A Second Generation of Mindfulness-based Intervention

A Second Generation of Mindfulness-based Intervention

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In one of our research papers that was published this summer in the journal Mindfulness, we identified and discussed a recent development in mindfulness research and practice. Until a few years ago, mindfulness research within psychology has primarily focussed on what have been termed First Generation Mindfulness-Based Interventions (FG-MBIs). FG-MBIs refer to interventions such as Mindfulness-Based Stress Reduction (MBSR) developed by Kabat-Zinn in the late 1970s and Mindfulness-Based Cognitive Therapy (MBCT) developed by Segal, Williams, and Teasdale in 2002. According to Professor Nirbhay Singh and colleagues, one of the primary purposes and achievements of FG-MBIs has been gaining acceptance of mindfulness within Western clinical and scientific domains.

However, due to the speed at which mindfulness has been integrated into western research and public healthcare settings, concerns have been raised by scientists and Buddhist teachers regarding the ‘authenticity’ of FG-MBIs and whether they actually teach mindfulness in a manner that still bears any resemblance to the traditional Buddhist model. These concerns do not detract from the fact that there is a growing evidence-base that supports the efficacy of FGMBIs as clinical and behavioural interventions, but they give rise to a number of questions that have important implications for mindfulness research and practice:

  1. If mindfulness is efficacious when it is taught in isolation of many of the practices and principles that are traditionally deemed to make it effective, then how much more effective will it be when taught in a manner that includes and embodies these supporting elements?
  2. Is it ethically correct to inform service users and members of the public that they are receiving training in a method that is grounded in Buddhist practice (a claim often made about FG-MBIs), when in fact this is not the case?
  3. Is it essential to “de-spiritualise” psychological interventions before they can be used in clinical contexts, or – based on a “what-works approach” – can interventions that are openly spiritual in nature be considered as viable and mainstream public healthcare treatments?

In an attempt to overcome some of the above issues concerning FG-MBIs, efforts have been made in recent years to formulate and empirically evaluate a second generation of mindfulness-based interventions. Second Generation Mindfulness-based Interventions (SG-MBIs) are still intended to be used in public healthcare contexts (i.e., they are still secular in nature)  but – as explained in the following quote from our recently published Mindfulness paper – they are openly spiritual in nature and are more traditional in the manner in which they construct and teach mindfulness:

Due to the suggestion that some individuals may prefer to be trained in a version of mindfulness that more closely resembles a traditional Buddhist approach, recent years have witnessed the development and early-stage evaluation of several Second Generation Mindfulness-Based Interventions (SG-MBIs) … Although SG-MBIs still follow a secular format that is suitable for delivery within Western applied settings, they are overtly spiritual in aspect and teach mindfulness within a practice infrastructure that integrates what would traditionally be deemed as prerequisites for effective spiritual and meditative development. At the most basic (but by no means the least profound) level, such prerequisites include each element of the Noble Eightfold Path. The Noble Eightfold Path comprises each of the three quintessential Buddhist teaching and practice principles of (i) wisdom (i.e., right view, right intention), (ii) ethical conduct (i.e., right speech, right action, right livelihood), and (iii) meditation (i.e., right effort, right mindfulness, right concentration). Each of these three fundamental elements (Sanskrit: trishiksha – the three trainings) must be present in any path of practice that claims to expound or be grounded in authentic Buddhadharma and they apply to (and form the basis of) the Fundamental or Theravada vehicle just as much as they do the Mahayana and Vajrayana Buddhist vehicles. Thus, for mindfulness practice to be effective, it must be taught as part of a rounded spiritual path and it must be taught by a spiritual guide that can transmit the teachings in an authentic manner.

The development and empirical evaluation of a second generation of mindfulness-based intervention appears to represent an emerging trend in mindfulness research. Outcomes from our own research work with the eight-week SG-MBI known as Meditation Awareness Training (MAT) suggest that SG-MBIs may have applications in the treatment of (i) workaholism, (ii) work-related stress, (iii) stress, (iv) anxiety, (v) depression, (vi) schizophrenia, and (vii) pathological gambling. Recent MAT studies that we have conducted have also demonstrated that SG-MBIs can help to improve work effectiveness, decision-making competency, and leadership/management skills more generally. SG-MBI studies by other researchers also indicate a range of clinical and non-clinical applications for SG-MBIs. For example, studies led by Professor Nirbhay Singh indicate that SG-MBIs may have utility as (i) a smoking cessation program for individuals with mild intellectual disabilities, (ii) an anger regulation method for individuals with schizophrenia, and (iii) a training and support program for parents in order to reduce the aggressive and disruptive behaviour of their children/adolescents. However, it needs to be remembered that research into SG-MBIs is still at a very early stage and so although the abovementioned outcomes are promising, further empirical investigation is obviously required. Furthermore, it is our view that rather than directly compete with FG-MBIs, SG-MBIs simply provide an alternative approach to practising mindfulness that – for some individuals – may be more appealing.

Please note: This article provides a summary of, and is adapted from, a discussion that first appeared in a paper we published in the journal Mindfulness.

 Ven Edo Shonin & Ven William Van Gordon

Further Reading

Carrette, J., & King, R. (2005). Selling spirituality: The silent takeover of religion. New York: Routledge.

Kabat-Zinn, J. (1994). Wherever you go, there you are: Mindfulness meditation in everyday life. New York: Hyperion.

McWilliams, S. A. (2014). Foundations of Mindfulness and Contemplation: Traditional and Contemporary Perspectives. International Journal of Mental Health and Addiction, 12, 116-128.

Rosch, E. (2007). More than mindfulness: when you have a tiger by the tail, let it eat you. Psychological Inquiry, 18, 258-264.

*Shonin, E., & Van Gordon, W. (2014) Manager’s experiences of Meditation Awareness Training. Mindfulness, DOI: 10.1007/s12671-014-0334-y. [Source Article].

Shonin, E., Van Gordon, W., & Griffiths, M. D. (2013a). Mindfulness-based interventions: Towards mindful clinical integration. Frontiers in Psychology, 4, 1-4. DOI: 10.3389/fpsyg.2013.00194.

Shonin, E., Van Gordon, W., & Griffiths, M. D. (2014c). The treatment of workaholism with Meditation Awareness Training: A case study. Explore: The Journal of Science and Healing, 10, 193-195.

Shonin, E., Van Gordon, W., Dunn, T., Singh, N., & Griffiths, M. D. (2014d). Meditation Awareness Training for work-related wellbeing and job performance: A randomized controlled trial. International Journal of Mental Health and Addiction,  DOI 10.1007/s11469-014-9513-2.

Shonin, E., Van Gordon, W., & Griffiths, M. D. (2014e). Cognitive Behavioral Therapy (CBT) and Meditation Awareness Training (MAT) for the treatment of co-occurring schizophrenia with pathological gambling: A case study. International Journal of Mental Health and Addiction, 12, 181-196.

Shonin, E., Van Gordon W., & Griffiths M. D. (2013). Meditation Awareness Training (MAT) for improved psychological wellbeing: A qualitative examination of participant experiences. Journal of Religion and Health, 53, 849-863.

Singh, N. N., Lancioni, G. E., Winton, A. S. W., Singh, J. Curtis, W. J., Wahler, R. G., & McAleavey, K. M. (2007). Mindful parenting decreases aggression and increases social behavior in children with developmental disabilities. Behavior Modification, 31, 749-771.

Singh, N. N., Lancioni, G. E., Winton, A. S. W., Karazia, B. T., Singh, A. D. A., Singh, A. N. A., & Singh, J. (2013). A mindfulness-based smoking cessation program for individuals with mild intellectual disability. Mindfulness, 4, 148-157.

Singh, N. N., Lancioni, G. E., Winton, A. S. W., Karazsia, B. T., & Singh, J. (2014a). Mindfulness-Based Positive Behavior Support (MBPBS) for mothers of adolescents with autism spectrum disorders: Effects on adolescents’ behavior and parental stress. Mindfulness, DOI: 10.1007/s12671-014-0321-3.

Singh, N. N., Lancioni, G. E., Myers, R. E., Karazsia, B. T., Winton, A. S. W., & Singh, J. (2014b). A randomized controlled trial of a mindfulness-based smoking cessation program for individuals with mild intellectual disability. International Journal of Mental Health and Addiction, 12, 153-168.

Singh, N. N., Lancioni, G. E., Karazsia, B. T., Winton, A. S. W., Singh, J., & Wahler, R. G. (2014c). Shenpa and compassionate abiding: Mindfulness-based practices for anger and aggression by individuals with schizophrenia. International Journal of Mental Health and Addiction, 12, 138-152.

Van Gordon, W., Shonin, E., Sumich, A., Sundin, E., & Griffiths, M. D. (2014b). Meditation Awareness Training (MAT) for psychological wellbeing in a sub-clinical sample of university students: A controlled pilot study. Mindfulness, 5, 381-391.

Van Gordon, W., Shonin, E., Zangeneh, M., & Griffiths, M. D. (2014). Work-related mental health and job performance: Can mindfulness help? International Journal of Mental Health and Addiction, 12, 129-137.

Van Gordon, W., Shonin, E., & Griffiths, M. D. (2015). Mindfulness and the Four Noble Truths. In: Shonin, E., Van Gordon W., & Singh, N. N. (Eds). Buddhist Foundations of Mindfulness. New York: Springer.

Shonin, E., & Van Gordon, W. (2013). Searching for the present moment, Mindfulness, 5, 105-107.

Shonin, E., Van Gordon, W., Compare, A., Zangeneh, M., & Griffiths, M. D. (2015). Buddhist-derived loving-kindness and compassion meditation for the treatment of psychopathology: A systematic review. Mindfulness, 6, 1161-1180.

Van Gordon, W., Shonin, E., & Griffiths, M. (2015). Towards a second-generation of mindfulness-based interventions. Australia and New Zealand Journal of Psychiatry, 49, 591-591.

Shonin, E., Van Gordon, W., & Griffiths, M. D. (2013). Meditation as medication: Are attitudes changing? British Journal of General Practice, 63, 654.

Shonin, E., & Van Gordon, W. (2015). The lineage of mindfulness. Mindfulness, 6, 141-145.

Una nuova generazione di interventi basati sulla Mindfulness

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In uno dei nostri documenti di ricerca che è stata pubblicata questa estate sulla rivista academica Mindfulness, abbiamo identificato e discusso un recente sviluppo nella ricerca e nella pratica della mindfulness Fino a pochi anni fa, la ricerca di mindfulness all’interno della psicologia si è concentrata principalmente su ciò che sono stati definiti Interventi di Prima Generazione cioè First Generation Mindfulness-Based Interventions (FG-MBIs). FG-MBI si riferisce a interventi quali Mindfulness-Based Stress Reduction (MBSR) sviluppato da Kabat-Zinn alla fine del 1970 e Mindfulness-based Cognitive Therapy (MBCT) sviluppato da Segal, Williams e Teasdale nel 2002. Secondo il professor Nirbhay Singh e colleghi, uno degli scopi e conquisti principali di FG-MBI è stato di ottenere l’accettazione della mindfulness all’interno dei domini clinici e scientifici occidentali.

Tuttavia, a causa della velocità alla quale la mindfulness è stato integrato nella ricerca occidentale e nelle strutture sanitarie pubbliche, le preoccupazioni sono state sollevate da scienziati e insegnanti buddisti per quanto riguarda il ‘autenticità’ di FG-MBI e se insegnano effettivamente mindfulness in un modo che ancora oggi porta qualsiasi somiglianza con il modello tradizionale buddista. Queste preoccupazioni non toglie il fatto che vi è una crescente evidenza empirica che sostiene l’efficacia di FGMBIs come interventi clinici e comportamentali, ma danno luogo a una serie di domande che hanno importanti implicazioni per la ricerca e la pratica della mindfulness:

  1. Se la mindfulness è efficace quando si è insegnato in isolamento di molte delle pratiche e principi che sono tradizionalmente considerati a renderla efficace, allora quanto più efficace ne sarà quando insegnato in un modo che include e incorpora questi elementi di supporto?
  2. È eticamente corretto a informare gli utenti del servizio e membri del pubblico che essi ricevono una formazione in un metodo che è radicato nella pratica buddista (un’affermazione spesso fatta dai FG-MBI), quando in realtà questo non è il caso?
  3. È necessaria che gli interventi psicologici vengono “de-spiritualizzate” prima di poter essere utilizzati in contesti clinici, o – basati su un approccio “ciò che funzione” – possono gli interventi che sono apertamente spirituali nella loro natura essere considerati come trattamenti sanitari pubblici attuabile, accettabile e affermati?

Nel tentativo di superare alcune delle questioni di cui sopra riguardanti FG-MBI, si sono compiuti degli sforzi negli ultimi anni per formulare e valutare empiricamente una seconda generazione di interventi basati sulla mindfulness. Interventi basati sulla mindfulness di seconda generazione (SG-MBI) ancora sono destinati ad essere utilizzati in contesti sanitari pubblici (vale a dire, essi sono ancora secolari in natura) ma – come spiegato nel seguente citazione tratta dal nostro articolo recentemente pubblicato nella rivista academica Mindfulness -sono apertamente spirituale in natura e sono più tradizionali nel modo in cui costruiscono e insegnano la mindfulness:

Grazie al suggerimento che alcuni individui possono preferire di essere formati/addestrati in una versione della mindfulness che assomiglia più ad un approccio tradizionale buddista, negli ultimi anni si è assistito alla valutazione di sviluppo e le fasi iniziali di diversi interventi basati sulla mindfulness di seconda generazione (SG-MBI) … Sebbene SG-MBI seguono ancora un formato secolare che è adatto per essere insegnato in tutta una gamma di impostazioni psicologiche, sono apertamente spirituale in aspetto e insegnano la mindfulness dall’interno di un’infrastruttura di pratica che integra quello che è tradizionalmente considerata come prerequisiti per un effettivo sviluppo spirituale e meditativo. Al livello più basilare (ma non il meno profondo), tali prerequisiti includono ogni elemento del Nobile Ottuplice Sentiero. Il Nobile Ottuplice Sentiero comprende ciascuno dei tre quintessenziale principi delle pratiche e degli insegnamenti buddisti di (i) la saggezza (cioè la retta visione, la retta intenzione), (ii) il comportamento etico (cioè la retta parola, la retta azione, il retto sostentamento), e (iii) la meditazione (cioè, il retto sforzo, la retta mindfulness, la retta concentrazione). Ciascuno di questi tre elementi fondamentali (sanscrito: trishiksha – i tre addestramenti) devono essere presente in qualsiasi percorso di pratica che pretende di esporre o di essere radicati nella autentica Buddhadharma e sono applicabili a (e costituiscono la base del) veicolo fondamentale o Theravada tanto quanto sono applicabili ai (e costituiscono la base dei) veicoli Mahayana e Vajrayana buddista. Così, per la pratica più efficace della mindfulness, essa deve essere insegnato come parte di un percorso spirituale comprensivo e deve essere insegnato da una guida spirituale che può trasmettere gli insegnamenti in modo autentico.

Lo sviluppo e la valutazione empirica di una seconda generazione di interventi basati sulla mindfulness sembra rappresentare una tendenza emergente nella ricerca della mindfulness. I risultati dal nostro lavoro di ricerca con Meditation Awareness Training (MAT), un SG-MBI corso di otto settimane, indicano che SG-MBI possono avere applicazioni nel trattamento di (i) workaholism, (ii) stress legato al lavoro, (iii) stress, (iv) l’ansia, (v) la depressione, (vi) la schizofrenia, e (vii) il gioco d’azzardo patologico. Recenti studi MAT che abbiamo condotto hanno anche dimostrato che SG-MBI possono contribuire a migliorare l’efficacia al lavoro, competenza decisionale e capacità di leadership/gestione più in generale. Studi di SG-MBI da parte di altri ricercatori anche indicano una vasta gamma di applicazioni cliniche e non-clinici per SG-MBI. Ad esempio, studi guidati dal Professor Nirbhay Singh indicano che SG-MBI possono avere utilità come (i) un programma di cessazione di fumare per persone con disabilità intellettiva lieve, (ii) un metodo di regolazione ddella rabbia per gli individui con schizofrenia e (iii) un programma di formazione e sostegno per i genitori al fine di ridurre il comportamento aggressivo e dirompente di loro bambini/adolescenti. Tuttavia, è necessario ricordare che la ricerca di SG-MBI è ancora in una fase iniziale e quindi, anche se i risultati di cui sopra sono promettenti, ulteriori indagini empiriche sono ovviamente necessari. Inoltre, è nostra opinione che piuttosto che competere direttamente con FG-MBI, SG-MBI semplicemente forniscono un approccio alternativo alla pratica della mindfulness che – per alcuni individui – può essere più attraente.

Please note: This article provides a summary of, and is adapted from, a discussion that first appeared in a paper we published in the journal Mindfulness.

Ven Edo Shonin & Ven William Van Gordon

Ulteriori letture

Carrette, J., & King, R. (2005). Selling spirituality: The silent takeover of religion. New York: Routledge.

Kabat-Zinn, J. (1994). Wherever you go, there you are: Mindfulness meditation in everyday life. New York: Hyperion.

McWilliams, S. A. (2014). Foundations of Mindfulness and Contemplation: Traditional and Contemporary Perspectives. International Journal of Mental Health and Addiction, 12, 116-128.

Rosch, E. (2007). More than mindfulness: when you have a tiger by the tail, let it eat you. Psychological Inquiry, 18, 258-264.

*Shonin, E., & Van Gordon, W. (2014) Manager’s experiences of Meditation Awareness Training. Mindfulness, DOI: 10.1007/s12671-014-0334-y. [Source Article].

Shonin, E., Van Gordon, W., & Griffiths, M. D. (2013a). Mindfulness-based interventions: Towards mindful clinical integration. Frontiers in Psychology, 4, 1-4. DOI: 10.3389/fpsyg.2013.00194.

Shonin, E., Van Gordon, W., & Griffiths, M. D. (2014c). The treatment of workaholism with Meditation Awareness Training: A case study. Explore: The Journal of Science and Healing, 10, 193-195.

Shonin, E., Van Gordon, W., Dunn, T., Singh, N., & Griffiths, M. D. (2014d). Meditation Awareness Training for work-related wellbeing and job performance: A randomized controlled trial. International Journal of Mental Health and Addiction,  DOI 10.1007/s11469-014-9513-2.

Shonin, E., Van Gordon, W., & Griffiths, M. D. (2014e). Cognitive Behavioral Therapy (CBT) and Meditation Awareness Training (MAT) for the treatment of co-occurring schizophrenia with pathological gambling: A case study. International Journal of Mental Health and Addiction, 12, 181-196.

Shonin, E., Van Gordon W., & Griffiths M. D. (2013). Meditation Awareness Training (MAT) for improved psychological wellbeing: A qualitative examination of participant experiences. Journal of Religion and Health, 53, 849-863.

Singh, N. N., Lancioni, G. E., Winton, A. S. W., Singh, J. Curtis, W. J., Wahler, R. G., & McAleavey, K. M. (2007). Mindful parenting decreases aggression and increases social behavior in children with developmental disabilities. Behavior Modification, 31, 749-771.

Singh, N. N., Lancioni, G. E., Winton, A. S. W., Karazia, B. T., Singh, A. D. A., Singh, A. N. A., & Singh, J. (2013). A mindfulness-based smoking cessation program for individuals with mild intellectual disability. Mindfulness, 4, 148-157.

Singh, N. N., Lancioni, G. E., Winton, A. S. W., Karazsia, B. T., & Singh, J. (2014a). Mindfulness-Based Positive Behavior Support (MBPBS) for mothers of adolescents with autism spectrum disorders: Effects on adolescents’ behavior and parental stress. Mindfulness, DOI: 10.1007/s12671-014-0321-3.

Singh, N. N., Lancioni, G. E., Myers, R. E., Karazsia, B. T., Winton, A. S. W., & Singh, J. (2014b). A randomized controlled trial of a mindfulness-based smoking cessation program for individuals with mild intellectual disability. International Journal of Mental Health and Addiction, 12, 153-168.

Singh, N. N., Lancioni, G. E., Karazsia, B. T., Winton, A. S. W., Singh, J., & Wahler, R. G. (2014c). Shenpa and compassionate abiding: Mindfulness-based practices for anger and aggression by individuals with schizophrenia. International Journal of Mental Health and Addiction, 12, 138-152.

Van Gordon, W., Shonin, E., Sumich, A., Sundin, E., & Griffiths, M. D. (2014b). Meditation Awareness Training (MAT) for psychological wellbeing in a sub-clinical sample of university students: A controlled pilot study. Mindfulness, 5, 381-391.

Van Gordon, W., Shonin, E., Zangeneh, M., & Griffiths, M. D. (2014). Work-related mental health and job performance: Can mindfulness help? International Journal of Mental Health and Addiction, 12, 129-137.

Van Gordon, W., Shonin, E., & Griffiths, M. D. (2015). Mindfulness and the Four Noble Truths. In: Shonin, E., Van Gordon W., & Singh, N. N. (Eds). Buddhist Foundations of Mindfulness. New York: Springer.

Deconstructing the Self: A Buddhist perspective on addiction and psychotherapeutic treatment

Deconstructing the Self:

A Buddhist perspective on addiction and psychotherapeutic treatment

(By Ven. Edo Shonin, Ven. William Van Gordon, and Dr. Mark Griffiths)

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Psychological approaches to treating mental illness or improving psychological wellbeing are invariably based on the explicit or implicit acceptance that there is an inherently existing ‘self’ or ‘I’ entity. In other words, irrespective of whether a cognitive-behavioural, psychodynamic, or humanistic psychotherapy model is employed, these approaches are ultimately concerned with changing how the ‘I’ relates to its thoughts, feelings, and beliefs, and/or to its physical, social, and spiritual environment. Although each of these psychotherapeutic modalities have been shown to have utility for improving psychological health, there are inevitably limitations to their effectiveness and there will always be those individuals for whom they are incompatible. Given such limitations, research continuously attempts to identify and empirically validate more effective, acceptable and/or diverse treatment approaches. One such approach gaining momentum is the use of techniques that derive from Buddhist contemplative practice. Although mindfulness is arguably the most popular and empirically researched example, there is also growing interest into the psychotherapeutic applications of Buddhism’s ‘non-self’ ontological standpoint (in which ontology is basically the philosophical study of the nature or essence of being, existence, or reality).

Within Buddhism, the term ‘non-self’ refers to the realisation that the ‘self’ or the ‘I’ is absent of intrinsic existence (Shonin, Van Gordon, & Griffiths, 2014a). On first inspection, this might seem to be a somewhat abstract concept but it is actually common sense and the principle of ‘non-self’ is universal in its application. For example, Buddhism teaches that the human body comprises the five elements of water, wind (i.e., air), earth (i.e., food), sun (i.e., heat/energy), and space (i.e., in the bodily cavities and between molecules, etc.) (Shonin et al., 2014a). This means that although the body exists in the relative sense, it does not exist in the absolute sense because the body cannot be isolated from all of its contributing causes. Just as a wave does not exist in separation from the ocean, the body does not exist in separation from all other phenomena. According to the Buddhist teachings, when looking at the body, we should also be able to see the trees, plants, animals, clouds, oceans, planets, and so forth (Shonin et al., 2014a). Thus, the body, and indeed the entire array of animate and inanimate phenomena that we know of, cannot be found to exist intrinsically or independently.

The Buddhist teachings go on to assert that suffering, including the entire spectrum of distressing emotions and psychopathologic states (including ‘addiction’), results from adhering to a false view about the ultimate manner in which the self (and reality more generally) exists. As a means of operationalising this notion within Western psychological and clinical domains, we recently introduced the concept of ‘ontological addiction’. Ontological addiction can effectively be considered a new category of addiction (i.e., in addition to what are typically called chemical addictions and behavioural addictions) and is defined as “the unwillingness to relinquish an erroneous and deep-rooted belief in an inherently existing ‘self’ or ‘I’ as well as the ‘impaired functionality’ that arises from such a belief” (Shonin, Van Gordon, & Griffiths, 2013, p.64). Due to a firmly-embedded (yet scientifically and logically implausible) belief that the self is an inherent and independently existing entity, Buddhism asserts that afflictive mental states arise as a result of the imputed ‘self’ incessantly craving after objects it considers to be attractive or harbouring aversion towards objects it considers to be unattractive (Shonin et al., 2014a).

In Buddhist terminology, this process is known as ‘attachment’ and it is deemed to be an undesirable quality that reinforces ontological addiction.  We have previously defined attachment as “the over-allocation of cognitive and emotional resources towards a particular object, construct, or idea to the extent that the object is assigned an attractive quality that is unrealistic and that exceeds its intrinsic worth” (Shonin et al., 2014a, p.4). Thus, attachment takes on a different meaning in Buddhism in relation to its construction in Western psychology where attachment (i.e., in the context of relationships) is generally considered to exert a protective influence over psychopathology.

Having understood from a Buddhist perspective that attachment (and harbouring an erroneous belief in an inherently existing self) is not advisable for adaptive psycho-spiritual functioning, Buddhism teaches that the next step towards recovery from ontological addiction is to embrace ‘non-self’ and begin deconstructing our mistaken belief regarding the existence of an ‘I’. Based on this Buddhist approach, a number of novel psychotherapeutic techniques have recently been developed that integrate meditative practices aimed at cultivating an understanding of the ‘non-self’ construct. For example, Buddhist Group Therapy (BGT) is a six-week program that has been shown to be effective for treating anxiety and depression (Rungreangkulkij, Wongtakee, & Thongyot, 2011). Another example is Meditation Awareness Training (MAT), an eight-week secular program that, in a number of separately published studies, has been shown to be an effective treatment for individuals with anxiety and depression, schizophrenia, pathological gambling, workaholism, work-related stress, and fibromyalgia (e.g., see reviews by Shonin et al., 2013, 2014a, 2014b).

From a mechanistic point of view, greater awareness of ‘non-self’ is believed to assist in gradually uprooting egoistic core beliefs and can complement therapeutic techniques that work at the surface level of behaviour and cognition (Chan, 2008). Furthermore, an understanding of non-self can enhance therapeutic core conditions because “the more the therapist understands non-self, the less likelihood that the therapy will be about the selfhood of the therapist” (Segall, 2003, p.173).

For some, Buddhist concepts such as non-self may be difficult to conceptually grasp and reflect what might be seen as a paradigm shift when compared with well-established Western psychological beliefs regarding the ego and the self. As such, psychotherapists will carefully need to assess the suitability of utilising ‘non-self’ meditative techniques for their own clients. Although further empirical evaluation of these new approaches is required, preliminary findings indicate that techniques aimed at cultivating an awareness of the Buddhist ‘non-self’ construct may have applications in psychotherapy settings.

Ven. Edo Shonin, Ven. William Van Gordon, and Dr. Mark Griffiths

References

Chan, W. S. (2008). Psychological attachment, no-self and Chan Buddhist mind therapy. Contemporary Buddhism, 9, 253-264.

Rungreangkulkij, S., Wongtakee, W., & Thongyot, S. (2011). Buddhist Group Therapy for diabetes patients with depressive symptoms. Archives of Psychiatric Nursing, 25, 195-205.

Segall, S. R. (2003). Psychotherapy practice as Buddhist practice. In S. R. Segall (Ed.), Encountering Buddhism: Western Psychology and Buddhist Teachings (pp. 165-178). New York: State University of New York Press.

Shonin, E., Van Gordon W., & Griffiths, M. D. (2013). Buddhist philosophy for the treatment of problem gambling. Journal of Behavioural Addictions, 2, 63-71.

Shonin, E., Van Gordon W., & Griffiths, M. D. (2014a). The emerging role of Buddhism in clinical psychology: Towards effective integration. Psychology of Religion and Spirituality, doi: 10.1037/a0035859.

Shonin, E., Van Gordon W., & Griffiths, M. D. (2014b). Mindfulness as a treatment for behavioral addiction. Journal of Addiction Research and Therapy, 5, e122. doi: 10.4172/2155-6105.1000e122.

The Absorbing Mind

The Absorbing Mind

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“Meditation has helped to open my eyes, to open my ears, and to open my heart. When I find myself listening to Mozart’s Piano Concerto No. 21, or to Johann Christian Bach’s Symphony for Double Orchestra, now I can really feel what the composers were trying to say. I can experience what they were feeling. I can hear their thoughts. The music is alive and I am alive with it. Each note rings clear. I can truly taste [their] brilliance.” (Quote from the interview transcript of a senior manager who participated in a recent randomized controlled trial that we conducted examining the effects of meditation on work-related wellbeing and job performance.)

 

More and more countries are making it a legal requirement for cigarette packets to display a health warning. The warnings usually contain words to the effect that “Smoking can seriously damage your health”. People are becoming increasingly aware that our health is directly influenced by the types of food and non-food substances that we inhale or ingest. The idea behind placing warnings on cigarette packets, and behind including detailed nutritional information on the labels of food packaging, is to help consumers make a health-informed decision about what products they buy. If there is reliable evidence that certain products can have a beneficial or adverse effect on a person’s health, then without taking things too far, it makes sense that people should be able to access this information at the point of sale.

Interestingly, however, similar types of warnings and/or “nutritional information” are not currently displayed on the vast majority of magazines, newspapers, books, television shows, films, and computer games that are readily available for purchase from big-name supermarkets, high street stores, and online retailers. We would argue that when (for example) people read a magazine, watch a television show, or play a computer game, they are effectively “ingesting” these products into their system. When we mentally consume such products, and subject to how much intelligence we apply when so doing, we are basically allowing the newspaper journalist or the film maker to pour a part of their mind into ours. Depending upon that writer’s intentions and on their levels of spiritual awareness, this may or may not be a good thing.

When guiding a specific form of meditation, we sometimes ask people to visualize themselves as a body made of rainbow light, and to then see themselves seated at the centre of all universes. As the meditation progresses, we invite people to visualize and experience this rainbow body as being connected by golden threads to all sentient beings. One of the reasons for suggesting that people make this practice, is to try and help them appreciate just how connected we are with all other sentient beings, and how each and every one of our thoughts, words, and actions influences those beings. It might be difficult to comprehend or accept that every single one of our thoughts, words, and deeds directly touches every single life form and phenomenon throughout the entire ‘multidimensional multiverse’. However, even if this is difficult to accept, most people don’t have any difficulty in understanding that the words they utter can directly affect the behaviour and wellbeing of others. For example, in our post entitled ‘Forgive them Father’, we discussed how just a few venomous whispers by some of the high priests was all it took for the people to work themselves into a state of anger and rage and consent to the public crucifixion of Jesus Christ.

As each second goes by, an unimaginable variety of stimuli and phenomena, including the thoughts, words, and intentions of others, are constantly bombarding and being absorbed by our minds. Given the extent to which these “ingestible products” can influence our wellbeing, we wonder how people in (for example) the newspaper industry would react if it became a legal requirement for certain newspapers to print the following statement on their front page: “Warning: Reading this can Seriously Damage your Health”. Perhaps then, people might be more selective about the type of materials they read, and perhaps the newspapers would take greater care not to use words that water the seeds of fear, hatred, and ignorance in people’s hearts and minds.

It seems fairly obvious that other peoples’ written and spoken words can directly affect our mood and wellbeing, and there is plenty of evidence from clinical and neuroimaging studies that supports this view. However, there is also evidence indicating that our state of wellbeing is also influenced by more subtle factors such as the passive ambient rhythm or energy of the environment in which we find ourselves. A good example of this relates to a research project that our team is currently planning where we will be exploring the relationship between meditation and nature (we are joined in this project by Professor Carol Morris of Nottingham University who is a Human Geographer and an expert in how human beings interact with their physical environment). Research conducted in this study area (generally referred to as the study of Ecopsychology), indicates that certain “natural” and/or man-made environments are much more conducive to wellbeing than others. This accords well with the Buddhist view that the mind has the capacity to absorb its external physical and social environment. Although we personally feel that psychology still has a lot of progress to make in order to fully appreciate the strength of the connection between mind and environment, it seems that a growing number of psychologists would agree that our general levels of wellbeing are heavily influenced not only by psychosocial factors, but also by the physical environment that we are exposed to.

When we visit a Buddhist monastery or a meditation practice centre, it is really easy to tell how diligently people are practicing. If people are practicing well, then almost immediately upon entering and before even meeting anybody, one is engulfed by an air of awareness, deep calm, and gentleness. However, where monasteries or practice centres exist just for making money or where they have forgotten about the Buddhadharma, then all you encounter is a stale smell of mindlessness and selfishness. Have you ever wondered what type of atmosphere and subtle ambient rhythm is present in your own home? Is it an environment that is conducive to spiritual growth? Are people considerate and are they gentle with one another? Do the people who live there think before they speak? Do they avoid petty bickering and forcing their opinions onto each other? Do they move through the house with joy and awareness? Are things sensibly orderly and is there a good level of basic cleanliness? Have you created a living environment where you can be happy?

Fortunately, although we are continuously exposed to other people’s minds, and to the background “energy” of any given environment, there are strategies that we can use to help buffer and regulate how these stimuli affect us. One of the best strategies that we know of is to cultivate mindfulness. We definitely shouldn’t become complacent and have the view that because we are mindfulness practitioners, it doesn’t matter what type of materials we read, who we spend our time with, or that we are above having to keep our home environment clean and tidy. However, cultivating mindfulness means that we become increasingly more aware of the various different “products” that we are continuously mentally (and physically) ingesting. Although we can’t (and shouldn’t try to) block certain stimuli from entering our field of awareness, what we can do is make an assessment of their “nutritional value”. By being fully aware of what we consume with our minds, we essentially empower ourselves to make a choice as to which words and products we allow to penetrate and nourish our being, and which stimuli should be allowed to simply pass us by. As we discussed in our post titled ‘Do we really exist?’, this means that relative to the normal person who does not practice awareness, the meditation practitioner is somebody who is fully in control of their spiritual development and the ‘self’ that they are creating.

From the meditation practitioner’s perspective, it’s not just with respect to incoming words and stimuli where we need to apply awareness, but also with respect to the type of products and stimuli that we send in other peoples’ direction.  Indeed, given the extent to which our thoughts, words, and actions can influence other peoples’ minds and wellbeing, it is important that we ensure our speech, writing, and general behaviour is infused with wisdom and awareness. In this respect, it is useful to remember that the human being is a creator. The difference between the everyday person and the realized being is that the latter is fully aware of their inherent creative potency. The realized being is like a master artist who uses the tools of insight, compassion, and skilful means to create a dynamic masterpiece of interwoven mind and matter upon the canvas of all-pervasive emptiness.

Each of our thoughts, words, and actions dictate who we are now and who we will be in the future. Those same thoughts, words, and deeds also influence who others will be in the future. Therefore, the next time you write something or create a product for other peoples’ minds, perhaps you might like to consider how your “mental food” will affect the wellbeing of the consumers. It should be reasonably easy to tell where somebody is writing with awareness because their words should be easily absorbed and should be alive with wisdom. Such words should effortlessly fly off the page and talk to you directly. Reading mindful words should leave us feeling spiritually nourished, calmer, and with a clearer perspective. Mindful words should help us to stop and be, to let go a little, and to feel bathed and refreshed by that person’s compassion and awareness. Mindful words should help us to remember that we were born, that we are currently living, but that in the future we will die. Upon reading words written in awareness, we should, if we really want to, be able to just unwind, take a few conscious breaths in and out, and start to allow the mind to relax into its natural state. Perhaps we could say that words written with mindfulness provide us with all five of our ‘spiritual five a day’.

Ven Edo Shonin & Ven William Van Gordon

Further Reading

Howell, A.J., Dopko, R.L, Passmore, H., & Buro, K. (2011). Nature connectedness: associations with well-being and mindfulness. Personality and Individual differences, 51, 166-171.

Louv, R. (2008). Last Child in the Woods: Saving our Children from Nature-deficit disorder. Algonquin Books.

Ross, C.A. (Ed.). (2012). Words for Wellbeing. Penrith, UK: Cumbria Partnership NHS Foundation Trust.

Segal, S. (Ed). 2003. Encountering Buddhism: Western Psychology and Buddhist Teachings. New York: State University of New York Press.

Shonin, E., Van Gordon, W., & Griffiths, M.D. (2013). Mindfulness-based therapy: A tool for Spiritual Growth? Thresholds. Summer Issue, 14-18.

Voigt, C., Brown, G., & Howat, G. (2011). Wellness tourists: in search of transformation. Tourism Review, 66, 16-30.

Wolsko, C., & Lindberg, K. (2013). Experiencing connection with nature: The matrix of psychological well-being, mindfulness, and outdoor recreation. Ecopsychology, 5, 80-91.

Acknowledgment: This post was used as a platform for developing themes, insights, and elucidations to be included in an expanded article written for the Mindfulness in Practice section of the journal Mindfulness.

Tips for using Mindfulness in Psychotherapy Contexts

Tips for using Mindfulness in Psychotherapy Contexts

psychotherapy 2

Recently, we were joined by our friend and academic colleague Professor Mark Griffiths in writing a paper on ‘Meditation as Medication: Are Attitudes Changing?’ (the paper is currently in press with the British Journal of General Practice).1 The paper discusses how, amongst both patients and clinicians, the prospect of using mindfulness and meditation as a mainstream medical intervention is becoming increasingly acceptable. Over the last 12 months or so, in addition to mainstream research journals such as the above, we have also published (or had accepted for publication) a series of articles in more practitioner-based and/or professional journals where we offer suggestions on how best to use and teach mindfulness (and other meditative techniques) within medical and/or mental health settings. Examples are articles published in Corrections Today (a journal of the American Correctional Association),2 Thresholds (a journal of the British Association for Counselling and Psychotherapy), 3 Addiction Today (a practitioner-focused journal focusing on addiction recovery), 4 Education Today (the nationwide journal of the School and Student Health Education Unit), 5 and the quarterly publication of the National Council on Problem Gambling.6

Based on a synthesis of the recommendations outlined in the abovementioned professional/practitioner journals, and based on insights from our own and others’ research and practice of meditation, today’s post outlines what we consider to be helpful strategies for the effective use of mindfulness techniques within client-therapist settings:

1. Therapist-led practice: Findings from our own empirical research into Meditation Awareness Training (MAT) indicate that clients and patients place tremendous importance on the extent to which the therapist’s own thoughts, words, and actions are infused with mindful awareness.7 A therapist who is ‘well-soaked’ in meditation naturally exerts a reassuring presence that helps clients to relax and connect with their own capacity for spiritual awareness. As we discussed in our posts on ‘Teaching Mindfulness to Children and ‘Predicting your Enlightenment, if a meditation teacher (or a therapist) is going to instruct others on how to practise mindfulness correctly, then it is essential that they do so from an experiential standpoint. Furthermore, clinicians and psychotherapists are particularly at-risk for compassion fatigue – a type of secondary traumatic stress caused by working with clients who have an illness of a distressing nature or who have directly experienced a traumatic event.3 Therapist mindfulness practice has been shown to exert a protective influence over compassion fatigue and therefore helps to improve the therapeutic experience for client and therapist alike.8

2. Insight-led practice: This point is closely related to the above point on therapist-led practice and refers to the importance of psychotherapists appreciating that there are many ‘activating agents’ that are essential for the development of ‘right mindfulness’. As outlined in our most recent post on ‘Exactly what is the Present Moment?’, an example of such an activating agent is cultivating insight into the ‘impermanent’, ‘non-self’, and ‘empty’ nature of reality. A firmly embedded understanding by therapists of the principles that underlie effective mindfulness practice (i.e., non-self, emptiness, impermanence, etc.) is likely to enhance therapeutic outcomes in the long term. Indeed, according to psychotherapists Maura Sills and Judy Lown, greater therapeutic connection and transformation can take place as client and therapist begin to acquaint themselves with the non-self construct and work in an “open and empty ground state”.9 Similarly, as Professor Seth Segall of Yale University School of Medicine acknowledges a firm understanding of non-self can improve therapeutic core conditions because “the more the therapist understands anatta [non-self], the less likelihood that the therapy will be about the selfhood of the therapist”.10

3. Deep listening: As with all psychotherapy modalities, the therapist’s ability to listen deeply to what the client is saying, as well as to what they are not saying, is a vital part of the therapeutic process. However, in the context of mindfulness-based therapy, the practice of deep listening takes on a slightly different meaning compared with the more conventional therapeutic modes. When the mindfulness practitioner (or therapist) listens deeply to another person, believe it or not, the emphasis is actually placed more on listening to oneself rather than the client. Let’s clarify what is meant by this statement. Normally, any kind of discussion with another person triggers various kinds of emotional and cognitive responses. The way we interpret the words of others, and the types of thoughts and feelings that are engendered by those words, is heavily influenced by our own conditioning and beliefs. In other words, it is through the lens of the conditioned mind that we experience ourselves and others. So as meditation practitioners, the reason why we make an effort to listen to our own mental chatter during dialogue with others, is to try to limit the extent to which our own conditioning might colour our interpretation of what the other person is actually saying. As we referred to in a short vajragiti (a type of spontaneous spiritual song or poem) called Simply Being with Nothing to Be, the best way to listen deeply to ourselves in this manner is by being fully present with ourselves. When we are fully present with ourselves and are perfectly content with where and who we are, when we are happy to simply experience the present moment without trying to modify it, the pain that has built up inside the other person begins to talk to us. This happens naturally and without us having to look too hard. We can see all of the person’s suffering, we can smile gently at it, and that person’s pain knows that it now has a friend and is no longer alone. Their suffering has exposed itself to us, and because we are not lost or caught-up in our own thoughts or ego-attachments, a true communion of compassion and loving-kindness can now occur.

4. Life integration: Although it is undoubtedly beneficial for a client to meet with the therapist once or twice a week, it goes without saying that emphasis should be placed on empowering the client to introduce mindfulness into all aspects of their lives. Many clients find a CD of guided meditations and written resources about mindfulness practice to be useful props in this respect. Another factor that can make a big difference to the success of the therapy is working with the client to establish a routine of mindfulness practice. Our personal preference is to do this on a case by case basis (i.e., rather than prescribing a blanket-amount of formal meditation practice time for all people). When working with patients or meditation practitioners as part of our research or monastic work, we generally encourage people to try to adopt a dynamic meditation routine. In this manner, people are dissuaded from drawing divisions between meditation during formal sitting settings and meditation during everyday activities.11 As referred to in our post on ‘The Top Ten Mistakes made by Meditation Practitioners’, the purpose of this is to reduce the likelihood of dependency on the need for formal meditation sessions.

5. Meditative anchors: Integral to effective mindfulness training, particularly at the beginning stages, is the use of meditative anchors.3 A good example of a meditative anchor is observing the breath. Full-awareness of the in-breath and out-breath helps clients ‘tie their mind’ to the present moment and to subdue ruminating thought processes. Where clients have noticeably low levels of concentration, then teaching them to count their breath can be quite helpful. However, when using breath awareness as a meditative anchor, it is important to discourage clients or patients from forcing their breathing. In other words, the breath should be allowed to follow its natural course and to calm and deepen of its own accord (i.e., as a regular consequence of it being mindfully observed).3

6. Mindfulness reminders: In addition to meditative anchors, the maintenance of mindfulness during everyday activities appears to be facilitated by the use of mindfulness reminders. An example of a mindfulness reminder is an hour chime (e.g., from a wrist-watch or wall clock), which, upon sounding, can be used as a trigger by the client to gently return their awareness to the present moment and to the natural flow of the in-breath and out-breath (and to the space and time between each in-breath and out-breath).3 Some clients seem to prefer a less sensory reminder such as a simple acronym. For example, in the aforementioned eight-week Meditation Awareness Training program, clients are taught to use the following SOS technique to facilitate recovery of meditative concentration by ‘sending out an SOS’ at the point when intrusive thoughts arise:

 

The three-step SOS technique3,4

 1. Stop

2. Observe the breath

3. Step back and watch the mind

 

7. Meditative posture: Although the focus of mindfulness practice should be directed towards its maintenance during everyday activities, formal daily seated-meditation sessions are an essential aspect of mindfulness training. As part of seated meditation practice, a good physical posture helps to facilitate the cultivation of a good mental posture. The most important aspect of the meditation posture is stability which can be achieved whether sitting up-right on a chair or on a meditation cushion. The analogy used in Meditation Awareness Training for the appropriate meditation posture is that of a mountain. A mountain has a definite presence, it is upright and stable yet at the same time it is without tension and does not have to strain to maintain its posture – it is relaxed, content, and deeply-rooted in the earth.3

8. Psychoeducation: In most psychotherapeutic approaches, a degree of psychoeducation regarding the mechanisms of action and projected hurdles to recovery is generally regarded as a means of augmenting client-therapist trust and therapeutic alliance. Mindfulness-based therapy is no exception to this, and clients generally welcome advance notice of the difficulties they are likely to encounter as their meditative training progresses. One such difficulty, particularly in the beginning stages, is the feeling by patients or clients that their mind is becoming more discursive than before. However, rather than an actual reduction in levels of mindfulness, our own research into meditation has shown that such feelings generally result from a greater awareness by clients of the “wild” nature of their cognitive and emotional processes that had hitherto remained unnoticed.7 Particularly within the context of mindfulness-based therapy, psychoeducation should be regarded as a two-way process. In other words, in working with the client to discuss and explore different dimensions of their mindfulness practice, a co-produced form of understanding or wisdom often emerges. This is something that both the client and therapist can benefit from and is consistent with the Buddhist technique known as ‘Dharma sharing’.

Although the above points are not exhaustive, we believe that when they are implemented as part of a therapeutic relationship based on trust, patience, loving-kindness, and compassion, they will help to add authenticity to the transmission that takes place between client and therapist.

 

Ven Edo Shonin & Ven William Van Gordon

 

References

  1. Shonin, E., Van Gordon, W., & Griffiths, M.D. (2013). Meditation as medication: Are attitudes changing? British Journal of General Practice. In Press.
  2. Shonin, E., Van Gordon, W., & Griffiths, M.D. (2013). Mindfulness meditation in American correctional facilities: A ‘what-works’ approach to reducing reoffending. Corrections Today, In Press.
  3. Shonin, E., Van Gordon, W., & Griffiths, M.D. (2013). Mindfulness-based therapy: A tool for Spiritual Growth? Thresholds. Summer Issue, 14-18.
  4. Shonin, E., Van Gordon W., & Griffiths, M.D. (2013). Meditation for the treatment of addictive behaviours: Sending out an SOS. Addiction Today, March, 18-19.
  5. Shonin, E., Van Gordon, W., & Griffiths, M. D. (2012). The health benefits of mindfulness-based interventions for children and adolescents. Education and Health, 30, 94-97.
  6. Shonin, E., Van Gordon, W. & Griffiths, M.D. (2013). Mindfulness-based interventions for the treatment of problem gambling. Journal of the National Council on Problem Gambling, 16, 17-18.
  7. Shonin, E., Van Gordon W., & Griffiths M. D. (2013). Meditation Awareness Training (MAT) for improved psychological wellbeing: A qualitative examination of participant experiences. Journal of Religion and Health. DOI: 10.1007/s10943-013-9679-0.
  8. Christoper, J.C., & Maris, J.A. (2010). Integrating mindfulness as self-care into counselling and psychotherapy training. Counselling and Psychotherapy Research, 10, 144-125.
  9. Sills, M., & Lown, J. (2008). The field of subliminal mind and the nature of being. European Journal of Psychotherapy and Counselling, 10, 10: 71-80.

10. Segall, S.R. (2003). Psychotherapy practice as Buddhist practice. In S. R. Segall (Ed.), Encountering Buddhism: Western Psychology and Buddhist Teachings (pp. 165-178). New York: State University of New York Press.

11. Van Gordon, W., Shonin, E., Sumich, A., Sundin, E., & Griffiths, M.D. (2013). Meditation Awareness Training (MAT) for psychological wellbeing in a sub-clinical sample of university students: A controlled pilot study. Mindfulness. DOI: 10.1007/s12671-012-0191-5.