The Physio-Cognitive Stage

The Physio-Cognitive Stage

  1. Mind and Body
  2. Cause and Effect
  3. Three Characteristics

I call the first phase of mediation the physio-cognitive stage because the insights associated with it are primarily about the body, mind, and their connection and characteristics. This stage can feel pretty mundane, and practioners often don’t even know that they are in this stage. I had no idea that I had gone through it the first time it happened. It wasn’t until things got exciting that it became clear that I must have already gone through these and it wasn’t until I went through them many times that I was even able to see them clearly.


Mind and Body

The physio-cognitive section of the path begins when the meditator enters into the stage of Mind and Body. During this stage the meditator’s mind begins to sync up with the beginnings of phenomena, and when they note whatever comes into awareness the meditator begins to distinguish their thoughts from their bodily sensations. This can seem pretty mundane and uneventful, but it is actually pretty valuable information. It is an understanding that is needed before any further insights are possible. For those who are particularly attuned to their own states, they may notice a subtle shift from being the thoughts and sensations to watching them.

The primary insight that is gained in this stage is that the mind and the body are truly different. Of course we all know that this is so on a cognitive level, but there is a big difference between knowing this and seeing it in real time. Actually seeing these truths as they are happening has a profound effect on the mind. Oddly, while the effect can be profound, in that certain doubts vanish, it is an effect that can be easy to miss. This is often true of many of the insights that occur. This is because the insights do not leave an imprint on us at a cognitive level, but at a much deeper level.

Cause and Effect

As the meditator continues to see the mental and physical phenomena arising in awareness, a moment happens (and it often is just a moment or two) where some connection or interaction between mind and body becomes apparent. For example, let’s imagine that a meditator is doing noting -style meditation where they make a brief note of whatever arises in experience.  The meditator sees that there is an image in their mind of the car that cut them off in traffic that morning, they may note “image”, then directly following that is “anger” and then the next notes are “tightness”, “ache”, “tension”, etc. In that instant a connection between what the mind does and the body experiences becomes obvious (so obvious that we often miss it). Here we see that thoughts are connected to feelings are connected to behaviors are connected to thoughts and so on, in a chain of cause and effect.

Beginners usually do not know that they have even been through cause and effect, not only because it is brief and uneventful, but because this is usually stuff that we think we know already. But we only know it at a cognitive level, and if you haven’t guessed it already, I don’t give the cognitive level much respect when it comes to the path. Knowing something at the cognitive level can make it seem like we understand something, but the big difference between a cognitive understanding and a deep insight is that cognitive understandings change what we think, but deep insights change how we are.

An important thing to note about the stage of cause and effect is that some people can easily get stuck there. Because cause and effect is all about the connections between things, it can be a quagmire for one’s individual mental content, in other words, your “stuff.” But please remember that the path is not about understanding your stuff (though that can be a nice side-effect), it is about understanding reality itself. Getting caught in your stuff can be a very tempting distraction. For example, during this stage it is not unusual to think about something insensitive that you did or said and then notice tension in the face, or burning in the chest or abdomen. Before you know it, you’ll be spinning out scenarios about how your relationship issues or family problems are leading to emotional and physical distress. Will these scenarios be wrong? Not necessarily. But will they support you in seeing reality clearly? Not at all.

Three Characteristics

At some point the meditator begins to notice three things about the mental and physical phenomena they are watching: none of them are really “me” (because “I” am watching them), all of them are impermanent, and almost all of them are actually pretty unpleasant or at least unsatisfactory in some ways that are obvious and some that are pretty subtle.  These three insights do not usually occur at a cognitive level (though they sometimes do). A meditator who has gone through this stage might not be able to name what it has taught them, but if they hear about these three characteristics they will instantly recognize the truth of them. From this point forward, there will be something compelling about the three characteristics – they will just make intuitive sense.

For some, this stage can be pretty unpleasant. The effects of seeing the three characteristics can lead to negative emotions for some meditators. It is impossible to tell ahead of time how strong the possible negative effects of this stage might be, but there is the potential to get stuck in the negativity that this stage can summon up in the meditator. If you are experiencing difficult emotions and wonder if they might be related to this stage, it is worth working it out with a meditation teacher. Don’t stay stuck in any stage longer than necessary to get the insights needed and move on.

The Physio-Cognitive Stage and Modern Psychology

A couple of interesting points about these three stages are worth noting before moving on. First, people who are familiar with psychology and with cognitive-behavioral theory in particular will recognize that the first two stages constitute what is called the “cognitive model.” The cognitive model is the notion that thoughts, feelings and behaviors are directly linked and that if you change one of them the other two must change as well. It is the foundation of most modern psychotherapy. Needless to say, getting some direct experience of this and seeing the reality of it can certainly help one to see how to get into and out of problems. Modern CBT, sometimes called “Third Wave CBT”, takes advantage of this by encouraging people in treatment to practice mindfulness and see how thoughts, feelings and behaviors are connected in the moment.

Because the first two stages are essentially covering the ground that is the foundation of modern psychotherapy, most of what constitutes “mindfulness” training in most clinical settings is actually the experience of these two initial stages and sometimes the third. Mindfulness therapies like MBSR, DBT and ACT emphasize these three insight stages and the therapeutic benefit that can come with them. These kinds of therapies are particularly good at helping people to recognize when they are getting caught in cause and effect, and moving them on to three characteristics. I’d would venture to say that most basic mindfulness trainings that occur outside of clinical settings tend to cover just these three insight stages and end there. Sometimes these stages are even presented as the whole path. However, as you will discover, there is far more.

Once one has gained insight into mind and body, cause and effect and the three characteristics, the attention moves on and syncs up with the peak of sensate experience. The next stage is the Arising and Passing Away.

  1. Hello Ron,

    I appreciate the time you must be taking to explain the progress of insight in a way that is comprehensible. There are some points which I would like some clarification on.

    First, you make reference to the idea that the insights gained through vipassana meditation happen at a “deeper level” than the “cognitive level”. What would you call this deeper level? You wrote “deep insight” a number of times, but it’s not clear what you mean by this. I’ve heard this “deeper” level described as meta-cognitive awareness (awareness beyond thought), which sounds awfully clinical, but could be describing the level fairly accurately.

    Next, I’m not sure how you came to the conclusion that mindfulness-based psychotherapies like MBSR, MBCT, DBT, and ACT only reach insight stages 1-3 and the associated therapeutic benefits. I think you know from experience that stages 2 and 3 (especially the latter) are hardly therapeutic. I have a hard time imagining someone coming out of a MBSR program having reached the “Three Characteristics” stage and feeling like they made progress toward experiencing lower levels of stress. The opposite is true for me. And while the 2nd stage (Cause and Effect) can reveal the way that certain thoughts, feelings, and body sensations have what appears to be a pre-programmed function that is either pleasant, unpleasant, or neutral, there is very little information at this stage regarding how to transform the functions of these private events. In my understanding, this is where insight meditation starts to provide a more therapeutic benefit that is not rooted in the cognitive model.

    Personally, I think that these third-wave CBTs can provide a vehicle for much deeper insight than what you describe here. Many of the descriptions I’ve encountered from people who have completed the MBSR program provide phenomenal descriptions of what sounds more like the 11th stage (Equanimity) than any other.

    It is also worth mentioning that four of the six key processes of ACT (contacting the present moment, acceptance, cognitive defusion, and self-as-context) seem to highly resemble the four facets of R.A.I.N. (recognition, acceptance, investigation, non-identification) as taught by IMS teachers such as Jack Kornfield. One could argue that these processes are some of the more important and universal mechanisms of mindfulness, and that affecting them in the direction of increase will aid in one’s development on the path of insight. This has certainly been the case for me. I hate to divorce mindfulness-based psychotherapeutic processes and insight training when the divide may not be as clear as some would think. Besides, aren’t all four of the ACT and R.A.I.N. processes affecting via vipassana meditation? I wonder if targeting them separately, via different technologies, would also prove to be beneficial. It’s something to consider.

    Thanks for taking the time to read and (hopefully) respond.

    • Hey Jackson – wow that’s a lot!

      There are two really good points here: what the heck is this “deeper” level of mind, and why limit the 3rd wave therapies to the first three stages?

      As far as the first point, there are lots of names for what I’m talking about here. In psychodynamic theory it’s the unconscious, in behavioral theory it’s that pesky “black box” that can’t be known (which got smaller and smaller over the years), in cognitive theory it’s that metacognition stuff you reference. But what you call it really isn’t important, what’s important is what actually happens in experience, which is that meditators get insights before they even “know” they have them. It was my experience again and again that I could not put into words yet what had changed because of something in meditation, it couldn’t be organized into what we would call a thought, but it was there and it was working on how I saw reality. I see this all the time in people’s reports of their experiences. As far as what this deeper level of mind should be called, my suggestion would be that the meditator pick a name that best fits with their particular paradigm and go with that.

      The second question is more tricky because really no one knows what to make of these therapies yet and how they fit into the maps. I will say that I’ve been back and forth on this, and my position could do a complete 180 next week. In fact, it wasn’t that long ago that I was sure these therapies were sending people into the Dark Night without telling them. Ironically, you set me straight on that one by telling me (on a thread on KFD) that you didn’t think they could even get people to the A&P. That made me stop and reconsider, because you are such an accomplished meditator and you know a thing or two about these therapies.

      In the past year during my post-doc I’ve had a lot more exposure to these therapies and some of the leaders in the field, particularly DBT and MBSR. After seeing a lot of folks go through DBT and MBSR groups, and after having been involved in some cases with ACT, I have to say that your initial assertion was correct. These therapies are not sending people to A&P or beyond, at least not most people, and that is because the people administering the therapies have not gone that far. Some might have, but I have not met any, and I’ve learned this stuff from the people who are creating it.

      My best guess is that there may be a small percentage of people who are being taught this stuff who are getting to A&P and beyond, but the vast majority never get past cause and effect. And though these stages can be unpleasant, they really aren’t anything like the suffering that drives people into therapy in the first place. Getting stuck in cause and effect, or even three characteristics, would be a relief compared to the kind of hurt people start therapy with.

      I hope that helps you to understand why I took this position on it. Like I said, it could change at the drop of a hat, but at this point, I really see these therapies as addressing the first three stages.


      P.S. You always have asked the best questions – they have always helped me a lot!

      • Hello Ron, and thank you for the substantial reply. This is proving to be a fruitful dialog.

        I appreciate your additional details regarding the “deeper level”. You’re right that there are many different ways of conceiving of this level beyond discursive thought. I was just curious about whether or not you had a preferred explanation.

        Regarding third-wave therapies — what I hear you saying is that your experience in both observing and participating in some of these third-wave/mindfulness-based treatments supports the notion that they are not actively leading people beyond a certain stage of meditative development; specifically, the 3rd stage (Three Characteristics). For the majority of cases, I think you’re right in suggesting that most of the participants of these programs will not (on the first go-round) develop the skills necessary to traverse the A&P and beyond. If this is what you are suggesting, than I agree. These are not designed as “enlightenment programs”, and thus, are not delivered as such.

        I think what I was not so clear about was what I saw as a potential assumption that these technologies are somehow incapable of producing the results that traditional meditative practices are known to deliver. My contention is that the targeted processes of some of these therapies — ACT in particular — are the very processes that are more thoroughly affected through serious, disciplined meditative development over the long haul. Clarifying some of these processes (mediators and potential mechanisms) of mindfulness practice has been a great aid for me in understanding just what it is about meditation that leads to well-being regardless of the form and frequency of psychological events (e.g. thoughts, feelings, overt and covert behaviors). I think if these therapeutic processes are taken far enough, we may see effects similar to those of more traditional meditative practices. Because I only know this from my own experiential practice, it remains simply as an informed hypothesis.

        In a nutshell, I think the third-wavers are on to something far more profound than many of them may comprehend at present. Applied to populations suffering from the effects of psychological inflexibility, the results seem promising for alleviating enough suffering to bring them back to baseline mental health. But, I think that these processes can be further applied to encourage the development of a more optimal mental health, especially when paired with a pragmatic meditative technology such as, or similar to, vipassana. I think that both the psychotherapy and insight communities are going through an inevitable refining process, and that they’re each helping each other along — or at least they should be, in my view. What I would LOVE to see are evidence-based insight meditation practices with empirically supported principles of change. (A guy can dream.)

    • Ditto man – on everything you just wrote. You are absolutely onto something with that. More research needs to be done and the potential is huge.

      My big concern is where the DN fits into all this. When I talk to people who have done DBT, even therapists who have done it for years with thousands of people, they seem to have no idea that the DN or anything like it exists. This is just crazy, because DBT is the treatment of choice for chronically suicidal patients. You’d think that if they are going back for multiple treatments, like you suggest, they might master the skills and tip right over into the rougher stages of the path. There seems to be no plan for how to handle that.

      We absolutely need more research and the field needs to know about the map. That’s one of the reasons I’ve been collaborating with Willoughby Briton at Brown to collect info on the DN. Hopefully we can get NIMH to fund a study on it.

      The good news is that people in psychology seem pretty receptive to it. I’ve heard from other psychologists about this and they are amazed and excited that the map exists. I gave a presentation on it at the hospital that I work at and the staff were shocked that they had not heard about this stuff before. What we need is some empirical research on it so that we can fit it into the existing paradigm.

      If that happens, then these 3rd wave therapies would likely explode. And along with that, they’d likely be more sensitive to the potential negative effects of what they are doing.

      Please keep dreaming – who knows, you might be the person to really get this out there. Are you doing any big research projects for your program? If you need one, we should talk and see if you could work on this dark night project at Brown.

      BTW – I’m going to organize a discussion during the BG conference on this topic, it would be awesome if you were there. Hope you can make it!


      • Can you guys explain your acronyms, please? Just for us poor fools who would like to makes sense of this discussion, that is.


      • Ha! Yeah, here goes:
        MBSR – Mindfulness Based Stress Reduction
        DBT – Dialectical Behavior Therapy
        ACT – Acceptance and Commitment Therapy
        MBCBT – Mindfulness Based Cognitive Behavioral Therapy

        And for folks who don’t know DN = Dark Night.

        Jackson may be able to add some to this, but basically MBSR is teaching people some simple mindfulness techniques and pairing it with relaxation strategies. It is really popular in hospitals right now for patients with a lot of stress or chronic pain.
        DBT is a set of techniques where one actually learns how to meditate and there is a formal sitting group each week that is part of treatment, along with weekly one-on-one sessions. The one-on-one sessions build on the group sits by having the person switch out of “emotion mind” and into “wise mind” when discussing their issues. It has a ton of research showing how effective it is.
        ACT is a newer therapy that is modulized and starts off by teaching the person some basic mindfulness. The goal is to get them to stop identifying with their thoughts while accepting them which is called “defusion” in this approach. Once they can do this they move onto to developing a clear set of personal values and goals.
        MBCBT is, as far as I can tell, a bit of a hybrid between MBSR and cognitive behavioral therapy. The therapist does regular CBT, teaches the person the cognitive model and gets them to identify and change thoughts that lead to problems, while also teaching mindfulness. The strategy here is to help the person relax enough to be comfortable watching their own thoughts and putting them into words, so they can get on with the work of CBT.

        Hope that helps – this is actually a really abbreviated description and some core ideas are missing, but I think it has some of the basics.

      • I like what Ron said. Here’s some more info…

        MBCT is, as Ron said, based on and delivered much like MBSR. The literature supports that MBCT is effective for the treatment for major depressive disorder (recurrent), and that it reduces the frequency of future depressive episodes.

        Besides pharmacotherapy, DBT is the only well established evidence-based treatment for borderline personality disorder, for which is was designed. (I would say that DBT is more effective than drug therapy alone.) There are many facets to this therapy, and the mindfulness component takes a prominent focus as a means of increasing emotional stability and decreasing self-harming behaviors. DBT is also used to treat other personality disorders, as well as substance abuse disorders and trauma related disorders like PTSD.

        ACT (said a one word, “act”) is a wide reaching psychological treatment method which has the aim of reducing experiential avoidance behaviors, increasing psychological flexibility, and increasing values-based action in place of actions preoccupied with managing private experiences. Though not a mindfulness-based treatment per se (as it does not require systematic training in mindfulness meditation), ACT targets six key processes (contact with the present moment, acceptance, defusion, self-as-context, values, and committed action) that share much in common with mindfulness-based interventions. ACT is widely recognized as an evidence-based treatment that is as effective (and sometimes more effective) in the treatment of OCD, depression, and many other forms of psychological suffering. For the purpose of full disclosure, I’ll share that my theoretical orientation as a therapist in training is very much in line with ACT.

  2. My god, the words “evidence-based insight practice” exist outside of my youthfully naive pipe dreams? Actual practicing psychologists took interest in the insight maps without dismissing them as ancient religious descriptions of affective or dissociative disorders?

    There was just a study done here between the religious studies department and the psychology/neuroscience department, investigating meditative and mindful-movement activities. That indicates 2 professors here interested in it, both of whom I know personally, one of whom is in my department. And she’s hyperthymic, so she’s good at getting things done. (Who else but a hyperthymic could sleep 5 hours a night, and birth a daughter, and advise students, and teach classes, and run the psychology internship program, and conduct research, and conduct therapy with patients, all while being in a genuinely good mood 90% of the time?) Additionally, there is an adjunct religious studies professor who knows about the insight stages, the jhanas, has done extensive retreat time including months of insight practice, and one of her main academic interests is the split between what we’d call mushroom dharma and practical dharma in the modern USA. (She counts herself on the “practical” side of that split.) So that makes at least three.

    You know, I’ve been looking for an opportunity to do a research project next semester, instead of some dumb directed study on theories of personality. Maybe this could be it. What do you think, Ron and Jackson? (Well, really, anyone reading this is more than welcome to comment.)

  3. well i think i might be able to help here. from the other side. let me explain- i had some pretty heavy abandonment issues, and painful childhood that spiraled me into a chronic depression in my teens. then later it worsened i wound up in a severe depression i had to quit grad school and i was bedridden for 5 years most of it was agony. in retrospect i wish i had just become a drug addict to cope with the pain – it was that bad. like waking in the morning with anxiety attacks because i would immediately be overwhelmed with heart on fire pain – and it was NON STOP AGONY. like i was burning alive slowly. my father came back from living in europe just to take care of me.
    throughout my life i was on meds. a few made me worse, ( doctors didnt believe me then and kept me on one like that for a year.) i was hosptalized for suicide attempts- i was too scared to go through with it but desperate for someone to help me i think is all it was.

    i was slapped with a bipolar label. more meds, i asked for ECT but they wouldnt do it on me as i was too young ( in my late 20s) i tried CBT, DBT ( where i was labelled borderline – mostly because my family and i fought so much that i was convinced it was me- i had very bad reactions to their self absorption and reacted with rage when i was made to feel more worthless, not that unusual in retrospect, i had every right to be angry when i look back on it, i just didn’t know what to do with my anger and frustration is all)

    anyway i give you this so you know i was suffering lol ! i wasn’t a passive sufferer either. i was on the net daily researching neuroplasticity, new medicines, therapies, i read self help books ,i tried to meditate (i just cried through it) and exercise ( which once my dad could help me to encourage me to just tie my shoes and get to the gym downstairs- did help for only a few hours at a time though. weights =carido.

    now here is my experience with these modalities- all can help. im sure there is no one right answer for everyone. for me i am very open, and i worked with doctors, i was never repressed, very aware, therapy to be honest did nothing for me – but i didn’t stick at it longer than a year – casually- because i wasn’t learning anything to be honest. and it didn’t make the pain of abandonment go away. also it is a huge amount of money i felt my parents were wasting on stuff i already knew.

    there is a difference between cognitive understanding and realization. i knew all the stuff that made me what i was, but rehashing or just changing thoughts- finally i found ( by myself and went all the way to the US from Canada) for my miracle anti- depressant which is *ridiculously controversial – suboxone – which finally made me a normal person again.

    after over 20 different drugs and horrendous side effects- one made me not walk an entire month, another more suicidal, the others- at the most brought me from suicidal to chronic level of depression- a big jump but nothing to carry me over the next hurdle- interesting as i noted this same phenomenon in other patients, also the latest research has shown meds to do just that- not useful for chronic depression, but yes help suicidal patients like i was.

    suboxone works on me as it would likely on most treatment resistants- because of the kappa inhibitor im told. who knows i dont care, it works i have been “normal :for years now.
    no doctors want to risk their licences now, everyone is afraid were gonna turn into addicts, but i am glad i took that risk- i think the depression has to get treated first =people are dying but i am sad because there is a great cure out there.

    dont get me wrong i still have bouts of depression- lack of sleep, stress can triggor mild episodes, but NOW i can meditate well. and i have found it useful in my bouts of depression.

    i gave you my childhood because as therapists im sure you know by now most depressives sufferred some kind of neglect, abuse -emotional or otherwise.

    this means at the core they feel unworthy or unloved ( many im sure at any rate)

    why did these doctors latch on to mindfulness when there is an obvious better choice and even recommended for depression by many buddhist masters.

    Metta/ loving kindness was a godsend for me. mindfulness was ok, but often people draw their minds into the moment and just into the pain they feel and it can be a trap…

    for depressives there is nothing like Metta which connects those back to the source, gives them a sense of worthiness and sense of lovability they may have never experienced.

    It connects the fragmented self back to the source = stream which is love. the unworthy feels worthy again, the life is rendered meaningful

    I hope you realize i only wrote you the beginning not for any kind of sympathy i just want you to know that im a very very experienced sufferer lol !!

    so because of my CV, and on behalf of other depressives, you will perhaps consider that metta is truly an overlooked modality and i am sure the best one for those suffering depression, perhaps narcissism and psychopathy also.

    just my 2 cents.
    yeshe 🙂

    • I have to second your recommendation for people to practice metta — not only for depression, but also for anxiety! Those two are the most common causes of insomnia, especially when you consider that what most people call “stress” is, more specifically, “anxiety” — this might be why the Buddha recommended metta for sleepless nights, especially those filled with worry. This seems to apply just as much to worry over bills and relationships as to worries about demons in the forest.

      It has been my personal experience that the best way to deal with depression is to combine positivity-increasing approaches (like activity scheduling, jhana, or stimulating antidepressants) with negativity-reducing approaches (like correcting cognitive distortions, for those who find it helpful, or calming antidepressants).

      And sometimes bare mindfulness feels unbearable right in the midst of major depression with anxiety, like you said! A person already on the breaking point because of mundane issues might not be able to make it through Reobservation, though of course, there are encouraging stories of people surrendering to the pain and suddenly stumbling into Equanimity…

      • I am putting together a practice instruction page for Metta right now and it should be up soon.

        It is a meditation practice that tends to get over or under emphasized in a lot of teachings as far as I can tell. People either don’t do it until they are really hurting, or they rely on it and think it is the whole of the path – two big mistakes. It is an amazing support for sila, concentration and wisdom, and should be used with insight techniques to support awakening and transformation.

        Viva Metta!

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