intuit (for example) the ‘non-self’,‘non-dual’,and
‘empty’nature of reality (Dalai Lama and Berzin 1997). Therefore, although mindfulness
meditation is certainly insight-generating in the sense that it can facilitate an intimacy with
the workings of the mind, ‘mindfulness meditation’is not ‘insight meditation’according
to the traditional Buddhist construction.
3. Context for practice: Mindfulness is traditionally practiced in the context of spiritual
development. Indeed, within Buddhism, mindfulness is practiced in conjunction with
numerous other spiritual practices and is just one aspect (in fact, the seventh aspect) of
a key Buddhist teaching known as the Noble Eightfold Path (Van Gordon et al. 2013). At
its essence, the Noble Eightfold Path elucidates that the successful establishment of
mindfulness relies upon a deep-seated understanding of the three root spiritual principles
of: (i) wisdom, (ii) meditation, and (iii) ethics (collectively known as ‘the three train-
ings’—Sanksrit: trishiksha). Consequently, there is ongoing scientific debate relating to
Int J Ment Health Addiction
whether mindfulness needs to be practiced within the wider context of spiritual develop-
ment (i.e., as opposed to the sole purpose of overcoming a health complaint or for
personal and/or career development).
As a spiritual phenomenon, it is probable that certain dimensions of the mindfulness
construct will always remain ineffable and only ever fully understood by those individuals
who can tap into them on the experiential rather than the academic plane (Shonin et al. 2014b).
As such, it is unlikely that an ‘absolute’and all-encompassing definition of mindfulness will
ever be operationalized. However, in so far as this represents a problem, it can be easily
reconciled if academicians are prepared to accept that “the definition of mindfulness will vary
depending on whether one is interested in mindfulness from a social, psychological, clinical, or
spiritual context, or from the perspective of a researcher, clinician, or a practitioner, and their
various combinations”(Singh et al. 2008, p.661).
Mindfulness in the Workplace: Current Research Directions
In light of the significant health and economic burden imposed by WRS and addiction to work,
various initiatives have been implemented in recent years with the objective of improving
levels of work-related wellbeing via the cultivation and enhancement of healthy working
environments. Examples are HSE-led schemes such as Management Standards (HSE 2007)
and Health, Work, and Wellbeing (HSE 2008)—both of which comply with legislative
requirements of the 2004 European Framework Agreement on Work-Related Stress.Several
recent cross-sectional and intervention studies (e.g., Allen and Kiburz 2012;Malarkeyetal.
2013; Manocha et al. 2011) have directly or indirectly assessed the extent to which MBIs may
present a cost-effective solution for organizations seeking to implement such schemes.
To date, there has been only one cross-sectional study that has explicitly investigated the
relationship between dispositional mindfulness and work-related wellbeing among employed
individuals (i.e., Allen and Kiburz 2012). They found that trait mindfulness was positively
correlated with work-life balance, sleep quality, and vitality in parents (n=131) working more
than 20 h per week. These findings are consistent with a randomized controlled trial (RCT)
involving 178 full-time employees of non-specified work backgrounds (with approximately
50 % not educated beyond secondary school level) that received meditation and mindfulness
training. Meditating participants demonstrated significant reductions compared with the con-
trol group in levels of stress and depression-dejection (Manocha et al. 2011). A more recent
RCT study found that 186 university employees that practiced mindfulness meditation showed
significant increases over controls in levels of dispositional mindfulness (Malarkey et al.
2013). There have also been several controlled intervention studies of individuals employed
in caregiver roles (e.g., primary care physicians, nurses, etc.) that indicate mindfulness can
reduce: (i) the risk of burnout and improve levels of client-centered and empathic care (Krasner
et al. 2009), (ii) levels of WRS (Warneke et al. 2011), and (iii) levels of anxiety and depression
(Kang et al. 2009).
Despite increasing prevalence rates for workaholism, there is a paucity of workaholism
treatment studies, and clinical guidelines tend to be based on either theoretical propositions
(Sussman 2012) and/or anecdotal reports elicited during clinical practice (e.g., Robinson
1998). Indeed, the only published intervention study exploring the effectiveness of meditation
for work addiction is a clinical case study conducted by Shonin et al. (2014a). This study
presented the case of a director of a blue-chip technology company that, based on scores on the
Bergan Work Addiction Scale (Andreassen et al. 2012), demonstrated clinically significant
Int J Ment Health Addiction
improvements in levels of work addiction following completion of an 8-week secular mind-
fulness intervention called Meditation Awareness Training (Van Gordon et al. 2013). Signif-
icant pre-post improvements were also observed for sleep quality, psychological distress, work
duration, and work involvement during non-work hours. However, the single-participant
nature of this study significantly limits the generalizability of these findings.
Other related current research directions involve exploring the utility of mindfulness for
improving job performance. However, such empirical enquiry is notably underdeveloped
(Dane 2011) and is limited to just a few exploratory studies. One such study was a cross-
sectional study of 412 Taiwanese technological company workers that found employee
meditation/mindfulness experience was positively associated with self-directed learning, orga-
nizational innovativeness, and organizational performance (Ho 2011). The aforementioned
MAT case study (i.e., Shonin et al. 2014a) also assessed work performance and found that
mindfulness/meditation lead to improvements in employer-rated job performance.
Mechanisms of Action
The existing conceptualizations of the WRS construct are (in essence) based on an ‘exposure-
environmental’model of work stress. In such conceptual models, WRS is invariably opera-
tionalized as a function of the extent to which employees are exposed to sub-optimal working
conditions (see Edwards et al. 2008). Examples of such conditions are: (i) inadequate support
systems, (ii) inflexible working hours, (iii) conflicting demands, (iv) overly-taxing and/or
unrealistic deadlines, and (v) low-work autonomy. This operational model of WRS emphasizes
the importance of the employee’s‘external’work environment (i.e., as opposed to their
‘internal’psychological environment). However, this is a different conceptual approach to
that utilized in the traditional mindfulness and meditation teachings. From the traditional
Buddhist perspective, rather than exact changes to the external work environment, the most
effective means of reducing stress (and all other forms of psychological distress) is to modify
the ‘internal’(i.e., psychological) working environment (Nhat Hanh 1999).
By facilitating a perceptual-shift in the mode of responding and relating to sensory and
cognitive-affective stimuli, the meditator is better positioned to objectify their cognitive
processes and to apprehend them as passing phenomena. This manner of transferring the locus
of control for stress from external work conditions to internal metacognitive and attentional
resources can be analogized as the difference between covering the entire outdoors with
leather, versus simply adorning the feet with a leather sole (Santideva 1997). Therefore, MBIs
may be considered as cost-effective organization-level work-related mental health interven-
tions due to them not actually requiring any (‘externally-orientated’) modifications to human
resource management (HRM) systems and practises.
Another important mechanism by which mindfulness is believed to modulate dysphoric
mood states (whether work-related or otherwise) is via the cultivation of compassion and self-
compassion. Research has shown that mindfulness can lead to a greater awareness of the
individual’s own suffering and psychological distress, and this helps to embed a greater
awareness of the suffering of others (Shonin et al. 2013c). Accordingly, greater levels of
compassion and self-compassion are thought to lead to improvements in levels of tolerance,
cooperation (e.g., with senior management), and interpersonal skills more generally (Shonin
et al. 2013e). Related to the increased levels of compassion/self-compassion is the growth in
spiritual awareness that is often a consequence of mindfulness practice. Spiritual development
has been shown to broaden perspective and induce a re-evaluation of life priorities in
individuals that are addicted to work (Shonin et al. 2014a). Although superficially this may
Int J Ment Health Addiction
appear to contraindicate job performance, a more balanced level of organizational identifica-
tion is likely to be beneficial for both employees and the organizations they work for.
The acquisition of problematic addictive behaviors, including workaholism, is associated
with maladaptive avoidance strategies that individuals often employ when trying to escape
from negative affective states such as guilt, depression, and anxiety (Griffiths 2005,2013;
Griffiths and Karanika-Murray 2012). Accordingly, in the context of addiction, mental urges
essentially reflect a conscious or sub-conscious wish to modify mood and receive temporary
sensory and/or affective gratification. Mechanisms for the ameliorating effect of mindfulness
meditation on addictive behavior are based on a phenomenon known as ‘urge surfing’(Appel
and Kim-Appel 2009). Urge surfing refers to the meditative process of adopting an observa-
tory, non-judgemental, and non-reactive attentional-set that helps to instill an understanding
that mental urges are effectively transient and impermanent in nature. By understanding that
mental urges will arise and subside of their own accord, the meditation practitioner is no longer
at the disposal of habitual compulsive responses but can derive contentment by looking to the
source of their mental urges (i.e., their own mind) and simply observing such urges as transient
mental phenomena.
Breath awareness—a central feature of mindfulness practice—has been shown to moderate
extraneous cognitive activity and help reduce autonomic and psychological arousal via
increases in prefrontal functioning and vagal nerve output (Gillespie et al. 2012). However,
it is important to highlight that the use of breath observance in MBIs does not preclude other
experiences from entering into the attentional sphere. In essence, the breath is used to help
anchor concentration in the ‘here and now’, and this concentration is most accurately described
as one that is of a broad (rather than narrow) attentional aspect (Dane 2011; Singh et al. 2008).
As a consequence, mindfulness permits employees to attend with due attention to whatever
tasks they are engaged in, but without becoming so immersed or lost in such tasks that their
situational awareness and cognitive functionality is compromised. Accordingly, although
present-moment (i.e., mindfulness-based) working styles and future-orientated (i.e., goal-
based) working styles appear to involve competing attentional resources, empirical evidence
suggests that mindfulness facilitates rather than impairs goal attainment (see Dane 2011).
Are MBIs Viable as Work-Related Wellbeing Interventions?
As has been demonstrated, there is growing interest amongst occupational stakeholders into
the applications of mindfulness (and related meditative techniques) in workplace settings. The
key strengths of MBIs as work-related mental health interventions are that they are: (i) cost-
effective (e.g., an 8-week group MBI comprising one 2-h session per week that is delivered by
one mindfulness instructor to 16 employees corresponds to just one instructor hour per
employee), (ii) not invasive to the organization (the practice of mindfulness does not neces-
sitate changes to HRM infrastructure), (iii) not invasive to the employee (i.e., there are few
reports of adverse effects associated with MBIs), (iv) acceptable to employees from diverse
cultural, religious, and education backgrounds (i.e., MBIs are typically delivered in secular
format and have been shown to be acceptable for individuals from both ends of the intellectual
functioning continuum [e.g., Singh et al. 2013b; Van Gordon et al. 2013]), (v) functional as ‘on
the job’practices (i.e., mindfulness can be practiced whilst engaging in work tasks), and (vi)
potentially able to concurrently effectuate improvements in work-related mental health and job
performance.
Many of the factors that may impede the operationalization of MBIs within occupational
settings are applicable to all organization-level work-related wellbeing interventions. For
Int J Ment Health Addiction
example, organizations may be reluctant to adopt a strategic approach to employee wellbeing
and may see the roll-out of such interventional initiatives as a threat to short-term revenue-
generation. Furthermore, the effectiveness of any human-taught intervention is significantly
dependent upon the aptitude of the facilitating instructors. This is particularly relevant for
MBIs because it has been argued that there is currently a shortage of suitably experienced
mindfulness/meditation instructors that are able to impart an embodied authentic transmission
of the mindfulness teachings (Shonin et al. 2013d). However, based on the preliminary
empirical findings outlined here, and on the outcomes of MBI studies with clinical popula-
tions, it is concluded that MBIs appear to be viable interventional options for organizations
wishing to improve employee levels of work-related mental health.
Conflicts of Interest The authors have no competing interests to declare.
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