Do I have a self? (and other useful questions from Buddhist mindfulness)

Scientific interest in mindfulness has grown exponentially over the past two decades, and a number of Mindfulness Based Interventions (MBIs) have been widely disseminated. Western MBIs, including Kabat-Zinn’s seminal Mindfulness Based Stress Reduction (MBSR), are explicitly grounded in Buddhism.

There are longstanding concerns that mindfulness may be denatured when removed from its original Buddhist context. A recent ANZJP Debate (Van Gordon et al., 2015) speaks to this issue by introducing MBIs that adopt a more traditional Buddhist approach (‘Buddhist MBIs’ for the present purposes). The aim of this paper is to encourage further critical discussion of mindfulness by unpacking some issues raised by that article.

Mindfulness in Buddhism

All major schools of Buddhism consider mindfulness to be the seventh limb of the Eightfold Path. The eight limbs fall into three domains – wisdom (view, intention), engaged action in the world (speech, action, livelihood) and mental or meditative development (effort, mindfulness and concentration). Importantly, the Eightfold Path is a description of the structure of reality in Buddhism; ‘right’ practices help align one’s conduct to this reality, inexorably leading to the cessation of suffering in the world.

Right mindfulness is one stage of the sequential Eightfold Path, embedded in and supported by practices encouraging emergence of wisdom, ethical conduct and concentration. The aim of mindful meditation is not to decrease stress, but to foster insights into subtle concepts (or facts from the Buddhist worldview), including impermanence and emptiness. Presented outside this context, mindfulness may be weakened (is an appreciation of impermanence necessary for mindfulness’ full effect?), ambiguous (does mindfulness have spiritual outcomes?) or unethical (is a sniper mindful?).

Buddhist MBIs

Van Gordon et al. (2015) are leading proponents of emerging Buddhist MBIs (the first two authors are Buddhist monks). In their Debate piece, Van Gordon et al. (2015) suggest that these interventions are the second-generation MBIs, but other better-researched interventions (e.g. compassion-focussed approaches) could also be considered second-generation.

The content of Buddhist MBIs is explicitly spiritual, and all elements of the Eightfold Path are taught. Van Gordon et al. propose that the widely accepted definition of ‘mindfulness’ as non-judgemental attention to the present moment is incomplete in the context of Buddhist MBIs. Mindfulness as part of Buddhist training shares the accepted meaning of a particular quality of consciousness (remembering to maintain attention on a chosen feature of the present moment), but also connotes active, ethical participation in the here and now, with an overarching spiritual intent. Indeed, Buddhist MBIs should only be delivered by an appropriately trained spiritual guide (Shonin and Van Gordon, 2014). As noted by Van Gordon et al., research into the effectiveness of Buddhist MBIs is in its infancy, and there have been no head-to-head comparisons with existing evidence-based MBIs.

What might Buddhist MBIs add over existing evidence-based MBIs?

In the absence of consensus about the therapeutic mechanisms of existing Western MBIs, considerations here are largely limited to comparison of surface content and stated aims.

Buddhist MBIs include explicit teaching about Buddhist metaphysics (impermanence), ethics (interconnectedness) and the pathogenic illusion of self (see below). While these topics are less apparent in Western MBIs, they may not be altogether missing from the interventions. First, irrespective of its intellectual context, mindfulness as an experiential exercise appears to increase awareness of the world as process, and weaken attachment to mental constructs including ideas about oneself. Second, the Buddhist MBI emphasis on active engagement (versus passive observation) has parallels in the Western MBI aim of flexible, contextualised engagement with one’s environment. Third, it is not clear that Western MBIs strip ethics from mindfulness: While a single set of ethics is not imposed, many practitioners of Western MBIs would expect mindfulness practice in the real world to support attuned, sensitive and respectful responses to the environment.

Finally, while Buddhist MBIs differ from Western MBIs in having an overarching spiritual intent, Western mindfulness practices may enhance subjective spirituality via an expanded awareness of process and disengagement from a narrow self-focus. Indeed, there is evidence that an increased sense of spirituality is one mechanism of MBSR’s benefits for wellbeing (Greeson et al., 2011). The explicit focus on spirituality or transcendence may nonetheless be a strength of Buddhist MBIs: One study found spiritual growth important to some 70% of US adults, so situating mindfulness training in a spiritual frame may be culturally congruent for a significant proportion of the Western population.

In sum, Western MBIs may encourage the philosophical insights that are the stated aim of Buddhist MBIs. From the viewpoint of psychiatry/psychology, more research is required to test whether, and under what circumstances, wellbeing outcomes are enhanced by adding explicit Buddhist philosophy to mindfulness.

Implications of Buddhist MBIs for the science of psychopathology

Buddhist concerns about flagship Western MBIs constitute useful prompts for reflection about the philosophical assumptions of Western psychotherapies more broadly.

To take one example, Buddhism rejects a duality between subject and object, and formulates suffering as an ontological error. Suffering is caused by a falsely imputed ‘self’ mindlessly grasping for reifications it deems attractive and avoiding reifications it considers unattractive. In Buddhist MBIs, this ‘addictive misunderstanding’ is introduced to the trainee via mindfulness meditation and direct instruction, leading to potentially beneficial insights:

We’re brought up to see the world as something that belongs to us, something that’s mine, something that I’m always at the centre of. When you start to see that the self simply cannot exist, it’s a shock at first, but it’s a shock that you would never have wanted to have missed … Don’t get me wrong though, understanding emptiness is one thing, but keeping that understanding with you when you’re at work is an entirely different ball game. (Qualitative data reported in Shonin and Van Gordon, 2014)

At the level of theory, then, Buddhist MBIs continue the trajectory of ‘third wave’ psychotherapies away from ‘second wave’ cognitive behavioural therapies, in which the cognising self is a pivotal construct. It is noteworthy that a number of older Western psychotherapies also deconstruct or minimise the conventional self: Gestalt therapies privilege present experience over elaborated self-narratives, and body psychotherapies view mind, body and environment as interpenetrant (Leitan and Murray, 2014).

Conclusion

The second generation of MBIs (whatever form they take) should be built on better understanding of the specific mechanisms of mindfulness in its various contexts. Emerging Buddhist MBIs are a timely stimulus for this research, provoking incisive questions about the nature and intent of mindfulness and psychotherapy more broadly.