“Jill” is 32 and works as a lawyer in the southwest. She wrote to me explaining that during her meditation she sometimes feels a panic attack coming on and has disturbing mental images. She cannot control it and does not know what she is doing wrong. When we talk for the first time I ask her when it began. “It started a few months after my therapist taught me mindfulness…”
Third wave Cognitive-Behavioral Therapy (CBT) is the marriage of modern psychology and ancient buddhist meditation. It has grown rapidly in the past decade, and many psychologists and meditation teachers are enthusiastic about the development, seeing it as a blend of the very best of eastern wisdom with western psychological science. Third wave CBT goes under a variety of names such as Mindfulness-Based CBT (MBCBT), Dialectical Behavior Therapy (DBT), Acceptance and Commitment Therapy (ACT) and Mindfulness-Based Stress Reduction (MBSR). There are also less structured approaches and informal sitting groups springing up in clinics across the country. It is the rare hospital or clinic that does not have a meditation group these days. This has resulted in a historically unique situation. Psychologists, medical doctors, social workers and counselors are rapidly becoming the vanguard of meditation in the west, introducing people who may have never meditated to the practice.
All these approaches have the common elements of CBT (recognizing and challenging maladaptive thoughts) and a version of meditation that goes under the moniker “mindfulness meditation” or sometimes just “mindfulness.” A review of the treatment manuals for DBT, ACT, MBSR and MBCBT suggest that “mindfulness meditation” is something close to a “soft-vipassana.” The person doing meditation in these treatment protocols is instructed to watch thoughts and feelings come and go on their own without judgment. This leads to the insight that one does not need to believe in, or act on, thoughts or feelings. This is perfect for CBT, which emphasizes the importance of thoughts and beliefs as the drivers of mood disorders. I call mindfulness meditation a “soft” version of vipassana because it stops short of instructing the person to see that everything in awareness is coming and going and is not owned. It also does not emphasize the kind of intense or rapid momentary concentration that marks some vipassana techniques. Instead, clinical mindfulness focuses on relaxation and gentleness (but not samadhi) and points the person to watch thinking and emotional reactions. I would argue that these differences are a very good thing because, despite popular opinion, traditional vipassana would be terrible medicine for a person who is emotionally distraught, unstable, and unable to cope.
That last sentence may be a bit shocking to some. If you are like most people, you associate meditation, all types of meditation, with happiness, relaxation, and maybe even bliss. The idea that it could produce difficulty is not only counter intuitive, it is anathema to how meditation is presented in the west. If anything difficult does occur during the meditation the meditator is likely to feel that they are doing something wrong. If he or she goes to a meditation teacher the advice will likely be to just “let it go,” “drop it,” or my favorite, “thank your mind for it.” This is patronizing. It gives the false impression that if anything distressing does occur during meditation, the problem is one of technique or reactivity on behalf of the meditator. In reality difficult experiences in meditation, ones that are remarkably similar to the symptoms of many mood disorders, are so normal that the most ancient surviving meditation manuals in Buddhism go into great detail about them, categorizing them into six distinct types that occur in a specific order. Far from being a sign of poor meditation, they are actually described as a sign of deepening insight. In other words, the most ancient manuals not only affirm that difficult experiences occur during serious meditation, they posit that these experiences are supposed to happen. They are a definite sign of one’s movement along what the famous Burmese meditation master Mahasi Sayadaw coined The Progress of Insight, and are known as the “dukkha nanas” or “insights into suffering.” This might sound bad, but the good news is that these more distressing insights only occur when one is well on the way and down the path. Meditators usually have to go through a lot of sitting time, develop strong concentration, and become very equanimous before they can enter into the later insights. For this reason it is unlikely that a soft-vipassana approach can get one very far beyond the initial insights and into the dukkha nanas. So in a clinical setting if you stick to the instructions and don’t overdo it, nothing unsettling is likely to occur. I do not believe mindfulness meditation is intentionally designed for this, but if it was it would be a damn clever modification of traditional vipassana.
Despite the limits of mindfulness meditation, there is a problem. A small number of people in clinical settings are unexpectedly good at meditation. With the barest instruction, some people are able to launch themselves deep into the rabbit hole of insights that vipassana is intended to produce. It is an experience that can be troubling and even destabilizing, particularly if one has no idea that it is coming. As third wave CBT has boomed in the past decade these people have become a significant minority in the meditation community. Introduced to meditation through therapy, they find themselves on an emotional ride to which they never agreed, encountering upheavals and difficult truths at the very moment in their lives when they are least able to handle them. That is bad enough, but much worse is that many of the well-intentioned clinicians who teach these techniques have no idea that anything troubling could occur.
Many of the developers of these approaches received their training in meditation through Zen, which eschews the more old fashioned stage-models of insight, and therefore does not formally recognize the predictable difficulties that arise (though every Zen teacher I’ve met is cognizant of them and is well-prepared to handle them). Additionally, for reasons too complex to go into here, traditional vipassana teachers in the west have elected to present the practice without much emphasis on the traditional stages of insight. And so, without intending to, they often leave the simplistic impression that there are no difficulties associated with insight, and that more meditation equals more happiness. The inspired psychologists who learn from these teachers come away greatly impressed with meditation, but with little to no knowledge of the dukkha nanas. They return to their clinics, offices and hospitals and find novel ways to integrate meditation into the treatments of unstable people. Most of these people get great benefit. Some have a different experience, one that is unsettling. And while many meditators may object to this characterization, pointing out that their own experience of dukkha nanas was not so difficult, I would argue that most people who go through it with little trouble are not in the midst of therapy or suicidal.
People who have had this unexpected experience are growing in numbers and are starting to share with each other and with more traditional meditators. They have come to call the dukkha nanas the “dark night” after the Christian experience (some teachers believe they may be in the same mystical family if not the same thing). They are sharing and seeking advice on internet forums and in settings such as the Cheetah House and Dark Night Project where they feel they will not be told to simply “drop it” but will be supported in gaining understanding. They are an unseen, and as yet unrecognized, growing minority of western meditators. Many have no sangha, no formal teacher, no texts or canon, no philosophy or anything resembling “faith.” They are frequently alone, searching the Internet for anyone like themselves, trying to sift through the overwhelmingly positive pitch for meditation for some nugget of information that can illuminate their experience. Like refugees with no home, they do not understand what is happening to them or why, and they often do not know what to do or where to go for help.
This issue is not abstract for me and perhaps my own experience will shed light on why I care so much. Two years ago I received the green light from my teacher to begin teaching insight meditation. I put up a website, told those who knew me what I was up to, and waited to see who would be interested. While I made an effort to write in my own voice, which can be irreverent, what I presented was right down the middle vipassana. However, I did do one thing that was unusual and for which I am very grateful. I went against the common practice of downplaying the insight stages and instead put them front-and-center on the site. I did this because my teacher was clear about them with me, so I followed suit and was candid about them in my teaching. I made sure to include a rich description of the dukkha nanas and cautions to those who may be about to plunge into them. Unbeknownst to me this one gesture of understanding came to define my experience of teaching for the next two years, as the great majority of people who contacted me, and continue to contact me, are in the dark night. Most got into it through formal practice (amazingly, it doesn’t seem to matter much which technique or tradition). But I was alarmed when it seemed that a significant number, perhaps a third, learned to meditate from their therapist or from a group in a clinical setting. Sometimes they were actively suicidal at the time they learned to meditate. Interestingly, the majority never discussed their negative experiences while they were in therapy. Like the therapists themselves, they wanted to believe that meditation was helping, and so they dismissed what was occurring or blamed it on the thing that brought them to therapy in the first place.
As a psychologist this is more than a bit embarrassing, it is troubling. It is one of the ethical principles of psychology that no intervention is done without fully explaining the risks and benefits of the treatment. If an intervention could possibly cause distress, even mild distress, psychologists are ethically obligated to inform the person of this possibility and gain their informed consent before proceeding. Psychologists are not doing this when it comes to mindfulness meditation, chiefly because they do not know there are risks. But more and more people who have participated in it know that there are. This is not a situation created by malice, but by ignorance. Psychologists simply were not told this could ever happen, and were given the impression that the results of meditation were exclusively happiness, calm, and increased wellbeing. They are not to be blamed for this situation, as they have merely borrowed a problem that already existed in the way meditation was being taught to students in the west. It is a problem that continues and in some ways defines what “mainstream” meditation teaching is in the west.
While this is not psychology’s fault, it is only a matter of time before the consequences lay squarely on the shoulders of psychologists who teach mindfulness meditation. Sooner or later, those who teach it will learn about the progress of insight and the dark night. Either from writings like this or from patients themselves. When they do they will face an ethical dilemma about whether to continue teaching meditation in clinical settings. While meditation teachers can essentially “get away” with not telling people about the dark night, psychologists do not have this luxury. Ethically, we are obligated to acknowledge the risks and be cautious. This is not happening yet, but it is my sincere hope that those enamored of third wave CBT will examine not only the manuals and the studies, but look deeply into the descriptions of insight in the pali cannon. Even better, talk with meditators who have experienced a dark night, researchers who study it, or best of all dive into it and see what it is like. Psychologists might benefit most from going beyond mindfulness meditation, breaking loose of the manual, and seeing how far this practice can go. Then there might be more respect for the powerful, and sometimes life-shaking, changes that vipassana can create in the heart and mind. It is my hope that psychology will soon lose its infatuation with meditation, and begin to evaluate it as a tool for change in a more mature light, seeing both the promise and the dilemmas. Until this happens I expect the community of mindfulness meditation refugees to grow.
Mindfulness has become a wildly popular concept. It is rare that a term from a contemplative tradition breaks into popular culture with such vividness and recognition. Self-help sections in bookstores are now chock-full of guides on mindfulness for everyday living. In psychology, an alphabet soup of therapies capitalize on mindfulness, such as MBSR, MB-CBT, ACT, and DBT. It is no longer unusual to hear business gurus describe mindfulness as a way to increase productivity, sports trainers claim it as way to get in the zone and or celebrities tout it as fashionable. Mindfulness has struck a nerve in our popular culture, and people are looking to it for answers to their problems.
Mindfulness is sometimes presented as a panacea, a magic bullet that will strike down our illusions in a moment and make us smarter, happier and stress-free. This hype around mindfulness, while bringing greater attention to meditation, also blurs mindfulness in the public imagination into a vague cure-all. This snake-oil approach to mindfulness is what I call the Myth of Mindfulness.
With so much hype about mindfulness, it would be easy to assume that everyone knows what it is. Students who are new to meditation are often not clear on what mindfulness really is, and are too embarrassed to ask, because they assumed that if everyone is talking about it, then everyone else gets it. But in reality, pop culture definitions show that it is greatly misunderstood. So sincere practitioners get confused and are too embarrassed to ask about it. It sometimes gets defined as “attention,” “focus” or “being completely in touch.” In more mystical writings I have seen it described as “presence,” “surrender” or “being in the here and now.” In the psychological and stress reduction literatures there is a focus on mindfulness as being “nonjudgmental attention” and “radical acceptance.”
This is where meditators are often left scratching their heads. If mindfulness boils down to nonjudgmental acceptance of everything, and paying full attention in the moment, then how does it liberate us from our illusions? After all, someone deeply engrossed in a rampage during a game of Grand Theft Auto has great mindfulness by that definition. Someone breaking into a house is very mindful of every little noise they make, and is totally “present”. If you stop to think about it, I’m sure you can imagine many scenarios in which people can be “mindful” and do awful or even stupid things. So for someone trying to awaken, mindfulness by some of the most popular definitions doesn’t make a lot of sense. In the context of Buddhist meditation what does mindfulness really mean?
Mindfulness in four easy pieces
The reason why the popular definitions confuse beginning meditators is because they are meant to serve totally different ends than those in meditation. In the therapy literature mindfulness is intended to help the person relax and get in touch with their feelings, which is not the focus of mindfulness in Buddhist meditation (though it is often a nice side-effect). In the self-help literature mindfulness is often intended as a way to help the ego accomplish something or get something – which is actually the opposite of what mindfulness is used for in contemplative traditions. It may be cynical to say, but celebrity versions of mindfulness are simply meant to enhance a public persona and will remain in the public eye until mindfulness has jumped the shark. If the meditator relies on pop concepts of mindfulness, they will be working against the path rather than moving forward.
Many definitions of mindfulness that are out there leave out three-fourths of the picture. They have it right when they include attention, so we can think of that as the first piece. What follows is a discussion of the other three missing pieces.
Piece 2: Mindfulness of… a meditation object
In order to pay attention, accept, or be nonjudgmental you need something to pay attention to and be nonjudgmental about. What you need is called an “object” in meditation. An “object” has a special place in the world of meditation; it is what the meditator selects as the focus and centerpiece of the meditation. Objects come in all shapes and sizes. Just about anything (and literally “no-thing”) can be an object. Objects are what the mind uses to get the meditation going and keep it going. Some traditional objects are the breath, sensations in the body, a repeated word or phrase, a question, the flow of thoughts, mental images, painted discs called kasinas, emotions and hundreds of other things. In some traditions the goal of the meditation is to maintain an awareness of the object through literally every waking moment. In specialized practices the mind is allowed to freely wander and whatever it naturally focuses on becomes an object for an instant, before it moves on to something else. In the context of practice it is important to remember that mindfulness is always “mindfulness of…” there is always an object to which the attention is applied. This crucial piece is what is often missing in pop definitions of mindfulness, as if it were a disembodied process with nothing to anchor it in reality.
Piece 3: The Quality of Attention – Falling in love with the object
But this is not the whole picture. Mindfulness is not just being present in the moment. It is not simply attention, and it is not the object either. And it is not both. It is an intimacy between the meditator and object that is unique depending on the person and object. At this point, the attitude of the meditator plays a great role in mindfulness. The meditator begins to build a relationship with the object, to learn about it, understand it, and become deeply alive to it. The meditator needs to generate curiosity, interest and affection for the object. I once heard the concentration meditation teacher Tina Rasmussen describe this process as “falling in love with the object.” This is a perfect way of describing it.
Piece 4: Remembering to remember
Adding to the complexity, and depth, of this practice-oriented view of mindfulness is that it also includes the act of remembering – the last piece of the picture. Staying focused on an object, even for a few minutes, can be difficult. There is effort involved in staying with the object, especially at first, because the mind likes to wander off. What is needed is a constant act of remembering to pay attention to the object. This act of remembering is also referred to with the shorthand: “mindfulness.” This is the work of meditation and it can be very difficult for some meditators. I have been meditating for years and I still need to put effort in each time I choose an object and “put mindfulness before” me, as the Buddha described it. That initial effort gets easier and easier as time goes on, and eventually you will even take joy in that effort, as if the act of remembering brings with it the inspiration to keep at it.
A mature practitioner will see that though mindfulness does indeed include attention to the present moment, it is so much more. Mindfulness is the gentle, recurring, building of a relationship between the mind of the meditator and an object of meditation. To build this relationship the meditator constantly guides the mind back to the object and surrenders as much attention to the object as they can. In this process, the mind becomes quiet and still, and the object starts to become more and more joyful to watch. Once the meditator begins to master mindfulness, they will find that they are wondering “…is this it? There must be more than this.” And the answer is that there is much, much more. When mindfulness increases, so do the other factors of meditation, particularly concentration, energy and investigation. At this point, two things can happen, the meditator can increase attention so much that they experience “absorption” with the object, in which the object seems to absorb the whole of experience, or the meditator can begin investigating the object to see if the teachings of the Dharma are true (check out the General Dharma page for more). What the meditator will inevitably discover though, is that mindfulness is not all that there is to meditation and awakening. Mindfulness is the foundation upon which more complex and subtle meditative techniques rest. It is the first skill a meditator learns, the one that is done throughout all of one’s practice as a supporting background, and the one that continues to need refreshing even after enlightenment.
Once the meditator has mastered mindfulness, they may be surprised by what he or she is not experiencing. The meditator finds that mindfulness does not translate into a complete lack of stress, or a solution to the problems of life. The meditator will not become more beautiful, begin to make genius business decisions or suddenly dunk baskets like a star. In fact, becoming even more sensitive and attentive in general might make you more irritable, not less! This might seem like a let down to those who have bought into the myth of mindfulness, but that is only because the myth caters to the very thing that all of pop culture caters to: the ego. In developing and truly experiencing mindfulness, the meditator cannot help but gradually shed illusions, and the biggest illusion of all is the self. This can happen in a sudden wallop of absorption, on through the gradual erosion of illusion that insight produces. Either way, if you engage in a sincere practice of mindfulness you will find that while the myth sounded nice, the reality is far far better.