State of mindfulness

For three years, Faculty of Humanities Dean Chris Goto-Jones has been teaching a free, online course through Leiden University called Demystifying Mindfulness. More than 112,000 people have so far enrolled in the massive open online course (MOOC). Here, Goto-Jones explains the origins, contemporary interest and the continuing evolution of mindfulness in the health sector.

Connections between mindfulness and Buddhism are usually seen as profound and intimate. In fact, the word can be traced back to British scholar TW Rhys-Davids, who is usually credited as being the first to translate the Pali term sati as mindfulness in 1891.

For Buddhists, mindfulness is tied very closely to the idea of samma sati or right mindfulness—the seventh practice of the Noble Eightfold Path toward an ethical, meritorious, awakened life that is ultimately liberated from suffering. For many people involved in mindfulness today, especially (but not only) outside the Buddhist context, the practice is less associated with the moral or spiritual cultivation of right mindfulness and more associated with the evidence-based, therapeutic advantages of something like pure awareness.

This kind of mindfulness stands as a kind of secular technology or commodity that can be consumed like a form of medicine by anyone in need of its benefits.

While it’s fair to say that the Buddha had something to do with popularizing the concept of mindfulness, it’s certainly true that the contemporary explosion of interest in it started in the late 1970s and early 1980s, when innovative and exciting work was being done by clinicians. One specialist often credited with originating modern mindfulness is Jon Kabat-Zinn, whose pain clinic at the University of Massachusetts Medical Center changed everything. Kabat-Zinn realized that there was a whole category of hospital patients who were not responding to drugs and whose chronic pain was preventing them from living their daily lives. With a background in Buddhism himself, he started to teach a secularized form of mindfulness meditation, explaining that this would not cure their pain but that it might help them to transform their relationship with that pain so that it was no longer as debilitating.

Kabat-Zinn was careful to present mindfulness as a secular technique in order to make it accessible (and less controversial) to a North American public. He talks about the importance of never mentioning the ”B” word in those early sessions.

Kabat-Zinn’s clinic sparked tremendous interest in mindfulness as a clinical and therapeutic technology, which kick-started the development of the treatment protocols that we use today. It became the basis of Mindfulness-Based Stress Reduction (MBSR), and then in the early 1990s, Zindel Segal, John Teasedale and Mark Williams developed Mindfulness-Based Cognitive Therapy (MBCT) to help address depression relapse.

More recently, MBCT has also been used in the treatment of depression and suicidal tendencies. Interest in mindfulness has also been fuelled by neuroscientific studies, such as those by Richie Davidson, who, with the blessing of the Dalai Lama him.self, studied the brain activity of Tibetan monks as they medi.tated. Interestingly, despite the attempts to keep Buddhism out of contemporary mindfulness, work like that of Davidson has sometimes been seen as manifesting a form of collusion between science and religion.

The language of Buddhism is finding its way back into a more mature and stable discussion about mindfulness today, although not without controversy.

My sense is that interest in mindfulness has grown for a variety of reasons. Some reflect modern society’s fetish for scientific data, meaning that mindfulness has become interesting partly because we now seem able to measure and monitor it in ways that can be represented and mapped scientifically. People are more willing to accept that mindfulness is ”real” now that technology has become able to identify it. Of course, mindfulness has always been real, as many millions of Buddhists and others have known for millennia.

The flipside, however, is that our ability to study mindfulness in these new ways has transformed mindfulness into a form of technology that can be tuned and honed and streamlined to make it maximally efficient in the accomplishment of specific goals and outcomes, where those outcomes have become framed in increasingly secular, instrumental ways. It has also become possible to commodify and sell mindfulness in the private sector.

We see a thriving and growing mindfulness industry of trainers, apps, monitors and paraphernalia. The tremendous growth of an unregulated industry has led to great concerns among some clinicians about the responsibility of teachers; there are moves in several countries to regulate and licence qualified mindfulness teachers.

Perhaps another reason for the popularity of mindfulness is actually sociological or cultural. It is often remarked that modern societies are increasingly secular—part of a technical meaning of the term modern—and that this can lead to a vacuum of meaning for people. That is, by gradually excluding religion from society, people seem to lose their contact with spirituality and their sense of the significance of their lives.

There’s a case to be made that mindfulness helps people to fill this gap without undermining their modernity. It’s no longer unusual for a doctor to prescribe a mindfulness program to patients suffering from conditions such as stress, anxiety and depression. This course of treatment has all kinds of benefits to the medical system: it’s much cheaper than prescribing drugs (and often equally or more effective); it doesn’t intervene in the biochemistry of the body and thus risk side effects; and it empowers patients to manage their own health by using the skills and techniques they learn, helping to reduce pressure on the medical system.

Mindfulness also draws attention to the interaction between mind and body in the accomplishment and maintenance of health and provides us with a ready-made technology to address the mind-body as one. Mindfulness is one way in which medicine can make use of millennia of knowledge and expertise from other fields—especially the humanities—to enrich its practice and to find ways to treat the person as a whole. The so-called health humanities are seeing a real resurgence today.

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