Clinical Handbook of Mindfulness (13 page)

(Teasdale, Segal, & Williams, 1995),
suggests redirecting attention to manage emotional distress.

Process definitions are especially valuable because they identify
processes

of change
or
mechanisms of action
that may help particular patients. In ther-

apy, “mindfulness” in general is considered a change process and so are the

individual elements that constitute therapeutic mindfulness—acceptance,

present experience, and awareness. Different patients might require more

emphasis on one element or another. For example, self-critical persons

might benefit most from “acceptance,” obsessive patients might be helped

by focusing on “present moment sensations,” and people with impulse con-

trol disorders might benefit most from greater “awareness”—observing the

precursors to problem behaviors such as drinking, gambling, or overeating.

We can break down the processes even further to fine-tune treatment for

particular individuals. For example, there are different styles of awareness

that can benefit certain patients:
metacognitive
awareness (“thoughts are

not facts”) helps chronically depressed people disentangle from depressive

ruminations
(Teasdale et al., 2002),
while people with a schizoid or detached style of relating to their feelings might benefit from a more
participatory

observational style—intimately observing feelings as they arise in the body.

Meditation practice
: When someone says, “I practice mindfulness medita-

tion,” what is he or she actually doing? There are three key meditation skills

often subsumed under the heading of “mindfulness meditation.”

Concentration meditation
: This technique has a focal object, such as the

breath or a mantra. The instruction is, “When you notice that your mind has

wandered, gently bring it back to [the object].” Concentration meditation

produces a feeling of calmness. The Pali word most associated with con-

centration practice is
samatha
, while the traditional word for meditation is

bhavana
, which means “developing.” “Concentration meditation” is a trans-

lation of
samatha bhavana
, the cultivation of concentration. The “relax-

ation response”
(Benson & Klipper, 2000)
is a well-known example of this meditation approach.

Mindfulness meditation

The instruction for mindfulness meditation is, “Notice whatever predomi-

nates in awareness, moment to moment.” Here the intention is
not to choose

a single object of focus, but rather to explore changing experience. The skill

of mindfulness cultivates insight into the nature of one’s personal condition-

ing (e.g., “fear of disapproval,” “anger at authority”) and the nature of mental

reality (“it’s changing,” “it’s often unsatisfactory,” “the ‘self’ is fluid”).

This is primarily what distinguishes “mindfulness meditation” from other

forms of meditation, such as concentration meditation and various forms

of visualization meditation, and it is a unique contribution of Buddhist psy-

chology. The Pali words for mindfulness meditation are
vipassana bhavana
,

which translates well as the cultivation of insight or “insight meditation.”

Western researchers and clinicians usually use the expression “mindfulness

meditation” to refer to this practice.

Making matters a bit more complicated,
sati
is actually cultivated by, and

necessary for, both concentration and mindfulness meditation techniques.

28

Ronald D. Siegel, Christopher K. Germer, and Andrew Olendzki

That is, we need to know where the mind is to concentrate on either a single

object or many arising objects. Since the mind is actively engaged with a

wider range of experiences during mindfulness meditation, it can be said

that
sati
is more deliberately developed in this particular practice.

During mindfulness or insight meditation, the meditator can always return

to concentration practice to stabilize attention if he or she becomes lost

in daydreams and discursive thinking. In this regard, concentration practice

(
samatha
) facilitates mindfulness or insight (
vipassana
) practice.

Lovingkindness meditation
: Lovingkindness is the
emotional
quality

associated with mindfulness. Translated from the Pali word,
metta
, lov-

ingkindness meditation can be a form of concentration meditation. The prac-

titioner returns attention again and again to phrases such as “May I and all

beings be safe, happy, healthy, and live with ease.” This technique allows

the person to soften into and allow arising experience to be just as it is.

It is cultivating the
intention
to be loving and kind, rather than superim-

posing warm feelings on our moment-to-moment experience. The emotional

flavor of affectionate awareness typically follows our kindly intentions. Lov-

ingkindness (feeling safe, peaceful, healthy, and free from suffering) keeps

the
function
of mindfulness practice clear in the mind of the practitioner.

It is a quality of mind that ideally pervades the other meditation practices.

Therefore, while practicing concentration meditation, we work to receive

mental distractions with openheartedness rather than sternness; when prac-

ticing mindfulness or insight meditation, we greet all mental contents like

welcome visitors.

When our
sati
(mindfulness) is strong, we can choose to switch flu-

idly among
metta
(lovingkindness),
samatha
(concentration), or
vipassana

(mindfulness or insight) practices, as needed, even in a single sitting of med-

itation. For example, if dealing with psychological trauma, we can notice

when we are overwhelmed and can choose to redirect attention to the breath

or external sights and sounds (
samatha
). We can also add some lovingkind-

ness (
metta
) to our experience to reestablish a measure of calmness. When

we feel more stable, we can open up the field of awareness again to observe

how the trauma memories are experienced in the mind and body (
vipas-

sana
). In other words, the three skills—concentration, mindfulness, and

lovingkindness—can be selectively emphasized in meditation and daily life

to reduce suffering and increase happiness.

Common usage

To make matters even more confusing, the general public in Western culture

uses the term “mindfulness” loosely to refer to every variety of formal and

informal secular Buddhist practice. Under this label, we have not only the dif-

ferent meditation skills just mentioned—lovingkindness, concentration, and

mindfulness or insight—but also visualization techniques and innumerable,

informal meditation strategies to deal with everyday life. Visualization medi-

tations include practices that cultivate equanimity, such as imagining oneself

as a solid mountain unaffected by the wind and weather or as a deep pond

unperturbed by the waves.

As mindfulness is incorporated into diverse fields such as health care, edu-

cation, and business, the term will probably continue to accrue an increasing

Chapter 1 Mindfulness

29

array of meanings. Within clinical psychology, “mindfulness” is already used

interchangeably with “acceptance” to describe the third wave of behavioral

treatments. In the field of education, Ellen
Langer (1989)
describes “mindfulness” as a cognitive process that implies openness, curiosity, and aware-

ness of more than one perspective. In the business world, Richard Boyatzis

and Annie McKee
(2005)
encourage “mindfulness practice” to “observe emo-

tional reality” (p. 124) in an organization and “avoid narrow focus and con-

stant multitasking” (p. 131).

Despite the recent proliferation of interest in mindfulness and its multiply-

ing meanings, the various uses of the term still have much in common. Only

time will tell what happens to “mindfulness” as the theory and practices

that began in Buddhist psychology move into new, heretofore unimaginable

domains.

Radical Roots

The cultivation of mindfulness in a rigorous way comes from a tradition with

ancient roots and lofty goals. These origins are important to understand so

that modern clinicians don’t inadvertently miss its profound potential for

psychological transformation.

As far back as 4,000 years ago, we find images of yogis in ancient India

sitting cross-legged in meditation, gazing inward with eyes half closed. Train-

ing the mind was understood as the principle means of achieving mental and

physical health, emotional equanimity and for perfecting the human condi-

tion.

Mindfulness, as we are coming to know it in the West, was most clearly

described in ancient times in the teachings of the historical Buddha. Accord-

ing to tradition, he was born a prince some 2,500 years ago. At the age of

29, he renounced a life of comfort and privilege to undertake rigorous men-

tal and physical disciplines for 7 years. Finally, at age 36, he experienced

a breakthrough of understanding that profoundly reordered his mind. He

wandered from place to place for the next 45 years, exhibiting behaviors

devoid of the usual human propensities toward attachment, aversion, or delu-

sion. The psychological teachings he left behind—including how to cultivate

mindfulness—are still accessible to us today.

For the Buddha, the mind and body are seen as the product of material

causes, lacking the divine essence that was assumed by the Indo-European

religions of his time. Nonetheless, in the Buddha’s view the body and mind

can be the vehicle for a profound experience of transcendence. Rather than

breaking through to something divine, however, this experience results from

a radical transformation of the mind. Consciousness itself, though condi-

tioned, can be purified to such an extent that it entirely understands itself

and its conditioning. The result is not only a deep sense of personal well-

being, but also the possibility of a more evolved way of being human.

The primary interest of this tradition is the quality of consciousness in

the present moment. How exactly is the mind and body manifesting here

and now? Consciousness arises from a whole network of interdependent fac-

tors, including all of the details of our genetic makeup and personal history.

Each moment of consciousness, in turn, has an impact upon our subsequent

30

Ronald D. Siegel, Christopher K. Germer, and Andrew Olendzki

beliefs, feelings, and behaviors. Knowing both the causes and the effects of

a moment of consciousness allows us to participate intentionally in the pro-

cess of living, to steer a course away from suffering and toward healthier

states.

What the Buddha saw with great lucidity on the night of his awakening was

the workings of his own mind. His insights have profound implications for

modern psychotherapy, as they reveal how our minds construct our experi-

ence moment by moment and how these constructions can lead to suffering.

The following description is not for the faint hearted—it is a radically new

psychology for many readers, and somewhat complicated, so we encourage

you to consider it slowly.

How We Construct Our Experience

The Buddha saw that all experience involves a process in which the raw

data streaming into the mind through the sensory organs or “sense doors”

is compiled and synthesized into a virtual world of meaning. There are six

sense doors in all: eye, ear, nose, tongue, body, with the mind itself viewed

as the sixth. There are also five primary categories, or systems, whereby the

information flowing through these sense doors is processed.

The first category is
material form
, which acknowledges that the mind

and body have a material, biological foundation. The next is
consciousness
,

or the act of becoming aware of an object by means of one of the six sense

organs (again with the mind as the sixth organ). At this stage the eye sees, the

ear hears, the tongue tastes, and so on. The third and fourth systems, which

shape how consciousness manifests, are
perception
and
feeling
. Perception

identifies
what
is experienced through a series of associations, interpreting

incoming data in the light of historically learned patterns of recognition. For

example, you can recognize just two dots and a curved line to be a face

or identify the object in your hands to be a book. “Feeling” provides an

affect tone for each moment of cognition,
pleasant, unpleasant
, or
neutral
.

This is a hedonic assessment of each object’s value to the organism. In every

moment, we like, dislike, or aren’t interested in what we perceive.

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

formations
and reflects the intentional stance we take toward all objects

that we perceive and toward which we have feelings. Volition or intention is