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Mindful : October 2018
that we demand today.” Meanwhile, in the two years that the section was live, Headspace’s claims about addiction, depression, and health made their way across the internet, getting cited in blogs and tweets, spreading the idea that app-based mindfulness is a proven health treatment. While many mindfulness apps do not use scienctific claims to promote themselves or purport to teach users how to practice mindfulness, in the last decade, a number of apps have appeared on the market that do. Researchers say there is a serious dearth of evidence to back up mind- fulness apps, even though they are increasingly perceived as proven treat- ments for mental health. So far, the preliminary research has suggested that some of the apps might show promise for treating stress, depres- sion, anxiety, and craving. But it’s too soon to know whether or not the most popular apps on the market can achieve any of those aims. There isn’t even any research on whether these apps actually teach mindfulness. WHAT’S IN AN APP? The excitement and hype around mindfulness apps is having a big impact on the culture of mindfulness. For example, a 2017 study found that 1 in 20 mental healthcare providers in the UK’s National Health Service recommend Headspace for stress, anxiety, or depression—meaning they’re recommending an unproven treatment to patients and expecting it to alleviate real suffering. In June, Headspace announced a new subsidiary, Headspace Health, to develop medical apps. The company said it would seek FDA approval— which requires rigorous scientific testing. Headspace Health will con- duct randomized controlled trials on its new products in 2018 and hopes to have doctors writing prescriptions by 2020. “Health professionals have long recommended Headspace as an effec- tive tool in treating a wide variety of health problems,” wrote Headspace CEO Rich Pierson in the announce- ment. “Now we’re leading the effort to validate and deliver prescription med- itation solutions to doctors and their patients for physical conditions.” Richard Davidson, one of the world’s leading researchers on neuro- science and mindfulness, is working on a well-being app based on careful science, but he’s skeptical of what’s currently out there. “I don’t know of any scientific evidence to show that any mindfulness app ‘works,’” he says. By his reckoning, the research pro- duced so far on mindfulness apps has been insufficiently rigorous to draw any conclusions on their efficacy. So far, a handful of studies have been published on the efficacy of mind- fulness apps, thanks in part to Head- space. In hopes of getting its app sci- entifically validated, the organization has partnered on more than 60 studies with 35 academic institutions. In the long term, scientists at Headspace say, they genuinely want to advance our understanding of mindfulness. In the meantime, in lieu of research proving that apps work, marketers tend to draw a false equivalence to in-person meditation programs, draw- ing on their credibility to suggest—or outright claim—that meditation apps offer the same benefits as clinically validated mindfulness therapy. Head- space, for one, says that “online mind- fulness training does produce results similar to in-person training.” In fact, there is no research indi- cating that mindfulness apps have the same effect as in-person training. To back up the claim that they do, Headspace cites a research paper by Marion Sommers-Spijkerman that analyzed the effectiveness of 15 different web-based mindfulness programs. But Sommers-Spijkerman says that her study, which focused on desktop-based programs, offered no conclusions about phone-based mindfulness apps and didn’t inves- tigate Headspace. “ We cannot draw any conclusions regarding the specific effects of app-based meditation or mindfulness training,” says Som- mers-Spijkerman. Davidson says when we talk about the efficacy of meditation apps, research on in-person mindfulness training is irrelevant. “There could be a plethora of research showing the impact of meditation, but that’s not necessarily relevant to under- standing how—and if—an app may be working,” says Davidson. “ It’s delivered in a completely different way, in a different context. It may procure the same effects, but we just don’t know.” On top of that, the Sommers-Spijkerman paper actually found that desktop-based programs were slightly less effective than in-person training at treating anxiety and depression. Mindfulness apps have a big chal- lenge. Mindfulness, at its core, is a tool for disrupting habits—especially unhelpful habits. If you get distracted easily, mindfulness helps curb the habit of distraction. If anxiety keeps you up at night, mindfulness might be able to mitigate the habit of anxiety. This is why researchers expected a 10-day meditation course might help drug users break their substance addictions. Addiction is another strong habit. But, in contrast, apps become popular and profitable by get- ting users lightly addicted to repetitive use. Whether it’s refreshing your Ins- tag ram feed, checking a notification, or sending an email, apps—and smart- phones themselves—are designed to reward us with dopamine in exchange for usage, creating a habitual, if not addictive, pattern of craving and satisfaction. So, can an app really treat addiction, or is it inherently part of the problem? As of now, we don’t know the answer to that question. The fact is, we know very little about meditation apps—good or bad. Pending further research, we don’t know what effect mindfulness apps might have on your brain. In the meantime, they are precipitating a much grander shift—a change in how mindfulness is understood and practiced around the world. → October 2018 mindful 61 mindful tech