Critical Reflections from a Buddhist Perspective
First Published in Psychotherapy in Australia, Vol 12 No 4, August 2006
By Geoff Dawson and Liz Turnball
There is no dispute that mindfulness can be an effective therapeutic method in the clinical treatment of a variety of psychological disorders. However, Geoff Dawson and Liz Turnball argue that more critical reflection is needed of the social and cultural contexts of mindfulness, and the unintended consequences that arise from its contemporary adaptation into the fields of psychotherapy and psychology. What are the consequences of the practice of mindfulness in isolation from a Buddhist context that integrates wisdom and ethics, inquires into the roots of narcissism and cultivates compassion? Reduced to a psychological technique, mindfulness can become another palliative to reduce symptoms of distress without sufficiently addressing the deep causes. Modern forms of alienation arguably are the root causes of pervasive feelings of depression and anxiety. A radical inquiry into and a deep understanding of the myth of the self-enclosed individual leads to the death of narcissism and the end of alienation. Are we willing to question critically the interconnections of psychology formed by and functioning within economic and social structures that condition these modern forms of alienation and suffering?
Mindfulness is practised in Buddhism in a context of seeking an end to suffering. More recently, it has achieved wide acceptance as an effective therapeutic method in the clinical treatment of a variety of disorders- anxiety; depression; borderline personality disorder; eating disorders; chronic pain and other body-mind conditions (Melbourne Academic Mindfulness Interest Group 2006; Germer C. K.,Siegel R.D, & Fulton 2005; Baer 2003; Segal, Williams & Teasdale 2002; Kristeller & Hallett 1999; Hayes, Strosahl & Wilson 1999; Linehan 1993; Kabat-Zinn 1990).
Around 2500 years ago the Buddha taught that it was possible not only to understand the nature of human suffering and its causes, but also to end it. This understanding was given in the Four Noble Truths: an understanding of suffering (dukkha) and its cause, its ending and the path leading to its ending. Cessation of suffering, or ‘unbinding’ is the outcome of practising the Fourth Noble Truth which is detailed in the Eightfold Noble Path-a systematised set of practices, methods and philosophical views aimed at cultivating wisdom, ethical conduct and meditative awareness and concentration (Samyutta Nikaya 56.11 in Bhikkhu Bodhi, 2000).
Following the life and teachings of the Buddha, ‘Buddhism’ became institutionalised and various traditions evolved and adapted to prevailing historical, social and cultural forms. It is notably syncretic. In the generative ‘meeting with the west’, Buddhism has been interpreted enthusiastically and variously as a religion, a spiritual practice, a philosophy, and a psychology.
As Buddhist practitioners, we have shared in this enthusiasm for many years. Yet when we have discussed mindfulness in psychotherapy between ourselves, as well as with other Buddhist influenced therapists and Buddhist teachers, we find a common unease or ambivalence about the clinical adaptation of mindfulness. We regard it as invaluable and foundational to our work and the recent research and clinical application is both welcome and confirming. It makes mindfulness accessible- as Kabat-Zinn points out (in Sykes Wylie and Simon R., 2004), mindfulness is very democratic and can be practised without any religious or spiritual framing. However, we have concerns about the implications or unintended consequences about the adaptation and incorporation of mindfulness within the fields of psychology and psychotherapy.
The benefits are not in dispute. Our concern is that sufficient critical reflection-more sociological and philosophical-is not being undertaken. As with many traditional practices (for example, yoga), Buddhist practices of mind training have become dislodged from their ethical and philosophical frames and redefined in ways intelligible to secular, scientific minds. What kinds of reductions, elisions, and distortions take place in the adaptation of a method of meditation into the modern field of psychological treatment?
The dark side of mindfulness
This question is not being framed within a binary of the superiority of Buddhism and the inferiority of modern forms of psychological treatment. We feel we need to be critically self-reflective as both therapists and as Buddhists, recognizing that there are shadows in our history. The case of Japan’s ‘Holy War’ disturbingly exemplifies what can happen in the cultural and social adaptation of Buddhism (Victoria, 2003; 1997) The ideals of Zen Buddhism and the practice of meditation, or zazen, became harnessed to the goals of nationalism and militarism in Japan pre-World War Two. The military elite sought through zen training to eliminate or transcend life and death. With Zen becoming ‘the true spirit of the imperial military’, zazen or mindfulness became ‘combat zazen’:
‘Zen priests did, of course, have a unique methodology for the training of imperial subjects: the practice of zazen. Zazen was used not only to train officers and soldiers but also workers-known at the time as ‘industrial warriors’ (sangyo senshi)-in war-industry factories. The training sessions were held either in the factory dormitory or in a nearby Zen temple, and they lasted for up to one week. Participants would seek ‘to discover, through a thorough-going examination of the self, the origin of the power which enabled them, in their various work capacities, to serve the emperor’. They were urged not to forget that ‘the merit resulting from their practice of zazen would enable them to realize infinite power’. (Victoria, 1997,p. 144, quoting Ichikawa Hakugen, 1967).
Regretfully, those of us who fondly inherit this centuries old tradition are aware of how it can be turned so easily to narcissistic and harmful ends. Zazen enhanced the capacity to concentrate in order to kill, to act serenely and without question. Hogen Yamahata, a Japanese Zen Teacher living in Australia, said some years ago, ‘meditation is not sufficient, it can also make very good killers’. Is this a particular historical aberration, an exaggerated ideological distortion with little relevance to the issue of the benefits of mindfulness in psychological treatment? To our minds it is a cautionary historical tale underscoring the significance of the social and cultural contexts of mindfulness training. As we are seeing, in modern secular societies, these are increasingly the fields of psychology and medicine.
Modern contexts
Modernity is characterised by an ever pervading calculative-technical rationality oriented towards profit, productivity and efficiency. Arguably, every sphere of life and culture is subject to incorporation by this instrumentalising logic. The organizing principles of the market place subject all forms of life to objectification and commodification. Intertwining corollaries of the market place are ideologies of neo-liberalism and individualism, and a consequential narcissistic style.
The extensive field of psychological treatment (we’ll refer to it as psychology) is not immune to this instrumental rationality, functioning as it does within the broader social and political structures of a consumer society driven by demands of corporate or global capitalism. While psychology has gained legitimacy as a form of scientific knowledge defining ‘objective truths’ about the nature of the human condition- some how value neutral yet capable of defining normative standards of how to be human inevitably, it functions as a normalising discourse and set of institutionalised practices that frames the governance of the population and the production of a subjectivity in the form of an enclosed or privatised sense of self (Carrett & King, 2005; Rose, 1998; Foucault, 1982).
When mindfulness is appropriated as another technique within this logic it too undergoes a form of reduction. It becomes a means to particular ends defined by contemporary horizons of consumer society and subjectivity-self-fulfilment and happiness. It is very adaptable and, as noted, very democratic. This is the beauty of it. It can improve health, it can increase happiness, productivity, competitiveness and sales. Recently Sydney Zen Centre was approached to train corporate executives to improve their performance. They declined to be involved. Zazen can just as well be ‘corporate zazen’ as it can be ‘combat zazen’. It does not ‘naturally’, by virtue of its neurological impact produce ethical, wise and serene human beings as is sometimes propounded. Its potential efficacy has a high correlation to social and cultural contingencies.
A concern is that in this reduction to a psychological technique, mindfulness becomes another palliative to reduce symptoms of distress without sufficiently addressing the deep causes.
As stated in the Zen text, Shodoka, Song of Realising the Way (Yung-Chia Hsuan Che, 1982): ‘Cut out directly the root of it all, I’m not concerned about leaves and branches.’ The root is narcissism, which is based on a fundamental misunderstanding of the nature of our being in the world. Narcissism in this Buddhist sense is an alienated state because it is based on the mistaken premise of separate or self-enclosed being, rather than on interconnectedness. Interconnectedness refers to the highly contingent nature of all phenomena, including consciousness, with everything participating, conditioning and being conditioned within constitutive reciprocal relations. Some close parallels to this understanding of dependent origination in contemporary thought can be found in complex dynamic systems theory (see Macy, 1991), and postmodern views of intersubjectivity that recognize how the sense of self is founded emergently on identification processes within relational and contextual dynamics (Watson, 2002).
Wisdom, Ethics and Meditation
To understand mindfulness within its Buddhist context we need to make reference to the Eightfold Noble Path:
Wisdom
1) Wise View
2) Wise Thinking
Ethics
3) Wise Speech
4) Wise Conduct
5) Wise Livelihood
Meditation
6) Wise Effort
7) Wise Mindfulness
8) Wise Concentration
These eight aspects are traditionally put into three categories of Wisdom, Ethics and Meditation. (They are traditionally translated as ‘Right View, Right Thinking…’ but we prefer ‘wise’ to suggest an embodied ‘know how’ and to avoid the fixed or imposed dichotomy of ‘right’ and ‘wrong’. (See Watson (2002) for an expansion on similar views.) The cyclical harmonisation of these aspects make up the whole practice of Buddhism.
Wisdom as it progresses is a radical inquiry into how things really are. It is a penetrating, nonconceptual insight into the inherent transience of all things, the absence of self-enclosed being (no-self) and the understanding of the interconnectedness of all phenomena; and it is the actions that flow from this insight into the world. Penetrating insight into interconnectedness leads to a lived understanding of the ’empty’ or no-self nature of things. One’s identity as a consequence becomes large rather than small as the dualistic constructions of self/other, inside/outside, this/that, here/there, superior/inferior dissipate.
Compassion is both cultivated through seeing things as they are and ethical practices of identification and generating positive feeling states, and it develops as wisdom develops. Then compassion naturally arises as we love the other as we would ourselves. As the theologian Martin Buber expressed it so eloquently, we move from an ‘I/It’ to an I/Thou’ relationship with others. This is both an ontological position and an expression in the world.
A radical inquiry into and a deep understanding of the myth of the self enclosed individual leads to the death of narcissism and the end of alienation. The modern form of alienation we are addressing is arguably the root cause of pervasive feelings of depression and anxiety. At it’s existential heart it is the same as the alienation the Buddha was addressing. If Buddhism can be distorted towards finding happiness for the narcissistic self, then it follows that mindfulness in a clinical context can be oriented towards upholding self-interest, and the enclosed sense of self within the prevailing contexts of consumerism.
Just as wisdom or radical inquiry informs the direction of mindfulness so does ethics. Buddhist ethics is based on the foundation of non-harming. One contemporary understanding of Buddhist ethics is offered in ‘Waking Up To What You Do’ by American Zen teacher, Diane Eshin Rizzetto (2005):
‘I take up the way of speaking truthfully,
I take up the way of speaking of others with openness and possibility,
I take up the way of meeting others on equal ground,
I take up the way of cultivating a clear mind,
I take up the way of taking only what is freely given and giving freely of all that I can,
I take up the way of engaging in sexual intimacy respectfully and with an open heart,
I take up the way of letting go of anger, I take up the way of supporting lift.’
These are not commandments, but are intended as ethical guidelines. We have noticed that when individuals practise meditation without cultivating an ethical foundation then meditation can become a dissatisfying and frustrating experience that reflects the chaotic lifestyle often found in people with poor boundaries and impeded maturation. Mindfulness meditation without an ethical foundation leads to superficial calmness. It also follows that ethics without mindfulness and wisdom can lead to moral rigidity and self-righteousness. Wisdom without meditation and ethics can lead to a dry intellectualised view of life and disengagement from intimacy. It is the synergy in the practice of wisdom, ethics and meditation that brings about the transformation of the individual.
A metaphor that may help to explain this integration is that a flute can have a pure clear sound when played on its own, but when it harmonises with fiddles and harps and bodhrans, as well as poetic lyrics and a sweet soulful human voice to give them life, it makes up Irish music. One could not have a full appreciation of Irish music, or even of the Irish flute, if one only listed to flute solos.
Contexts of training
When we consider the wholistic or systemic context of mindfulness within a Buddhist framework this has important implications for training. Many of the trainers of mindfulness within psychology have had an extensive training in Buddhist contexts and have integrated these three aspects in their practice. For example, as noted above, Jon Kabat-Zinn, has had substantial exposure to traditional Buddhist training that has informed his application of mindfulness in clinical settings.
Kabat-Zinn has set high standards for mindfulness-based training at his institute in Massachusetts based upon the principle in Buddhism of extensive personal practice. In the ‘Guidelines for Assessing the Qualifications of Mindfulness-Based Stress Reduction (MBSR) Providers’ (Santorelli & Kabat-Zinn, 2005), the minimum meditation experience requirement for Level l Providers is:
– a daily meditation practice,
– three years of consistent mindfulness meditation practice,
– two cloistered, silent, teacher-led, mindfulness meditation retreats (each retreat 5-10 days).
Minimum meditation experience for Level II Providers is:
– five years of consistent mindfulness meditation practice,
– five extended intensive meditation retreats (5-10 days).
The story of how Segal, Williams, and Teasdale (2002) developed Mindfulness-Based Cognitive Therapy for Depression is also instructive. At first they thought they could teach mindfulness as a technique without practising it themselves. After a somewhat unsuccessful beginning to duplicate the results of the MBSR program they returned to the staff of the Stress Reduction Clinic and realised that for it to be effective they needed to practice it themselves.
‘The staff at the Stress Reduction Clinic had consistently emphasized the importance of instructors having their own meditation practice, and within minutes of first meeting us, they asked about our personal commitment to the practice of mindfulness. We had now seen for ourselves the remarkable way they were able to embody a different relationship to the most intense distress and emotion in their patients. And we saw the MBSR instructors going further in their work with negative effect than we had been able to do in the group context, by staying within our therapist role. This ultimately persuaded us of the wisdom of the advice we had not wholly heeded on our first visit.’
By contrast, neither Acceptance and Commitment Therapy or Dialectical Behaviour Therapy requires any specific periods of mindfulness practice before therapists utilize mindfulness principles with patients (Hayes, Strosahl & Wilson 1999; Linehan, 1993).
Our concern is that as mindfulness becomes operationalised and stripped down-perhaps in the effort to ‘despiritualise’ mindfulness in order to emphasize its therapeutic efficacy, clinical definitions of mindfulness become dominant and normalised for example the definition offered by Germer, Siegel & Fulton (2005): ‘(1) awareness, (2) represent experience, (3) with acceptance’ (p. 7).
The transformative potential of the Eightfold Path may then become backgrounded and it’s efficacy undervalued through this adaptation and its iterations and the ‘taken for granted’ nature of dominant constructs.
Conclusion
In conclusion, the impact of mindfulness in therapy is one of recognizing the transformative nature of acceptance rather than an emphasis on change and restructuring. However, when we consider this dialectically, if mindfulness works only towards acceptance it is easy to overlook the other side of the dialectic-the dimension of radical inquiry and change. In Buddhism the cutting edge of wisdom is the radical inquiry into the no-self nature of the self. These are the two sides of the dialectic required for the full maturation of the individual. A number of questions arise here. Do we need to ask ourselves as both therapists and Buddhists whether this radical inquiry is missing in our work? Radical inquiry directed by an understanding of interconnectedness and no-self does lead us to questions about how we live. As therapists, whether Buddhist or not, are we willing to question critically the interconnections of psychology entailed by and functioning within economic and social structures that condition the causes of modern forms of alienation and suffering? The unease we feel provokes this question: Is mindfulness the new opiate of the masses?
References
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Author Notes
Geoff Dawson is the teacher of the Ordinary Mind Zen School in Sydney and a psychologist in full time private practice.
Liz Turnball is a psychotherapist in full time private practice in Sydney and a director of Somatics-Body Oriented Psychotherapy. She is a student of Zen and has a Ph.D. in Sociology.