What are the dangers of using mindfulness-based techniques for individuals suffering from Schizophrenia? I am unable to find much research on the application of mindfulnesss for those suffering from Schizophrenia. A recent study by Chien and Lee (2013) focuses on the application of a psychoeducation program for Chinese patients with Schizophrenia. However, I do not have the pleasure of reading this but findings indicate that it can improve psychosocial functioning (http://www.cme.psychiatryonline.org/article.aspx?articleID=1653271).

Though the study show promising results for alleviating symptoms in Schizophrenic patients, I feel - prima facie - that there might be a risk in exacerbating symptoms by educating Schizophrenic patients to adopt a non-judgmental awareness towards positive symptoms such as hallucinations and delusional thinking. I am a supporter of mindfulness-based interventions except I can't seem to find much literature on its limitations and risks for Schizophrenia.

As the neurological and biological evidence around Schizophrenia is far from conclusive, I am narrowing this down to only psychological and ethical risks/dangers that could potentially arise from mindfulness practice and Schizophrenic individuals. For clarity around the theory underpinning Schizophrenia, I would refer to the Theory of Mind as the overarching philosophical foundation for understanding Schizophrenia and interactions with mindfulness practice. A definition is given by Pedersen et al (2012):


  "Theory of mind (ToM), the ability to think about mental states such as
  thoughts and beliefs in oneself and others, is a complex cognitive
  function that requires the integration of information from multiple
  sources. Substantial evidence has accumulated that patients with
  schizophrenia have impaired ToM functions (Sprong et al., 2007; Bora
  et al., 2009) that result in social-interactive deﬁcits."


On a cognitive perspective, what dangers does mindfulness pose to a Schizophrenic individual's ability to discern their self-concept and their relations with the world? 

Example

This is purely for illustrative purposes.

X suffers from Schizophrenia and visual hallucinations. X does engage in mindfulness practice regularly. His/her mindfulness practice involves paying non-judgmental attention in the present moment. Initially, X paid too much attention to the occasional visual hallucinations through his mindfulness exercises. This triggered a higher amount of distress and anxiety for X and caused him/her to believe in the 'reality' of the hallucination. It could be said that there may be a potential danger that existed in the initial stages of X's introduction to mindfulness practice.

Questions


What are the dangers of using mindfulness-based techniques for
individuals suffering from Schizophrenia?
What are the mechanisms that make mindfulness practice effective when an individual is experiencing a delusional episode?


EDIT:

I have provided some more information around the scope of the question primarily around what type of 'dangers' could result from the interaction between mindfulness practice and those suffering from Schizophrenia.

References

Chien, W.T., Lee, I.Y.M. (2013). The mindfulness-based psychoeducation program for Chinese patients with schizophrenia. Psychiatric Services 2013
I cannot answer your question, because I'm not an expert on schizophrenia, but I would like to point out that the answer will depend on your theory of schizophrenia.

Post-mortem research on the brains of schizophrenic patients has found consistent anomalies:


widening of the ventricles (meaning a loss of subcortical brain cells)
structural abnormalities in the subcortical temporal-limbic areas such as the hyppocampus and basal ganglia
structural abnormalities in the prefrontal and temporal cortex


CT and MRI research on the brains of living schizophrenics has found similar anomalies:


enlarged ventricles
loss of cortical substance in the temporal and frontal areas
reduced volume in the basal ganglia (nucleus caudatus) and limbic structures


It appears that there is a general atrophy of brain tissue in schizophrenics, and from my non-expert knowledge there is nothing you can do to reverse this. Typical therapy in schizophrenia (today) is to give anti-psychotica to reduce symptoms, behavioral therapy to enhance social abilities, and family therapy to reduce hostility, excessive worrying etc. ("expressed emotion" plays a role in the etiology of schizophrenia). So basically what you do is not "heal" the disorder but alleviate the symptoms and help the patients with their everyday problems.

Since cognitive behavioral therapy (in which the patient is encouraged to consciously deal with his thoughts, including, I'd guess, the paranoic ones) is a normal part of clinical routine with schizophrenia, I don't see why mindfulness could not be beneficial. I believe it might well enhance the CBT in the same way as in the therapy of depression, where mindfulness and CBT are successfully applied in conjunction.