Category: mindfulness

The Role of Refuge in Mindfulness Practice

Refuge – A Buddhist concept missed by meditation scientists

Why the Absence of Refuge Undermines Western Mindfulness

Western psychology has embraced mindfulness as a panacea, an intervention linked to reduced stress, treating clinical depression, and even improving cognitive function. However, despite its popularity, the lack of robust evidence for its clinical benefits has led many practitioners and scientists to speculate on why the presumed effects of traditional meditation have not been translated into clinical practice.

One of the key elements of traditional meditation, often missing from Western mindfulness, is the concept of Refuge. Refuge is a foundational concept in many meditation traditions, orienting the practitioner’s mind within a broader spiritual and relational framework. In Buddhist meditation, mindfulness is not a standalone technique; it arises within the context of the Refuge in the Buddha, the Dharma (the Buddha’s teachings), and the Sangha (the community of practitioners). Taking Refuge in these three elements provides an existential grounding and generates confidence in the meditation practice.

The precise nature of Refuge can vary according to the practitioner’s experience and Buddhist school within which the meditation is practised. However, in almost every case, it provides a mindset that serves as a stable base for meditation. Without Refuge, the act of mindfulness risks becoming an attentional exercise, uncoupled from many of the mental processes present in Buddhist meditation. There is growing unrest among some practitioner-scientists about the decontextualisation of mindfulness from traditional forms of meditation; that is, in Westernising and commodifying meditation, the benefits of traditional practice may have been lost.

Segall (2001) argues that when stripped of its Buddhist theoretical frameworks, Western mindfulness loses its transformative potential, becoming susceptible to institutional agendas and materialist objectives.1 Khong (2012) also highlights the limitations of detaching mindfulness from its Buddhist theoretical frameworks.2

Refuge in mindfulness practice
Refuge – The foundation of mindfulness practice

The absence of Refuge is likely to impact cognitive processes and mechanisms able to mediate wellbeing in several ways:

Firstly, a lack of existential orientation: Refuge provides a holistic and spiritual telos, enabling a sense of direction towards awakening and compassion. Without these processes, Western mindfulness tends to privilege mundane, dualistic awareness, overlooking its transcendent and ethical purposes.

Isolation and individualism: The concept of Sangha offers a broader sense of community and collective purpose. The tendency of mindfulness to focus on individual, solitary needs disrupts the balance between self and other, which is central to most nondual Buddhist meditation.

Cognitive reductionism: Buddhist Refuge engages the whole person in context, emotionally, ethically and spiritually. Western clinical meditation methods typically privilege the extrinsic brain network, overlooking mental processes rooted solely in the intrinsic system.

Commodification: The absence of Refuge enables the reconfiguring of mindfulness as a health product, enabling the technique to be co-opted by corporations and institutions, including the military. This shift reshapes the mental processes used in meditation, reinforcing systemic stressors rather than challenging them.

Refuge and the commidification of meditation
The commodification of meditation may have limited its health benefits

The commodification of meditation may have limited its health benefits compared to both traditional practices and scientifically validated interventions. Taking the bigger picture into account, these concerns are the tip of an iceberg.

There is growing disquiet about the cost of the ‘mindfulness experiment’. Estimates of the global bill for the scientific investigation of mindfulness from the 1970s to date range between £1 bn and £5 bn. Several billion more represent the cost of the proliferation of the technique and the investment in training teachers and providing wider support materials. Most scientists working in this field would agree, practising mindfulness brings a degree of relaxation equivalent to and sometimes slightly greater than hundreds of other mundane human behaviours, like art or gardening.

Refuge is a concept rooted in a dual/nondual tension. An issue that is ignored by almost all meditation scientists. The psychological sciences generally present consciousness as a dualistic enterprise. For psychologists, even a preliminary understanding of Buddhism’s theoretical foundations requires a reimagining of mindfulness to access the health benefits of traditional meditation methods. On the balance of evidence, Western versions of traditional meditation are oversimplified and entirely uncoupled from the original curative network that so attracted Western academics from the 1930s onward.

The results of 90 years of meditation research have demonstrated that focusing solely on technique has been a significant error. Integrating elements of Refuge, even from a secular perspective, is likely to restore depth and direction to meditation methods. For example, a starting point for the reintroduction of Refuge could include: The use of transdisciplinary research to establish the cognitive components present in traditional Refuge and to develop the relevant theoretical framework. Encouraging practitioners to understand the concept of Refuge and apply the theoretical framework to their own conditions. Framing mindfulness within a broader narrative of healing, ethical living and growth. Developing secular practices that can cultivate interdependence, compassion and shared community.

Khong has convincingly argued that the maturation of Western mindfulness requires a return to its roots, not to replicate religious forms, but to realign the Westernised practice with the original mental processes that may hold robust potential rather than the marginal benefits that most reliable, optimistic studies present.

The concept of Refuge reminds us that dualist presence alone is not transformative, not on the spiritual nor the clinical levels.  Its absence from Western practices, even in a secular form, evidences the current limitations in how psychology understands and engages with mindtraining originating in non-scientific domains.

References:

Khong, B. S. L. (2021). Revisiting and Re-Envisoning Mindfulness: Buddhist and Contemporary Perspectives. The Humanistic Psychologist, 49(1), 3 -18.  

Segall, S. Z. (2021). Mindfulness In and Out of Context of Western Buddhist Modernism. The Humanistic Psychologist, 49(1), 40-55.

How Psychology Misunderstood Mindfulness and What We Do Now

Part 2: Evolution, not Revolution

This is part 2; part 1 can be found here.

Part 1 describes the processes through which mindfulness has been converted from a religious to a scientifically validated practice. On this page, I outline the implications of treating religious and scientific knowledge as congruent. This ‘congruence’ is an ‘imaginary’, an illusion created where scientific communities abandon rational thinking in favour of other motivations. Once the imagined form of mindfulness is created, it can be absorbed into psychology. The evidence suggests that the psychological sciences may need to reevaluate their underlying theoretical frameworks and reconsider how non-scientific knowledge is treated, particularly concepts and techniques originating in religious traditions.

If science and religion, in general, have incompatible theoretical frameworks, how was Buddhist mindfulness ‘transformed’ into a Western medicalised practice? The reality is that a few scientists and clinicians simply claimed that religious meditation and psychology were complementary. They provided no evidence or scientific explanation to support this position. They also appeared to lack the knowledge and experience necessary to make reliable generalisations about religious thought and practice. By focusing on meditation methods, not the underlying cognitive processes, psychologists could not evaluate the innate value of the traditional approaches for health benefits. In this way, psychology appropriated and relocated meditation techniques they never understood.

Western psychologists avoided meaningful, rational investigation of traditional meditation, preferring to ‘imagine ‘ what the techniques were from Western dualistic perspectives.

Why is this important? Science can measure the physiological effects of meditation, such as how it affects heart rate and blood pressure. However, because of the uncertainty regarding the boundaries between belief and science, early meditation and mindfulness experiments rarely progressed beyond a preliminary stage. Further, some psychologists overreached themselves by claiming they understood the essence of Buddhist meditation. These errors were compounded because the wider scientific community accepted unevidenced claims about the congruence between belief and science. These problems mean that much of the £5bn invested in researching meditation and mindfulness added little meaningful scientific value. Secondly, the actual curative potential of traditional meditation has been ignored. Primarily because researchers focused on meditation methods rather than the underlying mental processes engaged with by traditional meditators.

Before 2000, many scientists believed that they ‘instinctively’ understood traditional meditation without needing any meaningful training or research. Perhaps being part of elite academic institutions allowed them to feel they had the right or ability to subordinate religious thought and practice to dualistic scientific understanding. In relocating mindfulness, they stripped it of its most important cognitive components. Still today, many Western forms of meditation lack mental processes such as compassion, intention, and other concepts central to traditional meditations. Even where scientists attempted to ‘evolve’ mindfulness into a more compassionate or focused practice, the meditation nearly always remained dualistic and, therefore, distant from its original form.

Compassion for oneself and others is central to most Buddhist practices.

The fate of Western mindfulness, to have become a stripped-down dualistic version of a traditional practice, is not unusual. We have seen such approaches in relocating acupuncture, yoga and other traditional healing technologies. A subtle but observable pattern is documented in the History of Science of scientists reconfiguring nondual knowledge to sit within dualistic frameworks. As with mindfulness, this approach can lead to the original technique being misunderstood, mistranslated or distorted.

The problems evidenced in the ‘mindfulness revolution’ have complex causes, not least of which are decades of low-quality and often unreplicated research. However, the failure of scientists to recognise the presence of nondual thought and practice is also a significant concern. As a case study, mindfulness reveals a profound limitation in the psychological sciences and our understanding of the human mind. We experience life through a number of different mental states, including dual and nondual awareness. Science tends to privilege duality, which is adequate for most scientific disciplines but fails to fully explain human consciousness and experience. Duality became the default theoretical model for descriptions of human mental states, the ‘lingua franca’ of the psychological sciences. As such, non-dual concepts and practices are abstract to most psychologists and often considered superstitious or childlike. This worldview relies on evaluating nondual phenomena with dualistic instruments.

The presumption that dualistic approaches deliver ‘truth’ while nondual insights are irrelevant or inferior is possibly a continuation of the colonial mindset. Western ways of knowing are frequently assumed to be the ‘gold standard’ against which non-scientific thought and practice can be measured. There is little evidence that scientists thought Buddhist meditation methods were worth studying in their own right. Analysis indicates that the psychological sciences reduced Buddhist meditation to the terms they understood and could measure. In this way, the opportunity for scientists to identify different forms of consciousness, mental processes and health treatments in meditation was lost.

I’m sure many meditation scientists acted in good faith, but their inability to realise they were encountering different rather than inferior knowledge systems has been a costly mistake. This limitation was only possible because of a phenomenon called incommensurability. Incommensurability is the belief that one’s perspective of the world is an objective reality. The scientists first encountering Buddhist meditation may have been entirely unaware of nonduality. Presuming that their dualistic outsider view of Eastern religious practices was complete and informed. This is not simply an issue rooted in cultural misunderstandings; incommensurability likely limits encounters between science and Western spiritual practices. For example, the value of early esoteric Christian teachings was judged against the dualistic values of science and evaluated accordingly. Today, dualistic science is held to be the dominant knowledge system, and many alternative ways of understanding and experiencing the world have been subordinated without any systematic study or rational evaluation. There are almost no signs that the scientific community are aware of the potential value of non-scientific knowledge being lost.

This is part two of a six-part series. The Introduction is here.

Why the ‘Mindfulness Revolution’ Failed: Understanding the Boundaries Between Science and Religion

Part 1: Going Back to Basics: Dual and Nondual

Perhaps as much as $5 bn has been spent by scientists investigating the benefits of meditation and mindfulness over the last 50 years. Over 30,000 scholarly studies, primarily scientific, have been published in the peer-reviewed literature. In 2010, mindfulness enthusiasts and entrepreneurs announced the arrival of a new age of understanding through the ‘mindfulness revolution’. However, credible reviews of meditation research demonstrate that Western scientific understanding of mindfulness practices is, at best, preliminary. Further, almost no progress has been made in understanding what traditional Buddhist forms of meditation are, let alone how they work on the psychological level.

Scientists and clinicians initially appropriated religious meditation methods because of evidence that, in their original forms, they could provide profound health benefits. In the 1950s, long before the ‘Mindfulness Revolution’, psychologists were using Buddhist meditation to treat intractable mental health conditions. Since the early 1980s, Western scientists and clinicians developed hundreds of new versions of mindfulness. The best of these diverse forms can provide a degree of relaxation, often equivalent to or slightly more significant than a placebo effect. Unfortunately, the hope that mindfulness could be a powerful technique to treat and cure problematic mental health has evaporated.

Scientists gambling on a mindfulness miracle
Has the £5 bn mindfulness gamble paid off?

Today, the scientific understanding of mindfulness is fragmented, with growing scepticism about its benefits from many sections of society. Mindfulness is most frequently seen as a ‘welbeing’ intervention and is often taught by trained volunteers rather than psychologists or therapists. However, hyped claims of mindfulness’s benefits, supported by big business, politicians, and social policy, have ensured mindfulness’s popularity and longevity. Mindfulness has even been earmarked as a tool to keep people working and consuming when their material conditions are being eroded, a dramatic departure from the original purpose of Buddhist meditation.

The scientific history of mindfulness raises many problems. The most crucial issue is to consider how scientific engagement with religious meditation led to less rather than more understanding of the practices. By researching this question, we have started to gain much more insight into the fundamental nature of Buddhist thought and practice and the problems that arise when the boundaries between religion and science are altered.

No one factor can explain why thousands of scientists, spending a vast fortune in research funding, have made so little progress. Many studies have been critical of the scientific investigation of meditation. However, they often see the solution to the ‘mindfulness crisis’ as producing more, better-quality experiments. Fortunately, several academics have begun to question the nature of the relationship between science and religion, especially Buddhism.

In essence, the scientific method is part of a dualistic knowledge system based on certain principles, such as empiricism (all ‘true’ knowledge comes from sensory experience and empirical evidence) and reductionism (complex behaviours can be understood by isolating and understanding individual elements of the behaviours). Buddhism is divided into very different knowledge systems, most of which are explicitly and implicitly nondual. For example, Mahayana Buddhism is set in a theoretical framework where emptiness (all things are empty of intrinsic nature or existence) is held to be the underlying nature of reality. So, in any meaningful way, experimental psychology cannot understand Buddhism because they do not share the same frames of reference (ontology and epistemology). Psychology can see the effect of meditation but is unable to understand what it is.

Just to be clear, psychological science can measure the psychological and physiological effects of meditation. But it cannot currently understand what spiritual meditators do, the underlying cognitive processes, or what their spiritual goals are. Similarly a spiritual practice is unable to calculate the speed of light or the atomic weight of an element. By definition, different knowledge systems are incompatible because they address different human needs in different ways.

Dr Stephen Gene Morris

The second part of this article can be found here.

The Legacy of Mindfulness: Has Science Failed to Understand Buddhist Meditation?

Western forms of mindfulness were based on ‘imaginaries’ of Buddhist thought and practice. This problem has increased uncertainty over the mindfulness concept. However, by translating and reducing nondual religious practices to dualistic scientific ideas, the actual healing potential of traditional meditation may have been misunderstood or overlooked.

The Missed Opportunity of Mindfulness: How Science Failed to Understand Buddhist Meditation

Has science missed the point of meditation?

Credible challenges to the reliability of mindfulness research have led to many attempts to explain how Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Interventions (MBIs) developed. In particular, how mindfulness was adopted by health and social policy in the UK ahead of robust evidence for its benefits. Originally, MBSR was promoted as a fusion or bridge between Buddhist and scientific knowledge. Although few scientific studies repeated this trope, it has been influential in giving MBSR spiritual authority to support preliminary scientific claims. One of the most important reviews of the ‘bridging hypothesis’ was published in 2006. Mechanisms of Mindfulness was a paper by Shauna Shapiro and others for the Journal of Clinical Psychology and illustrates major problems in how science understands and treats religion.1

MBSR was a paradigmatic concept that set the trajectory for many of the 30,000 peer-reviewed mindfulness studies published since 1981.2 Psychology can easily measure the empirical effects of meditation, changes to heart rate, blood pressure, and oxygen consumption, for example. However, research has illustrated that rather than ‘bridge’ science and Buddhism, mindfulness researchers failed to establish a coherent theoretical framework from either perspective. The idea that MBSR did not reflect Buddhist thought and practice is not new; dozens of academic papers have sought to explain what is missing from the mindfulness paradigm. Of these Mechanisms of Mindfulness may illustrate the profound limitations in how science understands Buddhist thought and practice.

Meditate without intention or compassion.

The first point to make is that Mechanisms of Mindfulness took a favourable view of mindfulness’s potential health benefits; it was not a ‘critical’ challenge.

Over the past 20 years, the majority of research has focused on clinical intervention studies to evaluate the efficacy of mindfulness-based interventions such as the Mindfulness Based Stress Reduction (MBSR) program. This line of research has primarily addressed the first order question “Are mindfulness-based interventions effective?” These studies have led to promising data suggesting that MBSR is an effective intervention for treatment of both psychological and physical symptoms. p. 374

However, the main issue the paper raised is that MBSR created a conceptual vacuum in which treatment was delivered. That is, in the previous quarter of a century, mindfulness was being used without a clear scientific understanding of what it was or how it worked.

However, an equally important direction for future research is to address the second order question“How do mindfulness-based interventions actually work?” p.374

This uncertainty confirms that MBSR was not established using scientific or Buddhist rationales. However, Shapiro and her co-authors went further, claiming that key elements of Buddhist mindfulness (intention and compassion) were removed in the creation of the Western versions of the practice:

When Western psychology attempted to extract the essence of mindfulness practice from its original religious/cultural roots, we lost, to some extent, the aspect of intention, which for Buddhism was enlightenment and compassion for all beings. p. 375

Surprisingly, MBSR lacked the foundational elements, concepts, and methods of the Buddhist traditions it claimed to have had congruence with. When researchers pointed out these limitations, some mindfulness advocates, such as Jon Kabat-Zinn, doubled down on the unevidenced claims that MBSR reflected Buddhist values. Ignoring the criticisms of Buddhist scholars, Kabat-Zinn suggested his writings had synthesized, to some extent, the Buddha’s wisdom:

My intention and hope was that the book might embody to whatever degree possible the dharma essence of the Buddha’s teachings put into action and made accessible to mainstream Americans facing stress, pain, and illness. p. 282. 3

Despite the controversial nature of such a statement, the idea that MBSR and MBIs reflected Buddhist practices persisted. The failure of the scientific community to push back against unevidenced claims of Buddhist congruence was a major contribution to the crisis in mindfulness research. Lacking a stable theoretical framework, mindfulness was neither ‘scientific’ nor ‘Buddhist’. It was used pragmatically to demonstrate correlations between meditation and health rather than explain how it worked.4 Criticisms of the scientific quality of mindfulness research are widespread. The main issue raised here is the freedom with which religious thought and practice is presented in peer-reviewed literature.

By making unevidenced claims about Buddhist mindfulness, MBSR and MBIs were built on theoretical uncertainty. Perhaps even more problematic is the ease with which Buddhist thought and practice were adapted and misrepresented in the search for new health interventions. There are important issues here about the subordination of religion by science, which can lead to misunderstanding in the wider society. However, the great loss is that by manufacturing an imaginary of mindfulness rather than developing a comprehensive understanding, we know very little about the benefits of traditional forms of meditation. Most Buddhist meditation methods tend to a nondual view, while science is essentially dualistic. In reinventing meditation through a dualistic lens, the richness and potential benefits of nondual meditation have been removed from contemporary practices.

References

  1. Shapiro, Shauna L., Linda E. Carlson, John A. Astin, and Benedict Freedman. “Mechanisms of mindfulness.” Journal of clinical psychology 62, no. 3 (2006): 373-386.
  2. Morris, Stephen Gene. “The Scientific History of Mindfulness: 1938 to 2020.” PhD diss., University of Kent,, 2024. https://kar.kent.ac.uk/106240/
  3. Kabat-Zinn, Jon. “Some reflections on the origins of MBSR, skillful means, and the trouble with maps.” In Mindfulness, pp. 281-306. Routledge, 2013.
  4. Van Dam, Nicholas T., Marieke K. Van Vugt, David R. Vago, Laura Schmalzl, Clifford D. Saron, Andrew Olendzki, Ted Meissner et al. “Mind the hype: A critical evaluation and prescriptive agenda for research on mindfulness and meditation.” Perspectives on psychological science 13, no. 1 (2018): 36-61.

The Scientific History of Mindfulness: Unveiling the Paradox

The findings of a new four-year investigation provide comprehensive insights into how mindfulness developed and its current status. Despite significant scientific concerns, the research illustrates how mindfulness was promoted as an influential health and well-being intervention. The least known but most controversial aspect of the ‘mindfulness revolution’ is the reconfiguring of spiritual practices as tools for social and economic control.

The latest in-depth research explains why scientists and clinicians are rethinking the idea that mindfulness is a universal mental health treatment.

The most comprehensive scientific review of the popular Western form of mindfulness meditation, medicalised mindfulness, has just been completed. The Scientific History of Mindfulness (SHoM) describes the creation of Mindfulness-Based Stress Reduction (MBSR) in the late 1970s and charts the development of hundreds of Mindfulness-Based Interventions (MBIs) in the following decades. MBSR was part of a movement that sought to capture the health benefits of spiritual practices. Uniquely, MBSR was presented as a health intervention that ‘bridged’ scientific and religious knowledge. In 2004, Mindfulness-Based Cognitive Therapy (MBCT) was endorsed for clinical use in the UK, increasing public and scientific confidence in medicalised meditation. By 2010, mindfulness stakeholders declared that a ‘mindfulness revolution’, which would profoundly impact society, was taking place.

Politicians and health policy agents enthusiastically promoted the benefits of mindfulness, particularly in the UK. The hype also bled into social policy, where in 2014, mindfulness was presented as a tool for social control and improved economic performance. Under the concept of ‘mental capital,’ the rollout of mindfulness in UK schools was made a priority.

“The idea that mindfulness training could help to boost workplace productivity, even if employee working conditions were eroded requires much more research and discussion. Using mindfulness to pacify workers to benefit employers or the wider economy challenges the trope that medicalised mindfulness was Buddhist.”

Dr Stephen Gene Morris

By 2018, many meditation scientists were criticising the experimental findings on which mindfulness’s success had been built. Over the decades, reviews of meditation experiments have frequently highlighted limitations in mindfulness research. However, a tendency among some scientists and policymakers to ignore negative scientific evidence established misunderstandings about mindfulness and the benefits it could bring to practitioners and consumers.

“This SHoM goes some way to explaining why, despite over forty years of clinical and scientific activity, costing billions of pounds, we have little certainity about what mindfulness is and how it mediates health and wellbeing.”

Dr Stephen Gene Morris

The SHoM describes how reducing Buddhist meditation methods to Western psychological interventions created ontological conflicts. These conflicts helped sustain paradoxical positions where experimental studies were regarded as both reliable and unreliable. This permitted mindfulness stakeholders to pick and choose the ‘science’ supporting the use and deployment of MBIs. Mindfulness became widely accepted after 2000 despite its known weaknesses, which is a significant concern for scientific and clinical communities and their funders. As a case study, the history of mindfulness offers evidence of substantial problems in how knowledge is created and disseminated in the psychological sciences. Further, the review highlights how overstating scientific findings based on preliminary research can lead to problems in other domains, such as health care and social policy.

A clear understanding of the mindfulness paradox and research crisis offers new perspectives on the Western understanding of meditation. There is a pressing need to reevaluate and rationalise mindfulness research, a problem that SHoM addresses directly. This careful transdisciplinary investigation has also highlighted systemic issues in the areas where scientific and non-scientific knowledge intersect. In particular, scientists and scholars have often explained religious thought and practice empirically, subordinating their actual nature and obscuring their curative potential.

“As a case study, medicalised mindfulness has evidenced a sometimes corrosive relationship between religion and science that reduces knowledge to a very narrow scientific perspective. Recent scholarship supports the need for a major review of the scientific treatment of non-scientific knowledge.

Dr Stephen Gene Morris

One obvious conclusion from the SHoM is that a failure to establish reliable scientific foundations has been very costly. Thousands of peer-reviewed papers repeated the same experimental limitations, and unreliable ‘scientific’ narratives about religion and meditation have entered popular discourses. Today, a significant effort by the contemplative science community is needed to restore the reputation of meditation research and establish meaningful boundaries between scientific and religious knowledge systems.

(If you’re looking to understand why science has failed to understand religion, click here. The Legacy of Mindfulness: Has Science Failed to Understand Buddhist Meditation?)

Notes:

1 The Scientific History of Mindfulness: 1938 to 2020

Morris, Stephen Gene (2024) The Scientific History of Mindfulness: 1938 to 2020. University of Kent,. (doi:10.22024/UniKent/01.02.106240) (KAR id:106240). https://kar.kent.ac.uk/106240/

2. Dr Stephen Gene Morris is a Consultant in Applied Neuropsychology and has spent over 25 years understanding knowledge at the intersections of science and belief. In June 2024, he completed this PhD thesis, funded by a Scholarship from the University of Kent.

3. The SHoM will be officially launched on the 30th of September 2024. Press releases and summaries of findings will be distributed to relevant media outlets. To register for an electronic copy of the press pack, complete the contact form here with ‘Press Pack’. To contact Stephen directly on matters linked to

Mindfulness: The Great Paradox

7th Regional Medical Humanities Seminar on the 13th of October

Stephen Gene Morris @ 7th Regional Medical Humanities Seminar on the 13th of October

Happy to have shared exciting mindfulness research at the 7th Regional Medical Humanities Seminar on the 13th of October in Maidstone. Thanks for all the great questions, feedback, and follow-up invitation.

Explored from a historical perspective, the scientific study of meditation reveals some great opportunities and significant limitations. Not least is the mindfulness paradox; despite a billion-dollar research investment, science and medicine remain divided over the reliability of mindfulness research and, thus, its clinical potential.

Evaluating the billion-dollar mindfulness experiment: promising but not proven

A new study may have discovered why, despite a huge scientific investment, mindfulness research has been problematic for decades.

Photo by Alex Azabache on Pexels.com

With the aim of bridging these two epistemologies of science and dharma, I felt impelled to point out in the early years of MBSR the obvious etymological linkage of the words medicine and meditation and articulate for medical audiences their root meanings.

Jon Kabat-Zinn1

The version of mindfulness founded by Jon Kabat-Zinn in 1979 has always been problematic to validate scientifically. Over the last forty years, scientists, clinicians and other academics have been trying to understand what mindfulness is and how it works.2 My recently published study argues that attention to Kabat-Zinn’s claims about the origins of mindfulness hold an explanation for the current research crisis.3

There is (and always has been) a paradox in the scientific understanding of mindfulness. Thousands of preliminary clinical studies claim health benefits linked to its use. At the same time, strategic scientific reviews have illustrated that many of these studies cannot be regarded as scientifically reliable. And as the research interest has grown, the mindfulness paradox has become more problematic. We may have also reached the stage where mindfulness may be considered by health and social policy as too big to fail’. Mindfulness is now a global phenomenon; there are over 30,000 published papers in academic databases. And many scientists and institutions have continued to promote the use of mindfulness despite the presence of scientific uncertainty. In financial terms, the cost of meditation and mindfulness research is estimated at over $1.6 bn. The vast majority of this investment has been made since 2012.

In financial terms, the cost of meditation and mindfulness research is estimated at over $1.6 bn. The vast majority of this investment made since 2012.

Stephen Gene Morris

Based on a three-year study of the scientific literature, I contend mindfulness can only be fully understood by looking at its origins. The paradigm established by Jon Kabat-Zinn is rooted in the medicalised meditation movement founded in 1970. And in one sense follows the trajectory of the Religion of Science, a popular philosophy in the first decade of the twentieth century. Mindfulness has been built on a belief that an ontological congruence exists between religion and science. Unpacking this claim is key to resolving the costly mindfulness paradox and charting a more scientifically reliable future.

Notes:

1. Kabat-Zinn, Jon, ‘Some Reflections on the Origins of MBSR, Skillful Means, and the Trouble with Maps’, Contemporary Buddhism, 12.1 (2011), 281–306. https://doi.org/10.1080/14639947.2011.564844

2. For an overview of the current issues, see: Van Dam, Nicholas T., Marieke K. Van Vugt, David R. Vago, Laura Schmalzl, Clifford D. Saron, Andrew Olendzki, Ted Meissner et al. “Mind the hype: A critical evaluation and prescriptive agenda for research on mindfulness and meditation.” Perspectives on psychological science 13, no. 1 (2018): 36-61. https://journals.sagepub.com/doi/abs/10.1177/1745691617709589

3. Morris, Stephen,””The Rise of Medicalised Mindfulness During the 1970s and 1980s: The Attempted Convergence of Religion and Science.” Brief Encounters 6, no. 1 (2022). http://www.briefencounters-journal.co.uk/BE/article/view/296“

The mindfulness concept can be saved, but a major revision is needed

The latest study of mindfulness in schools found that it ‘does not improve mental health’ and is contraindicated for some students.

Everything might have an ‘effect’, but how do we evaluate it?

On Tuesday 12th of July, the Guardian published details of a scientific study that raised important questions about the use of mindfulness in secondary schools. This article discussed a My Resilience in Adolescence (Myriad) trial of the benefits of School-based mindfulness training (SBMT), a major research effort involving 8,376 students in the 11–13 age range across different sites. The study had robust clinical methodologies, and it’s perhaps the most reliable SBMT investigation published to date. However, the Guardian headline claimed that ‘SBMT does not improve mental health’. But the original paper offers even more challenging findings:

SBMT as delivered in this trial is not indicated as a universal intervention. Moreover, it may be contraindicated for students with existing/emerging mental health symptoms.

Clinical implications:

Universal SBMT is not recommended in this format in early adolescence. Future research should explore social−emotional learning programmes adapted to the unique needs of young people.1

This is not the first scientific study of SBMT; the Guardian describes earlier research as ‘mixed’. Taken together, the earlier and current findings for the benefits of SBMT reflect an established pattern in the science of mindfulness that is frequently ignored, a tension between tentative early-stage studies and more robust scientific evidence. Demonstrating positive preliminary effects has never been a problem in the scientific engagement with meditation. In the first twenty years of mindfulness research, spectacular claims were frequently made about the benefits of meditating, but few of those preliminary findings were confirmed by large-scale randomised controlled trials (RCTs).

Since the 1980s, scientists have warned that preliminary uncontrolled, unrandomised, unreplicated mindfulness studies must be treated cautiously. And strategic reviews of mindfulness research frequently found initial claims to be unreliable on both theoretical and methodological grounds. But these evidence-based problems have had little effect on the scientific and social policy enthusiasm for mindfulness. This binary of positive preliminary studies challenged by more scientifically reliable evidence continues to this day. And traces of it can be seen in other forms of medicalised meditation. The problem illustrated by this Myriad trial of SBMT is simply the latest example of the paradoxical nature of mindfulness, an intervention frequently more promising than proven. 

The rationales underpinning many mindfulness clinical studies have provoked concerns. One of the harshest from Nicholas Van Dam and 14 co-authors who, in 2018, claimed that methodological weaknesses and unreliable reporting of initial claims might lead mindfulness consumers to be harmed.2 As a meditator and meditation scientist, nobody wants to see the success of medicalised meditation methods more that I. But there is evidence that we are in an epistemological crisis in meditation research. A state confirmed by my current project to write a scientific history of mindfulness. However, rather than a simple description, my work has identified the causes of the crisis and, thus, the possible solutions. But given the current trajectory of mindfulness research, there is little hope of significant change until the mindfulness community confronts the systemic research problem in this field present since the 1980s.

Notes

  1. Montero-Marin, Jesus, Matthew Allwood, Susan Ball, Catherine Crane, Katherine De Wilde, Verena Hinze, Benjamin Jones et al. “School-based mindfulness training in early adolescence: what works, for whom and how in the MYRIAD trial?.” Evidence-Based Mental Health (2022).
  2. Van Dam, N.T., Van Vugt, M.K., Vago, D.R., Schmalzl, L., Saron, C.D., Olendzki, A., Meissner, T., Lazar, S.W., Kerr, C.E., Gorchov, J. and Fox, K.C., 2018. Mind the hype: A critical evaluation and prescriptive agenda for research on mindfulness and meditation. Perspectives on psychological science, 13(1), pp.36-61

Do we need more balance when reporting mindfulness research?

As mindfulness heads towards another incarnation, unresolved issues linked to its scientific reliability remain unresolved.

https://www.theguardian.com/world/2022/may/04/eu-bureaucrats-being-trained-meditate-help-fight-climate-crisis

On the 4th of May, the Guardian published an article describing the benefits of ‘applied mindfulness’ courses. However, many of the tropes observed in earlier mindfulness discussions were still prominent. Below is my reply to the Editor.

“I enjoyed the feature on EU officials learning to meditate published in The Guardian on the  4th of May. It’s hard to argue against any attempt to use the ‘potential of meditation to encourage lower-carbon lifestyles.’ But as a researcher documenting the scientific history of mindfulness, it would be remiss of me not to draw your attention to some problems with this article. So, if you permit, I’ll signpost some evidence that offers a more complete perspective of mindfulness than that normally seen in the UK media.

I’m a trained meditation neuroscientist, but my research changed direction in 2018  when I read a new scientific study called Mind the Hype.[1] Fifteen of the leading meditation scientists and clinicians reviewed the evidence supporting claims made for mindfulness. They found that: ‘Misinformation and poor methodology associated with past studies of mindfulness may lead public consumers to be harmed, misled, and disappointed.’ These claims appeared to run counter to much of the reported evidence and many of the media accounts I’d seen; I decided to take a closer look.

The published evidence (rather than the media hype) revealed that scientists such as Michael West had been warning against methodological problems in the research of medicalised meditation (of which mindfulness is part) since 1970.[2]  These warnings consistently appear in strategic reviews of meditation research. In the 1980s, Marguerite Malone and Michael Strube confirmed the presence of ‘spectacular’ claims based on limited experimental approaches.[3] The robust application of the scientific method to mindfulness experiments has continued to challenge promising but frequently unproven claims. The characterisation of criticisms of mindfulness using the trope of ‘McMindfulness’, ignores dozens, perhaps over a hundred systematic studies by credible mainstream scientists and academics.

Your article repeated claims about mindfulness-based cognitive therapy’s (MBCT) benefits. And while MBCT is based on a more reliable methodology, there are important and often undiscussed issues here. MBCT combines cognitive behavioural therapy (CBT) with mindfulness. Research has indicated that the clinical benefits of MBCT are comparable with CBT, leading critics to argue that removing mindfulness from MBCT does not alter its clinical effectiveness. As you mention, there is cross-party political support for mindfulness through the Mindfulness All-Party Parliamentary Group (MAPPG) at Westminster. Therefore, it is unfortunate that the 2015 MAPPG report failed to discuss many of the evidenced limitations in the science supporting mindfulness. Further many of the protagonists in this field appear unaware of the social policy agenda linking mindfulness to economic objectives through the concept of ‘mental capital’.

To describe mindfulness as ‘Buddhist inspired’ is problematic in my opinion. Jon Kabat-Zinn, the founder of mindfulness-based stress reduction (MBSR) described it as a ‘bridge’ between belief (Buddhism) and science, an improbable fusion of world views.[4] And while mindfulness is now a fragmented technology with over 30,000 studies in the academic databases, the scientific paradigm developed by Kabat-Zinn in the 1980s is present in much contemporary research.

I appreciate this is a complex area, and I have had the advantage of researching this field for many years. But New Scientist began to ask critical questions about the ‘hype’ behind mindfulness last year. So I’m sure many of your readers would be interested in a more balanced perspective on mindfulness research and practice.

Regards

Stephen Gene Morris”

[1] Nicholas T. Van Dam and others, ‘Mind the Hype: A Critical Evaluation and Prescriptive Agenda for Research on Mindfulness and Meditation’, Perspectives on Psychological Science, 13.1 (2018), 36–61 <https://doi.org/10.1177/1745691617709589&gt;.

[2] Michael West, ‘Meditation.’, The British Journal of Psychiatry : The Journal of Mental Science, 135.5 (1979), 457–67 <https://doi.org/10.1192/bjp.135.5.457&gt;.

[3] Marguerite D. Malone and Michael J. Strube, ‘Meta-Analysis of Non-Medical Treatments for Chronic Pain’, Pain, 34.3 (1988), 231–44 <https://doi.org/10.1016/0304-3959(88)90118-2&gt;.

[4] Jon Kabat-Zinn, ‘Some Reflections on the Origins of MBSR, Skillful Means, and the Trouble with Maps’, Contemporary Buddhism, 12.1 (2011), 281–306 <https://doi.org/10.1080/14639947.2011.564844&gt;.

Non-judgement and mindfulness meditation; costs and opportunities

The absence of judgement from medicalised mindfulness suggests an uncoupling from traditional meditation methods. Why did this happen, and what does it mean?

Why was judgement removed from medicalised meditations

Although definitions across contemporary forms of mindfulness are varied, we usually find mindfulness-based interventions (MBIs) are explicitly non-judgemental. In the context of meditation technologies, we think about ‘non-judgement’ being both operationalised in the meditation practice itself and in the broader ethical context surrounding meditation. This lack of judgement in MBIs appears to have been one of its foundational principles, present since its medicalisation1. This absence is somewhat surprising, given the presumed conceptual relationship with Buddhist forms of mindfulness, where judgement and ethics are woven into their theoretical frameworks.

Scholars and practitioners have considered if the non-judgemental approach in MBIs has uncoupled them from traditional forms of meditation, if so what have we lost or gained in the process?2 This debate has been illuminated recently by Chokyi Nyima Rinpoche, who wrote that meditation alone is not enough3. That understanding the ontology and epistemology of the method is an essential part of the meditation process. Although Rinpoche talked specifically about Buddhist practices, his view supports the notion that meditation, stripped of its ethical and judgmental elements, becomes different. We should be clear that although there are Buddhist methods which operationalise a non-judgemental view, they are conducted within an ethical/judgemental setting. However, the questions from a history of science perspective are more linked to how and why things developed this way. What does the apparent paradox (judgemental practices translated as non-judgemental), mean about the scientific context in which mindfulness was established and now resides?

“If we use these precious resources to examine things critically, we can understand both the way things appear and the way they truly are.”

Chokyi Nyima Rinpoche3

From a psychological perspective, the separation of meditation from its foundational judgement and ethics raises three crucial questions. Firstly, given the widespread presence of spiritual practitioners in the research and teaching of meditation, are students of MBIs getting ad hoc judgement/ethics to fill the gap? Secondly, judgement and reflection require engagement with essential processes in the brain’s intrinsic networks; therefore, what are the differences between the results obtained from judgemental and non-judgemental approaches. And finally, if judgement is central to traditional meditation technologies, why has it been removed? It is this last question that holds the greatest significance.

Psychology is free to develop whatever forms of meditation it sees fit; it can also investigate spiritual meditation methods. But the creation of contemporary mindfulness interventions, based on traditional forms prompts questions. If we knew the Buddhist practice(s) mindfulness was translated from, their theoretical and operational components could be established. Then by conducting comparative studies with MBIs, an understanding of what was added or subtracted might be reached. However, the scientific provenance of MBIs is shrouded in mystery; this gap in our knowledge is a probable factor in the failure to establish reliable theoretical frameworks for MBIs.4 Therefore, although contemporary mindfulness stresses a close relationship with Buddhist meditation technologies, this is not generally supported with evidence. So why and how did things turn out this way? Understanding this issue may provide the insights needed to signpost the next stage in mindfulness’s development.

References

1 Kabat-Zinn, Jon. “Some reflections on the origins of MBSR, skilful means, and the trouble with maps.” Contemporary Buddhism 12, no. 01 (2011): 281-306.

2 King, R. (2016). ‘Paying Attention’ in a Digital Economy: Reflections on the Role of Analysis and Judgement Within Contemporary Discourses of Mindfulness and Comparisons with Classical Buddhist Accounts of Sati. In Handbook of Mindfulness (pp. 27-45). Springer, Cham. From a practitioners persective see Bodhi, Bhikkhu. “What does mindfulness really mean? A canonical perspective.” Contemporary Buddhism 12, no. 01 (2011): 19-39.

3 Nyima Chokyi. “Why Meditation isn’t Enough.” Lion’s Roar (2019). https://www.lionsroar.com/why-meditation-isnt-enough/

4 Van Dam, Nicholas T., Marieke K. van Vugt, David R. Vago, Laura Schmalzl, Clifford D. Saron, Andrew Olendzki, Ted Meissner et al. “Mind the hype: A critical evaluation and prescriptive agenda for research on mindfulness and meditation.” Perspectives on Psychological Science 13, no. 1 (2018): 36-61.