April 17, 2025 by Alex Brewer, PharmD, MBA
TL;DR
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Mindfulness refers to awareness of your surroundings and internal state – your feelings, thoughts, and emotions in the moment.
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Peer-reviewed, evidence-based studies show promising results for mindfulness as a treatment for certain symptoms and conditions, although stronger evidence is needed.
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Authors such as Dr. Lauren Alderfer are helping combine mindfulness and microdosing specifically; as well as a way to approach psychedelics in general, interweaving science and art to cultivate personal growth and exploration.
This 2 part series is a collaboration with Dr. Lauren Alderfer and inspired from her work. She is the award-winning mindfulness author of Teaching from the Heart of Mindfulness. Dr. Alderfer comes to the world of microdosing and the use of entheogens through the lens of her many decades of meditation.
What is Mindfulness?
As defined by the American Psychological Association (APA), “Mindfulness is awareness of one’s internal states and surroundings.” Mindfulness can be thought of as “paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally,” as described by Jon Kabat-Zinn. Simply put, mindfulness can help us detect when we go on autopilot, and bring ourselves back into the present.
Let’s get one thing out of the way – going on autopilot doesn’t mean something is broken or “wrong” with you. The human mind is really good at problem-solving. Humans aren’t the fastest or strongest creatures on Earth. Our bodies don’t come equipped with killer claws or fangs or poison barbs. But we’ve evolved beyond our base reptile brain to think of innovative, unique ways to survive and thrive.
The issue is, the mind doesn’t like being put on the backburner. It will look for problems, even ones that aren’t immediately in front of you. So even if you have a roof over your head, a bed to retire to, and food in the pantry, the mind is constantly looking for problems to solve. This can lead to rumination, worrying when it isn’t necessary.
For example: it’s Friday night, and you’re at a concert with friends. You bought tickets months ago, and the day is finally here: time to have fun! What’s that, mind? I have a work report due next week? Oh shit. When am I going to get to that? Let’s run through next week…Monday is already full, we have Tuesday set aside for team-building, Wednesday is mostly weekly committee reports…annnnnnnnnnd the concert is over and you barely caught a single song because your mind became fixated on some future problem that you are currently in no position to solve.
The point of mindfulness isn’t to stop intrusive thoughts. Instead, it’s a resource for catching intrusive thoughts and spiral patterns as soon as possible, telling them to shove off, and bringing yourself back into the moment.
I look at mindfulness techniques in two ways: acute work, and preventive work. Acute work helps us in the moment. It’s useful when we catch ourselves caught up in thought. But you may find acute work difficult if you don’t also practice preventive work. Preventive work is intentional time set aside to practice being mindful.
Mindfulness techniques often can – and should – be used as both acute work and preventive work. LeBron James is known for engaging in meditative moments during games. While this makes for great viral clips and helps LeBron do LeBron things on the court, he also puts in the preventive work necessary for effective in-the-moment meditation and breathwork. Practicing mindfulness in calm, planned moments is the best way to prepare yourself for using these techniques in acutely stressful situations.
Mindulness Techniques
Some examples of mindfulness techniques include:
Breathing Methods
Focus your attention on your breath. Zero in on the exact place where you feel your breath coming in on the inhale, and where it leaves your body on the exhale. You can also count your breath. This can be as simple as counting “one” on the inhale, and counting “two” on the exhale. Or you can count up to a set number: “one” on the inhale, “two” on the exhale, “three” on the inhale, and so on. There’s also box breathing: inhale as you count from one to four, hold for a 4-count, exhale for a 4-count, hold for a 4-count, and repeat.
Guided Imagery
Use your imagination and visualize yourself in a peaceful, calm setting. Engage as many of your five senses as you can. For example – close your eyes and picture yourself somewhere that you feel calm. For me, it’s the beach. Hear the waves gently rolling in. See the blue water turn to white foam as the waves break on the shore. Feel the sand between your toes and the ocean breeze brush against your face.
Mindul Movement
Mindfulness can go beyond sitting still in a closed-off space. Mindful walking involves moving at a leisurely but intentional pace, engaging as many senses as you can as you amble about.
Now that we’re up to speed on what mindfulness is (and isn’t), let’s review a few recent studies on mindfulness and how it can serve as a treatment modality for a range of conditions.
Science on Mindfulness
Below are some peer-reviewed, evidence-based studies evaluating the effectiveness of mindfulness for treating medical conditions.
Study 1:
“The mindfulness-based stress reduction program for improving sleep quality in cancer survivors: A systematic review and meta-analysis”. (Hyo-Weon Suh, et al. 2021.)
Sleep problems are common in cancer survivors. In fact, it’s the most common complaint according to this study – 51% of long-term cancer survivors report sleep disturbances, with 20% reporting poor sleep quality and 28% reporting use of sleep medications. I suggest
This meta-analysis (a review of studies) evaluated the use of mindfulness-based stress reduction (MBSR) program, an 8-week group based program developed by Professor Jon Kabat-Zinn at the University of Massachusetts Medical Center. Dr. Kabat-Zinn’s work with mindfulness-based stress reduction interventions have shown effectiveness at:
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Treating chronic pain. “An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: theoretical considerations and preliminary results.” (Kabat-Zinn, J. 1982.)
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Treating anxiety disorders, such as generalized anxiety disorder. “Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders.” (Kabat-Zinn, J., et al. 1992.)
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A subsequent 3-year follow up study found continued positive results in the medication-based intervention.
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Treating moderate to severe psoriasis, used in conjunction with phototherapy. “Influence of a mindfulness meditation-based stress reduction intervention on rates of skin clearing in patients with moderate to severe psoriasis undergoing phototherapy (UVB) and photochemotherapy (PUVA)”. (Kabat-Zinn, J., et al. 1998).
The results of this particular meta-analysis support the “possibility” for using MBSR, but effectiveness results were inconclusive due to a low number of quality studies to evaluate. In other words – initial returns show promise, but we need larger, high-quality studies to confirm effectiveness in improving sleep quality for cancer survivors.
Study 2:
“Psychological treatments for comorbid chronic pain and opioid use disorder: Current research and future directions”. (Schwebel, et al., 2025.)
This study evaluated cognitive behavioral therapy-based, mindfulness-based, and integrated treatments for comorbid chronic pain and opioid use disorder. The best outcomes came from integrated treatments and mindfulness-based treatments. One drawback is these required in-person delivery. This can create access barriers, particularly for rural patients. I’d like to see a similar study evaluating digital mindfulness-based interventions, or using a self-guided at-home approach. But it’s promising to see the effectiveness of non-pharmacological methods.
Mindfulness-based interventions (MBIs) effectively treat anxiety symptoms across different anxiety and related disorders (ARDs), including panic disorder, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder, and post-traumatic stress disorder.
–https://pubmed.ncbi.nlm.nih.gov/39740743/
Study 3:
“Mindfulness interventions and quality of life in anxiety-related disorders: A systematic review and meta-analysis” (Fortes, P.P., et al. 2024).
Another meta-analysis, this study evaluated whether mindfulness-based interventions (MBIs) improve quality-of-life in people with anxiety-related disorders, such as generalized anxiety disorder, social anxiety disorder, and post-traumatic stress disorder. This review included 15 randomized controlled trials with a total of 1,465 participants. Researchers found MBIs were more effective than control and non-gold-standard interventions. But there wasn’t a significant difference between MBIs and gold-standard interventions, such as cognitive-behavioral therapy (CBT). It’s important to note that “no significant difference” simply means neither MBI nor CBT were found to be significantly more effective. Which leads me to the question: what about combining the two?
Study 4:
“The correlation between mindfulness and problematic smartphone use: A meta-analysis”. (Ru, Y., et al., 2025.)
This analysis looked at 29 studies evaluating mindfulness-based approaches in both Eastern and Western cultures to address problematic smartphone use, specifically in educational settings. Researchers found a “significant negative correlation between mindfulness and problematic smartphone use (r = -0.399, 95 % CI [-0.457, -0.338], p < 0.001).” In other words, children/adolescents who scored higher on mindfulness measures were less likely to have problematic smartphone use.
I can give my own anecdotal experience here – mindfulness is extremely effective at keeping me off my phone. Through practicing present-body awareness, I noticed a correlation between feeling anxious and a desire to look at my phone – particularly in public. Now I can sit by myself waiting for takeout or at a coffee shop and simply observe the world around me. It’s amazing how slow and relaxed five minutes can feel when you don’t spend it scrolling through social media apps that are intentionally designed to form addiction.
Additional Studies
Here are additional studies on mindfulness, if you’re curious and would like to read more:
Mindfulness and Microdosing
“Neat. But isn’t this a psychedelic newsletter?” Why yes, yes it is. Thank you for the mindful reminder. Let’s take a moment to explore the relationship between mindfulness and microdosing
I’ll quote Lauren Alderfer, PhD, award-winning author of Mindful Microdosing: A Guidebook and Journal, and our partner for this post:
“A hallmark of mindfulness is the silencing of the mind, giving way to the expanding expression of the heart in the all-knowing present moment. In that stillness there emerges a sacred connection to all. Mindful microdosing cultivates this spaciousness of mind and expansiveness of heart.”
Mindful microdosing combines science and art to unveil profound self-awareness.
[Click to read more on the the study and the review.]
Conclusion
I’ll end this article by getting personal: I credit mindfulness practice as an essential habit and, combined with CBT, an amazing treatment for my personal struggles with depressive and anxiety disorders.
Although there are a growing number of studies on psychedelics at high doses, there are still few studies on microdosing. Most of the results of microdosing are through citizen science; namely, self-reported data, This makes it difficult to assess both efficacy and safety. Large, controlled studies are needed, but results to date are promising. What we do know is that when participants are properly screened for contraindications to psychedelics, it is generally considered safe as there is a lack of reported serious adverse effects.
Remember: This content is for educational purposes and isn’t medical advice. Consult with your primary care provider and make sure you familiarise yourself with potential benefits and risks, as well as legalities in your area.