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Mindfulness Within the Full Range of Buddhist and Asian Meditative 4 Practices Mindfulness Within the Full Range of Buddhist and Asian Meditative 4 Practices Geoffrey Samuel Introduction traditions of lay Buddhist meditation developed in the Theravāda Buddhist countries of Burma and The interest in mindfulness as a therapeutic Thailand in the early to mid-twentieth century. modality within Western medicine got going in The specific techniques on which MBSR drew, 1979, with Jon Kabat-Zinn’s introduction of the particularly the Vipassanā practices associated Mindfulness-Based Stress Reduction program with U Ba Khin, S.N. Goenka, Ajahn Cha, and (MBSR) at the University of Massachusetts others, had already been taught widely in Western Medical Center (Kabat-Zinn 2003). There is by Buddhist contexts, in North America and else- now a very substantial literature both on where, from the 1960s and 1970s onward. These Mindfulness-Based Stress Reduction and on the Southeast Asian and North American approaches family of techniques and therapies that derive already represented what can be called a Buddhist from it, and also a substantial critical literature, modernism, or modernist Buddhism, particularly including a couple of my own contributions in their presentation of Buddhism as a philosophy (Samuel 2014, 2015a). Here I hope to take the or scientific teaching rather than a religion. argument further, but begin with a brief summary Kabat-Zinn and his associates were aware of and of points I made in the two earlier pieces, in influenced by other forms of Buddhism, particu- particular to emphasize the extent to which larly varieties of Ch’an (Zen) Buddhist medita- MBSR and related techniques are already quite a tion, but these too had undergone substantial long way distant from anything that might be rethinking in modern terms, both in their native labeled as ‘mindfulness’ in pre-modern Buddhist context of Japan and in the West. contexts. This ‘modernist Buddhist’ background pro- Firstly, the core techniques of MBSR were vided the basis for a further modernization and derived from recent developments in Buddhist secularization of Buddhism in the form of MBSR practice. They were drawn for the most part from itself and the various associated and derivative techniques, such as Mindfulness-Based Cogni- tive Therapy (MBCT) developed in the UK by Mark Williams and others. Here I am using the This chapter is a revised version of my presentation at term ‘secularization’ to refer to the removal of the conference, ‘Mindfulness and Compassion: The Art and Science of Contemplative Practice,’ San Francisco explicitly religious, spiritual and ethical content State University, June 3–7, 2015. and to the presentation of the practices as ‘sci- entific’ and as explainable in materialist terms. G. Samuel (&) School of Languages and Cultures, University of Admittedly ambivalence persists regarding Sydney, Sydney 2006, NSW, Australia how far MBSR and MBCT should still in some e-mail: [email protected] © Springer International Publishing Switzerland 2016 47 R.E. Purser et al. (eds.), Handbook of Mindfulness, Mindfulness in Behavioral Health, DOI 10.1007/978-3-319-44019-4_4 48 G. Samuel sense be seen as ‘Buddhist.’ Jon Kabat-Zinn out new guidelines on depression which ‘rec- himself is a committed Buddhist practitioner, as ommended MBCT for people who are currently were many of those involved in developing and well but have experienced three or more episodes teaching the various Mindfulness techniques. of depression’ (Williams and Kuyken 2012). Kabat-Zinn’s writings tend to play it both ways: However, while the mindfulness-based tech- Mindfulness is not Buddhism, but it also in some niques are certainly being taught, and presum- sense represents the essence of Buddhism, the ably practiced, on a very large scale, there have one significant core message of the tradition. been few other major breakthroughs of this kind, However, it is clear that MBSR, MBCT, and and it is less than clear how good mindfulness most of the derivative techniques have been actually is as a therapeutic technique. intended by their originators to be seen by both For what it is worth, a series of systematic therapists and patients as non-religious, and reviews and meta-analyses have so far been unable indeed to be accessible because of this to demonstrate that mindfulness-based therapies non-religious character to those who might reject are any better than other available therapies. Some an explicitly ‘Buddhist’ approach. In addition, of the problems here are methodological rather while ‘mindfulness’ is an attractive label, its than substantive; despite the large number of meaning in these contemporary contexts is sig- studies, there are not very many high-quality nificantly different from the various meanings of studies of the right kind on the mindfulness-based the Buddhist terms—sati in Pali, smṛti in San- therapies to evaluate their usefulness. Willoughby skrit, dran pa in Tibetan, and so on—which it Britton, herself a significant researcher in this purports to translate.1 field, comments on the latest major systematic The rejection of religion has led to some review, the Association for Health and Research commentators raising the question of whether the Quality (AHRQ)’s 2014 report (Goyal et al. new mindfulness-based approaches represent an 2014), ‘This review—and pretty much every one authentic version of the Buddhist teachings. This before it—has found that meditation is not any question is worth taking seriously, if only better than any other kind of therapy.’ She goes on because it alerts us to the distance between the to say that ‘The important thing to understand Buddhist origins of these practices and their about the report is that they were looking for active present form. However, in many ways the busi- control groups, and they found that only 47 out of ness of origins can be a distraction from the over 18,000 studies had them, which is pretty perhaps more significant questions of what our telling: it suggests that there are fewer than 50 present culture and society is doing with these high-quality studies on meditation.’2 practices, what we are using them for, and what Evidence-based medicine, with its clinical tri- else we might be doing with them. als, randomized double-blind protocols and I think that we can accept that the introduction meta-analyses, is a major minefield in its own of the mindfulness-based therapies has, by and right, and part of the problem is that meditation large, been a good thing. There are certainly does not fit well into this frame. Neither, it might arguments about whether they are as effective as be said, do a lot of other things that are also is sometimes claimed, both in terms of the probably quite good for us. Evidence-based standard and quite restrictive procedures of medicine is primarily a way of making decisions evidence-based medicine, and in more general about resource allocation. It cannot tell what is the terms. In terms of official recognition, perhaps best treatment for any individual person. But it the high point came in 2009 when the UK’s should also be said that if the mindfulness-based National Institute for Clinical Excellence brought techniques are no better than the alternatives in 2Britton’s comments are in a 2014 interview with Tricycle 1For this reason, I generally speak below of ‘mindfulness- (Britton 2014). For an earlier report, see Chiesa and based’ techniques or practices, rather than of ‘mindfulness.’ Serretti (2010). 4 Mindfulness Within the Full Range of Buddhist and Asian … 49 terms of their ability to meet specific therapeutic or transpersonal aspects affect the practice of goals, they may at least be less harmful. The mindfulness-based techniques in the contempo- mindfulness-based techniques have helped to rary world? What sense can we make of these legitimate a substantial reduction in the massive aspects within contemporary scientific contexts? default prescribing of psycho-active drugs for More generally, if the growth of these techniques psychiatric illness. They have probably enabled in their new global context offers us an significant numbers of people who might have unprecedented opportunity, and I believe that it become dependent on such drugs to gain some does, then how do we grasp that opportunity in autonomy, agency, and control over their situa- order to respond to the equally unprecedented tion. If so, we should surely welcome these problems that we, the human population living developments. The mindfulness-based techniques on this finite planet, will have to face over the are also, I would suggest, of value in that they years to come? have allowed psychiatry, clinical psychology, and related disciplines to start taking consciousness and its role in human function seriously once Mindfulness as Panacea and the Range more, and in a new way. I shall say some more of Approaches about this later on. The discussion which follows in this chapter I start, as I said, with the question of ‘mindful- takes the above points more or less for granted. To ness as a panacea.’ If MBSR encodes the sketch the argument I am going to present: I will essential message of the Buddhist teachings, as begin by emphasizing that, while there remains a Kabat-Zinn and others have told us, then it tendency for the MBSR model to be taken as the should be good for everybody, since that mes- default approach, and even to be regarded as a sage is of universal applicability. At least, this kind of panacea, it is far from appropriate for all seems to have been the general orientation of situations and all people. In the following sections many of the early proponents of mindfulness, of my argument I shall note that we have in the particularly of MBSR, which in any case has a Buddhist tradition, and in the various other Asian pretty generic remit.
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