Skip to main content
Log in

Shenpa and Compassionate Abiding: Mindfulness-Based Practices for Anger and Aggression by Individuals with Schizophrenia

  • Published:
International Journal of Mental Health and Addiction Aims and scope Submit manuscript

Abstract

Uncontrolled anger is often expressed as verbal and physical aggression. Some people with schizophrenia engage in verbal and physical aggression when they cannot control their anger either through the use of psychotropic medication or psychosocial interventions. In this study, we taught three individuals with long-standing anger management problems the concept of shenpa—the almost instantaneous reaction of the mind to some internal or external stimulus that hooks them to a negative emotion—and a mindfulness-based practice that helped them to intuit this without attachment or anger. In addition, we taught them the mindfulness-based practice of compassionate abiding for dealing with emotionally arousing feelings that follow shenpa. Using a multiple baseline design, we assessed the effects of the two mindfulness-based practices on anger, verbal aggression and physical aggression. The three individuals were able to decrease their anger, greatly reduce verbal aggression, and virtually eliminate physical aggression.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  • Adkins, A. D., Singh, A. N., Winton, A. S. W., McKeegan, G. F., & Singh, J. (2010). Using a mindfulness-based procedure in the community: translating research to practice. Journal of Child Family Studies, 19, 175–183.

    Article  Google Scholar 

  • Allen, M. H., Currier, G. W., Carpenter, D., Ross, R. W., & Docherty, J. P. (2005). The expert consensus guideline series. treatment of behavioral emergencies 2005. Journal of Psychiatric Practice, 11(supplement 1), 5–108.

    Article  PubMed  Google Scholar 

  • Allen, M., Bromley, A., Kuyken, W., & Sonnenberg, S. J. (2009). Participants’ experiences of mindfulness-based cognitive therapy: it changed me in just about every way possible. Behavioural and Cognitive Psychotherapy, 37, 413–430.

    Article  PubMed  Google Scholar 

  • Barlow, D. H., Nock, M., & Hersen, M. (2009). Single-case experimental designs (3rd ed.). New York: Allyn & Bacon.

    Google Scholar 

  • Beck, R., & Fernandez, E. (1998). Cognitive-behavioral therapy in the treatment of anger: a meta-analysis. Cognitive Therapy and Research, 22, 63–74.

    Article  Google Scholar 

  • Bobes, J., Fillat, O., & Arango, C. (2009). Violence among schizophrenia out-patients compliant with medication: prevalence and associated factors. Acta Psychiatrica Scandinavica, 119, 218–225.

    Article  CAS  PubMed  Google Scholar 

  • Buchanan, R. W., Kreyenbuhl, J., Kelly, D. L., Noel, J. M., Boggs, D. L., Fischer, B. S., & Keller, W. (2010). The 2009 schizophrenia PORT psychopharmacological treatment recommendations and summary statements. Schizophrenia Bulletin, 36, 71–93.

    Article  PubMed Central  PubMed  Google Scholar 

  • Buckley, P., Citrome, L., Nichita, C., & Vitacco, M. (2011). Psychopharmacology of aggression in schizophrenia. Schizophrenia Bulletin, 37, 930–936.

    Article  PubMed Central  PubMed  Google Scholar 

  • Chilvers, J., Thomas, C., & Stanbury, A. (2011). The impact of a ward-based mindfulness programme on recorded aggression in a medium secure facility for women with learning disabilities. Journal of Learning Disabilities & Offending Behaviour, 2, 27–41.

    Article  Google Scholar 

  • Chödrön, P. (2007). Don’t bite the hook: finding freedom from anger, resentment, and other destructive emotions. Boston, MA: Shambhala Audio.

    Google Scholar 

  • Chödrön, P. (2010). Taking the leap: freeing ourselves from old habits and fears. Boston, MA: Shambhala.

    Google Scholar 

  • Citrome, L. (2007). Comparison of intramuscular ziprasidone, olanzapine, or aripiprazole for agitation: a quantitative review of efficacy and safety. Journal of Clinical Psychiatry, 68, 1876–1885.

    Article  CAS  PubMed  Google Scholar 

  • Del Vecchio, T., & O’Leary, K. D. (2004). Effectiveness of anger treatments for specific anger problems: a meta-analytic review. Clinical Psychology Review, 24, 15–34.

    Article  PubMed  Google Scholar 

  • DiGiuseppe, R., & Tafrate, R. C. (2003). Anger treatment for adults: a meta-analytic review. Clinical Psychology: Science and Practice, 10, 70–84.

    Google Scholar 

  • Edmondson, C. B., & Conger, J. C. (1996). A review of treatment efficacy for individuals with anger problems: conceptual, assessment, and methodological issues. Clinical Psychology Review, 16, 251–275.

    Article  Google Scholar 

  • Fazel, S., Gulati, G., Linsell, L., Geddes, J. R., & Grann, M. (2009). Schizophrenia and violence: systematic review and meta-analysis. PLoS Medicine, 6, e1000120.

    Article  PubMed Central  PubMed  Google Scholar 

  • Fix, R. L., & Fix, S. T. (2013). The effects of mindfulness-based treatments for aggression: a critical review. Aggression and Violent Behavior, 18, 219–227.

    Article  Google Scholar 

  • Heppner, W. L., Kernis, M. H., Lakey, C. E., Campbell, W. K., Goldman, B. M., Davis, P. J., & Cascio, E. V. (2008). Mindfulness as a means of reducing aggressive behavior: dispositional and situational evidence. Aggressive Behavior, 34, 486–496.

    Article  PubMed  Google Scholar 

  • Hodgins, S. (2008). Violent behavior among people with schizophrenia: a framework for investigations of causes, and effective treatment, and prevention. Philosophical Transactions of the Royal Society B, 363, 2505–2518.

    Article  Google Scholar 

  • Kabat-Zinn, J. (1990). Full catastrophe living: how to cope with stress, pain and illness using mindfulness meditation. New York, NY: Dell.

    Google Scholar 

  • Kinney, T. A., Smith, B. A., & Donzella, B. (2001). The influence of sex, gender, self-discrepancies, and self-awareness on anger and verbal aggression among U.S. college students. Journal of Social Psychology, 141, 245–275.

    Article  CAS  PubMed  Google Scholar 

  • Kongtrül, D. (2008). Light comes through: Buddhist teaching on awakening to our natural intelligence. Boston, MA: Shambhala.

    Google Scholar 

  • Krakowski, M. I., Czobor, P., Citrome, L., Bark, N., & Cooper, T. B. (2006). Atypical antipsychotic agents in the treatment of violent patients with schizophrenia and schizoaffective disorder. Archives of General Psychiatry, 63, 622–629.

    Article  CAS  PubMed  Google Scholar 

  • Malterud, K. (2001). Qualitative research: standards, challenges, and guidelines. Lancet, 358, 483–488.

    Article  CAS  PubMed  Google Scholar 

  • Maron-Katz, A., Ben-Simon, E., Sharon, H., Gruberger, M., & Cvetkovic, D. (2014). A neuroscience perspective on meditation. In N. N. Singh (Ed.), Psychology of meditation (pp. 99–128). New York: Nova.

    Google Scholar 

  • Parker, R. I., & Vannest, K. (2009). An improved effect size for single-case research: nonoverlap of all pairs. Behavior Therapy, 40, 357–367.

    Article  PubMed  Google Scholar 

  • Parker, R. I., Hagan-Burke, S., & Vannest, K. (2007). Percentage of all non-overlapping data (PAND): an alternative to PND. Journal of Special Education, 40, 194–204.

    Article  Google Scholar 

  • Samuelson, M., Carmody, J., Kabat-Zinn, J., & Bratt, M. A. (2007). Mindfulness-based stress reduction in Massachusetts correctional facilities. Prison Journal, 87, 254–268.

    Article  Google Scholar 

  • Scheier, M. F., Fenigstein, A., & Buss, A. H. (1974). Self-awareness and physical aggression. Journal of Experimental Social Psychology, 10, 264–273.

    Article  Google Scholar 

  • Singh, N. N. (2014). Psychology of meditation. New York: Nova.

    Google Scholar 

  • Singh, N. N., Wahler, R. G., Adkins, A. D., Myers, R. E., & and the Mindfulness Research Group. (2003). Soles of the feet: a mindfulness-based self-control intervention for aggression by an individual with mild mental retardation and mental illness. Research in Developmental Disabilities, 24, 158–169.

    Article  PubMed  Google Scholar 

  • Singh, N. N., Lancioni, G. E., Singh, S. D., Winton, A. S. W., Sabaawi, M., Wahler, R. G., & Singh, J. (2007a). Adolescents with conduct disorder can be mindful of their aggressive behavior. Journal of Emotional and Behavioral Disorders, 15, 56–63.

    Article  Google Scholar 

  • Singh, N. N., Lancioni, G. E., Winton, A. S. W., Adkins, A. D., Singh, J., & Singh, A. N. (2007b). Mindfulness training assists individuals with moderate mental retardation to maintain their community placements. Behavior Modification, 31, 800–814.

    Article  PubMed  Google Scholar 

  • Singh, N. N., Lancioni, G. E., Winton, A. S. W., Adkins, A. D., Wahler, R. G., Sabaawi, M., & Singh, J. (2007c). Individuals with mental illness can control their aggressive behavior through mindfulness training. Behavior Modification, 31, 313–328.

    Article  PubMed  Google Scholar 

  • Singh, N. N., Lancioni, G. E., Manikam, R., Winton, A. S. W., Singh, A. N. A., Singh, J., & Singh, A. D. A. (2011a). A mindfulness-based strategy for self-management of aggressive behavior in adolescents with autism. Research in Autism Spectrum Disorders, 5, 1153–1158.

    Article  Google Scholar 

  • Singh, N. N., Lancioni, G. E., Singh, A. D. A., Winton, A. S. W., Singh, A. N. A., & Singh, J. (2011b). Adolescents with Asperger syndrome can use a mindfulness-based strategy to control their aggressive behavior. Research in Autism Spectrum Disorders, 5, 1103–1109.

    Article  Google Scholar 

  • Singh, N. N., Lancioni, G. E., Karazsia, B. T., Winton, A. S. W., Myers, R. E., Singh, A. N. A., et al. (2013a). Mindfulness-based treatment of aggression in individuals with intellectual disabilities: a waiting list control study. Mindfulness, 4, 158–167.

  • Singh, N. N., Lancioni, G. E., Winton, A. S. W., Karazsia, B. T., & Singh, J. (2013b). Mindfulness training for teachers changes the behavior of their preschool students. Research in Human Development, 10, 211–233.

    Article  Google Scholar 

  • Smith, J. A., Flowers, P., & Larkin, M. (2009). Interpretative phenomenological analysis: theory, method and research. Thousand Oaks, CA: Sage.

    Google Scholar 

  • Suinn, R. (2001). The terrible twos—anger and anxiety: hazardous to your health. American Psychologist, 56, 27–36.

    Article  CAS  PubMed  Google Scholar 

  • Swanson, J. W., Swartz, M. S., Van Dorn, R. A., Elbogen, E. B., Wagner, H. R., Rosenheck, R. A., et al. (2006). A national study of violent behavior in persons with schizophrenia. Archives of General Psychiatry, 63, 490–499.

    Article  PubMed  Google Scholar 

  • Tafrate, R. C. (1995). Evaluation of treatment strategies for adult anger disorders. In H. Kassinove (Ed.), Anger disorders: definition, diagnosis, and treatment (pp. 109–129). Washington, DC: Taylor & Francis.

    Google Scholar 

  • Tafrate, R. C., Kassinove, H., & Dundin, L. (2002). Anger episodes in high- and low-trait-anger community adults. Journal of Clinical Psychology, 59, 1573–1590.

    Article  Google Scholar 

  • Torrey, E. F. (2011). Stigma and violence: isn’t it time to connect the dots? Schizophrenia Bulletin, 37, 892–896.

    Article  PubMed Central  PubMed  Google Scholar 

  • Volavka, J. (2013). Violence in schizophrenia and bipolar disorder. Psychiatria Danubina, 25, 24–33.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Nirbhay N. Singh.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Singh, N.N., Lancioni, G.E., Karazsia, B.T. et al. Shenpa and Compassionate Abiding: Mindfulness-Based Practices for Anger and Aggression by Individuals with Schizophrenia. Int J Ment Health Addiction 12, 138–152 (2014). https://doi.org/10.1007/s11469-013-9469-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11469-013-9469-7

Keywords

Navigation