mindfulness : - mindful self-compassion - christopher germer, phd

From Didonna, F. (Ed.) (2008).

Clinical Handbook of Mindfulness.

New York: Springer.

nicabmwww.nicabm.com

Mindfulness:WhatIsIt?

WhereDoesItComeFrom?

Distributed with permission by:

The National Institute for

the Clinical Application

of Behavioral Medicine

Ronald D. Siegel PsyD

Christopher K. Germer PhD

Andrew Olendzki, PhD

Ronald D. Siegel, PsyD • Christopher K. Germer, PhD • Andrew Olendzki, PhD

Distributed with permission by

The National Institute for the Clinical Application of Behavioral Medicine

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Mindfulness: What Is It? Where Did It Come From?


RonaldD.SiegelPsyD,ChristopherK.GermerPhD,AndrewOlendzki,PhD

We can make our minds so like still water that beings gather about

us, that they may see, it may be, their own images, and so live for

amomentwithaclearer,perhapsevenwithafiercerlifebecauseof our quiet.

WilliamButlerYeats

Throughouthistory,humanbeingshavesoughttodiscoverthecausesofsufferingand

themeanstoalleviateit.Soonerorlater,weallaskthesamequestions:“WhyamInotfeeling

better?”“WhatcanIdoaboutit?”Inhabitingaphysicalbodyinevitablyexposesustopain

associatedwithsickness,oldage,anddeath.Wealsostruggleemotionallywhenconfrontedwith

adversecircumstances,orwithbenigncircumstancesthatweseeasadverse.Evenwhenourlives

arerelativelyeasy,wesufferwhenwedon’tgetwhatwewant,whenwelosewhatweoncehad,

andwhenwehavetodealwithwhatwedonotwant.Frombirthuntildeath,wearerelentlessly

tryingtofeelbetter.

Asthisbookwillshow,mindfulnessisadeceptivelysimplewayofrelatingtoall

experiencethatcanreducesufferingandsetthestageforpositivepersonaltransformation.Itisa

core psychological process that can alter how we respond to the unavoidable difficulties in life—notonlytoeverydayexistentialchallenges,butalsotoseverepsychologicalproblemssuchas

suicidalideation(Linehan,1993),chronicdepression(Segal,Williams&Teasdale,2002),and

psychoticdelusions(BachandHayes,2002).

Mindfulness is not new. It’s part of what makes us human—the capacity to be fully consciousandaware.Unfortunately,weareusuallyonlyinthisstateforbriefperiodsoftime,

andaresoonreabsorbedintofamiliardaydreamsandpersonalnarratives.Thecapacityfor

sustainedmoment-to-momentawareness,especiallyinthemidstofemotionalturmoil,isa

specialskill.Fortunately,itisaskillthatcanbelearned.

Mindfulnessisanelusive,yetcentral,aspectofthe2500year-oldtraditionofBuddhist

psychology.Wecantalkaboutmindfulnessorwriteatlengthaboutit,buttotrulyunderstand

mindfulnesswehavetoexperienceitdirectly.Thisisbecausemindfulnesspointstosomething

intuitive and pre-conceptual. With committed practice, every person can gradually figure out how to become more and more mindful in life, even in the face of significant suffering. Cultivating mindfulnessis,andhasalwaysbeen,adeeplypersonaljourneyofdiscovery.




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The Ancient Meaning of Mindfulness

“Mindfulness,”asusedinancienttexts,isanEnglishtranslationofthePaliword,sati,which

connotesawareness,attention,andremembering.(Paliisthelanguageinwhichtheteachingsof

the Buddha were originally recorded. The first dictionary translation of sati into “mindfulness” dates to 1921 (Davids & Stede, 1921/2001). As we shall see, the definition of “mindfulness” has been somewhat modified for its use in psychotherapy, and it now encompasses a broad range of ideasandpractices.

Awarenessisinherentlypowerful,

andattention,whichisfocusedawareness,

ismorepowerfulstill.Justbybecoming

awareofwhatisoccurringwithinand

aroundus,wecanbegintountangle

ourselvesfrommentalpreoccupationsand

difficult emotions. Sometimes this can be quitesimple,asinthecaseofamentally

retardedmanwhomanagedhisanger

outburstsbyshiftinghisattentiontothe“solesofthefeet”wheneverhenoticedhewasangry

(Singh,Wahler,Adkins,&Myers,2003).Byredirectingattention,ratherthantryingtocontrolor

suppressintenseemotions,wecanregulatehowwefeel.

Anotheraspectofmindfulnessis“remembering.”Thisdoesnotrefertomemoryofpast

events.Rather,itmeansrememberingtobeawareandpayattention,highlightingtheimportance

ofintention in mindfulness practice. Each moment we remind ourselves: “Remember—be aware!”

But“mindfulness”meansmorethanbeingpassivelyaware,orbeingawarefor

awareness’sake.TheBuddhistscholar,

JohnDunne(2007)haspointedoutthat

awareness,attention,andremembering

(sati)arepresentwhenasniper,withmalice

inhisheart,takesaimataninnocentvictim.

Obviouslythisisnotwhatwe’retryingto

cultivateaspsychotherapists,norisitthe

goalofBuddhistpsychology.Rather,the

purposeofmindfulnessinitsancientcontextistoeliminateneedlesssufferingbycultivating

insightintotheworkingsofthemindandthenatureofthematerialworld.Themindfulness

Just by becoming aware of what is occurring within and around us, we can begin to untangle ourselves from mental preoccupations and difficult emotions.

The mindfulness practictioner is actively working with states of mind in order to abide peacfully in the midst of whatever happens.




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practitionerisactivelyworkingwithstatesofmindinordertoabidepeacefullyinthemidstof

whateverhappens.

Throughmindfulness,wedevelop“streetsmarts”tomanagethemind(Bhikkhu,2007).

It helps us to recognize when we also need to cultivate other mental qualities—such as alertness, concentration, lovingkindness, and effort—to skillfully alleviate suffering. For example, if in meditationwearebeingself-critical,wemaywanttoaddadoseofcompassion;ifwearefeeling

lazy,wemightwanttotrytoraisethelevelofenergyinthemindorbody.Mindfulnessaloneis

not sufficient to attain happiness, but it provides a solid foundation for the other necessary factors (Rapgay&Brystrisky,2007).Intheclassicalliterature,mindfulnesswasusuallydiscussedin

termsofitsfunction,notasagoalinitself.Mindfulnessisultimatelypartofaprojectdesigned

to uproot entrenched habits of mind that cause unhappiness, such as the afflictive emotions of anger,envy,orgreed,orbehaviorsthatharm

ourselvesandothers.

Therecentfocusonmindfulawarenessin

psychotherapyisastrategiccorrectiontosome

moderntreatmenttrends.Manywell-intentioned

therapists prematurely attempt to “fix” a patient’s problems,unwittinglybypassingself-acceptance

andself-understanding.Aswillbedemonstratedthroughoutthisvolume,ouremotionaland

behavioral problems can be amplified by our instinctive efforts to avoid discomfort by propelling ourselvesintochange-seekingactivity.Theapproachofthenew,mindfulness-orientedagendais

“awareness and acceptance first, change second.”

Therapeutic Mindfulness

AsmindfulnessisadoptedbyWesternpsychotherapyandmigratesawayfromitsancient

roots,itsmeaningisexpanding.Mostnotably,mentalqualitiesbeyondsati(awareness,attention,

andremembering)arebeingincludedin“mindfulness”asweadaptittoalleviateclinical

conditions.Thesequalitiesincludenon-judgment, acceptance,andcompassion

JonKabat-Zinn,theforemostpioneerinthetherapeuticapplicationofmindfulness,

defines it as “the awareness that emerges through paying attention on purpose, in the present moment,andnonjudgmentallytotheunfoldingofexperiencemomenttomoment”(Kabat-Zinn,

2003, p. 145). In 2004, Bishop et al offered a consensus paper on the definition of mindfulness: Mindfulnessis“self-regulationofattentionsothatitismaintainedonimmediateexperience,

Mindfulness is ultimately part of a project designed to uproot entrenched habits of mind that cause unhappiness...




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therebyallowingforincreasedrecognitionofmentaleventsinthepresentmoment.”And,

“adoptingaparticularorientationtowardone’sexperiencethatischaracterizedbycuriosity,

openness, and acceptance” (p. 232). The second part of this definition captures an essential emotionalorintentionalattitudeofmindfulnessinclinicalsettings.

A stripped-down definition of “therapeutic mindfulness” that we and our colleagues at the Institute for Meditation and Psychotherapy find useful is awareness,ofpresent experience,

with acceptance(Germer,Siegel,&Fulton,2005).Thesethreeelementscanbefoundinmost

modernpsychologicalliteratureonmindfulness.Althoughthe“acceptance”componentis

impliedintheclassicalBuddhisttexts,ithelpstomakeitexplicitforclinicalapplication.Other

relatedshorthandexpressionswemightusefortherapeuticmindfulnessinclude“affectionate

awareness,”“mindfulacceptance,”“openheartedpresence,”and“mindfulcompassion.”

Theexplicitadditionof“acceptance”tothemindfulnessformulamakessensetomost

psychotherapists.Thisisespeciallythecasewhenourpatientsareconfrontedwithoverwhelming

traumaticcircumstances.Awarenesswithoutacceptancecanbelikelookingatascaryscene

under a bright floodlight. Sometimes we need softer light—like a candle—to approach difficult experience. The more intensely we suffer, it seems, the more we need acceptance and compassiontobeabletoworkwithwhat’soccurringinourlives.Conversely,kindnesswithout

clear awareness can lead to sugar coating the difficulties of life that need to be addressed. Sans

awareness,acceptancecouldbecomeaformofdefensiveavoidance.

Whenpatientscometopsychotherapy,theyareoftenindiredistress,seekingaperson

whowilltakethetimetounderstandwhotheyareandwhytheysuffer.Theydesperatelywant

astrategyforrelief.Compassionistheinvisiblematrixthatholdstheentireenterprise.The

word“compassion”comesfromtheLatinroots,com pati,orto“sufferwith.”That’showwe

really come to understand what our patients are going through—we suffer withthem.Ifweoffer

helpful advice to a patient without first providing acceptance and compassion, he or she simply feelsmisunderstood.

Similarly,intheintrapersonal, therapeutic relationship—the one we have with ourselves—compassion is also important. Self-compassion and self-acceptance are “skillful means”forbeingawareundertryingcircumstances.Weneedanopenhearttohaveopeneyes.

Whenwepracticemindfulnessbyourselves,self-acceptanceishopefullypartofouremotional

landscape;inthetherapyrelationship,acceptanceandcompassionareessentialfortheprocessto

beeffective.




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Mindfulness and Mindlessness

Apsychotherapistneedstoexperiencemindfulnessinordertointegrateitintohisor

herclinicalpractice.Learningmeditationfromanexperiencedteacheristhebestwaytobegin

and is strongly recommended. Psychotherapists also benefit from a conceptual road map to guide their work. To this end, we suggest using the definition of mindfulness just mentioned: (1) awareness, (2) of present experience, (3) with acceptance(Germer,Siegel,&Fulton,2005).

Amomentofmindfulnesscontainsthesethreeintertwinedelements.Themindfulness-oriented

therapistmayask,momenttomoment,“HowdoIcultivateawarenessofpresentexperiencewith

acceptance,formyselfandmypatient?”Thiscanbeatouchstoneforpractice.

While its definition is easy to remember, the directexperienceofmindfulnessismoreelusive.

Sometimesmindfulnessiseasiesttounderstandby

examiningitsopposite.Evencasualself-examination

revealsthatourtypicalmentalstateisremarkably

mindless.Wespendmostofourtimelostinmemories

ofthepastandfantasiesofthefuture.Moreoftenthannot,weoperateon“autopilot,”whereour

mindsareinoneplaceandourbodiesareinanother.

Anembarrassingexampleofthishappenedtooneofusrecentlywhiledrivingtopresent

aworkshoponmindfulnessandpsychotherapy:

Iwasinarushandrunninglate.Suddenly,afewminutesintomydrive,Irealizedthat

I was heading in the wrong direction on the Massachusetts Turnpike—a toll road on which theexitscanseemasthoughtheyare50milesapart.Iwondered,“Whowasdrivingthecar?”

“Whodecidedtoheadwest?Mymindwasbusypreparingmypresentation,whilemybodywas

steeringthecarautomatically,skillfullyheadinginthewrongdirection.

Similarexamplesabound.ConsidertheleadingcauseofemergencyroomvisitstoNew

YorkhospitalsonSundaymornings:bagel-cuttingaccidents.Whileinteractingwithfamily

membersontheweekend,manypeoplearesodistractedbyinterpersonaleventsthattheirbodies

cut bagels on automatic—and their bodies aren’t very good at this without guidance from the consciousmind.

Another,lesspainful,exampleofeverydaymindlessnessoccursinrestaurants.Haveyou

noticedhowmuchrestaurantconversationrevolvesaroundwhereyouateinthepast,orwhere

Psychotherapists also benefit from a conceptual road map to guide their work.




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youmighteatinthefuture?Onlyoccasionallydoweactuallytastethefoodthatwe’reeating.

And then there are our deliberate efforts to escape the present moment—trying to get to the “good stuff.” Do you ever find yourself rushing through the dishes to get to your cup of tea,book,ortelevisionprogram?Haveyoueverhadthethought,perhapstenminutesintoa

psychotherapy session with a frustrating patient, “Darn, forty minutes to go!” When we reflect honestly,wenoticethatwe’rerushingthrough,ortryingtogetridofmuchofourlifeexperience.

Youmaynoticethiseveninthepresentmoment:Asyoureadthesesentences,where

hasyourmindgone?Haveyouhadthoughtssuchas,“Iwonderifthisbookisgoingtobe

worthwhile?”“MaybeIshould’vegottenanotherone,”or“Thisisprettyinteresting,Ihopethe

restofitisgoodtoo.”Perhapsyourmindhasleftthebookentirely,andyou’rethinkingabout

whatyou’lldolater,orwhathappenedearliertoday.

Thepervasivenessofeverydaymindlessnessisparticularlystrikingwhenweinquire

intowhatreallymattersinourlives.

Takeafewsecondstorecallamomentin

yourlifethatyoureallyvalued.(Really,

stopreadingforamomentandthink

ofone.)Perhapsitwasaspecialtime

withsomeoneyoulove,oramagical

experienceinnature.Duringthismoment,wherewasyourmind?Wasitfocusedonrecallingthe

past, or imagining the future? Most people find that the moments they value the most are those in whichthey’refullypresent,noticingwhatishappeninghereandnow.

Thesearemomentsofmindfulness.Wenoticethepositionsofourhands,andthe

sensationsofholdingaknifeandbagel.Weareawareofourbodiessittinginthecarwhen

wedrive,andwenoticetheothercars,theroad,thescenery.Wetastethefoodweeat,and

weactuallyexperiencethesight,sound,andemotionalpresenceofourpatientsduring

psychotherapy.Rightnow,trynoticingthepositionofyourhandsasyouholdthisbook,

thephysicalexperienceofsittingorlyingdown,andhowyourmindreactstothesewords.

Mindfulnessinvolvesbeingpresenttoourlives.

When we reflect honestly, we notice that we’re rushing through, or trying to get rid of much of our life experience.




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While notoriously difficult to convey with words, the Zen Haiku tradition endeavors to capturemomentsofmindfulness.HereisaclassicexamplefromMatsuoBasho,awandering

Japanesepoetofthe17thcentury:

Anoldpond!

A frog jumps in — Thesoundofwater.

(Toyomasu,2001)

Mindfulness Practice

Whileitcanbedisturbingtonoticehowfrequentlywearemindless,andhowmuchof

ourliveswewishaway,thereisalsogoodnews:mindfulnesscanbecultivated.Justaswecan

improve physical fitness through regular physical exercise, we can develop mindfulness through deliberatementalpractices.

Mindfulnesspracticesallinvolve

someformofmeditation.Especiallyin

theWest,misconceptionsaboutmeditation

practiceabound.Itmaythereforebehelpful

toexaminesomeofthemostcommon

misunderstandings.

Not Having a Blank Mind:While

someconcentrationpracticesaredesignedtoemptythemindofthought,thisisnotanaimof

mindfulnesspractice.Nordowewishtobecomestupid,orloseouranalyticalabilities.Instead,

mindfulnesspracticeinvolvestrainingthemindtobeawareofwhatitisdoingatalltimes,

includingbeingawarethatwearethinkingwhenwethink.

Not Becoming Emotionless:Manypeoplesecretlyhopethatmindfulnesspracticewill

relievethemoftheburdenofemotion.Especiallywhenindistress,thefantasyofbecoming

emotionlesscanbequiteappealing.Inreality,mindfulnesspracticeoftenhasquitetheopposite

effect.Becausewepracticenoticingthecontentsofthemind,wecometonoticeouremotions

morefullyandvividly.Ourabilitytorecognizehowwefeelincreasesaswerelinquishnormal

defenses,suchasdistractingourselvesfromdiscomfortwithentertainmentoreating.

Just as we can improve physical fitness through regular physical exercise, we can develope mindfulness through deliberate mental practices.




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Not Withdrawing from Life: Because most meditation practices were originally refined bymonks,nuns,andhermits,peopleoftenassumethattheyinvolvewithdrawingfromliving

a full, interpersonally rich life. While there are certainly benefits to be derived from practicing mindfulness in a simplified environment, even in these settings one isn’t exactly withdrawing. Instead,thevicissitudesoflifeareexperiencedmorevividly,becausewe’retakingthetimeto

payattentiontoourmoment-to-momentexperience.

Not Seeking Bliss:Theimageofthespiritualmasterblissfullysmilingwhiletherest

ofusstrugglewithexistentialrealityisveryappealing.Earlyintheirmeditationcareers,many

people become distressed when they find that their minds wander and they feel agitated or unsettled.Whileexceptionallypleasantstatesofminddooccur,inmindfulnessmeditationwe

allow them to arise and pass—not clinging to blissful states nor rejecting unpleasant ones.

Not Escaping Pain:Ratherthanescapingpain,mindfulnesspracticehelpsustoincrease

ourcapacitytobearit.Wedeliberatelyabstainfrom

automaticactionsdesignedtomakeourselvesfeel

better.Forexample,ifwearemeditatingandanitch

arises,atypicalinstructionistoobservetheitchand

noticeanyimpulsesthatarise(suchastheurgeto

scratch)—but to not act on the urge. As a result, we actuallyexperiencepainanddiscomfortmorevividly.Thisextendsbeyonditchesandphysical

paintoincludethefullspectrumofemotionaldiscomfortaswell.Asweexploreandaccept

theseunpleasantexperiences,ourcapacitytobearthemincreases.Wealsodiscoverthatpainful

sensationsaredistinctfromthesufferingthataccompaniesthem.Weseethatsufferingarises

whenwereacttopainwithresistance,protest,oravoidanceratherthanmoment-to-moment

acceptance.

Forms of Pracitce

Therearemanywaystocultivateawarenessofcurrentexperiencewithacceptance.Not

surprisingly,alloftheminvolverepeatedpractice.Ifwewanttoimproveourcardiovascular

fitness, we might begin by integrating physical exercise into our everyday routine—taking the stairsinsteadoftheelevator,orridingabicycleinsteadofdrivingtowork.Ifwewanttobecome

even more physically fit, we might set aside time to exercise formally, perhaps at a gym or health club. To really accelerate the process, we might go on a fitness-oriented vacation, in which much ofthedayisspentinvigorousexercise.Similaroptionsareavailableforcultivatingmindfulness.

Rather than escaping pain, mindfulness practice helps us to increase our capacity to bear it.




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Everyday Mindfulness:Thisinvolvesremindingourselvesthroughoutthedaytopay

attentiontowhatishappeninginthemomentwithoutradicallyalteringourroutines.Itmeans

noticingthesensationsofwalkingwhenwewalk,thetasteofourfoodwhenweeat,andthe

appearanceofoursurroundingsaswepassthroughthem.TheVietnameseZenteacherThich

NhatHahnsuggestsanumberoftechniquestoenhanceeverydaymindfulness.Forexample,

when the telephone rings, try just listening at first, attending to the tone and rhythm of the sound asonemightlistentoamusicalinstrument.Orwhiledriving,whentheredtaillightsofanother

vehicleappear,tryappreciatingtheircolorandtextureasonemightinlookingatabeautiful

sunset.

Formal Meditation Practice:Thisinvolvessettingasidetimetogotothemental“gym.”

Weregularlydedicateacertainperiodtositquietlyinmeditation.Therearemanytypesof

meditationthatcancultivatemindfulness.Mostinvolveinitiallychoosinganobjectofattention,

suchasthebreath,andreturningourattentiontothatobjecteachtimethemindwanders.This

developsadegreeofcalmnesswhich,inturn,enablesustobetterfocusthemindonthechosen

object.Oncesomeconcentrationisestablished,mindfulnessmeditationentailsdirectingthe

mind to whatever begins to predominate in the mind—usually centering on how the event is experiencedinthebody.Theseobjectsofattentioncanbephysicalsensationssuchasanitch,

ache,orsound;oremotionalexperiencesastheymanifestinthebody,suchasthetightnessinthe

chestassociatedwithanger,orthelumpinthethroatthatcomeswithsadness.Regardlessofthe

chosenobjectofattention,wepracticebeingawareofourpresentexperiencewithacceptance.

Retreat Practice:Thisisthe“vacation”thatisdedicatedentirelytocultivating

mindfulness.Therearemanystylesofmeditationretreats.Mostinvolveextendedperiodsof

formalpractice,oftenalternatingsittingmeditationwithwalkingmeditation.Theyareusually

conductedinsilence,withverylittleinterpersonalinteraction,exceptforoccasionalinterviews

with teachers. All of the activities of the day—getting up, showering, brushing teeth, eating, doing chores—are done in silence, and used as opportunities to practice mindfulness. As one observer put it, the first few days of a retreat are “a little like being trapped in a phone booth with a lunatic.” We discover how difficult it is to be fully present. The mind is often alarmingly activeandrestless,spinningstoriesabouthowwellwe’redoingandhowwecomparetoothers.

Memoriesofundigestedemotionaleventsenter,alongwithelaboratefantasiesaboutthefuture.

Wegettovividlyseehowourmindscreatesuffering

inanenvironmentwhereallofourneedsaretended

to. Many people find that the insights that occur—duringevenasingleweek-longintensivemeditation

retreat—are life transforming.

The effects of mindfulness practice seem to be dose-related.




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Theeffectsofmindfulnesspracticeseemtobedose-related.Ifonedoesalittlebitof

everydaypractice,alittlebitofmindfulnessiscultivated.Ifonedoesmoreeverydaypractice,

andaddstothisregularformalpracticeandretreatpractice,theeffectsaremoredramatic.While

this has long been evident to meditators, it is beginning to be documented through scientific research(Lazaretal,2005).

Why Mindfulness Now?

Wearecurrentlywitnessinganexplosionofinterestinmindfulnessamongmentalhealth

professionals.InarecentsurveyofpsychotherapistsintheUnitedStates

(Simon,2007),thepercentageoftherapistswhosaidthattheydo“mindfulnesstherapy”atleast

someofthetimewas41.4%.Incomparison,cognitive-behavioraltherapywasthemostpopular

model(68.8%),andpsychodynamic/psychoanalytic

therapytrailedmindfulnessat35.4%.Two

yearsago,wespeculatedthatmindfulnesscould

eventuallybecomeamodelofpsychotherapyinits

ownright(Germer,Siegel,&Fulton,2005).That

timeisrapidlyapproaching.

Why?Oneexplanationisthattheyoungpeoplewhowerespiritualseekersand

meditatorsinthe1960’sand70’sarenowseniorclinicalresearchersandpractitionersinthe

mental health field. They have been benefiting personally from mindfulness practice for many years and finally have the courage to share it with their patients.

Anotherexplanationisthatmindfulnessmaybeacoreperceptualprocessunderlying

all effective psychotherapy—a transtheoretical construct. Clinicians of all stripes are applying mindfulnesstotheirwork,whethertheyarepsychodynamicpsychotherapistswhoprimarily

workrelationally,cognitive-behavioraltherapistswhoaredevelopingnew,moreeffective,

structuredinterventions,orhumanistic

psychotherapistsencouragingtheirpatientsto

enterdeeplyintotheir“feltexperience.”The

commontherapeuticquestionis,“HowcanI

helpthepatienttobemoreacceptingandaware

ofhisorherexperienceinthepresentmoment?”

Perhapsthestrongestargumentforthenewfoundpopularityofmindfulnessisthat

...mindfulness may be a core preceptual process underlying all effective psychotherapy...

...the soft science of contemplative practice is being validated by “hard” scientific research.




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science is catching up with practice—the soft science of contemplative practice is being validated by “hard” scientific research. Meditation is now one of the most widely studied psychotherapeutic methods (Walsh and Shapiro, 2006)—although, admittedly, many of the studies have design limitations(AgencyforHealthcareResearchandQuality,2007).Between1994and2004,the

preponderanceoftheresearchonmeditationhasswitchedfromstudiesofconcentrationmeditation

(suchastranscendentalmeditationandtherelaxationresponse)tomindfulnessmeditation(Smith,

2004).

Wearecurrentlyina“thirdwave”ofbehaviortherapyinterventions(Hayes,Follette,

& Linehan, 2004). The first wave focused on stimulus and response in classical and operant conditioning.Thesecondwavewascognitivebehaviortherapy,whichworkstochangethecontent

ofourthoughtstoalterhowwefeel.Thecurrent“thirdwave”ismindfulnessandacceptance-

basedtherapy.ResearcherssuchasStevenHayes,thefounderofAcceptanceandCommitment

Therapy,discoveredmindfulnessandacceptance-basedtreatmentstrategieswhilelookingfor

novelsolutionstointractableclinicaldilemmas.Others,suchasMarshaLinehan,whodeveloped

DialecticalBehaviorTherapy,hadapersonalinterestinZenBuddhismandsoughttointegrate

principlesandtechniquesfromthattraditionintoclinicalpractice.Wearenowinthemidstof

a fertile convergence of modern scientific psychology with the ancient Buddhist psychological tradition.

Inthenewmindfulnessandacceptance-basedapproach,therapistshelppatientsshift

theirrelationshiptopersonalexperienceratherthandirectlychallengingmaladaptivepatternsof

thought,feeling,orbehavior.Whenpatientscometotherapy,theytypicallyhaveanaversionto

what they are feeling or how they are behaving—they want less anxiety or less depression, or want todrinkoreatless.Thetherapistreshapesthepatient’srelationshiptotheproblembycultivating

curiosityandmoment-to-momentacceptanceof

uncomfortableexperience.

Forexample,apanicpatient,Kaitlin,

spent the previous five years white-knuckling the steeringwheelofhercarwhiledrivingtowork.

Shewasdoingallthetraditionalbehavioral

strategies:sheexposedherselftohighwaysand

bridges,shepracticedrelaxation,andshecould

effectivelytalkherselfoutofherfearofdyingfromaheartattack.Still,Kaitlinwonderedaloud,

“WhytheheckdoIstillsufferfrompanic?”TheansweristhatKaitlinneverlearnedtoreally

tolerateanxietyitself.Shewasalwaysrunningawayfromit.Sheneededthemissinglinkthatthe

third generation of behavior therapies addresses—learning to accept inevitable discomfort as we

...the missing link that the third generation of behavior therapies addresses is learning to accept inevitable discomfort as we live our lives in a meaningful way.




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liveourlivesinameaningfulway.

Anotherarenaofresearchthatisfuelinginterestinmindfulnessisbrainimagingand

neuroplasticity. We know that “neurons that fire together, wire together” (Hebb, 1949 in Siegel, 2007), and that the mental activity of meditation activates specific regions of the brain. Sara Lazar andcolleagues(2005)demonstratedthatbrainareasassociatedwithintrospectionandattention

enlargewithyearsofmeditationpractice.Davidsonetal(2003)foundincreasedactivityintheleft

prefrontalcortexfollowingonlyeightweeksofmindfulnesstraining.Theleftprefrontalcortexis

associatedwithfeelingsofwell-

being.Increasedactivityinthis

partofthebrainalsocorrelated

withthestrengthofimmune

response to a flu vaccine. More dramaticchangescouldbefound

inthebrainsofTibetanmonks

whohadbetween10,000to50,000hoursofmeditationpractice(Lutzetal,2004).

The evidence from scientific studies is validating what meditators have long suspected, namelythattrainingthemindchangesthebrain(Begley,2007).Wearenowbeginningtosee

whereandhowmuchchangeispossible.Furthermore,thechangesthatoccurinthebrainwhen

weareemotionallyattunedtoourowninternalstatesinmeditationseemtocorrelatewiththose

brain areas that are active when we are feeling connected to others (Siegel, 2007)—suggesting thattherapistscantraintheirbrainstobemoreeffectivetherapeuticallybypracticingmindfulness

meditation.

Practical Applications of Psychotherapy

Psychotherapistsareincorporatingmindfulnessintotheirworkinmanyways.Wemight

imagine these on a continuum, from implicit to explicit applications—from those hidden from viewtothosethatareobvioustothepatient.

Onthemostimplicitendisthepracticing

therapist.Asjustmentioned,whenatherapist

beginspersonallypracticingmindfulness,hisor

hercapacityforemotionalattunementseemsto

increase.Regardlessoftheoreticalorientation,

The evidence from scientific studies is validating what meditators have long suspected, namely that training the mind changes the brain.

...when a therapist begins personally practicing mindfulness, his or her capactiy for emotional attunement seems to increase.




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modelsofpsychopathology,ormodesofintervention,thetherapistseemstobeabletomore

carefully attend to and empathize with a patient’s experience. The therapist’s need to “fix” problemsdiminishesasheorshecultivatesthecapacitytobewithanother’spain.Therapistsfeel

closertotheirpatients,developingcompassionbothbybecomingawareoftheuniversalityof

suffering,andbyseeingmoreclearlytheirinterconnectionwithothers.Researchinthisareais

justbeginning(Grepmair,Mitterlehner,Loew,&Nickel,2006;Grepmair,Mitterlehner,Loew,&

Nickel,2007)

Nextalongthecontinuumisthepracticeofmindfulness-informedpsychotherapy

(Germer,Siegel,&Fulton,2005).Thisistreatmentinformedbytheinsightsthatderive

fromBuddhistpsychologyandmindfulnesspractice.Thetherapist’sunderstandingof

psychopathologyandthecausesofhumansufferingchangeasaresultofobservinghisorher

ownmindinmeditationpractice.Insightssuchasunderstandingthearbitraryandconditioned

nature of thought, seeing the counterproductive effects of trying to avoid difficult experience, andnoticingthepainfulconsequencesoftryingtobuttressoursenseofseparateself,allhavean

impactonhowweapproachourpatients’problems.

Finally,themostexplicitapplicationofmindfulnesstopsychotherapyismindfulness-

basedpsychotherapy(Germer,Siegel,&Fulton,2005).Mindfulness-basedtherapistsactually

teach mindfulness practices to patients to help them work with their psychological difficulties. Ahostofmindfulness-basedinterventionsarecurrentlybeingdevelopedforawiderangeof

clinicalproblems.Sometimesthepatientistaughtatraditionalmeditationpractice,andother

timesthatpracticeiscustomizedforthepatient’sparticulardiagnosis,personalitystyle,orlife

circumstances.

Untangling Terminology

As“mindfulness”isabsorbedintomodernpsychologyandWesternculture,thereis

growingconfusionabouttheterm.Ithascometocoveralotofground.Atleastsomeofthe

confusioncouldbeeliminatedifweusedPali,ratherthanEnglish,words.(Thereaderisreferred

toMindfulnessinPlainEnglishbyBhanteGunaratna(2002)foraremarkablylucidexpositionof

Palitermsandhowtheyrelatetomindfulnesspractice.)

Thefollowingisanefforttoteaseapartthedifferentmeaningsofmindfulnesscurrently

usedinmodernpsychology.




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Classical Concept:Asdiscussedearlier,thePalitermsati,whichisoftentranslatedas

“mindfulness,”denotes“awareness,”“attention,”and“remembering.”IntheBuddhisttradition,

satiiscultivatedasatoolforobservinghowthemindcreatessufferingmomentbymoment.Itis

practicedtodevelopwisdomandinsight,whichultimatelyalleviatessuffering.

Psychological Process: Process definitions have an instructional aspect—they indicate what we should do with our awareness. Two process definitions of mindfulness in clinical settingsare“moment-to-moment,nonjudgmentalawareness”(Kabat-Zinn,1990,2006)and

“awareness,ofpresentexperience,withacceptance”(Germer,Siegel,&Fulton,2005).These

process definitions suggest, “Look at your moment-to-moment experience, and try to do it with a spirit of acceptance.” Another process definition of therapeutic mindfulness, “attentional control” (Teasdale,Segal,&Williams,1995),suggestsredirectingattentiontomanageemotionaldistress.

Process definitions are especially valuable because they identify processes of change or mechanismsofactionthatmayhelpparticularpatients.Intherapy,“mindfulness”ingeneral

isconsideredachangeprocess,andsoaretheindividualelementsthatconstitutetherapeutic

mindfulness—acceptance, present experience, and awareness. Different patients might require more emphasis on one element or another. For example, self-critical persons might benefit mostfrom“acceptance,”obsessivepatientsmightbehelpedbyfocusingon“presentmoment

sensations,” and people with impulse control disorders might benefit most from greater “awareness”—observing the precursors to problem behaviors such as drinking, gambling, or overeating.

We can break down the processes even further to fine-tune treatment for particular individuals. For example, there are different styles of awareness that can benefit certain patients:metacognitiveawareness(“thoughtsarenotfacts”)helpschronicallydepressedpeople

disentanglefromdepressiveruminations(Teasdaleetal,2002),whilepeoplewithaschizoidor

detached style of relating to their feelings might benefit from a more participatory observational style—intimately observing feelings as they arise in the body.

Meditation Practice:Whensomeonesays,

“Idomindfulnessmeditation,”whatisheorshe

actuallydoing?Therearethreekeymeditation

skillsoftensubsumedundertheheadingof

“mindfulnessmeditation:”

Concentration Meditation:Thistechniquehasafocalobject,suchasthebreathora

mantra.Theinstructionis,“Whenyounoticethatyourmindhaswandered,gentlybringitback

There are three key meditation skills often subsumed under the heading of “mindfulness meditation:”




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to[theobject].”Concentrationmeditationproducesafeelingofcalmness.ThePaliwordmost

associatedwithconcentrationpracticeissamatha,whilethetraditionalwordformeditationis

bhavana,whichmeans“developing.”“Concentrationmeditation”isatranslationofsamatha

bhavana,thecultivationofconcentration.The“relaxationresponse”(Benson&Klipper,2000)is

well-knownexampleofthismeditationapproach.

Mindfulness Meditation:Theinstructionformindfulnessmeditationis,“Noticewhatever

predominatesinawareness,momenttomoment.”Heretheintentionisnottochooseasingle

objectoffocus,butrathertoexplorechangingexperience.Theskillofmindfulnesscultivates

insightintothenatureofone’spersonalconditioning(e.g.,“fearofdisapproval,”“angerat

authority”)andthenatureofmentalreality(“it’schanging,”“it’softenunsatisfactory,”“the‘self’

is fluid”).

Thisisprimarilywhatdistinguishes“mindfulnessmeditation”fromotherformsof

meditation,suchasconcentrationmeditationandvariousformsofvisualizationmeditation,and

itisauniquecontributionofBuddhistpsychology.ThePaliwordsformindfulnessmeditation

arevipassanabhavana,whichtranslateswellasthecultivationofinsightor“insightmeditation.”

Westernresearchersandcliniciansusuallyusetheexpression“mindfulnessmeditation”torefer

tothispractice.

Makingmattersabitmorecomplicated,satiisactuallycultivatedby,andnecessaryfor,

bothconcentrationandmindfulnessmeditationtechniques.Thatis,weneedtoknowwhere

themindistoconcentrateoneitherasingleobjectormanyarisingobjects.Sincethemindis

activelyengagedwithawiderrangeofexperiencesduringmindfulnessmeditation,itcanbesaid

thatsatiismoredeliberatelydevelopedinthisparticularpractice.

Duringmindfulnessorinsightmeditation,themeditatorcanalwaysreturnto

concentrationpracticetostabilizeattentionifheorshebecomeslostindaydreamsanddiscursive

thinking.Inthisregard,concentrationpractice(samatha)facilitatesmindfulnessorinsight

(vipassana)practice.

Lovingkindness Meditation:Lovingkindnessistheemotionalqualityassociatedwith

mindfulness.TranslatedfromthePaliword,metta,lovingkindnessmeditationcanbeaform

ofconcentrationmeditation.Thepractitionerreturnsattentionagainandagaintophrasessuch

as“MayIandallbeingsbesafe,happy,healthy,andlivewithease.”Thistechniqueallows

thepersontosoftenintoandallowarisingexperiencetobejustasitis.Itiscultivatingthe

intentiontobelovingandkind,ratherthansuperimposingwarmfeelingsonourmoment-to-

moment experience. The emotional flavor of affectionate awareness typically follows our kindly




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intentions.Lovingkindness(feelingsafe,peaceful,healthy,andfreefromsuffering)keepsthe

functionofmindfulnesspracticeclearinthemindofthepractitioner.Itisaqualityofmind

thatideallypervadestheothermeditationpractices.Therefore,whilepracticingconcentration

meditation,weworktoreceivementaldistractionswithopenheartednessratherthansternness;

whenpracticingmindfulnessorinsight

meditation,wegreetallmentalcontents

likewelcomevisitors.

Whenoursati(mindfulness)

isstrong,wecanchoosetoswitch

fluidly among metta (lovingkindness), samatha (concentration), or vipassana (mindfulness or insight)practices,asneeded,eveninasinglesittingofmeditation.Forexample,ifdealing

withpsychologicaltrauma,wecannoticewhenweareoverwhelmedandcanchooseto

redirectattentiontothebreathorexternalsightsandsounds(samatha).Wecanalsoadd

somelovingkindness(metta)toourexperiencetoreestablishameasureofcalmness.When

we feel more stable, we can open up the field of awareness again to observe how the trauma memories are experienced in the mind and body (vipassana). In other words, the three skills—concentration, mindfulness, and lovingkindness—can be selectively emphasized in meditation anddailylifetoreducesufferingandincreasehappiness.

Common Usage:Tomakemattersevenmoreconfusing,thegeneralpublicinWestern

cultureusestheterm“mindfulness”looselytorefertoeveryvarietyofformalandinformal

secularBuddhistpractice.Underthislabel,wenotonlyhavethedifferentmeditationskillsjust

mentioned—lovingkindness, concentration, and mindfulness or insight—but also visualization techniquesandinnumerable,informalmeditationstrategiestodealwitheverydaylife.

Visualizationmeditationsincludepracticesthatcultivateequanimity,suchasimaginingoneself

asasolidmountainunaffectedbythewindandweather,orasadeeppondunperturbedbythe

waves.

As mindfulness is incorporated into diverse fields such as health care, education, and business,thetermwillprobablycontinuetoaccrueanincreasingarrayofmeanings.Within

clinicalpsychology,“mindfulness”isalreadyusedinterchangeablywith“acceptance”to

describe the third wave of behavioral treatments. In the field of education, Ellen Langer (1989) describes“mindfulness”asacognitiveprocessthatimpliesopenness,curiosity,andawareness

ofmorethanoneperspective.Inthebusinessworld,RichardBoyatzisandAnnieMcKee(2005)

encourage“mindfulnesspractice”to“observeemotionalreality”(p.124)inanorganizationand

“avoidnarrowfocusandconstantmultitasking”(p.131).

...when practicing mindfulness or insight meditation, we greet all mental contents like welcome visitors.




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Despitetherecentproliferationofinterestinmindfulnessanditsmultiplyingmeanings,

thevarioususesofthetermstillhavemuchincommon.Onlytimewilltellwhathappensto

“mindfulness”asthetheoryandpracticesthatbeganinBuddhistpsychologymoveintonew,

heretoforeunimaginabledomains.

Radical Roots

Thecultivationofmindfulnessinarigorouswaycomesfromatraditionwithancient

rootsandloftygoals.Theseoriginsareimportanttounderstandsothatmoderncliniciansdon’t

inadvertentlymissitsprofoundpotentialforpsychologicaltransformation.

As far back as four thousand years ago, we find images of yogis in ancient India sittingcross-leggedinmeditation,gazinginwardwitheyeshalfclosed.Trainingthemind

wasunderstoodastheprinciplemeansofachievingmentalandphysicalhealth,emotional

equanimity,andperfectingthehumancondition.

Mindfulness,aswearecomingtoknowitintheWest,wasmostclearlydescribedin

ancienttimesintheteachingsofthehistoricalBuddha.Accordingtotradition,hewasborn

aprincesome2500yearsago.Attheageof29,herenouncedalifeofcomfortandprivilege

toundertakerigorousmentalandphysicaldisciplinesforsevenyears.Finally,atage36,

heexperiencedabreakthroughofunderstandingthatprofoundlyre-orderedhismind.He

wanderedfromplacetoplaceforthenext40yearsexhibitingbehaviorsdevoidoftheusual

humanpropensitiestowardattachment,

aversionordelusion.Thepsychological

teachings he left behind—including how to cultivate mindfulness—are still accessibletoustoday.

FortheBuddha,themindand

bodyareseenastheproductofmaterialcauses,lackingthedivineessencethatwasassumedby

theIndo-Europeanreligionsofhistime.Nonetheless,intheBuddha’sview,thebodyandmind

canbethevehicleforaprofoundexperienceoftranscendence.Ratherthanbreakingthroughto

somethingdivine,however,thisexperienceresultsfromaradicaltransformationofthemind.

Consciousness itself, though conditioned, can be purified to such an extent that it entirely understandsitselfanditsconditioning.Theresultisnotonlyadeepsenseofpersonalwell-being,

butalsothepossibilityofamoreevolvedwayofbeinghuman.

...in the Buddha’s view, the body and mind can be the vehicle for a profound experience of transcendence.




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Theprimaryinterestofthistraditionisthequalityofconsciousnessinthepresent

moment.Howexactlyisthemindandbodymanifestinghereandnow?Consciousnessarises

fromawholenetworkofinterdependentfactors,includingallofthedetailsofourgenetic

makeupandpersonalhistory.Eachmomentofconsciousness,inturn,hasanimpactupon

oursubsequentbeliefs,feelings,andbehaviors.Knowingboththecausesandtheeffectsofa

momentofconsciousnessallowsustoparticipateintentionallyintheprocessofliving;tosteera

courseawayfromsufferingandtowardhealthierstates.

WhattheBuddhasawwithgreatlucidityonthenightofhisawakeningwastheworkings

ofhisownmind.Hisinsightshaveprofoundimplicationsformodernpsychotherapy,asthey

revealhowourmindsconstructourexperiencemomentbymoment,andhowtheseconstructions

can lead to suffering. The following description is not for the faint-hearted—it is a radically new psychologyformanyreaders,andsomewhatcomplicated,soweencourageyoutoconsiderit

slowly.

How We Construct Our Experience

TheBuddhasawthatallexperienceinvolvesaprocessinwhichtherawdatastreaming

intothemindthroughthesensoryorgansor“sensedoors”iscompiledandsynthesizedintoa

virtualworldofmeaning.Therearesixsensedoorsinall:theeye,ear,nose,tongue,body,with

the mind itself viewed as the sixth. There are also five primary categories, or systems, whereby the information flowing through these sense doors is processed.

The first category is material form,whichacknowledgesthatthemindandbodyhave

amaterial,biologicalfoundation.Thenextisconsciousness,ortheactofbecomingawareof

anobjectbymeansofoneofthesixsenseorgans(againwiththemindasthesixthorgan).

Atthisstagetheeyesees,theearhears,thetonguetastes,etc.Thethirdandfourthsystems,

whichshapehowconsciousnessmanifests,areperceptionandfeeling. Perception identifies whatisexperiencedthroughaseriesofassociations,interpretingincomingdatainthelightof

historicallylearnedpatternsofrecognition.Forexample,youcanrecognizejusttwodotsanda

curved line to be a face☺, or identify the object in your hands to be a book. “Feeling” provides anaffecttoneforeachmomentofcognition,eitherpleasant,unpleasantorneutral.Thisisa

hedonicassessmentofeachobject’svaluetotheorganism.Ineverymoment,weeitherlike,

dislike,oraren’tinterestedinwhatweperceive.

The fifth and final component of the construction of experience is called formations and




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reflects the intentional stance we take toward all objects that we perceive and toward which wehavefeelings.Volitionorintentionistheexecutivefunctionofthemindwhichinitiates

conscious or unconscious choices. Whereas the first four systems yield a sense of what is happening at any given moment, the fifth decides what we are going to do about it.

Howdotheseprocessesunfoldtogether?Imaginethatyou’rehungry,andyouopenthe

refrigerator door. The eye sees patterns of light, dark, and color in the visual field, which are quicklyorganizedbythebrainandperceivedasafreshlymadesandwich.Instantaneouslya

positivefeelingtowardthesandwicharises,andanintentionformstopickitupandeatit.This

issoonfollowedbythebehaviorofactuallytakingabite.Consciousnesscreatesandrespondsto

ourrealitysoquicklythattheprocessisusuallyunconscious.

Intentionsandthebehaviorsthatfollowfromthemtendtobecomehabitualandturn

intodispositions.Dispositionsaretheresidueofpreviousdecisions,storedinmemoryashabits,

learnedbehaviors,personalitytraits,etc.,andprovidehistoricalprecedentsforhowtorespond

toeachnewlyarisingmoment.Feedbackloopsdevelop,wherebyone’spresentresponsetoany

situationisbothshapedbypreviousexperienceandgoesontomoldthedispositionsthatwill

influence future responses. If we enjoyed this and other sandwiches in the past, we may develop the habit of reflexively picking up and eating sandwiches, even when we’re not really hungry.

Putting this all together, the six sense doors and five systems interact simultaneously to formadynamicinterdependentlyarisingprocessofmindandbody,constructingmeaningfrom

anever-changingbarrageofenvironmentalinformation.Ineachmoment,whichcanbemeasured

inmilliseconds,allthisarisesconcurrently,organizesaroundaparticularbitofdata,andthen

passesaway.

OneuniquefeatureofBuddhistpsychologyisthatconsciousnessisregardedasan

unfoldingprocess,oranoccurringevent,ratherthanasanexistingentity.Nothingpermanent

abides(andthereisnoenduring“me”tobefound)becauseevery“thing”isaseriesof

interrelatedevents.Theeverydaysensethatwe(andotherbeings)haveseparateexistence

comesfromthefactthateachmomentofcognitionisfollowedbyanothermomentofcognition,

yieldingthesubjectivesenseofastreamofconsciousness.Wehavesimplylearnedtoconnect

thesnapshotstogetherintoacoherentnarrative.Thisisliketheillusionofcontinuousactionthat

ourmindscreateoutofseparateframesinamovie.AmongthegreatinsightsoftheBuddhist

traditionisnotonlythatthisisallhappeningbelowthethresholdofordinaryawareness,butalso

thatthisprocesscanunfoldineitherhealthyandunhealthyways,dependingontheskillsofits

handler.




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Thisanalysisofhuman

experiencehasimportantandradical

clinicalimplications.Itsuggeststhat

ourreality,includingthesenseof

“self”aroundwhichsomuchpersonal

psychologyiscentered,isbasedona

fundamentalmisunderstanding.Itis

asthoughwebelievedthatapowerful

automobile like a Ferrari was a living being—until we saw it disassembled on the floor of a workshop.Whenweknowthecomponentpartsandhowthey’reputtogether,wecanneverlook

ataFerrariinquitethesameway.Similarly,seeingthewaythe“self”isconstructedcanhelp

both us and our patients loosen our identification with the changing kaleidoscope of thoughts and feelings that arise in the mind, allowing us to live more flexible, adaptive, happier, productive lives.

A Physician of the Mind

TheBuddhasometimesreferstohimselfasaphysician,andtohisteachingasakindof

medicine. The illness he is treating is the fact that consciousness is continually influenced by patternsofconditioningthatinevitablyresultinunhappiness,frustration,anddisappointment.

Thisiscertainlyanobservationfamiliartothemodernpsychotherapist.Ratherthanchanging

brainchemistrybypharmaceuticalsorprobingpasttraumasarrestingnormaldevelopment,

however,theBuddha’sapproachistohelpthepatientgaindirectinsightintothenatureof

experience.Thistakesmanyforms.

Onetrackistonoticetheextentto

whichthepatternsofconditioningwe

acquire,throughlearnedbehaviors,

conditionedresponses,orcultural

osmosis,areforthemostpart

builtuponcertainillusionsoreven

delusions.Foremostoftheseareour

remarkablyrobusthabitoftakingwhat

isimpermanentandsubjecttochange

to be stable or reliable; believing that the satisfaction or gratification of desires is sustainable for longerthanafewmomentswhen,becauseoftheformerpoint,itisnot;andprojectingagainand

again onto the field of experience the notion of a person or agent that owns, controls, or consists

...our reality, incuding the sense of “self” around which so much personal psychology is centered, is based on a fundamental misunderstanding.

...we continuously delude ourselves into believeing that we can hold onto what we want and get rid of what we don’t want, despite considerable evidence to the contrary.




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ofwhatishappening.Inotherwords,wecontinuouslydeludeourselvesintobelievingthatwe

canholdontowhatwewantandgetridofwhatwedon’twant,despiteconsiderableevidenceto

thecontrary.Andontopofthis,wedeludeourselvesintobelievingthatastable,independent“I”

or“me”isrunningthisshow.Totheextentthesemisperceptionscanbegraduallyuncoveredand

corrected,considerablehealingcanoccur.

Forexample,thereisthestoryofamonkwhocomplainedtohisZenteacherthathewas

anangryperson.Theteachersaid,“Showme.”Sincethestudentwasnotangryatthemoment,

hecouldnotshowit,whereupontheteachersaid,“See,youarenotanangrypersonbecause

you are not angry all the time.” Such insight into the fluidity of experience and insubstantiality ofidentitycanbeenormouslyhelpfultopatientswhohavecorebeliefsaboutbeingunworthy,

unlovable,unintelligent,andsoforth.

Anotherapproachistorecognizethefactthatbehaviorisdrivenbydesire,both

consciousandunconscious,andtousethatknowledgetodiminishandeventuallyeliminatethe

roleofdesireinthemoment-to-moment

functioningofmindandbody.The

impulsetolikesomethingsanddislike

othersleadstopullingsomeobjectsof

experiencecloserandpushingothers

fartherawayfromasenseofselfthat

setsitselfapartfromwhatisactually

happening.Ironically,saytheBuddhists,

theverystrategiesweemployto

overcome the perceived shortcomings of the world as we find it—embracing what offers pleasure and rejecting what brings pain—have the result of causing and perpetuating greater suffering. Thesolutionistopracticelettinggoofdesireitself,whichcanbereplacedbyanattitudeof

equanimityoracceptance.Inclinicalpractice,weseecountlessexamplesthat“whatweresist

persists,”andhowpatientssufferterriblyfromwishingthatthingswouldbeotherthantheyare,

i.e.,fromnotfacing“reality.”

Theunderlyingtendenciesofbothdelusionanddesirearedeeplyembeddedin

humannature,butcanbesuccessfullydiminishedandeveneliminated.Theword“Buddha”

actuallymeans“awake,”andthehistoricalBuddhawasamanwhoundertookaprogramof

transformationthatresultedinhis“awakening”fromthemisconceptionsofdelusionandthe

addictionsofdesire.

Ironically, say the Buddhists, the very strategies we eomploy to overcome the perceived shortcomings of the world as we find it...have the result of causing and perpetuating greater suffereng.




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Bottom-Up Vs. Top-Down Processing

Moderncognitivescientistsdistinguishbetweenbottom-upandtop-downinformation

processing(Eysenck&Keane,2000).Attheheartofmindfulnessmeditationisanemphasis

uponbottom-up,ratherthantop-down,functionsofthemind.Thatistosay,mindfulnessseeks

tobringattentiondirectlytothestreamofsensorydataenteringexperiencethrougheachofthe

sensedoors:thevisualforms,sounds,smells,tastes,andbodilysensations,aswellastothe

arisingofthoughtsandimagesinthemind.Indoingso,itsteersattentionawayfromthemany

“upperlevel”schemas,narratives,beliefs,andotherconceptualmapswenormallyusetoguide

our way through a day’s experience. This is cognitive behavioral therapy on steroids—bringing attentiontosubtlesensoryexperience,andinsodoing,comingtoseeallthoughtsandtheir

associatedfeelingsasarbitrary,conditionedevents.Whileordinaryconsciousnesstendsto

overlookthedetailsofsensoryexperience(usuallywearejusttryingtoextractfromitwhatisof

interesttoachieveourgoals),mindfulnesspracticeinsteadfocusesuponthesensorydataitself,

foritsownsake,andinvitesthepractitionertoconsistentlyabandonconceptualjudgmentsand

narrativestories.Suchamethodhastheeffectofdeprivingthemindofmuchoftheenergythat

fuelsitsstoriesanddelusions,andtransfersourawarenesstotheareasthatwilldirectlyreveal

the transient, constructed, and selfless nature of experience.

Mindfulness in Context

Asmentionedearlier,mindfulnessispartofaprojectdesignedtouprootharmfulhabits

ofmind.InthetraditionalBuddhistcontext,mindfulness

isembeddedinaneight-foldpathtoalleviatesuffering;

mindfulnessisguidedanddirectedbysevenotherfactors.

Theyare:1)theviewonehasofwhatisreal,important

valuable,anduseful;2)howintentionisusedtoinitiate

andsustainactioninskillfulways;3)thenatureofspeech

that can be either harmful or beneficial; 4) the quality of action as it relates to ethical principles; 5)one’smeansofsustainingoneselfintheworldaslivelihood;6)thedegreeandqualityofeffort

employedtobringaboutchange;7)andconcentrationasafocusingandsupportingfactorto

mindfulness.Whenmindfulnessistakenoutofthisbroadercontext,itspowermaybelimited.

For example, it is difficult to sustain mindful awareness if we are causing harm to ourselves or others, or if we do not have the concentration and beneficial intentions to focus our efforts. In otherwords,it’shardtohaveagoodmeditationsessionafterabusydayofcheating,stealing,

andkilling.

TheBuddhisttraditionhasfocusedonuniversalchallengesinhumanlife,suchasthe

...mindfulness is part of a project designed to uproot harmful habits of mind.




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problemofsufferingingeneral.ManyaspectsofBuddhistpsychologyarethereforeasapplicable

todayastheywereinancientIndia.Asthisbookdemonstrates,psychotherapyisharnessingthe

powerofmindfulnessandacceptancetobringrelieftointractablepsychologicalconditions.

However,theproposedoutcomeofdedicatedBuddhistpracticeisradicallydifferent:the

completecessationofsuffering.Inmodernterms,thismeansenvisioningalifewithoutatrace

ofpsychologicalsymptomsfoundinourdiagnosticmanuals.Suchan“awakened”personlives

naturally,withafullrangeofphysical,emotionalandintellectualcapacities,butwithoutneeding

events to be other than they are in order to feel fulfilled. By practicing mindfulness, we can learn to lead a peaceful, balanced, loving, life, all the while working for the benefit of others. There is no need to wait for another time, place, or condition for this to occur—we can begin where we are,therapistsandpatientsalike.

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From Didonna, F. (Ed.)(2008)

Clinical Handbook of Mindfulness.

New York: Springer.Distributedwithpermission.

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mindfulness : - mindful self-compassion - christopher germer, phd

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