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Mindfulness is sometimes misunderstood as solely a Buddhist or secular practice. This chapter offers a toolkit for enhanced sensitivity and flexibility toward patients and populations of diverse spiritual and religious orientations and backgrounds. It explains a set of eight interrelated practices known as Passage Meditation (PM), and a subset known as the Mantram Repetition Program (MRP), both derived from Indian-born spiritual teacher Eknath Easwaran (1910-1999). These practices support mindfulness and can be pursued within any major religious tradition or outside all and facilitate drawing on spiritual resources within each tradition. Two empirical research programs based on these practices have generated more than 30 published research studies and seven randomized controlled trials. Each program has documented both enhanced mindfulness and a variety of improved mental health outcomes, often mediated by mindfulness gains. Guidance is provided for implementation, implications for diversity-related ethical obligations, and needed expansion of contemporary mindfulness toolkits.

Objective Mantram or holy name repetition has long been practiced in every major religious tradition. Repetition of a mantram as a mindfulness practice is helpful for stress management and resilience building. The objective of this article is to provide an overview of the key features of mantram and the Mantram Repetition Program (MRP) developed in the US Veterans Healthcare System, the evidence base for the MRP, and its applications. Methods MRP practices are portable and do not require an extended or regularized period of sitting, in contrast to most methods of meditation. Core functions of MRP practices include focus shifting, frame activation, and fostering of mindfulness. We review scientific research, including multiple randomized trials, that has investigated the MRP. Results Research on the MRP has documented reductions in posttraumatic stress symptoms, insomnia, hyperarousal, and depression, as well as enhancement of quality of life, self-efficacy, and mindfulness. Mantram repetition may possess comparative advantages for managing symptoms of various mental health conditions, including posttraumatic stress disorder, HIV/AIDS, cancer, and chronic diseases. Conclusions MRP practices can be integrated into daily routines to manage stress and improve coping, safety, efficacy, calmness, and resilience. The inclusion of mantram repetition alongside conventional mindfulness-based practices for stress management will improve their cultural and religious inclusiveness, enabling societies and organizations to build greater collective resilience. Mantram repetition can be readily used in the COVID-19 pandemic, focusing on healthcare workers, patients, and the public.

This chapter traces the history of modern meditation research. Meditation is conceptualized primarily as a seated practice for systematically training attention. Historically present in every major religion, meditation was traditionally used for spiritual purposes and usually accompanied by ancillary practices, such as spiritual fellowship. This chapter traces the dynamics and evolving interplay between dominant conceptions and forms of meditative practices under scientific study, as well as critiques of those conceptions, research questions, study designs, measurement instruments, and public reception and application. It describes how developments in each of these spheres have at different times opened up new lines of research, sometimes transforming other dimensions of ongoing research and practice. For the past fifty years, modern meditation research has progressed through partly overlapping periods that emphasized physiological measurement and secular adaptations; links to numerous health and well-being outcomes; emphasis on a sui generis psychosocial goal (mindfulness); advances in physiological and questionnaire-based empirical measurement; expansion of public, corporate, and governmental interest; increased concerns about abandonment of ethical bases and cultural context; and initial moves toward greater inclusiveness and integration of diverse methods and traditional perspectives.

We review the life and legacy of Eknath Easwaran (1910–1999) from the perspective of modern and Indian Psychology. A Kerala-born professor of English literature, Easwaran in 1959 travelled to the USA where he taught a system of eight spiritual practices known as passage meditation (PM). Its characteristic features include its meditative focus on memorized inspirational passages and using mantram repetition as a primarily “portable” practice throughout the day. The PM method is distinctive in emphasizing the principle, otherwise neglected in the modern psychology of meditation, that “we become what we meditate on”—a principle that possesses a basis in traditional Indian sources that include the Vedas, Puranas, Adi Śaṅkara, and Ramakrishna Paramahamsa. Two major programs of empirical research have evaluated Easwaran’s practices, each publishing multiple randomized controlled trials. We summarize findings from (i) studies of the full PM program, and (ii) studies of the Mantram Repetition Program (MRP), based on three of the eight PM points. Randomized evidence links each program to reduced stress, improved mental health, improved mindfulness, and increases in various spiritual measures. We describe ways that PM/MRP empirical research has reflected Indian Psychology perspectives, and suggest that Easwaran’s legacy enriches Indian Psychology with added value in at least three ways: emphasizing the importance of the choice of meditative focus, offering universally framed support for devotional (bhakti) orientations to spirituality, and supplying tools for improving how spiritual diversity is addressed in modern institutions such as health care, schools, and other organizations.

We introduce the topic of Indian/US collaboration in studying religion and spirituality (R/S), providing both historical and philosophical context. A fully in-depth and comprehensive study of R/S will require taking into account three potential types and sources of knowledge: (1) theoretically and intellectually oriented knowledge as exemplified by William James; (2) empirically oriented knowledge as exemplified by Gordon Allport; and (3) experience- and realization-derived knowledge based on reports from eminent spiritual figures. We sketch the distinct but mutually informative challenges of clinical and epistemic integration. We suggest several topics for future collaboration, arguing that the most comprehensive study of R/S will require combining the western attention to empirical knowledge with the Indian psychology movement’s attention to realization-derived knowledge. Suggested topics include processes of learning from spiritual exemplars and teachers; health effects from engagement in Hindu or other Indian religious practice; psychological and health effects of specific spiritual practices; the importance and influence of the focus used in meditation; the effects of japam, Ramnam, or similar repeated short prayers; how diverse spiritual practices affect mindfulness; and the nature and means of fostering skills for living in a religiously plural society.

This chapter reviews theories and empirical evidence on the associations between religion and spirituality (R/S) and public health education, promotion, and intervention – the public health subfield concentrations of about one-sixth of public health students nationwide. We discuss literature related to health programming at R/S sites, spiritually tailored treatments in healthcare settings, R/S interventions in workplaces, and meditation and mindfulness as spiritual interventions.

This present chapter concludes a 28 chapter volume on the relevance of religion and spirituality (R/S) to the field of public health. The volume contains 13 empirical reviews of R/S-health relations (Part I), two chapters addressing practical implications of R/S for public health (Part II), and eight chapters on how R/S factors have been incorporated into public health education and training offered at US-based schools and colleges of public health (Part III).

This chapter reviews theories and empirical evidence on relations between religion and spirituality (R/S), and mental health, a topic of increasing interest to public health.

Posttraumatic stress disorder (PTSD) is a serious mental health condition that affects physical health. However, many military veterans with PTSD refuse or drop out of commonly used trauma-focused, evidence-based treatments. Growing research supports the value of spiritual components in diverse type

An emerging scientific literature is investigating the construct of “compassionate love,” love that is “centered on the good of the other,” a construct empirically linked to physical and mental health. We evaluated effects of an 8-week, 16-hour programme for physicians, nurses, chaplains, and other health professionals, using nonsectarian, spiritually based, self-management tools. Participants were randomised to intervention (n = 30) or wait-list (n = 31). Pretest, post-test, 8- and 19-week follow-up data were gathered on six measures of prosocial qualities. Favorable treatment effects (p

Relational caregiving skills remain seldom studied in health professionals. We evaluated effects on health professional relational caregiving self-efficacy from an eight-week, 16-hour training in self-management tools. Physicians, nurses, chaplains, and other health professionals were randomized after pretest to treatment ( n = 30) or waiting list ( n = 31). Training used a previously researched program of Easwaran (1991/1978) derived from spiritual wisdom traditions. Changes were measured using a 34-item caregiving self-efficacy scale. Positive effects were observed at posttest, eight- and 19-week follow-up ( ds = .38, .47, .37, all ps < .05), and were mediated by adherence to practices and stress reductions ( p < .05), findings also obtained in qualitative interviews ( n = 24). Evidence suggests this program enhances health professional caregiving self-efficacy, and may merit inclusion in training curricula.

There has been great interest in determining if mindfulness can be cultivated and if this cultivation leads to well-being. The current study offers preliminary evidence that at least one aspect of mindfulness, measured by the Mindful Attention and Awareness Scale (MAAS; K. W. Brown & R. M. Ryan, 2003), can be cultivated and does mediate positive outcomes. Further, adherence to the practices taught during the meditation-based interventions predicted positive outcomes. College undergraduates were randomly allocated between training in two distinct meditation-based interventions, Mindfulness Based Stress Reduction (MBSR; J. Kabat-Zinn, 1990; n=15) and E. Easwaran's (1978/1991) Eight Point Program (EPP; n=14), or a waitlist control (n=15). Pretest, posttest, and 8-week follow-up data were gathered on self-report outcome measures. Compared to controls, participants in both treatment groups (n=29) demonstrated increases in mindfulness at 8-week follow-up. Further, increases in mindfulness mediated reductions in perceived stress and rumination. These results suggest that distinct meditation-based practices can increase mindfulness as measured by the MAAS, which may partly mediate benefits. Implications and future directions are discussed.

Effects of two meditation and mindfulness-based spiritual interventions were examined in college undergraduates (N=44). Compared to a control group, both interventions decreased negative religious coping (d=−0.80, p

The authors evaluated an 8-week, 2-hr per week training for physicians, nurses, chaplains, and other health professionals using nonsectarian, spiritually based self-management tools based on passage meditation (E. Easwaran, 1978/1991). Participants were randomized to intervention (n = 27) or waiting list (n = 31). Pretest, posttest, and 8- and 19-week follow-up data were gathered on 8 measures, including perceived stress, burnout, mental health, and psychological well-being. Aggregated across examinations, beneficial treatment effects were observed on stress (p = .0013) and mental health (p = .03). Treatment effects on stress were mediated by adherence to practices (p = .05). Stress reductions remained large at 19 weeks (84% of the pretest standard deviation, p = .006). Evidence suggests this program reduces stress and may enhance mental health.

This study examined how training in a nonsectarian toolkit of spiritually based self-management techniques affected the caregiving self-efficacy (confidence) of health professionals, including physicians, nurses, psychologists, and chaplains. Before and after an 8-week, 2-hour per week training in the meditation-based Eight Point Program of Easwaran (1978/1991b), participants ( n = 14) completed a newly developed 32-item caregiving self-efficacy questionnaire. Data were also gathered regarding sociodemographic characteristics, spiritual and religious self-perceptions and practices, and program adherence. Results indicated that mean pre/post self-efficacy increases were large (Cohen's d > 0.80), statistically significant ( p < 0.01), and associated with greater use of specific pro-gram practices. Three participants reported increases in self-perceived spirituality. Self-efficacy increases were largest for participants identifying themselves as least spiritual at pretest ( p < 0.05), or reporting increases in spirituality ( p < 0.05). Although preliminary, these findings support using this already widely crossculturally disseminated toolkit for a variety of purposes in clinical practice, health promotion, and health professional education.

Several evidence-based treatments are available to veterans diagnosed with posttraumatic stress disorder (PTSD). However, not all veterans benefit from these treatments or prefer to engage in them.The current study explored whether (1) a mantram repetition program (MRP) increased mindful attention among veterans with PTSD, (2) mindful attention mediated reduced PTSD symptom severity and enhanced psychological well-being, and (3) improvement in mindful attention was due to the frequency of mantram repetition practice.Data from a randomized controlled trial comparing MRP plus treatment as usual (MRP+TAU) or TAU were analyzed using hierarchical linear models.A total of 146 veterans with PTSD from military-related trauma were recruited from a Veterans Affairs outpatient PTSD clinic (71 MRP+TAU; 75 TAU).The Clinician Administered PTSD Scale (CAPS), PTSD Checklist (PCL), the Brief Symptom Inventory-18 depression subscale, Health Survey SF-12v2, and Mindfulness Attention Awareness Scale (MAAS) were used. Frequency of mantram repetition practice was measured using wrist-worn counters and daily logs.Intent-to-treat analyses indicated greater increases in mindful attention, as measured by the MAAS, for MRP+TAU as compared with TAU participants (P0.01). Mindful attention gains mediated previously reported treatment effects on reduced PTSD symptoms (using both CAPS and PCL), reduced depression, and improved psychological well-being. Frequency of mantram repetition practice in turn mediated increased mindful attention.The MRP intervention and specifically, mantram practice, improved mindful attention in veterans with PTSD, yielding improved overall psychological well-being. MRP may be a beneficial adjunct to usual care in veterans with PTSD.

The authors evaluated the effects on stress, rumination, forgiveness, and hope of two 8-week, 90-min/wk training programs for college undergraduates in meditation-based stress-management tools.After a pretest, the authors randomly allocated college undergraduates to training in mindfulness-based stress reduction (MBSR; n = 15), Easwaran's Eight-Point Program (EPP; n = 14), or wait-list control (n = 15). The authors gathered pretest, posttest, and 8-week follow-up data on self-report outcome measures.The authors observed no post-treatment differences between MBSR and EPP or between posttest and 8-week follow-up (p.10). Compared with controls, treated participants (n = 29) demonstrated significant benefits for stress (p.05, Cohen's d = -.45) and forgiveness (p.05, d = .34) and marginal benefits for rumination (p.10, d = -.34).Evidence suggests that meditation-based stress-management practices reduce stress and enhance forgiveness among college undergraduates. Such programs merit further study as potential health-promotion tools for college populations.

This qualitative study assesses the experience of an intervention that provided spiritually based self-management tools to hospital-based nurses. Drawing on wisdom traditions of the major world religions, the eight point program can be practiced by adherents to any religious faith, or those outside of all traditions. Five of eight program points were perceived as directly useful in improving the nurses’ workplace interactions and enhancing fulfillment of compassionate caregiving missions. The findings suggest that this program can be an effective intervention among nurses in dealing with the demands of the healthcare environment and may be a resource for continuing education curricula.