Posted: April 14, 2023
Author: Emily Ryan, MSW Student

Do you feel connected to your body? Maybe you are not even sure of the answer or what that feels like anymore. There is so much happening so quickly in the world around us. This fast-paced world can often lead to a subconscious disconnection from our bodies. If you experience chronic stress or pain, disconnection may be a welcome escape or distraction. This disconnection is something that I have noticed within myself an individual working in the mental health field, and something that I have frequently encountered in those I work with. I want to share about a type of meditation that can be a tool for reconnecting with the body and reducing stress and tension. 

Description of Intervention

A body scan meditation is a meditative practice that involves mindfully scanning the body for sensation and noticing those sensations without judgment. Body scan meditations can be done in a few minutes or as a longer meditation. The practice is intended to improve well-being by increasing somatic awareness and connection to the body, along with reducing stress and tension. Meditation in general has a long history of improving well-being in several ways. A report was published that was based on data from the National Health Interview Survey (NHIS) that was done in 2017, and found that, "U.S. adults' use of meditation in the past 12 months tripled between 2012 and 2017 (from 4.1 percent to 14.2 percent). The use of meditation by U.S. children (aged 4 to 17 years) also increased significantly (from 0.6 percent in 2012 to 5.4 percent in 2017 (NCCIH, 2016)." Because meditation has increased in popularity, it has become very accessible. Meditation can be done guided or unguided, and individuals seeking guided meditations can find many free options online or through free meditation apps.

The body scan meditation traditionally begins with an invitation for the person meditating to get comfortable, either sitting or lying down and an invitation to close the eyes. I like to invite the individual or group to first bring their awareness to the breath. After becoming aware of the breath and resting the awareness there for a few breaths, I would then invite them to bring their awareness to one part of the body. This would typically begin either with the feet or the head but may be modified depending on the client's presenting problem. I would then cue them to notice any sensations or lack of sensations in that part of the body. I might cue them to notice lightness, heaviness, warmth, or coolness. I would then invite the client to move their awareness and notice sensation throughout additional parts of the body, moving step by step through the body. Once the whole body has been scanned, I would invite them to allow their awareness to rest upon the whole body. Finally, I would have the client release their focus and gently open the eyes when they are ready if they were closed.

Historical and Cultural Origins

Body scan meditation first originates from the Buddhist practice, mindfulness of breathing. U Ba Khin started vipassana meditation in 1937 under the guidance of Saya Thet Gyi who taught mindfulness of breathing (Anālayo, 2019). S. N. Goenka was U Ba Khin's most well-known students who practiced and taught Vipassana meditation, increasing its popularity (Anālayo, 2019). Vipassana means insight in Sanskrit bringing insight into the body. Jon Kabat-Zinn learned Vipassana meditation at a retreat at the Insight Meditation Society in Barre, Massachusetts in 1979 and adapted it for Mindfulness Based Stress Reduction, popularizing it in the west (Anālayo, 2019). Jon Kabat-Zinn created MBSR in 1979. MBSR is an 8-week workshop that provides mindfulness training and combines meditation, body awareness, and mindful movement. The body scan Meditation is the first formal mindfulness practice taught in MBSR and it is done in each of the first 4 weeks of the program.

Philosophical and Theoretical Foundations

You may be wondering how a body scan works and how it can both increase connection and awareness of the body while also reducing stress. That connection with and awareness of the body is also known as interoceptive awareness. This is the ability to identify, become aware of, and respond appropriately to the internal signals coming from our bodies. One study from 2017 showed that doing a body scan meditation over the course of 8 weeks increased these interoceptive processes (Fischer et al., 2017). Research has also shown that mindfulness meditation enhances self-regulation, attention, and emotional regulation (Tang et al., 2015). This is thought to be related to the changes that meditation causes in the brain. A study from 2012 that was funded by the NCCIH suggested that "meditation can affect activity in the amygdala (a part of the brain involved in processing emotions), and that different types of meditation can affect the amygdala differently even when the person is not meditating" (NCCIH, 2016). Another study from 2019 on individuals participating in body scan meditations over the course of 8 weeks showed a reduction in both biological stress, through decreased cortisol, and psychological stress as reported by the individuals participating (Schultnen et al., 2019).  All these physical and psychological effects of body scan meditations are what work together to increase interoceptive awareness while reducing stress.

Literature Review

One of the populations that I work with is clients experiencing anxiety. A randomized controlled trial from 2011 studied MBSR for patients with anxiety disorders. There were 76 participants who were randomized to either MBSR or a waitlist control group. 38 participants were in the MBSR group, with 7 terminating before the end of the study (Vøllestad, Sivertsen, & Nielsen, 2011). The outcomes measured included measurements of anxiety, worry, insomnia, and mindfulness using different assessments. Those who completed treatment improved on all the outcome measures when compared to the waitlist control group. The greatest improvements were in anxiety and depression and the improvements were maintained at a 6-month follow up (Vøllestad, Sivertsen, & Nielsen, 2011). There were no adverse effects to the MBSR treatment. Some of the limitations of the study include the absence of an active comparison condition, and a lack of evidence that the mindfulness training is what contributed to the effects observed. This is because there are other factors that could have improved the treatment group members such as receiving attention, receiving treatment of any kind, or being in a group setting.

Another population that I work with is women who have experienced trauma due to interpersonal violence. A randomized controlled trial was done in 2016 on Trauma-Informed MBSR for female survivors of interpersonal violence. There were 39 participants and 19 were in the TI-MBSR group and 20 in the waitlist control group (Kelly & Garland, 2016). There were no adverse effects, but one participant did attend only one class and never returned. Those who participated in the TI-MBSR had reductions in PTSD symptoms, depressive symptoms, and anxious attachment (Kelly & Garland, 2016). Some of the limitations from the study were the small sample size, the use of a waitlist control, lack of follow-up, and the fact participants may have been in therapy outside of the study which could influence outcomes.

Training Necessary

Social workers and therapists would not need any specific additional training to lead clients in a body scan meditation. They may simply want to research examples or recordings of body scan meditations and first practice with friends, family, or coworkers before guiding a client. They should also have a meditation practice of their own. To become a teacher of the MBSR program, completing a teacher training program is typically required. There is no governing body or official association for MBSR training, but there are several organizations that have trainings and offer certifications.

Self-Care

The practice of a body scan meditation is a helpful tool in anyone's self-care toolbox, but it can be particularly supportive for social workers and therapists. Individuals who work in mental health care are often exposed to not only the stress of our own lives, but the stress of our clients' lives.  Mental healthcare jobs can include exposure to vicarious trauma and can lead to compassion fatigue or burnout. I know that in my work as a therapist, burnout is always something I am actively working to prevent. Since we know that body scan meditations reduce both physical and psychological stress it is a great self-care tool for those working in mental health. Meditations also increase self-regulation, attention, and emotional regulation which are all very important for social workers and therapists to have in their clinical sessions with clients. There are not many barriers to using this for self-care. Body scan meditations can be done on their own or guided through a free online source.

Application in Practice

This type of meditation is very applicable to my micro clinical work at a private group practice. In working with clients who are feeling disconnected from their bodies due to stress, anxiety, or trauma, I often bring up this type of meditation. I find for some clients it may be easier to start with a body scan instead of other types of meditation as it gives the mind something to focus on throughout the meditation. I would not bring this up with a client who is in active psychosis as it is contraindicated for those clients. I would also proceed with caution with clients who have experienced trauma, depending on how recent the trauma occurred and the type of trauma. I may also modify it for these clients, maybe having them keep the eyes open, or starting with just a few body parts such as the hands or feet or skipping certain parts of the body altogether.

If a client mentions that they are struggling with stress or feeling disconnected from their body, I would ask if they are open to trying a meditation. I would then share how the body scan meditation works and the benefits and risks involved. If they were open to it, I might guide them in one briefly during a session. Otherwise, I may also send them some they can try for free on their own at home. Body scan meditation is aligned with the NASW ethical principle of service in the Code of Ethics. The NASW Code of Ethics states, "social workers' primary goal is to help people in need" (NASW, 2021). Supporting individuals who are experiencing stress or feeling disconnected from their bodies is helping people in need and aligned with that value. It is also aligned with the value of dignity and worth of a person. The NASW Code of Ethics states, "Social workers promote clients' socially responsible self-determination" (NASW, 2021). This includes increasing a client's capacity to address their own needs. Since clients can do this meditation on their own without the support of the worker, it promotes their self-determination and capacity to care for themselves.

Conclusion

Next time you are looking to support a client or even support yourself with increasing somatic awareness, connection to the body, or reducing stress and tension, consider trying a body scan meditation. I have personally found this to be a supportive and accessible practice that feels like a much needed opportunity to slow down, destress, and connect with myself.