Mindfulness: friend or foe? 

 
One of the foundational principles of psychologists and therapists is to do no harm. One could add the principles of helping people find a place of wellbeing, helping people take responsibility as much as possible for their own health and wholeness, and the realisation that pain does not necessarily mean harm, to the ‘do no harm’ principle above.

Mindfulness has been much in the news as a way of helping people find health and wholeness. Sometimes articles or programmes put mindfulness in ‘scare quotes,’ and occasionally I get asked to respond. For example, Jolyon Jenkins did a radio programme on mindfulness recently for BBC’s Out of the Ordinary series.  The title of the programme is ‘Mindfulness and Madness,’ and the script that follows the programme asks the question ‘Is Mindfulness Meditation Dangerous?’ It is an important programme, but to me is an example of mindfulness in ‘scare quotes’ because it is journalism not research.

I am an independent researcher into mindfulness, not attached to any particular school. My personal aim is not to persuade people about the merits of mindfulness but to try and help them see it as it is. One of the problems with articles that put mindfulness in ‘scare quotes’ is that usually only a narrow aspect of mindfulness is presented.  Often mindfulness is collapsed into meditation, and different families of meditation are not distinguished from each other. Other problems are that often the evidence presented against mindfulness or meditation is anecdotal, and anecdotal evidence doesn’t prove causality. Such evidence should be taken seriously and steer research, but by itself is not sufficient proof.  

Sadly putting mindfulness in ‘scare quotes’ could cause harm, by putting people off who could benefit from mindfulness. Putting it in unrealistic ‘happy’ quotes is just as unhelpful by drawing in those for whom mindfulness might be contra-indicated. 

Seeing mindfulness for what it is is not easy. Indeed I began my research from the point of view of suspicion. I have now moved to a more mindful way of looking at research that I believe resonates with a Christian faith. I now try to look not suspiciously, but critically, but also with an open mind. I am not trying to avoid any difficulties with mindfulness (e.g. some Christians won’t engage with mindfulness because they believe it has exclusively Buddhist roots). In all of this it is important to face reality.  

 What is important that people are well-informed about mindfulness and that includes difficulties encountered with meditation. But mindfulness and meditation are not the same thing.

Mindfulness is not Felix Felicis or liquid luck, like the potion that helps teenage wizard Harry Potter, but nor is it a dark art.  

Mindfulness defined

 So if we are going to fairly analyse mindfulness we need to define it properly, and we need to distinguish it from meditation, and then we need to outline some of the possible experiential challenges with meditation as well as the benefits.

How might we define mindfulness? The most well-known definition is by Jon Kabat-Zinn: ‘Mindfulness means paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally.’ This definition can be broken down into three main components: of intention, attention and attitude.

 Principally, mindfulness is awareness – our universal human capacity for awareness and attention. Attention and awareness are central to human consciousness and perception, and so mindfulness can be defined as a quality of consciousness. It can, therefore, be worked with in different ways.

Mindfulness is a trait that exists naturally and states of mind that exist naturally. These can be used and cultivated without meditation. Ellen Langer who is a Harvard psychologist has worked for over forty years on cultivating mindfulness without meditation.

In another important idea, Jon Kabatt-Zinn says that in essence, ‘mindfulness - being about attention, awareness, relationality, and caring - is a universal human capacity, akin to our capacity for language acquisition’.
 

What if I’m thinking of trying mindfulness meditation?

We have what psychologists call a negativity bias; our brains are three to four times more sensitive to negative information than positive. That means we are very alert to ‘scare quotes.’ So let’s begin with what’s right about mindfulness.

Mindfulness research is mapping out our embodied minds, and the neural correlates for our human capacities to be attentive, aware, loving – as well as our fear-based reactions. Mindfulness practice can move us out of a place of fear into a place where we can respond rather than react. At a psychological level it is about learning self-regulation, learning to regulate our emotions, develop body awareness and through exposure learn to reappraise the life that exists under our skin – thoughts are not facts! 

In terms of mindfulness for health, the UK Mental Health Foundation’s 2010 Mindfulness Report lists a number of significant mental health conditions for which mindfulness is being used, through a number of different mindfulness-based or mindfulness-incorporating therapies. These include depression, insomnia, anxiety disorders, stress, chronic pain, psoriasis, fibromyalgia, chronic fatigue syndrome, drug abuse, psychosis, eating disorders, self-harm, borderline personality disorder, as well as to improve mood and reduce stress for those being treated for cancer. Many more conditions could be added.

Mindfulness as research also has a strong psycho-educational element, and is developing very useful research in the areas of relationships, parenting, creativity, leadership, cultural intelligence, ethics, and so on. Mindfulness can contribute to the psychology of attention, awareness and perception. Mindfulness of God is about developing an attentiveness that is Jesus-shaped.

Meditative practices are not for everyone at every stage of their life

It is universally acknowledged in the research I have done that mindful awareness or meditative practices are not for everyone at every stage of their life. Again the recommendation would be that if you have a mental health condition then check with a professional before trying mindful or meditative practices. 

 Why might it be challenging? Mindfulness is generally seen as a form of exposure. We face reality and in so doing come face-to-face with difficult thoughts and feelings that we might be avoiding experientially. These can be overwhelming when they flood into our awareness. 

The risk of harm can be reduced with these recommendations; I don’t think risk can be eliminated completely, because no amount of pre-screening will establish our predispositions to possible reactions to meditation. We need to remember that from a psychophysiological perspective meditation is ‘the intentional self-regulation of attention, in the service of self-inquiry, in the here and now.’

The key question for research is ‘who may be at risk if they participate in training in mindfulness meditation?’ Dobkin and her colleagues also point out that we can come into mindfulness practice with problems that make participation difficult.

 I’ll come onto some of the guidelines if you are a counsellor and psychotherapist. In the same article Dobkin et al suggest pre-screening your clients to make sure mindfulness meditation is not contra-indicated, they particularly ask about trauma, alcohol or substance abuse and any previous treatment for a mental health problem.

Conclusion

This is only an introduction which should cover most eventualities. I have not read every piece of research on the experiential challenges of meditation, but it is something I hope to come back to in a later article. 

My own experience of mindfulness was that it helped glue me back together at a time when I was falling apart, so I am empathic towards those experiencing challenges in their mental health. I want to be transparent about the experiential challenges that could be faced in meditation, without triggering a fear and avoidant reaction in those who might benefit from it! 

One other way to try it if you are going down a self-help route is gradual exposure. I am also keen on developing what I call natural mindfulness. Bringing mindfulness into the ordinary everyday things we do normally: walking mindfully, eating mindfully, reading mindfully, breathing mindfully and so on. I also think the psycho-educational elements of mindfulness are accessible to most people as well. 

From a theological perspective attention and awareness are God-given and hence created capacities. Because they are embodied in our senses we find a place of health and wholeness by returning to these capacities. In this sense mindfulness is a much-needed antidote to our virtual world. 

Natural mindfulness is as central to life as gravity, it is something worth paying attention to. Mindfulness for health is important, and we need a healthy approach to mindfulness – one that is not fear-based but well-informed and realistic.
 

References:

Jon Kabat-Zinn, Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life (New York: Hyperion, 1994), 4, quoted in Zindel V. Segal, J. Mark G. Williams and John D. Teasdale, Mindfulness-Based Cognitive Therapy for Depression (New York: Guilford Press, 2002), 40.

Shauna L. Shapiro et al., ‘Mechanisms of Mindfulness’, Journal of Clinical Psychology 62, no.3 (2006): 374. Available at http://dx.doi.org/10.1002/jclp.20237 (accessed 16th November 2015).

J. Mark G. Williams and Jon Kabat-Zinn, ‘Mindfulness: Diverse Perspectives on its Meaning, Origins, and Multiple Applications at the Intersection of Science and Dharma’, in Mindfulness: Diverse Perspectives on its Meaning, Origins, and Applications, eds. J. Mark G. Williams and Jon Kabat-Zinn (London: Routledge, 2013), 15.

Ellen J. Langer, The Power of Mindful Learning (Reading, Massachusetts: Addison-Wesley Publishing Company Inc., 1997).

Jon Kabatt-Zinn, p. 10 Mindfulness All-Party Parliamentary Group.

Britta K. Holzel, et al, “How Does Mindfulness Meditation Work? Proposing Mechanisms of Action From a Conceptual and Neural Perspective,” Perspectives on Psychological Science 6, no. 6(2011): 537-559.

Mental Health Foundation (2010), Mindfulness Report, London, 9-10.

Alberto Perez-de-Albenez and Jeremy Holmes, “Meditation: concepts, effects and uses in therapy,” International Journal of Psychotherapy 5, no. 1 (2000), 49.

Patricia L. Dobkin, Jule A. Irving and Simon Amar, “For Whom May Participation in a Mindfulness-Based Stress Reduction Program be Contraindicated?” Mindfulness Original Paper (2011), 44: http://dx.doi.org/10.1007/s12671-011-0079-9.