Mindfulness
for Everything
by
Vishvapani
Picture
an FWBO meditation class and you imagine
a room full of people sitting quietly on cushions in front of a Buddha
image.
But an increasingly common variation is a room of people lying down,
relaxing
deeply as the leader guides them in taking their attention through the
body.
The
body scan is a distinctive element in the
six, eight or ten week courses that are proliferating in FWBO centres
as they
engage with the world of Mindfulness-Based Therapy (MBT). The faculty
of
mindfulness—broadly defined as non-judgmental present-moment
awareness—has
always been a key element of the Buddhist path; and in recent years
psychologists and healthcare professionals have been recognizing its
value for
people experiencing conditions ranging from stress and depression to
addiction,
chronic pain and ill health. A natural crossover exists between this
growing
medical interest in mindfulness and the skills that FWBO meditators and
teachers have developed in their years of practice. So how are people
from the
FWBO engaging with MBTs, and what issues are emerging as they do so?
Mindfulness-Based
Therapies
Although
the world of Mindfulness-Based Therapy
is fairly new, it is already rather complicated, at least on the
surface.
Prepare to be bombarded by acronyms. There is Mindfulness-Based Stress
Reduction (MBSR); Mindfulness-Based Cognitive Therapy (MBCT);
Mindfulness-Based
Relapse Prevention (MBRP); Mindfulness-Based Pain Management (MBPM);
and more.
As the names suggest, these therapies apply mindfulness to various
conditions;
others, such as Acceptance and Commitment Therapy (ACT) or Dialectical
Behavioral Therapy (DBT) use mindfulness in conjunction with other
forms of
treatment.
The
alphabet soup was first stirred in 1979 when
Jon Kabat-Zinn wondered if the mindfulness meditation he practiced at
the
Insight Meditation Society could help the patients he was seeing at the
The
effect of MBSR courses was carefully
monitored and results were remarkable. People reported lower levels of
stress,
and even a reduction in their symptoms. Above all, they felt hopeful
and
empowered because mindfulness enabled them to affect their experience
for the
better. What’s more, follow-up studies showed that years
after taking the
course many participants continued to use the techniques they had
learned
Medical
authorities and funders were impressed, and they were delighted by the
course’s
cost-effectiveness. While conventional treatments involve expensive
drugs or
lengthy one-to-one therapy, MBSR can be taught to groups of up to
thirty people
at a time, and it uses the cost-free resources of the
participants’ own minds.
If this sounds mercenary, it is important to note that for Kabat-Zinn,
himself,
MBSR’s effectiveness springs from its spiritual depth. As he
writes in his
best-selling 1991 book Full
Catastrophe Living, ‘What we really offer
people is a sense that there
is a way of looking at problems that can make life more joyful and rich
… and
also a sense of being somehow in control.’
Kabat-Zinn’s
activities developed into the Center for
Mindfulness, and
their influence spread. One example is described in the book, Mindfulness-Based
Cognitive Therapy for Depression by three cognitive
psychologists, two
of whom are British. Their work with people suffering from depression
showed
them that, while drugs could help alleviate depression, seventy percent
relapsed if they ceased taking the drugs.
Cognitive Behavioral Therapy (CBT) could also help, with
more lasting
results, but there is a UK-wide shortage of qualified therapists. In any case depression, once
experienced, is
highly likely to recur - a new episode starts when someone starts to
ruminate
on thoughts of unworthiness or frustration, and this produces depressed
moods,
which in turn produce further negative thoughts. The result is a
descending
spiral that creates a strongly depressed state of mind. But if the
person can
notice that these thoughts are starting to recur before they have
gained in
strength, they can choose not to pursue them.
The
psychologists concluded that their patients
needed a technique that would help them to be aware of their thoughts;
and
their search for such a therapy led them to Kabat-Zinn, meditation and
mindfulness. Some years on, MBCT has been approved by the
Mindfulness
has also been used to treat
addiction, eating disorders, anxiety and numerous other conditions. Breathworks
is a
home-grown approach, developed by Vidyamala, a member of the Western
Buddhist
Order, which I will describe below.
How
Mindfulness-Based Therapy Works
Most
Buddhists are familiar with techniques for
developing mindfulness, such as the mindfulness of breathing meditation
practice, but how can they help with conditions such as chronic pain or
depression? In an excellent talk entitled Mindfulness
for
Just About
Everything (available online from Free Buddhist Audio),
Firstly,
he says, mindfulness enables people to notice
what is happening in their experience, especially
when they are engaging
in compulsive patterns of thought such as escapist fantasy, rumination
and
fixation which can prompt destructive or addictive behaviour. Secondly,
mindfulness offers a way for people to stay with experience
including whatever may be difficult, rather than pushing it away. This
produces
a change in perspective on those thoughts or
experiences, enabling
people to see that their thoughts are just thoughts, not facts or
reality, and
they need not be driven by them. Finally, the new perspective allows choice.
Rather than being driven by compulsive reactions to experience,
mindfulness
creates the mental space that enables people to respond differently.
The
practices taught on mindfulness-based
courses support people’s efforts to move away from depressive
thoughts, accept
physical pain, or respond to challenges with creativity rather than
stress.
Learning to pay attention to the breath helps in learning to notice
thoughts
and feelings, and in meditation brings calm, in which state it is
easier to
notice experience and stay with it. MBTs also emphasise grounding
awareness in
a sense of the body and the breath, and this is naturally healing in
itself.
Mindfulness-Based
Therapies in the FWBO
The
two main FWBO MBT projects are Breathing
Space at the
London Buddhist Centre (LBC), and Breathworks,
which is
based at the Manchester Buddhist Centre but trains people from many
different
places. The two projects engage with the MBT field in rather different
ways.
Breathing
Space
Members
of the LBC sangha responded
enthusiastically to
As
activities developed, they acquired a name—‘Breathing
Space’—and
Maitreyabandhu became the Director while
Breathworks
While
Breathing Space uses a version of MBSR and
MBCT, Breathworks’ approach has grown out of the experience
of Vidyamala, an
Order member with severe chronic pain. Chronic pain affects around
fifteen
percent of the population, and it confronts them with a raw version of
the
existential dilemma about which Buddhism speaks so much. The challenge
is to
respond constructively to suffering, rather than trying to escape it or
reacting angrily. Having learned, through years of struggle, to engage
mindfully with her own condition, in 2002 Vidyamala started to share
her
experience with other chronic pain sufferers by running courses in her
room.
A
year later Vidyamala teamed up with Sona and
Ratnaguna, (whose working name is Gary Hennessey), both of whom are
experienced
practitioners, to form Breathworks,
a not-for-profit company dedicated to making this work more widely
available.
They ran courses at the Manchester Buddhist Centre and elsewhere, and
quickly
attracted attention from both health professionals and other Buddhists.
Since
then Breathworks activities have ballooned. The team often run courses
for
health professionals and make presentations at conferences.
They
have devised a training course that takes
place over two weeks, and four such training weeks will be held at
The
intention of the Breathworks team is to
create a ‘Breathworks community’, that includes
many trainers around the world
who will meet for retreats, sharing of experience and further training.
While
the work’s initial focus was on people suffering chronic
pain, in 2005
Ratnaguna and Sona started the ‘Living Well’ course
that adapted Breathworks
techniques for others. In 2007 the course was extensively revised by
Ratnaguna
in the light of MBSR and its offshoots, and a new version called
‘Living Well:
Mindfulness for Stress’ was piloted in
The
demand for what Breathworks offers is seen
in the success of their guided meditation CDs, which have sold 12,000
since
they were launched in 2004, despite being self-published. Vidyamala is
currently writing a book about her approach to pain management (I am
her
editor), which will be published by in September 2008 by Piatkus, the
The
Breathworks programme differs from MBSR and
MBCT in several interesting ways. The Pain Management module includes
elements
drawn from other pain management courses, such as training in
‘pacing’ oneself
through the day. The suggestion that participants might decide to
actively
change their behaviour gives a subtly different message from the MBSR
emphasis
on noticing without judging or changing. The biggest difference,
however, is
that, in addition to the body scan and the mindfulness of breathing,
all Breathworks
courses include a ‘kindly awareness’ practice. This
is an adaptation of the metta
bhavana (loving
kindness)
meditation practice, which is taught at FWBO centres alongside the
mindfulness
of breathing. The kindly awareness practice starts with reflection on
one’s own
suffering and uses it as a key to develop empathy with others.
Vidyamala sees
this other-regarding dimension as an important adjunct to mindfulness
for
people seeking a more creative response to difficult experience.
Other
Projects
Mindfulness
Works
Kulananda,
a senior member of the Western
Buddhist Order who co-authored Mindfulness and Money,
took the MA in
Mindfulness-Based Approaches at
Mindfulness
Works activities have developed
successfully and Kulananda has led courses in the NHS, at business
schools, and
for corporate clients—including several large professional
service firms. As
the Mindfulness Works website points out, over half
a million people in
the UK say that stress, depression or anxiety was caused or made worse
by their
work, and employers increasingly realise that this affects their
businesses.
There is clearly a demand for mindfulness in the corporate
sector.
Other
FWBO Centres
The
Cambridge
Buddhist Centre runs MBSR courses led by Kulananda and
Issues
and Prospects
The
growing interest in MBTs in mainstream
healthcare and psychology creates opportunities for FWBO centres and
individuals, but also brings some risks. Depression, stress, anxiety
and
chronic pain affect large sections of the population, many whom
attending would
never think of attending a Buddhist centre or a meditation class. We
are
probably only at the start of the influence of mindfulness on
healthcare and on
society at large. In time, if research evidence mounts and health
budgets adapt
to include mindfulness, there may well be formal health service support
for
these therapies, whether they are taught by Buddhists or health
professionals.
Jon Kabat-Zinn reportedly described his work as ‘stealth
Buddhism’, introducing
Buddhist attitudes, experiences and values into the mainstream of
society and
potentially affecting many millions of people.
Teachers
of MBT courses report that participants
are often more motivated than those attending other classes at Buddhist
centres
because they have a real difficulty in their lives for which they need
help.
The courses are more intensive than other meditation courses, and
people often
experience benefits to match. I know from my own experience as a
teacher that
MBT course can be very rewarding.
MBT
courses can also help centres and
individuals financially. Buddhist centres are usually empty during the
day, and
at least some MBT courses can take place then. Because MBTs are
bracketed with
other healthcare offerings the amount that people expect to pay is
higher than
for other events, especially where they are paid for by health
authorities or
employers. This is particularly true in the corporate sector. However,
MBT is a
new area and there are few recognised ways of reaching the people who
might
benefit. For example, although Breathworks is highly respected by pain
specialists, they do not yet get many referrals and currently hospitals
cannot
buy in Breathworks trainers.
A
danger for Buddhists and Buddhist centres in
engaging with MBT is that it will subtly alter the flavour of their
teaching
work. Mindfulness Based Therapy is an emerging profession, and offering
meditation professionally is very different from the ‘mutual
generosity’ (dana)
basis of traditional Buddhist teaching. Buddhist centres that are under
considerable financial pressure need to take care that they do not
neglect
their mainstream activities for the sake of MBTs.
The
medical origins of MBSR and MBCT potentially
skew the understanding of mindfulness away from how it is seen in the
Buddhist
tradition. In Buddhist teachings mindfulness is always seen as an
aspect of a
path that includes other faculties and practices. But in MBTs
mindfulness is
often spoken of in isolation, or in conjunction with non-Buddhist
techniques
such as CBT. The resulting view of mindfulness in MBCT, for example,
strikes me
as very clear but rather narrow. I think it would be unfortunate if
views of
mindfulness among FWBO Buddhists were strongly influenced by this
approach,
unless it is thoroughly reviewed in the light of Buddhist teachings.
Breathworks’ inclusion of ‘balanced
effort’, kindly awareness and its plans for
a community of practitioners is an interesting response to the
narrowing of
views of mindfulness among ‘mindfulness
professionals’.
The
two main FWBO MBT projects—Breathing Space
and Breathworks—have developed in isolation from one another,
and there has
been little interaction between them. It would be good to see more
dialogue
between these and other FWBO MBT projects. Potentially, perhaps in
conjunction
with other Buddhists, they could help to bring a distinctively Buddhist
understanding of mindfulness to the MBT world.
Training
There
is no commonly recognised MBT
accreditation, but three training options are currently available for
anyone in
the
Breathing
Space offers on-the-job training in
MBCT/MBSR to would-be teachers in
Breathworks
offers a straightforward
practice-based training course. This is ideal for working with people
experiencing chronic pain, and the new Living Well with Stress course
opens up
the much wider field of stress management as well. Graduates can also
benefit
from the Breathworks community.
Finding
Out More
Books
Full Catastrophe Living:
How to Cope with Stress,
Pain and Illness Using Mindfulness Meditation by Jon
Kabat-Zinn, Piatkus (
Mindfulness-based
Cognitive Therapy for Depression: A
New Approach to Preventing Relapse
by Zindel V. Segal, J. Mark G. Williams, and John D. Teasdale;
Talks
and Articles
Mindfulness
for Just About Everything
(talk by
Embodying
Engagement
(article by Vishvapani on Jon Kabat Zinn &
Bernie Glassman): vishvapaniswriting.blogspot.com/2007/01/embodying-engagement-observations-of.html
Mindfulness
as Cognitive Training: a Contribution from Early Buddhist Thought
by
Michael Chaskalson MA dissertation available
on
FWBO
Mindfulness-Based Therapy Projects
Breathworks
(
Body
of Health (
Mindfulness
Works www.mbsr.co.uk/
Blue
Sky (
Breathing
Space (
Evolution
Arts,
Other
Mindfulness-Based Therapy Projects
Bangor
Centre for Mindfulness Research &
Practice www.bangor.ac.uk/mindfulness/