Mindfulness meditation as medication: An identity crisis?

Mindfulness meditation as medication: An identity crisis? 

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Several of the posts on our blog have referred to the marked increase of scientific research into mindfulness meditation that has occurred over the course of the last decade. Applications for mindfulness meditation are being identified in increasingly more walks of life including clinical, educational, forensic, and occupational settings. Based upon a recent comprehensive systematic literature search we conducted utilising the major electronic academic databases, over 600 scientific papers concerning mindfulness were published in 2013. This is more than the entire number of scientific papers concerning mindfulness published between 1970 and 2000. Results from our literature search suggest that mindfulness is one of the fastest growing areas of psychological empirical enquiry.Although mindfulness is fast becoming a buzzword in psychology, the ongoing roll-out of mindfulness into real-world settings is not without its problems. Recently, we were joined by our friend and research colleague Prof Mark Griffiths in writing a paper where we outlined and discussed some of these teething and integration issues. The paper is published in the journal ‘Frontiers in Psychology’ and is entitled ‘Mindfulness-based interventions: Towards mindful clinical integration’. Today’s post duplicates a short section of the article that discusses whether mindfulness, in terms of its use in Western psychological contexts, is currently experiencing an identity crisis. The article is an open access paper (with the copyright belonging to the authors) and the full-reference is as follows:

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

The full text can be downloaded for free by following the below link and anybody wanting to know more about the paper is welcome to contact us at the following email address:

Email: meditation@ntu.ac.uk

Full-text: http://www.frontiersin.org/Journal/10.3389/fpsyg.2013.00194/full

Note on abbreviations: MBI = Mindfulness-based interventions, MBSR = Mindfulness-Based Stress Reduction; MHF = Mental Health Foundation


Mindfulness meditation as medication: An identity crisis?

Recently, Williams and Kabat-Zinn (both leading proponents in the field of MBIs), have referred to mindfulness as “awareness itself”, a form of “innate capacity” that is “virtually transparent to us” (2011, p. 15). The same authors also refer to secular programs such as MBSR as “Dharma-based portals” (“Dharma” is an explicitly Buddhist term used to refer to the teachings of the Buddha, p. 12). However, such spiritually-laden language appears to be incongruent with the general presentation and conceptualization of MBIs in relation to their operationalization within clinical settings. Thus, the identity of MBIs as well as their primary underlying “intention” (i.e., a means of improving psychosomatic well-being or a tool for spiritual development) appears to be slightly confused, and this is potentially confusing for service-users.

“Intention” underlying mindfulness practice happens to be one of the principal factors that differentiates mindfulness as taught in MBIs from its Buddhist construal. Within Buddhism, rather than psychosomatic symptom relief, mindfulness is generally practiced for the primary purpose of long-term spiritual development. In addition to what is known as ‘right intention’ and according to the Buddhist view, mindfulness only becomes fully effective when subject to a process of cross-fertilization with numerous other practices and perspectives (Shonin et al., 2013a). Such perspectives include a profound understanding of concepts pertaining to (1) wisdom (i.e., impermanence, non-self, and suffering—known as the three Dharma “seals”), (2) meditation (including both concentrative and insight techniques), and (3) ethical awareness. These three core elements (i.e., wisdom, meditation, and ethical awareness—known in Buddhism as the “three trainings”) provide a platform for the effective development of mindfulness and are relatively undersold in the delivery of MBIs (Van Gordon et al., 2013).

Williams and Kabat-Zinn assert that rather than a “decontextualization” of mindfulness, MBIs such as MBSR execute more of a secular “recontextualization” of the Buddhist teachings in all of their “essential fullness” (2011, p. 15). However, and for the reasons outlined above, the accuracy of such assertions is highly questionable because even by flexible criteria, MBIs do not (and need not) represent a complete, rounded, and authentic path of Buddhist practice (secularized or otherwise). Consequently, concerns are increasingly being raised that relate to the general identity and credibility of MBIs, and the need for a unified operational approach (e.g., Rosch, 2007; Singh et al., 2008; Howells et al., 2010; McWilliams, 2011; Shonin et al., 2013b; Van Gordon et al., 2013).

Arguably the most important of these concerns are those with ethical implications for service-users. If, unbeknownst to service-users, MBIs are in fact attempting to teach Buddhism in reconstituted form within healthcare settings, then it is imperative to make this absolutely clear. Alternatively, given that MBIs claim a certain ‘grounding’ in Buddhist philosophy, if their primary intention is geared toward improving service-user psychosomatic well-being, then there is still a need for clarity regarding what is actually implied by such a ‘grounding’. In other words, service-users should be made aware that mindfulness as currently operationalized in MBIs is by no means congruent with the traditional Buddhist perspective.

A further concern relates to the credibility and aptitude of MBI facilitators (Shonin et al., 2013c). Whilst referring to the stream of mindfulness teachings formulated by the likes of Kabat-Zinn (i.e., the teachings currently imparted by MBI instructors), Cullen (2011) states that MBIs are “their own new lineage” (p. 186). Lineage is another important concept within Buddhism and essentially refers to the “authenticity” of Buddhist teachers. In addition to receiving direct transmissions from an accomplished meditation teacher, authentic Buddhist masters generally undergo decades of focussed meditation training with the aim of relinquishing attachment to worldly concerns such as wealth, career, or renown (Shonin et al., 2013a). This is in contrast to MBI instructors who may have as little as 1 year’s mindfulness experience following completion of a single 8-week course (Mental Health Foundation, 2010). Therefore, claims that MBIs constitute an authentic lineage in the traditional Buddhist sense are unrealistic.


Interest and supporting evidence for the clinical application of MBIs has increased substantially in the last decade. MBIs appear to represent cost-effective, acceptable, and non-invasive means for treating a broad spectrum of psychological and somatic illnesses. However, future studies should address some of the methodological issues that significantly limit the validity of findings at present. More importantly, service-users are potentially exposed to oversights or misappropriations concerning the general presentation of MBIs. Whilst a certain degree of porosity between the boundary of clinical and spiritual practice does not present a problem in itself, there is a need and duty to make service-users (and the wider scientific community) fully aware of the underlying intentions of MBIs and/or of the extent to which it can realistically be said that MBIs are actually grounded in traditional Buddhist practice.


Cullen, M. (2011). Mindfulness-based interventions: an emerging phenomenon. Mindfulness 2, 186–193.

Howells, K., Tennant, A., Day, A., and Elmer, R. (2010). Mindfulness in forensic mental health: does it have a role? Mindfulness 1, 4–9.

McWilliams, S. A. (2011). Contemplating a contemporary constructivist Buddhist psychology. J. Constr. Psychol. 24, 268–276.

Mental Health Foundation. (2010). Mindfulness Report. London: Mental Health Foundation.

Rosch, E. (2007). More than mindfulness: when you have a tiger by the tail, let it eat you. Psychol. Inq. 18, 258–263.

Shonin, E., Van Gordon, W., and Griffiths, M. D. (2013a). 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.

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

Shonin, E., Van Gordon, W., Slade, K., and Griffiths, M. D. (2013c). Mindfulness and other Buddhist-derived interventions in correctional settings: a systematic review. Aggression and Violent Behavior 18, 365-372.

Singh, N., Lancioni, G., Wahler, R., Winton, A., and Singh, J. (2008). Mindfulness approaches in cognitive behaviour therapy. Behav. Cogn. Psychother. 36, 1–8.

Van Gordon, W., Shonin, E., Sumich, A., Sundin, E., and 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.

Williams, J. M. G., and Kabat-Zinn, J. (2011). Mindfulness: diverse perspectives on its meaning, origins, and multiple applications at the intersection of science and dharma. Contemporary Buddhism 12, 1–18.

An Alternative Approach to Defining Mindfulness

An Alternative Approach to Defining Mindfulness

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It seems that nearly every academic paper concerning mindfulness includes a statement to the effect that ‘there is currently a lack of consensus amongst Western psychologists in terms of how to define mindfulness’. However, we’re not sure whether disagreement amongst psychologists regarding an appropriate definition for mindfulness is as prevalent as the academic literature might suggest. In other words, perhaps people are of the opinion that there is a lot of disagreement about mindfulness amongst Western psychologists only because everybody keeps saying that there is. Indeed, it could be argued that since it is only during the last few decades that mindfulness has been introduced into Western psychological settings, a certain number of ‘teething’ issues are to be expected and that, in terms of what constitutes some of the basic attributes of mindfulness practice, there is actually a decent level of concordance amongst psychologists. Examples of some of the things that Western psychologists generally seem to agree on in relation to mindfulness practice are that mindfulness: (i) is fundamentally concerned with becoming more aware of the present moment, (ii) can be practiced during everyday activities and not just when seated in meditation, (iii) is cultivated more easily by using concentrative anchors such as observing the breath, (iv) is a practice that requires deliberate effort, and (v) is concerned with observing both sensory and mental processes.

Our personal view is that too much emphasis is placed by Western psychologists on areas where there is disagreement rather than working with the aspects of mindfulness practice that have already been theoretically or empirically established. We also believe that too much emphasis is placed by academicians on attempting to devise and disseminate an ‘absolute’ or ‘all-encompassing’ definition of mindfulness. That is not to say that there are certain aspects of Western psychological definitions of mindfulness that wouldn’t benefit from additional clarification, but this doesn’t need to be made into too big a deal or detract from the insights and progress that have already been made. In today’s post, we briefly outline some of the key aspects of mindfulness practice where there is currently disagreement amongst Western psychologists. Following this, we propose a definition of mindfulness that (in our view) embodies a traditional Buddhist perspective on mindfulness and that may help to inform the ongoing scientific debate amongst Western psychologists in terms of how best to define the mindfulness construct.

Key Areas of Confusion in Western Psychology

1. Non-judgemental awareness: Arguably, the most popular definition of mindfulness employed in the Western psychological literature is the one proposed by Jon Kabat-Zinn who defines mindfulness as the process of “paying attention in a particular way: on purpose, in the present moment, and non-judgmentally”. In the context of this definition, some people believe that the use of the term ‘non-judgemental’ is appropriate because it implies that mindfulness involves the acceptance (i.e., rather than the rejecting or ignoring) of present-moment sensory and cognitive-affective experiences. However, others believe that the term ‘non-judgemental’ is unsatisfactory and/or too ambiguous because it could imply that the mindfulness practitioner is essentially indifferent and doesn’t seek to discern which cognitive, emotional, and behavioural responses are conducive to ethically wholesome conduct.

2. Insight generation: In the Western psychological literature, ‘vipassana meditation’ and ‘insight meditation’ are often regarded as being the same as ‘mindfulness meditation’. However, this portrayal of vipassana meditation (and insight meditation) is not consistent with the traditional Buddhist perspective. According to the classical Buddhist literature, vipassana meditation (which means ‘superior seeing’) involves the use of penetrative investigation in order to intuit (for example) the ‘non-self’, ‘non-dual’, and ‘empty’ nature of reality (please see our posts on ‘Do We Really Exist?’ and ‘Exactly What is the Present Moment?’). Thus, although mindfulness meditation is certainly insight-generating in the sense that it leads to an intimate awareness of the mind, ‘mindfulness meditation’ is not ‘insight meditation’ as per the traditional Buddhist understanding. Therefore, there is debate amongst psychologists as to the role of insight in mindfulness meditation.

3. Context for practice: Mindfulness is traditionally practiced in the context of spiritual development. Indeed, within Buddhism, mindfulness is practiced in conjunction with numerous other spiritual practices and is just one aspect (the seventh aspect) of a key Buddhist teaching known as the Noble Eightfold Path. As we discussed in our post on ‘Meditation: A Threefold Approach’, the successful establishment of mindfulness relies upon a deep-seated understanding of the three Buddhist root principles of: (i) wisdom, (ii) meditation, and (iii) ethics (collectively known as ‘the three trainings’ – Sanksrit: trishiksha). In Buddhist practice, these three elements interact to form a cohesive whole, and there isn’t a single Buddhist practice that is not encompassed by the trishiksha principle. Therefore, there is debate in the Western psychological literature relating to whether or not mindfulness needs to be practiced within the context of spiritual development.


Mindfulness: A Traditional Buddhist Perspective

Needless to say, within Buddhism, there are different views about what constitutes mindfulness practice. That said, and as inferred in our post ‘When Buddha and Christ met for Tea’, we personally believe that there is actually no contradiction in the teachings from any of the different cycles of Buddhist transmission (known as the various ‘Turnings of the Wheel of Dharma’). Accordingly, in terms of a traditional Buddhist depiction, we would define mindfulness as ‘the full, direct, and active awareness of experienced phenomena that is spiritual in aspect and that is maintained from one moment to the next’.

The intended meaning of each of the words in this definition is as follows:

  • Full awareness’ means that mindfulness is all-embracing – nothing is left out and everything is accepted. This is the passive aspect of mindfulness.
  • Direct awareness’ means that there is no gap or delay between the experienced phenomena and our awareness of it. This is the insight aspect of mindful awareness. However, this doesn’t mean that mindfulness is the same as (the traditional Buddhist depiction of) insight meditation or vipassana meditation. Insight can definitely arise during mindfulness meditation but we are not actively trying to induce it as with vipassana meditation practice. Depending on a person’s level of experience, ‘direct awareness’ means doing ones best during mindfulness practice to remember that there is ‘self in other’ and ‘other in self’, or, in the case of very experienced practitioners, it means directly perceiving that this is so.
  • Active awareness’ is discerning and means that the mindfulness practitioner should not only observe the present moment but should also participate in it. Active awareness allows us to determine how to act skilfully in a given situation as well as how to create and shape the present moment. It also allows us to discern the ‘nutritional value’ of our various experiences and which environmental stimuli should be allowed to penetrate and nurture our being (please see our recent post on ‘The Absorbing Mind’). Active awareness is (obviously) the active aspect of mindfulness.
  • Experienced phenomena’ means that we should be natural and not over-exert ourselves in our practice of mindfulness. It means that we take ‘experience now’ as the path. This includes both the ‘external’ phenomena and the ‘internal’ phenomena (sometimes called noumena) that enter our field of awareness. This is the effortless or spontaneous aspect of mindfulness.
  • Spiritual in aspect’ means that the primary intention for practicing mindfulness is to effect spiritual awakening in oneself and in others. This is the compassionate aspect of mindfulness.
  • Sustained from one moment to the next’ means that the practitioner tries to maintain an unbroken flow of awareness throughout the day (and even during sleep if they are experienced enough). This is the enduring aspect of mindfulness.

A Different Approach to Defining Mindfulness

Our hope from introducing the above definition, is to try and give a small amount of ‘food for thought’ to certain aspects of the ongoing debate amongst academicians regarding the formulation of a suitable definition for mindfulness. If you like this definition then please don’t get too worked-up about it. Equally, if you think it is an unsatisfactory definition then please try not to become too upset. It’s just a definition and it would be far better if you practiced and experienced what mindfulness is for yourself. That way, it wouldn’t really matter how other people defined it. In fact, we believe that it’s unlikely that an ‘absolute’ definition of mindfulness will ever be developed because as a spiritual phenomenon, certain dimensions of the mindfulness construct will always be difficult to express in words and can only be fully understood by those individuals who can tap into them on the experiential rather than the academic level. Furthermore, it should also be kept in mind that people will have different understandings depending upon why they are interested in mindfulness and on their level of meditative experience. In this sense, we believe that one of the most insightful and pragmatic approaches to reconciling aspects of the ‘mindfulness definition debate’ is the one taken by Professor Nirbhay Singh (a leading mindfulness expert) and his team. According to Professor Singh and colleagues, “the definition of mindfulness will vary depending on whether one is interested in mindfulness from a social psychological, clinical, or spiritual context, or from the perspective of a researcher, clinician, or a practitioner, and their various combinations”.

Ven Edo Shonin & Ven William Van Gordon


Further Reading


  1. Bodhi, B. (Ed.). (2009). Majjhima Nikaya: The Middle Length Discourses of the Buddha (4th ed.). (Bhikkhu Bodhi, & Bhikkhu Nanamoli, Trans.) Massachusetts: Wisdom Publications. (see the satipattana sutra [sutra no. 10] and the anapanasati sutra [sutra no. 118])
  2. Chah, A. (2011). The Collected Teachings of Ajahn Chah. Northumberland: Aruna Publications.
  3. Dalai Lama, & Berzin, A. (1997). The Gelug/Kagyu Tradition of Mahamudra. New York: Snow Lion Publications.
  4. Dorjee, D. (2010). Kinds and dimensions of mindfulness: Why it is important to distinguish them. Mindfulness, 1, 152-160.
  5. Gethin, R. (2011). On some definitions of mindfulness. Contemporary Buddhism, 12, 263-279.
  6. Kabat-Zinn, J. (1994). Wherever you go, there you are: Mindfulness Meditation in Everyday Life. New York: Hyperion.
  7. Kang, C., & Whittingham, K. (2010). Mindfulness: A dialogue between Buddhism and clinical psychology. Mindfulness, 1, 161-173.
  8. Nhat Hanh, T. (1999). The Heart of the Buddha’s Teaching: Transforming Suffering into Peace, Joy and Liberation. New York: Broadway Books.
  9. Rosch, E. (2007). More than mindfulness: when you have a tiger by the tail, let it eat you. Psychological Inquiry, 18, 258-264.
  10. Singh, N. N., Lancioni, G. E., Wahler, R. G., Winton, A. S., & Singh, J. (2008). Mindfulness approaches in cognitive behavior therapy. Behavioral and Cognitive Psychotherapy, 36, 1-8.
  11. Shonin, E., Van Gordon, W., & Griffiths, M. D. (2013d). Mindfulness-based interventions: Towards mindful clinical integration. Frontiers in Psychology, 4, 194, DOI: 10.3389/fpsyg.2013.00194.
  12. 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.