When mindfulness hurts
A friend pointed me to the very interesting article “Lotus Therapy” in today’s NY Times, which discusses the current state of the research, pro and con, on mindfulness as a clinical intervention.
Criticisms of mindfulness are particularly interesting to me, partly because I experience mindfulness, at root, to be a simple increase in awareness — and not even at the “synthetic” level of thought, but rather at the even more basic level of perception.
Since the practice of mindfulness is virtually synonymous with an increase in perception, or elementary awareness, I often find myself wondering, “How on earth can raising awareness be bad?”
So that is, perhaps, a philosophical bias I bring to the table, from the outset — I don’t understand how awareness can be bad. Ever. Not in principle, as a way of living.
Occasionally I get the impression that mindfulness is being criticized because the critic has something akin to a religious phobia, and their criticisms of mindfulness are just a by-product of that, since mindfulness therapies are derived, historically, from Buddhism.
I get that vibe, for example, in this quote from critic Scott Lilienfield in the article:
“What concerns me is the hype, the talk about changing the world, this allure of the guru that the field of psychotherapy has a tendency to cultivate.”
I personally attended a training in Mindfulness Based Stress Reduction (the gold standard in mindfulness as a clinical intervention) and I don’t recall anything about gurus or changing the world. If anything, the approach being taught seemed systematically stripped of it cultural underpinnings in Buddhism and the various Zen traditions from which it originated.
So I wonder where this concern of his is coming from; does it relate to the empirical treatments being offered, or is it something he picked up elsewhere?
Also, sometimes people criticize mindfulness meditation because they do not recognize the difference between mindfulness meditation (which involves increasing one’s awareness of reality) and transcendental meditation (which involves entering a trance and, essentially, temporarily decreasing one’s contact with reality).
The latter was quite popular, and controversial, in the 1970s, but is fundamentally dissimilar from mindfulness meditation.
On the other hand, there are certain criticisms of mindfulness that appear to have undeniable empirical merit — assuming the results upon which they’re based can be taken at face value:
A case in point is mindfulness-based therapy to prevent a relapse into depression. The treatment significantly reduced the risk of relapse in people who have had three or more episodes of depression. But it may have had the opposite effect on people who had one or two previous episodes, two studies suggest.
Why would mindfulness help people with three or more episodes, but hurt people with two or fewer?
Understanding the dynamics involved, it seems to me, could do much to increase our grasp of the human mind, as well as mindfulness therapies.
Could it be that, for patients with two or fewer episodes, the mind’s natural defense mechanisms are more safe or useful, at least in the short term, than an increase in awareness?
I would enjoy hearing theories from anyone with some grasp of the dynamics involved, and preferably some first-hand personal experience with mindfulness practice.
Why would mindfulness — even when removed entirely from any religious trappings — help certain patients, while hurting others?
i practiced mindfulness meditation almost daily for about 3 or 4 years, plus about 2 weeks of silent retreat per year.
if you had asked me back then about this form of meditation, i would have raved about it, said how helpful it was, and suggested you try it yourself.
in retrospect, however, i can see that this sentiment came entirely from self-deception, wishful thinking, and groupthink. mindfulness meditation did not make me less depressed, less anxious, more happy, or more peaceful. but it promised these things, and i wanted them very badly, and i didn’t know of any other path, so i convinced myself that this path was the path to be on.
it was only when i discovered an alternative–Adyashanti’s True Meditation–that i was able to admit to myself how unhelpful mindfulness meditation was to me.
adyashanti helped me to see, indirectly, that mindfulness meditation does not actually increase awareness. it simply focuses attention on particular objects, whether they be the breath, sensations, emotions, or thoughts. at its core, mindfulness meditation isn’t really that different from the so-called “concentration meditations”–which involve focusing on things like mantras and images–because they both involve manipulating attention. adyashanti explains–and i now know from experience–that awareness is present all the time. it’s just that sometimes it’s focused narrowly and sometimes it’s focused so diffusely that we don’t even realize that we’re aware.
regardless, therapeutic effects came to me not from being either mindful or concentrated, but from being non-manipulating. in other words, allowing the attention to focus on whatever it is naturally inclined to focus on, allowing the body to position itself in whatever position it is naturally inclined to position itself in (which, i’ve discovered, is never in an artificially rigid position on a so-called meditation cushion, for my body at least), and allowing the thoughts and emotions to move however they please. over the last year-and-a-half that i’ve been practicing “true meditation,” i’ve become significantly less depressed and anxious, and significantly more peaceful and happy. however, there have been times when the meditation has allowed a great deal of depression and anxiety to rise to the surface that i had previously been not allowing myself to fully experience, so this path is not always an easy one. however, the unpleasant feelings, i’ve found, naturally release themselves when i release control, which was notthe case when i practiced mindfulness meditation.
furthermore, spiritual teachers and counselors have noted to me the progress they’ve observed in me over the last year-and-a-half, which was not the case when i was involved in mindfulness meditation. furthermore, once i left the mindfulness meditation community and its tendencies towards groupthink, i began to meet people who were similarly unimpressed by its results.
so it doesn’t surprise me to read things like the following in the new york times article:
i don’t deny that mindfulness meditation may be somewhat helpful to some people for some problems in some contexts. however, in my experience and from what i’ve observed in others, it does not lead to the incomparable peace that the buddha supposedly experienced–which is not surprising, given how much distortion in his teachings probably occurred over the thousands of years since he died–while the “true meditation” that adyashanti describes can.
Very nice post! I am a psychologist who is trained in (and who trains others in) mindfulness-based interventions. I am very interested in the recent discussions in the media (including blogs) about mindfulness, the research support (or lack of support) for the effectiveness of mindfulness/meditation, and the question of contra-indications (i.e., is it harmful for some?). Bottom line: the early research (as reflected by the NIMH meta-analysis that came to no conclusion) was not well-designed, in part because there was very little if any financial (grant) support for sophisticated research designs with large numbers of subjects, control groups, etc. The work on Mindfulness-Based Cognitive Therapy (MBCT) is exciting and intriguing… but the conclusions that are being drawn from precisely TWO well-designed studies is, to say the least, premature… and premature in BOTH directions. Some are beating the drum saying that MBCT is a proven method for patients with a history of depression; others are saying that MBCT is harmful for patients with fewer than two prior episodes. Balderdash I say! It takes time, a lot of time and money, and more time and money, to design good research, get it funded, run the studies, analyze the results, write it up, submit it to journals and conferences, and wait for publication. What I am seeing now is that the big funding agencies (NIH, NIMH) are really funding high quality work at major institutions (USC, Emory, UCLA, U of Wisconsin), and the preliminary results I am hearing about, at research conferences, are looking good. Over the next five years, we will see where we are.
Also, it’s good to remember that there are really NO psychotherapeutic interventions, including psycho-pharmacology, that have really well-designed studies that truly demonstrate the kind of effectiveness that we would all like to see. Psychotherapy (and this includes mindfulness-based interventions) are multi-modal treatment packages, and it is nearly impossible to design true “control group” conditions. It is also very, very difficult to parcel out the different components that exist in all psychotherapeutic interventions. One of the comments to this post mentions the whole idea of self-deception, which is related to “placebo,” and expectancy effects, and just plain garden variety rationalization (I paid for this and worked really hard in the therapy and so therefore I MUST be feeling better, and it MUST be due to the therapy)…. Again, all this can, to some extent, be examined with well-designed research. But we really have to recognize that there are limitations to empirical research methods in some areas of human functioning. Remember that clinical research in medicine often consists of what we would really call the “anecdotal,” i.e., the single case study. Hard to call that “empirical research.” Yet it has SOMETIMES produced wonderful results, and it is still highly respected in the medical journals…
Lovely blog! Glad to have found it!
Delany
Damian,
Nice Post!!
Ironically the type of meditation Adyashanti teaches IS found inside the Zen tradition. It is called Shikantaza which translates as “Just Sitting”. Unfortunately Adya’s teacher came from a lineage whose teachings, including Shikantaza, were very muddled in a goal oriented fashion. The other unfortunate thing is that when Zen was transplanted to the west, Shikantaza was considered to advanced for westerners on so many of the teachers thought that we needed to learn to concentrate.
The only major difference between Adya’s “True Meditation” and “Shikantaza” is the later’s emphasis on posture(which as a clinical exercise operator I tend to agree with). In the Soto Zen tradition they make it very clear that Zazen or Shikantaza is NOT meditation.
Al
Al,
Very interesting…
In Adya’s true meditation, he says allow your body to sit (or stand, or lie down, or stand on your head) in whatever position it is inclined to be in, and do three things: (1) Let go of control. (2) Allow everything to be as it is. (3) Ask yourself the question, “What am I?”, recognize that anything the mind comes up with is false, and feel the body. (I personally never found the “what am I?” questioning helpful–I asked Adya about this and he told me that the only purpose of such questioning is as a means to the end of letting go, and if you’ve already discovered who you really are and can let go directly, then it’s better to do that.)
Anyway, my question to you, Al, is: Are these instructions or something similar given in Shikantaza or Zazen? I heard that oftentimes no instructions are given in these practices.
I also recall Adya saying he understands the idea behind concentrating on the breath to quell the mind before practicing “true meditation.” The problem is, he said (as I recall), that most people never get beyond focusing on the breath to practice true meditation. (And, incidentally, I would argue that mindfulness meditation is really just a more complex form of concentration practice, as one is still controlling the mind to focus on particular objects–whether it be a sensation, a feeling, or a thought–rather than letting go and allowing the mind do whatever it is naturally inclined to do.)
Damian
PS I think I recall Adya saying he did a great deal of damage to his knees sitting in full lotus position during zazen. Personally, I find meditating while lying in bed (sometimes thrashing, when my body is so inclined) much more comfortable
Damien,
You’re correct, very few instructions are given other than how to position the body. This varies from teacher to teacher though. In general you are told to just sit there and everytime you notice yourself drifting off to far, straighten up.
I value Adya’s True Meditation disc as it was my gateway into meditation. The problem for me was that when I let my body do whatever it wanted to I just fell asleep. Every single time I sat down to floow his method I was passed out in 5 minutes. I think for many people there is a reason for this. If the spine is held in a neutral position the autonomic nervous system tends to not veer to far towards the parasypathetic or the sympathetic. It stays balanced. I’ve personally recieved more help form Brad Warner’s Hardcore Zen and Sit Down and Shut Up as well as works by other Soto Zen masters. Their works tend to be much less spiritual.
Please don’t get me wrong. I like Adya’s teachings on meditation, I just don’t think his path with regards to his other teachings are for me( or the “little me”
Al
Al,
Your thoughts about positioning the body make some sense.
I should say, however, that in my experience, falling asleep is not a problem to be fixed. In fact, I spent years trying to stop myself from falling asleep during mindfulness meditation. I tried sitting up straight, I tried standing up, I tried walking around, I tried opening my eyes, etc., and nothing seemed to help. It was always a struggle, and it always caused suffering. When I discovered “true meditation,” I stopped trying to stop the body from falling asleep. I meditated lying down and allowed myself to fall asleep if and when the body was inclined to do so. Lo and behold, I felt so much better. I realized that the sleepiness was not an obstacle to be overcome, as some mindfulness teachers had suggested (sloth and torpor, some of them derogatorily call it). Instead, it was simply a sign that the body needed to rejuvenate, and when I allowed it to fall asleep, rejuvenate it did.
There is this idea amongst many mindfulness meditators and teachers, I’ve observed, that if we control the mind and the body enough, we’ll get into some special state. While this may be true, in some cases (and come to think of it, there were rare instances in which I did feel quite peaceful during and immediately following mindfulness meditation), I haven’t observed it to have a lasting effect. The first enlightened teacher I sat with, a Buddhist monk named Ajahn Jumnian, said some monks (such as himself, before he was enlightened) could become extremely peaceful doing long hours of concentration meditation year after year, but then when something untoward would happen to them, they would often explode with rage. And as I wrote in an earlier comment, I regard mindfulness meditation as essentially a complex form of concentration.
When I began practicing true meditation, I found that the distinction between “time spent meditating” and “time not spent meditating” dissolved. Now it feels like I’m meditating 24/7, and it happens naturally, because you don’t have to be sitting in quarter-lotus, half-lotus, or full lotus (or on a bench or in a chair) to let go of control and allow everything to be as it is. In fact, to truly let go of control and allow everything to be as it is, you have to allow the body to do what it wants, whether it be lying down, falling asleep, standing on its head, or gorging itself with pizza. This, unlike mindfulness, has allowed rage (and every other emotion under the sun) to arise and to pass through me, to start to reveal the natural, ever-present love and contentment underneath.
Damian
Damian,
I really value you’re insights and experience. I think the teachings between Shikantaza and True Meditation are the same except fot the posture thing. In all honesty this could merely be the Japanese influence and its cultural trappings(with regards to Shikantaza).
Al
This discussion raises a whole series of issues I find important.
Joshua’s point about how can awareness be bad reminds me of what Albert Ellis, a therapist about as far from mindfulness meditation as you can get, said about how he had to disabuse people of their judgmental attitudes before he could help them by disabusing them of their unrealistic ideas about themselves. If I think it is awful, unacceptable, to harbor any hateful feelings, and I then suddenly start practicing mindfulness meditation and become aware of my sometimes all-too-human hateful feelings, this may not prove to be a step toward long-term improvement.
On mindfulness meditation as involving manipulation: my favorite form of meditation from my Mindfulness-Based Stress Reduction courses is “choiceless awareness,” where one just lets oneself notice whatever comes up, without getting lost in thought any more than one must. This seems non-manipulative enough. However, after doing this kind of meditation for a couple of years, I have started wondering whether the very peaceful state I usually get into this way may be less useful than if some more “stuff” came up during the session so that I would have something more to process.
Equanimity is great, and it does carry over to a good extent to the rest of life, but I’d also like more troublesome stuff to deal with while I am in a mindful mode to deal. So I may try something more along the lines of “True Meditation.” I particularly like the idea of assuming whatever posture feels right at the time. I think much of the value that mindfulness meditation could have for westerners is missed due to some teachers’ thinking that eastern ways of sitting on the floor are somehow an important aspect of the practice. I do find that sitting (on a sofa) meditation leads to characteristically different results than lying (in a bed) meditation and I do find both quite valuable and both usually more or less pleasurable.
Thanks for the chance to think and talk about these matters.
Hi Ken,
I liked your post.
I particularly like your contrast between “choiceless awareness” and “true meditation.” I never got the equanimity you seemed to have gotten from “choiceless awareness,” but I did find that way more “stuff” came up during “true meditation.” When I stopped manipulating the mind (not to mention the body), even to try to make it more acutely aware, all kinds of repressed “stuff” came into my consciousness. And as I allowed the process of complete non-control to continue, the “stuff” seemed to pass through me and become fully “metabolized,” so that it became no longer trapped inside (this process continues with more “stuff” on a daily basis). It can be scary, I imagine, if one doesn’t realize that it is a normal, healthy part of the spiritual awakening/growth process, and if one has not realized that one’s judgments are just judgments. But if one is properly prepared and is ready to let go of control completely, it can be–in my experience, at least–the most liberating thing in the world.
Damian
Hey Damian,
I liked that post alot.
Have you read “Wake Up Now” yet?
Al
Hi Al,
I have not read Wake Up Now. It is sitting on my shelf along with many other unread books. I stopped reading books about a year ago. I feel like I have more than enough (too much, really) intellectual understanding, compared to experiential understanding; these days, I’m more interested in letting the awakening process unfold on its own and following the desires of the heart. And in the last year, the heart has not called me to read books, probably because I read way too many books prior to that. That said, I’m curious, if you’re reading it, what, if anything, you’re getting out of it.
Damian
Hey Damian,
I’ve only read through the intro and the first chapter in the book store. I t looks great, but like you, I think(maybe a bad thing) long and hard before adding another book to my already overflowing shelf. I do struggle with my love for reading and trying to not fill my head with ideas about experience.
Al