Mindfulness-based therapy treatments in modern psychology: Convergence and

divergence from early Buddhist thought by Ann Murphy University of South Wales, Australia

Introduction

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

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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 development.

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 Ñāṇapoṇika Thera’s (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 one’s inner and external worlds that is nonconceptual and nondiscriminatory with
a flexibility of awareness and attention.

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 Pāli 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
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overcoming of worry and desires for the world (DN iii 313). As an analogy, mindfulness is
likened to a gatekeeper guarding a King’s 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 Dhammasangaṇī, 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
Vibhaṅga , mindfulness is defined as constant, recollection, the act of remembering, bearing in
mind, non-superficiality, and non-forgetfulness (Vibh 220). In the Paṭisambhidāmagga
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 (Paṭis I 43).

Perhaps the clearest definition in the canonical literature is in the Milindapañha. Here, the
Buddhist monk Nāgasena 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
bodhipakkhiyā 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
(satipaṭṭhāna), as one of the spiritual faculties (indriyas), one of the spiritual powers (balas), one
of the factors of enlightenment (bojjhaṅgās), and as right mindfulness, the seventh factor in the
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Noble Eightfold Path (ariya aṭṭhaṅgika 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 silā aspects of right
speech, action, and livelihood of the Eightfold Path, while adopting the divine attitudes of the
brahma-vihāras of compassion (karuṇā), loving-kindness (mettā), sympathetic joy (muditā), and
equanimity (upekkhā), 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 (MABS).

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-

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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-Zinn’s personal experiences with Theravāda insight meditation and Mahāyāna
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-Zinn’s
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
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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 Vibhaṅga 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 Pāli Canon. For instance, in the discourse to Māgandiya, in the Māgandiya 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
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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 addictions.

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 (Hӧlzel 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 (Hӧlzel Carmody et al. 2011), and is
associated with positive alterations in emotional processing (Allen et al. 2012). These results

7
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, Hӧlzel, 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

8
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 (Hӧlzel, Lazar et al. 2011), and diminished bodily pain (Kerr et al. 2013).

Ethics

In early Buddhist thought, mindfulness and ethical conduct were inextricably-linked practices.
For laypeople, the Pāli 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 (sīla)
(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 sīla.

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 (paññā) 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 (samādhi) in daily life.
Hence, the practice of following the Eightfold Path encompasses the three core Buddhist
principles: paññā, sīlā, and samādhi.

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

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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

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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 Buddha’s said advice to Bhikkhu
Ᾱnanda on teaching the dhamma to others:

‘It isn’t easy, Ᾱnanda, 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 Pāli 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 jhāna, one who knows three Piṭakas, one who knows two Piṭakas, one who knows one
Piṭaka, in descending order’. If no one can be found who knows at least one Piṭaka, 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
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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 (dāna). 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 saṇgha), 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 Saṇgha’s role in teaching the dhamma.

Conclusion

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 Buddha’s 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 Buddha’s 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 saṇgha, 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
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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 ‘teacher’s 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.

References
 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: 230–241.
 Bodhi, B. (ed.) 1999. A comprehensive manual of Abhidhamma: The Abhidhammattha Sangaha of Ᾱcariya Anuruddha. Onalaska:
BPS Pariyatti Editions.
 Bodhi, B. (tr.) 2000. The connected discourses of the Buddha: A translation of the Saṃyutta Nikāya. Boston: Wisdom
Publications.
 Bodhi, B. (tr.) 2012. The numerical discourses of the Buddha: A translation of the Aṅguttara Nikāya. 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): 822–848.
 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-Sangaṇi: 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.

13
 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 Press.
 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.
 Hӧlzel, 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.
 Hӧlzel, 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.
 Hӧlzel, 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: 11-17.
 Ireland, J. D. (tr.) 1997. The Udāna and the Itivuttaka: Two classics from the Pāli Canon. Kandy: BPS.
 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: 1893-1897.
 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.
 Ñāṇapoṇika, T. 1962. The heart of Buddhist meditation: A handbook of mental training based on the Buddha’s way of
mindfulness. Kandy: Buddhist Publication Society.
 Ñyāṇamoli, B. (tr.) 1982. The path of discrimination (Paṭisambhidāmagga). London: The Pāli Text Society.
 Ñyāṇamoli, B. (tr.) 2011. The path of purification (Visuddhimagga). 3rd ed. Kandy: BPS.
 Ñyāṇamoli, B., and Bodhi, B. (trs.) 1995. The middle length discourses of the Buddha: A translation of the Majjhima Nikāya.
Boston: Wisdom Publications.
 Pesala, B. (ed.) 2001. The debate of King Milinda: An abridgement of the Milinda Pañha. 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 (Vibhaṅga). London: The Pāli 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 Dīgha Nikāya. Boston: Wisdom Publications.

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