You are on page 1of 16

Mindfulness-based therapy treatments in modern psychology:

Convergence and divergence from early Buddhist thought

by Ann Murphy University of South Wales, Australia

It is well-known that Buddhist philosophy and meditation have infiltrated many aspects of
modern day psychotherapy and healthcare. In particular, mindfulness-based training has
become increasingly popular for psychological treatment, with a burgeoning number of
empirical studies demonstrating positive effects on scientific measures of psychological
health and well-being. It is an interesting phenomenon that an ancient philosophy which
evolved around monastics seeking enlightenment has now converged with and been adapted
by psychological science and presented as an innovative form of therapy. In doing so, one
might wonder if the motivation to meditate has shifted in a global sense from the lofty goal
of liberation to a more modest but well-meaning intention of trying to help others to cope
with the stresses of modern life and to heal from mental suffering and physical illness.

While the effects demonstrated by research have been mostly positive; there remains a
polarisation in views between the general clinical community involved in psychological
practice and some Buddhist practitioners and scholars. For example, some clinical
psychologists maintain that meditation training, originating from a religious practice, is
inappropriate and requires stricter compliance with the rigorous standards upheld by
evidence-based research. On the other hand, Buddhist practitioners and scholars consider
traditional Buddhist meditation practice not appropriate for psychotherapy purposes,
particularly in the open arena of a secular, non-Buddhist population who resist traditional
Buddhist beliefs. For some time now, Buddhists have complained that secular mindfulness
has diluted and distorted the teachings of the Buddha to fit a commercialised version of
meditation training; now deemed palatable to the sensibilities of a westernised non-
Buddhist population who resist the suggestibility of an eastern religion.

So, given the well-cited benefits and relief that mindfulness training offers to those who are
suffering, are these concerns which imply non-treatment to others a response that is remiss
on compassion? Or has the secular mindfulness movement really lost its way by reneging
ethics for material gain? Indeed, the booming industry of mindfulness has now infiltrated
the corporate business world promising professionals more productivity and success, while
disconnecting the practice completely from the underlying root causes of greed, hatred, and
delusion, inherent in Buddhist philosophy. Mindfulness consultants, retreats, and courses
are emerging on a global scale and as a result, critics have cynically nicknamed the
mainstream introduction of secular mindfulness as McMindfulness.

Further, while mindfulness in the secular sense is essentially a tool for training the mind;
there remains the question of whether it could be potentially misused in ways that might

cause harm to self and others, by the dissolution of the restraints of morality, loving-
kindness, and compassion, as recommended by the Buddha. For instance, Dawson and
Turnbull (2006) expressed concern that a secular meditation practice in its reductionist form
and disconnected from the traditional framework of Buddhist ethics could present a number
of issues. For example, prior to World War Two, Zen meditation methods were adapted and
used to assist the Japanese military. More recently, the effort to incorporate mindfulness
training for the US military, in pre-deployment, has invoked criticism; with objections that
such efforts are at a discord with the peaceful teachings of the Buddha.

Moreover, mindfulness as portrayed in the media, is represented as the cure-all for the
masses and coincides with a collective rush to present research literature to promote its
effectiveness. However, one might also question if there has been an accompanying
reduction in critical thought by turning a blind-eye against the negatives and the less
appealing aspects of this new form of treatment. Consequently, more conservative health
care professionals regard the research with some degree of scepticism and question whether
it is appropriate for meditation to be practiced in a clinical setting. Clearly, in terms of
scientific inquiry, mindfulness-based interventions are still in its early stages of

Mindfulness-based therapy treatments

The most commonly accepted definition of mindfulness in the scientific literature is the
definition coined by Jon Kabat-Zinn (1994); paying attention in a particular way: on
purpose, in the present moment, and nonjudgementally. This definition was loosely derived
from Venerable apoika Theras (1962) classic book on meditation, The Heart of
Buddhist Meditation . Other definitions are the nonjudgmental observation of the on-going
stream of internal and external stimuli as they arise (Baer 2003), and the state of being
attentive to and aware of what is taking place in the present (Brown & Ryan 2003).
Following on from this, for the purposes of empirical study, a group of colleagues
developed a more comprehensive and mutually agreeable operational definition of
mindfulness as: a kind of nonelaborative, nonjudgmental, present-centered awareness in
which each thought, feeling, or sensation that arises in the attentional field is acknowledged
and accepted as it is (Bishop et al. 2004). Further, Germer (2005) defined mindfulness as a
3-part process: 1) awareness, 2) of present experience, 3) with acceptance. Brown, Ryan,
and Cresswell (2007) defined mindfulness as a clear awareness of ones inner and external
worlds that is nonconceptual and nondiscriminatory with a flexibility of awareness and

In sum, while a clear operational definition of mindfulness in the scientific literature has
been difficult to establish, the characteristics of awareness, attention, nonjudgment,
acceptance, and being in the present moment are the collective defining features found in
the modern literature. However, aspects of ethical conduct and the intentional cultivation of
wholesome states of mind are not incorporated within this common understanding.

In the Pli Canon, mindfulness is described as the ardent, clear, aware, and mindful
contemplation of the body, the feelings, the mind, and the objects of the mind, with the
overcoming of worry and desires for the world (DN iii 313). As an analogy, mindfulness is
likened to a gatekeeper guarding a Kings fortress to protect the inhabitants and ward off
outsiders (AN IV 110-111), which demonstrates the capacity for mindfulness to attend to
the activities of the mind in a highly protective and discriminatory manner. Memory and
recollection are also important aspects in the traditional definition of mindfulness. For
example: possessing supreme mindfulness and discretion, one who remembers and
recollects what was done and said long ago (SN V 197-8; trans. Bodhi 2000).

In the Visuddhimagga, mindfulness is described as remembering, or non-forgetting, and

states that its function is to guard the mind (Vsm IV 172). In the Dhammasanga,
mindfulness is enumerated as recollecting, calling back to mind, remembering, and bearing
in mind, and characterised as the opposite of superficiality and obliviousness (Dhs 14).
Similarly, in the Vibhaga , mindfulness is defined as constant, recollection, the act of
remembering, bearing in mind, non-superficiality, and non-forgetfulness (Vibh 220). In the
Paisambhidmagga mindfulness is described as the dominating power in the establishment
of the primary object (in meditation), and then once established, mindfulness presides in
conjunction with other cognitions associated with the primary object (Pais I 43).

Perhaps the clearest definition in the canonical literature is in the Milindapaha. Here, the
Buddhist monk Ngasena describes mindfulness in a way that includes both the cognitive
elements of recollection and astute discrimination:

Noting and keeping in mind. As mindfulness springs up in the mind of the recluse, he
repeatedly notes the wholesome and unwholesome, blameless and blameworthy,
insignificant and important, dark and light qualities and those that resemble them thinking,

These are the four foundations of mindfulness, these the four right efforts, these the four
bases of success, these the five controlling faculties, these the five moral powers, these the
seven factors of enlightenment, these are the eight factors of the noble path, this is serenity,
this insight, this vision and this freedom. Thus does he develop those qualities that are
desirable and shun those that should be avoided (Miln; Pesala 2001, 40-41).

Therefore, mindfulness in early Buddhist thought does not only include the faculty of
present-moment awareness, but additionally, contains a discriminative capacity orientated
towards cultivating wholesome states of minds, along with an element of recollection that
manifests together, and this recollective aspect of mindfulness involves the recollection of
the dhamma.

Indeed, mindfulness is considered such a core and significant part of Buddhist teachings
that mindfulness is listed eight times as part of the thirtyseven requisites of enlightenment;
the bodhipakkhiy dhammas. These are the factors said to be all presiding in unison at the
moment of enlightenment. Here, mindfulness is included in the four foundations of
mindfulness (satipahna), as one of the spiritual faculties (indriyas), one of the spiritual
powers (balas), one of the factors of enlightenment (bojjhags), and as right mindfulness,
the seventh factor in the Noble Eightfold Path (ariya ahagika magga). Moreover, in the
Abhidhamma, mindfulness is classified as one of the nineteen universal beautiful factors; a
category of mind states (cetasikas) said to be present in beautiful, uplifted states of
consciousness. Mindfulness arises concomitantly with other beautiful mind states including
faith, non-greed, non-hatred, equanimity, and tranquillity. Here, right mindfulness is
practiced with the sil aspects of right speech, action, and livelihood of the Eightfold Path,
while adopting the divine attitudes of the brahma-vihras of compassion (karu), loving-
kindness (mett), sympathetic joy (mudit), and equanimity (upekkh), all for the
progressive eradication of delusion (amoha) (Bodhi 1999, 85-90). The function of
discriminative analysis is considered a correct application of right view and right effort of
the Eightfold Path (Bodhi 2011).

Clearly, mindfulness in early Buddhist thought is comprehensive, multi-faceted, and

complex. Perhaps this might be a reason why as a term in the modern scientific literature,
mindfulness has been so difficult to define and to consistently replicate in a generic manner.

Similarly, there have been difficulties in the attempt to transpose mindfulness into a
measurable outcome for empirical study in the scientific literature. In this aim, a number of
widely available published selfreport questionnaires have been developed (Baer 2011). For
example: the 30-item Freiburg Mindfulness Inventory (FMI), the 15-item Mindful Attention
Awareness Scale (MAAS), the 39-item Kentucky Inventory of Mindfulness Skills (KIMS),
the 39-item Five Facet Mindfulness Questionnaire (FFMQ), the 12-item Cognitive and
Affective Mindfulness Scale-Revised (CAMS-R), the 16-item Southampton Mindfulness
Questionnaire (SMQ), the 20-item Philadelphia Mindfulness Scale (PHLMS), the 13-item
Toronto Mindfulness Scale (TMS), the 21-item State Mindfulness Scale (SMS), the
Mindfulness Process Questionnaire (MPQ), and the Meditation Attention Breath Scores

However, like a generic definition of mindfulness, efforts to operationalise and provide an

accurate and consistent measure of mindfulness have been problematic. For instance, these
measures of mindfulness range in complexity from a one summarised factor (MAAS, FMI,
SMQ, MABS, MPQ), to two factors (PHLMS, TMS, SMS), to four scales (KIMS, CAMS-
R), and to five facets (FFMQ). Further, issues associated with self-reporting present a
problem of bias and non-objectivity which may undermine authenticity in the responses.
Individual differences in the subjective understanding of mindfulness affect the
interpretation and therefore, the answers to the posed questions. Moreover, the variations in
an understanding of mindfulness in modern psychology reflect individual specialisations in
specific domains of psychological science and are at a discord with the multi-faceted,
dynamic quality of an experiential understanding of mindfulness, as known by Buddhist
meditation practitioners. Also, the inherent difficulties in accurately assessing a broad and
diverse range of practitioners, including cultural differences, across multiple domains such
as beginners in western secular mindfulness programs to long-term experienced meditators

from traditional Buddhist practices, by the use of one short and succinct psychological
questionnaire needs to be acknowledged.

As a short review, there are two main, commonly used mindfulness-based therapy
programs: Mindfulness- Based Stress Reduction (MBSR) and Mindfulness- Based
Cognitive Therapy (MBCT). Other psychotherapy interventions which include significant
components of mindfulness incorporated into treatment are Dialectal Behaviour Therapy
(DBT), originally developed for the treatment of borderline personality disorder, and
Acceptance and Commitment Therapy (ACT). Other variations of mindfulness-based
training programs are: mindfulness-based eating awareness training (MB-EAT),
mindfulness-based art therapy (MBAT), mindfulness-based relapse prevention (MBRP),
mindfulness-based relationship enhancement (MBRE), and mindfulness-based elder care.

The MBSR program initially began as a behaviour therapy treatment at the University of
Massachusetts Medical Centre (UMMC) for clients suffering with chronic pain. The
program was developed based upon an amalgamation of Buddhist meditation and yoga
practices derived from Jon Kabat-Zinns personal experiences with Theravda insight
meditation and Mahyna Soto and Rinzai Zen traditions, along with yogic traditions
originating from Vedanta and influences from the teachings of J. Krishnamurti and Ramana
Maharshi. It was Kabat-Zinns original intention to develop a structured curriculum based
upon underlying Buddhist principles, which was adapted in accordance with the evidence-
based constraints required for mainstream medical care (Kabat-Zinn 2011). MBSR is
conducted over an 8 week period consisting of group meetings for about 2.5-3.5 hours
every week combined with an all-day practice session of about 7.5 hours conducted in
silence during the sixth week of the program. Lovingkindness practices are included during
this silent all-day session. An orientation session and a brief private interview are also
recommended prior to commencing the MBSR program.

The meditation exercises in MBSR include practices that may be done both formally and
informally. The formal practices are comprised of sitting meditation, the body scan
exercise, walking meditation, and gentle mindful yoga postures. The informal practices are
outlined in a way that meditation can be incorporated into everyday life. These are
awareness of breathing, awareness of pleasant and unpleasant events, and deliberately
developing awareness during routine everyday activities such as eating, driving, brushing
teeth, washing the dishes, and so on.

MBCT was developed later in the 1990s by Zindel Segal, Mark Williams, and John
Teasdale, with the support and help from Jon Kabat-Zinn and his colleagues at the Stress
Reduction Clinic (UMMC). MBCT is based upon the MBSR program with the inclusion of
cognitive therapy as a core component of the treatment. Its original purpose was for use in
psychotherapy and was originally developed as a manualised methodology to specifically
target relapse in depression (Segal, Williams, and Teasdale 2002). There has been further
supporting research demonstrating its efficacy from a number of randomised-controlled
trials. The additional cognitive therapy component incorporated into MBCT was derived
from the work of Aaron Beck (Beck 1976), and was originally designed to address
persistent maladaptive thought processes that predict on-going negative thought patterns
and behaviour, which serve to perpetuate the reoccurrence of depressive episodes. The
MBCT program is also typically delivered as an 8-week program in a group setting.
However, it does not provide the one day silent retreat or the loving-kindness meditations
offered in MBSR.

The dhamma as medicine?

Arguably, the underlying premise of mindfulnessbased therapy is the notion that the
dhamma has not only a soteriological aim but it also promotes a healing of the mind and the
body. Indeed, the nature of the dhamma could be characterised as therapeutic, in the respect
that the assertion of the Four Noble Truths is to end suffering. In this context, suffering
encapsulates all physical and mental suffering. The Buddha clarified human suffering as
birth, ageing, death, sorrow, lamentation, pain, sadness, distress, attachment to the unloved,
separation from the loved, and not getting what one wants (DN ii 306). The Vibhaga
analysis on the multi-faceted nature of human suffering distinguishes pain in terms of either
physical or mental pain (Vibh 4. 190-202). The analogy of the dhamma as medicinal is a
common theme in various places throughout the Pli Canon. For instance, in the discourse
to Mgandiya, in the Mgandiya Sutta, the Buddha relates the dispensation of the dhamma
as comparable to the medicinal remedies prescribed by a physician (MN i 511).

In the offering of the dhamma, the Buddha is said to portray himself as an unsurpassed
physician and surgeon (Iti 100; Ireland 1997, 226). Further, the Buddha likens the
suitability of hearing the dhamma by different kinds of persons to that of a patient being
prescribed a suitable medicine to recover from an illness (AN i 121).The Buddha stated that
the teachings are the noble purgative just as a physician prescribes a purgative for
eliminating ailments (AN V 218). Here it is worth considering that in many circumstances
where people have experienced trauma, loss, pain, sickness, and myriad other forms of
suffering in their life, that their individual form of spiritual development may require a
preliminary and gradual healing of the mind and body before a dedicated effort towards
liberation might even be considered.

Has contemporary scientific research collaborated the healing effects of meditative practice
on physical health and well-being? To date, there is a substantial body of work on the
salutogenic effects of meditation. Mindfulness-based interventions have been applied across
a variety of domains in physical health, such as helping those suffering with chronic pain,
fibromyalgia, rheumatoid arthritis, improving mood and well-being in cancer patients, and
reducing stress and anxiety in patients with cardiovascular disease and hypertension. In
particular, those physical illnesses which are exacerbated by stress or tend to promote
anxiety and worry appear to be the most positively affected by mindfulness-based therapy
(Carlson 2012).

In the area of psychological research, empirical studies suggest that mindfulness meditation
training has a beneficial effect on psychological health and well-being (Keng, Smoski, and
Robins 2011). A meta-analysis on the efficacy of mindfulness-based interventions from 39
studies revealed a reliable effect on reducing levels of anxiety and depression (Hofmann,
Sawyer, Witt, and Oh 2010). A further recent meta-analysis of 209 studies concluded that
mindfulness-based therapy appears to be more effective in the treatment of psychological
problems compared to physical illnesses, and is most effective for specifically treating
anxiety and depression (Khoury et al. 2013). Mindfulness-based interventions have been
applied and demonstrated its efficacy in the treatment of a variety of mental health issues,
such as for depression, generalised anxiety disorder, panic disorder, bipolar disorder, post-
traumatic stress disorder, social anxiety disorder, borderline personality disorder, and for

The potential for mindfulness training to improve physical and mental health may be related
to the overall capacity for meditation practice to alleviate stress-related symptoms. For
example, increased levels of mindfulness and the amount of time spent in meditation
practice was associated with reduced perceived stress and improved psychological
wellbeing (Carmody and Baer 2008). Moreover, a recent study found that just three days of
25 minutes of mindfulness meditation practiced every day significantly reduced levels of
stress (Creswell Pacilio Lindsay and Brown 2014). Reducing stress levels is beneficial
because we know that the harmful effects of chronic stress suppress immune function,
increase inflammation, impair memory, promote bone mineral loss and muscle wasting, and
contribute towards metabolic syndrome (McEwen 2008). Again, after an 8-week MBSR
program, individuals who had previously been experiencing heightened levels of stress
reported significant reductions in levels of perceived stress. Another interesting fact is the
correlation between the levels of perceived stress and favourable structural changes in the
amygdala, an area of the brain implicated in stress and anxiety responses, was found in
those participants. In previous studies, exaggerated amygdala activation has been associated
with mental health conditions (Hlzel et al. 2010). In another study where participants
received 8-weeks of meditation training, the results revealed significantly smaller
inflammatory responses in the meditation group compared to a control group who
participated in a health enhancement program (Rosenkranz et al. 2013). Meditation practice
may also promote healing at the cellular level. For instance, greater telomerase activity was
observed in participants who engaged in a 3-month long meditation retreat, when compared
to controls (Jacobs et al. 2011).

Recent research in neurobiology has revealed links between meditation practice and the
capacity for structures of the brain to change in response to this experience, a phenomenon
termed neuroplasticity. Research indicates that meditation mindfulness training is
associated with alterations in pre-frontal asymmetry, an area of the brain related to positive
emotions (Davidson et al. 2003), increased cortical thickness of the brain (Lazar et al.
2005), increased brain gray matter density in brain regions related to learning, memory,
emotion regulation, perspective taking, and self-referential processing (Hlzel Carmody et

al. 2011), and is associated with positive alterations in emotional processing (Allen et al.
2012). These results suggest that prolonged meditation practice appears to alter brain
function in ways that improves memory, attention, learning, and mood.

So what are the proposed underlying mechanisms of change caused by mindfulness

meditation practice? Baer (2010) posits that the psychological process of change invoked by
mindfulness training encompasses various cognitive and emotional faculties. These
processes include higher levels of mindfulness, decentering from distressful and anxiety-
producing thoughts, emotion regulation, self-compassion, and enhanced neurobiological
changes in the brain, including alterations in attention and working memory capacity. In
particular, decentering has been found to have a mediating effect on psychological health by
observing and noting thoughts in the mind as mere transitory events, without judging or
letting the thoughts influence behaviour, subsequently reducing the propensity to engage in
rumination. Rumination has been demonstrated to enhance negative thinking styles which
predict and maintain depressive episodes, as well as exacerbate other psychopathology such
as anxiety. Mindfulness training promotes decentering by reducing negative automatic
thoughts and enhancing the ability to let go of negatively-biased thoughts more easily. More
recently, Hlzel, Lazar et al. (2011) defined distinct but interacting mechanisms from a
conceptual and neural perspective. These were outlined as attention regulation (sustained
and enhanced attention), body awareness (of breathing and bodily sensations), emotion
regulation (including reappraisal, exposure, extinction, and reconsolidation of emotion), and
changes in perspectives on self (including detachment from a fixed notion of self-identity).

Research suggests that mindfulness meditation supports emotion regulation (Chambers,

Gullone, and Allen 2009), which promotes improvements in mood and helps to reduce
anxiety and negative emotions. It is hypothesised that mindfulness meditation may improve
emotion regulation by enhancing executive control; the prefrontal area of the brain
responsible for the management and control of higher cognitive processes such as planning,
problem-solving, selective attention, handling novel situations, and inhibition of habitual
responses (Teper, Segal, and Inzlicht 2013). Additionally, mindfulness training has been
found to improve overall cognitive function by enhancing attention, working memory
capacity, and cognitive flexibility. The on-going practice of mindfulness meditation
emphasises concentration by a repeated and sustained focused attention on a primary object,
which supports an enhanced attentional capacity and therefore, has further positive
implications for mental health (Valentine and Sweet 1999). While enhanced attention has
been found to be demonstrably apparent in long-term meditators compared to short-term
meditators; improvements in attention have been reported within only 5 days of meditation
training and also associated with improvements in mood and lower stress levels (Tang et al.
2007). Improvements in attention are related to a better capacity for selfregulation, implying
meditators are more able to skilfully select and focus attention on more beneficial mental
activities with decreased rumination, leading to better psychological health (Chambers, Lo,
and Allen 2008). Indeed, it has been argued that selective attention is a critical antecedent
process in regulating emotions towards positivity (Wadlinger and Isaacowitz 2011).

Moreover, the sustained focus on the sensations of body, as specifically instructed by the
mindfulness body meditations and body scan exercise, increases interoceptive awareness or
internal body awareness, theorised to play an essential role in emotional awareness, emotion
regulation, empathy (Hlzel, Lazar et al. 2011), and diminished bodily pain (Kerr et al.

In early Buddhist thought, mindfulness and ethical conduct were inextricably-linked
practices. For laypeople, the Pli Canon endorses adherence to the Buddhist five precepts of
non-killing, non-stealing, no sexual misconduct, no wrongful speech, and non-partaking in
alcohol and drugs for the purpose of training in the establishment of mindfulness. A
violation of these precepts was considered a setback in the training (AN IV 457).However,
given its secular motivation, the five precepts are not integrated into the MBSR/MBCT
programs, with the potential implication that participants may continue to engage in
unhelpful or harmful behaviours while also meditating. In particular, any adverse effects of
combining alcohol or drugs in conjunction with intense meditation practice are not known.

Traditionally, in Buddhist countries, adopting the five precepts and the practice of morality
would often be performed for many years before commencing a sustained meditation
practice. Indeed, the Abhidhamma describes the faculty of mindfulness as accompanied by
skilful (kusala), wholesome state of consciousness (citta) which contain central aspects of
virtue (sla) (Shaw 2014, p. 148). Thus, mindfulness is not an isolated activity but rather, is
incorporated as part of a lifetime dedicated to perfecting the practice of the Eightfold Path.
In this regard, a Buddhist practitioner attempts to maintain mindful attention to the actions
of right speech, right action, and right livelihood in daily life as a sustained effort to fully
integrate mindfulness practice within the Buddhist aspects of sla.

As such, when transgressions are made, the accompanying presence of self-respect (hiri)
and a genuine fear of the consequences (ottappa) are present, which include an
understanding of kamma. Further, as part of the Noble Eightfold Path, wisdom (pa) is
developed by the cultivation of the two factors of right view and right intention, including
the study of Buddhist philosophy (the dhamma). The other factors of right effort, right
mindfulness, and right concentration comprise the unified, diligent practice of meditation
(samdhi) in daily life. Hence, the practice of following the Eightfold Path encompasses the
three core Buddhist principles: pa, sl, and samdhi.

Therefore, right mindfulness, as the seventh factor of the Eightfold Path, includes the
cultivation of wholesome, skilful mind states and the removal of less skilful mind states
such as greed, hatred, and ignorance (SN 45.8). Moreover, Buddhists will also often include
devotional practices such as chanting, prayers, bowing, and recollection of the Buddha to
help uplift the mind in a spiritually conducive manner. Conversely, in a westernised non-
Buddhist culture, the emphasis tends to be primarily focused on the meditation practice with
a downplaying of the equally important role of moral behaviour and ethical conduct. Here,

we see a divergence in approach between western secular mindfulness and the traditional
Buddhist practice.

In its portrayal, MBSR is a hybrid of Eastern Buddhist and yoga traditions with a
westernised, secular overlay and a uniquely scientific approach. For the purposes of
empirical study in the scientific literature and to secure funding for research, it has been
important that the mindfulness-based program remained devoid of religious connotations.
MBSR offers a supportive and safe environment that gently instructs and guides newcomers
to meditation in a way that is presented as non-threatening and nurturing. For non-
Buddhists residing in a predominately non- Buddhist and westernised country, this provides
an ideal introduction to meditation without the need to abandon their own religious beliefs
and personal ideals. However, it is also worth considering whether interest in secular
mindfulness has eventuated as a backlash to scandals in traditional Buddhist centres
established in western countries. Moreover, difficulties for westerners in accepting the
doctrine of rebirth as well as misogynistic attitudes towards women, particularly in regards
to Bhikkhuni ordination, found in traditional Buddhism are the oftcited reasons for the
global shift to secular Buddhism in western countries.

On the other hand, the issue of the calibre, integrity, and experience of mindfulness teachers
have come under the spotlight of critique in recent times. In order to address this, the Centre
for Mindfulness (the University of Massachusetts Medical School) insists upon adhering to
a rigorous and structured training program in order to be certified as a MBSR teacher,
which includes the pre-requisites of personally attending a number of silent meditation
retreats and maintaining an on-going meditation practice. In the UK, a formal mindfulness-
based interventions teacher assessment criteria (MBI: TAC) has been introduced to develop
a standardised framework to ensure teacher competence in teaching both MBSR and MBCT
programs. In addition, Bangor, Oxford, and Exeter Universities now offer postgraduate
training in MBSR and MBCT. However, other mindfulnessinformed interventions such as
ACT and DBT remain unchecked with no presiding certifying body to ensure a uniform
standard and formalised qualification for teaching. Further, psychologists and other
clinicians may incorporate mindfulness techniques in an adhoc fashion into their existing
treatment procedures with only minor training, such as attending a short professional
workshop on mindfulness as part of their on-going professional development. In these less
formal cases, the health practitioners may have no personal understanding of meditation.

Therefore, while it has been generally agreed in theory that mindfulness teachers should
have a well-established meditation practice of their own to inform their teaching practice,
this is not always the case. This raises the question of whether it is ethical for a counsellor
or mindfulness consultant to teach mindfulness when they are not a meditator themself and
do not possess a personal understanding of mindfulness. For example, adverse effects of
meditation have been reported, such as increased negativity, depression, anxiety-related
symptoms, or activation of past traumatic experiences. Often these effects are temporary but
a skilled instructor is required to deal with such issues if they arise (Melbourne Academic
Mindfulness Interest Group 2006).
In traditional Buddhism, the teaching of the dhamma is not at all considered elementary and
a significant number of years of personal meditation experience would typically be
endorsed before a Buddhist teacher would be considered adequately qualified to teach
others. Indeed, this is clearly stated in the canonical literature regarding the Buddhas said
advice to Bhikkhu nanda on teaching the dhamma to others:

It isnt easy, nanda, to teach the Dhamma to others. One who teaches the Dhamma to
others should first set up five qualities internally (AN III 184; Bodhi 2012, p. 773).

These five qualities in teaching the dhamma are specified as 1) giving a progressive talk
that is gradual, 2) a talk that shows reason, 3) giving a talk out of sympathy for others, 4)
not giving a talk that is intent on material gain, and 5) giving a talk without harming self or
others (AN III 184). Here, the prerequisites of the intention to teach out of compassion for
others without thought of personal material gain while seeking to do no harm is an integral
aspect required in the ethics of teaching meditation to others. Moreover, in the Pli Canon,
the good friend in the dhamma or the teacher is described as:

He is dear, respected, and esteemed, a speaker and one who endures speech; he gives deep
talks and does not enjoin one to do what is wrong (AN IV 32; Bodhi 2012, p. 1022).

Bhikkhu Buddhaghosa further states that the teacher, clarified here as the giver of a
meditation subject, must firstly be an arahant someone with cankers destroyed. However,
if no such person can be found, then Buddhaghosa suggests seeking an individual in the
following succession: a non-returner, a oncereturner, a stream-enterer, an ordinary man
who has obtained jhna, one who knows three Piakas, one who knows two Piakas, one
who knows one Piaka, in descending order. If no one can be found who knows at least one
Piaka, then Buddhaghosa suggests seeking a person who is knowledgeable of at least one
collection (of the canonical literature) and its associated commentaries and who also
presents themself as a conscientious individual (Vsm III 64). Thus, a teacher of the dhamma
should also be an adept and dedicated practitioner:

You should do yourself as you teach another; Well tamed, tame others for self, they say,
is hard to tame (Dhp 12.158; Roebuck 2010, p. 33).

Clearly, as represented here in the Buddhist literature, a teacher must be of high regard,
possess a deep knowledge of the Buddhist teachings, and maintain good ethical conduct
before they are considered adequately qualified to teach the dhamma to others.

Typically, the lay mindfulness meditation teacher has a sparse knowledge of Buddhist texts
and may not be a Buddhist. A further concern regarding mindfulness-based interventions is
the lack of on-going meditation support to assist the novice meditator. In actuality,
participants are often left with no on-going support after the program has ended. In a
traditional Buddhist setting, on-going access to the meditation teacher is typically always
made available. Moreover, in contradiction to the condition of not being intent on material

gain, there is in general, a high cost charged for attending mindfulness training programs.
While mindfulness participants are told that there is no need for them to go to a monastery
to learn meditation, it would be apropos to question if alternative information about other
meditation centres could also be provided, as Buddhist centres would typically offer similar
meditation training at no cost, with their funding provided solely by donation (dna).
Although, earning money from teaching the dhamma is not an intractable issue as clearly
there are incurred expenses in providing training courses. Perhaps, it is the primary
intention of offering the teachings out of compassion for others rather than specifically
being intent on material gain that might be the grey area of interpretation here.

Further, strict adherence to ethical conduct by teachers in respect to participants in the

mindfulness course has already become an issue. Most notably by the introduction of
secular mindfulness training is the loss of the connection to the Triple Gem (the Buddha,
the dhamma, and the sagha), which are the core and fundamental aspect of the Buddhist
teachings. Typically, the Buddha is not referred to as part of the mindfulness course and
was in fact discouraged in my personal experience while attending the MBSR teacher
training program. Finally, with the mass introduction of lay meditation teachers, there
would no longer be a requirement for the Saghas role in teaching the dhamma.

In conclusion, the enormous benefit of mindfulness practice offered by MBSR and MBCT
teachers for a primarily non-Buddhist population cannot be underestimated. Empirical
studies have provided a substantial body of evidence supporting improvements in both
physical and psychological well-being. Further, recent research based upon uplifted states
of consciousness such as compassion, self-compassion, loving-kindness practices, and
equanimity derived from the Buddhas teachings are a positive and complimentary addition
to mindfulness-based therapy research which promote more wholesome and altruistic states
of mind.

However, with the mindfulness movement, the connection to the Triple Gem has been lost.
Here, we are reminded of the Buddhas prediction regarding the downfall and eventual
disappearance of the dhamma by the loss of reverence from the four-fold assembly
(bhikkhus, bhikkhunis, male and female lay followers) towards the Buddha, the dhamma,
the sagha, the training, and the method of concentration (SN II 224). Therefore, care must
be exercised to avoid a reductionist approach towards mindfulness by its dilution into a
merely intellectual mind-training tool which emphasises a heightened form of attention and
reneges on ethical values. In terms of the polarisation that exists between scientists and
Buddhist scholars; this may always be the case, although this natural dichotomy may
protect against the imbalance of extreme views. To reiterate the Buddhist scholar Bhikkhu
Bodhi (2011, pp. 35-6), as scientific work progresses on mindfulness treatments and other
Buddhist-related research; an ethical responsibility is required to maintain the integrity and
respect for the Buddhist meditation practices, while reminding Buddhist practitioners and
scholars that the curative applications of the dhamma entails significant improvements in
the lives of others and in that regard, must be disseminated openly and without a closed
teachers fist (DN ii 100).

Finding an amenable balance between these two perspectives is a key factor in engendering
harmonious and collaborative advances in contemplative sciences in the future.

Allen, M., Dietz, M., Blair, K. S., Van Beek, M., Rees, G., Vestergaard-Poulsen, P., Lutz, A.,A.,
and Roepstorff, A. 2012. Cognitive-affective neuro plasticity following activecontrolled
mindfulness intervention. The Journal of Neuroscience 32(44): 15601-10.

Baer, R. A. 2003. Mindfulness training as clinical intervention: A conceptual and empirical review.
Clinical Psychology: Science and Practice 10: 125-143.

Baer, R. A. 2010. Mindfulness- and acceptance-based interventions and processes of change. In

Assessing mindfulness and acceptance processes in clients, edited by Ruth Baer, 1-21. Oakland:
New Harbinger Publications.

Baer, R. A. 2011. Measuring mindfulness. Contemporary Buddhism: An Interdisciplinary Journal

12(01): 241-261.

Beck, A. T. 1976. Cognitive therapy and the emotional disorders. New York: International
Universities Press.

California Press.

Bishop, S. Lau, M. Shapiro, S. Carlson, L. Anderson, N. Carmody, J. Segal, Z. Abbey, S. Speca,

M. Velting, D. and Devins, G. 2004. Mindfulness: A Proposed Definition. Clinical Psychology:
Science and Practice 11: 230241.

Bodhi, B. (ed.) 1999. A comprehensive manual of Abhidhamma: The Abhidhammattha Sangaha of

cariya Anuruddha. Onalaska: BPS Pariyatti Editions.

Bodhi, B. (tr.) 2000. The connected discourses of the Buddha: A translation of the Sayutta
Nikya. Boston: Wisdom Publications.

Bodhi, B. (tr.) 2012. The numerical discourses of the Buddha: A translation of the Aguttara
Nikya. Boston: Wisdom Publications.

Bodhi, B. 2011. What does mindfulness really mean? A canonical perspective. Contemporary
Buddhism: An Interdisciplinary Journal 12(01): 19-39.

Brown, K. W. and Ryan, R. M. 2003. The benefits of being present: mindfulness and its role in
psychological wellbeing. Journal of Personality and Social Psychology 84(4): 822848.

Brown, K. W., Ryan, R. M., and Creswell, J. D. 2007. Mindfulness: Theoretical foundations and
evidence for its salutary effects. Psychological Inquiry 18(4): 211-237.

Carlson, L. E. 2012. Mindfulness-based interventions for physical conditions: A narrative review

evaluating levels of evidence. ISRN Psychiatry 2012: 1-12.

Carmody, J., and Baer, R. A. 2008. Relationships between mindfulness practice and levels of
mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress
reduction program. Journal of Behavioural Medicine 31(1): 23-33.

Chambers, R., Gullone, E., and Allen, N. B. 2009. Mindful emotion regulation: An Integrative
review. Clinical Psychology Review 29: 560-572.

Chambers, R., Lo, B. C. Y., and Allen, N. B. 2008. The impact of intensive mindfulness training on
attentional control, cognitive style, and affect. Cognitive Therapy Research 32: 303-322.

Creswell, J. D., Pacilio, L. E., Lindsay, E. K., and Brown, K. W. 2014. Brief mindfulness
meditation training alters psychological and neuroendocrine responses to social evaluative stress.
Psychoneuroendocrinology 44: 1-12.

Davids, C. A. F. R. (tr.) 1900. Dhamma-Sangai: Compendium of states or phenomena. London:

The Royal Asiatic Society.

Davidson, R. J., Kabat-Zinn, J., Schumacher, J., Rosenkranz, M., Muller, D., Santorelli, S.
F.,Urbanowski, F., Harrington, A., Bonus, K., and Sheridan, J. F. 2003. Alterations in Brain and
Immune Function Produced by Mindfulness Meditation. Psychosomatic Medicine 65: 564- 570.

Dawson, G. and Turnbull, L. 2006. Is mindfulness the new opiate of the masses? Critical
reflections from a Buddhist perspective. Psychotherapy in Australia 12(4): 60-64.

Germer, C. K. 2005. Mindfulness: What is it? What does it matter? In Mindfulness and
Psychotherapy, edited by C. K. Germer, R. D. Siegel, and P. R. Fulton, 3-27. New York: Guilford

Hofmann, S. G., Sawyer, A. T., Witt, A. A., and Oh, D. 2010. The effect of mindfulness-based
therapy on anxiety and depression: A meta-analytic review. Journal of Consulting Clinical
Psychology 78(2): 169-183.

Hlzel, B. K., Carmody, J., Vangel, M., Congleton, C., Yerramsetti, S. M., Gard, T., and Lazar, S.
W. 2011. Mindfulness practise leads to increases in regional brain gray matter density. Psychiatry
Research: Neuroimaging 191: 36-43.

Hlzel, B. K., Lazar, S. W., Gard, T., Schuman-Olivier, Z., Vago, D. R., and Ott, U. 2011. How
does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural
perspective. Perspectives on Psychological Science 6(6): 537-559.

Hlzel, B. K., Carmody, J., Evans, K. C., Hoge, E. A., Dusek, J. A., Morgan, L., Pitman, R. K., and
Lazar, S. W. 2010. Stress reduction correlates with structural changes in the amygdala. SCAN 5:

Ireland, J. D. (tr.) 1997. The Udna and the Itivuttaka: Two classics from the Pli Canon. Kandy:

Jacobs, T. L., Epel, E. S., Lin, J., Blackburn, E. H., Wolkowitz, O. M., Bridwell, D. A., Zanesco, A.
P., Aichele, S. R., Sahdra, B. K., Maclean, K. A., King, B. G., Shaver, P.R., Rosenberg, E. L.,
Ferrer, E., Wallace, B. A., and Saron, C. D. 2011. Intensive meditation training, immune cell
telomerase activity, and psychological mediators. Psychoneuroendocrinology 36: 664-681.
Kabat-Zinn, J. 1994. Wherever you go, there you are: Mindfulness meditation in everyday life.
New York, NY: Hyperion.

Kabat-Zinn, J. 2011. Some reflections on the origins of MBSR, skilful means, and the trouble with
maps. Contemporary Buddhism: An Interdisciplinary Journal 12(1): 281-306.

Keng, S-L., Smoski, M. J., Robins, C. J. 2011. Effects of mindfulness on psychological health: A
review of empirical studies. Clinical Psychology Review 31: 1041-1056.

Kerr, C. E., Sacchet, M. D., Lazar, S. W., Moore, C. I., and Jones, S. R. 2013. Mindfulness tarts
with the body: Somatosensory attention and top-down modulation of cortical alpha rhythms in
mindfulness meditation. Frontiers in Human Neuroscience 7: 1-15.

Khoury, B., Lecomte, T., Fortin, G., Masse, M., Therien, P., Bouchard, V., Chapleau, M-A.,
Paquin, K., and Hofmann, S. G. 2013. Mindfulness-based therapy: A comprehensive meta-analysis.
Clinical Psychology Review 33: 763-771.

Lazar, S. W., Kerr, C. E., Wasserman, R. H., Gray, J. R., Greve, D. N., Treadway, M. T.,
McGarvey, M., Quinn, B. T., Dusek, J. A., Benson, H., Rauch, S. L., Moore, C. I., and Ischl, B.
2005. Meditation experience is associated with increased cortical thickness. NeuroReport 16: 1893-

Melbourne Academic Mindfulness Interest Group. 2006. Mindfulness-based psychotherapies: A

review of conceptual foundations, empirical evidence and practical considerations. Australian and
New Zealand Journal of Psychiatry 40: 285-294.

McEwen, B. S. 1998. Protective and damaging effects of stress mediators. New England Journal of
Medicine 338 (3): 171-179.

apoika, T. 1962. The heart of Buddhist meditation: A handbook of mental training based on
the Buddhas way of mindfulness. Kandy: Buddhist Publication Society.

yamoli, B. (tr.) 1982. The path of discrimination (Paisambhidmagga). London: The Pli Text

yamoli, B. (tr.) 2011. The path of purification (Visuddhimagga). 3rd ed. Kandy: BPS.

yamoli, B., and Bodhi, B. (trs.) 1995. The middle length discourses of the Buddha: A
translation of the Majjhima Nikya. Boston: Wisdom Publications.

Pesala, B. (ed.) 2001. The debate of King Milinda: An abridgement of the Milinda Paha. Penang:
Inward Path.

Roebuck, V. J. (tr.) 2010. The Dhammapada. London: Penguin Classics.

Rosenkranz, M. A., Davidson, R. J., Maccoon, D. G., Sheridan, J. F., Kalin, N. H., and Lutz, A.
2013. A comparison of mindfulness-based stress reduction and an active control in modulation of
neurogenic inflammation. Brain, Behaviour, and Immunity 27: 174-184.

Segal, Z. V., Williams, J. M. G., and Teasdale, J. D. 2002. Mindfulness-based cognitive therapy for
depression: A new approach to preventing relapse. New York: Guilford Press.

Shaw, S. 2014. The Spirit of Buddhist meditation. New Haven, CT: Yale University Press.

Tang, Y-Y., Ma, Y., Wang, J., Fan, Y., Feng, S., Lu, Q., Yu, Q., Sui, D., Rothbart, M. K., Fan, M.,
and Posner, M. I. 2007. Short-term meditation training improves attention and self-regulation.
PNAS 104(43): 17152-17156.

Teper, R., Segal, Z. V., and Inzlicht, M. 2013. Inside the mindful mind: How mindfulness enhances
emotion regulation through improvements in executive control. Current Directions in Psychological
Science 22(6): 449-454.

Thittila, S. U. (tr.) 1969. The book of analysis (Vibhaga). London: The Pli Text Society.

Valentine, E. R., and Sweet, P. L. G. 1999. Meditation and attention: A comparison of the effects of
concentrative and mindfulness meditation on sustained attention. Mental Health, Religion &
Culture 2(1): 59-70.

Wadlinger, H. A., and Isaacowitz, D. M. 2011. Fixing our focus: Training attention to regulate
emotion. Personality and Social Psychology Review 15(1): 75-102.

Walshe, M. (tr.) 1995. The long discourses of the Buddha: A translation of the Dgha Nikya.
Boston: Wisdom Publications