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.
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 meditation reveals that we may be overlooking many important findings from the past.
The history of meditation and mindfulness
A history of meditation and mindfulness
In the last century, we have seen four or five (it depends on how you categorise the research) waves of engagement between science and spiritual/meditation technologies. Careful attention to the successes and failures of each of these waves gives us important insights into the current crisis in meditation research. Understanding how the curative potential of meditation has been altered by its relocation to science should accelerate the development of more effective interventions. However, there are few reliable accounts of the scientific history of meditation from which to evaluate our progress. This short introduction highlights some of the important and often disregarded progress from past decades.
Buddhist meditation had been migrating for two and a half thousand years. From its conceptual birthplace in Northern India, Buddhism developed many schools and approaches, all loosely tied to foundational theoretical frameworks.[1] Buddhist meditation methods became transnational spiritual practices, frequently adapted to local conditions whenever they established a foothold.[2]
D. T Suzuki (image from Wikipedia)
The relocation of Buddhism from Asia to the West gained momentum in the first half of the twentieth century, bringing Buddhist knowledge and meditation to many Westerners for the first time. But as well as introducing Zen Buddhism to many in the West, academic and Zen teacher Daisetsu Teitaro Suzuki was also redrawing the boundaries between psychology and religion.[3] Suzuki’s ideas were shaped by the time he spent living and working with Paul Carus at the start of the twentieth century. Carus was an advocate of monism, a concept expressed through the Religion of Science (RoS). [4] The RoS held that a positivist symmetry existed between elements of science and religion. By the middle decades of the twentieth century, Suzuki had become increasingly influential with Western academics and opinion formers such as Alan Watts and Erich Fromm.
Fromm drew on Suzuki’s reformed, psychologised version of Zen to develop Zen psychotherapy in the late 1950s.[5] Fromm’s interest in Zen was part of a broader movement, and during the 1960s Eastern spiritual traditions became increasingly important in America and Britain. Promoted by poets, philosophers and global celebrities such as The Beatles, meditation in general and Transcendental Meditation, in particular, expressed the aspirations of a generation.[6] The growing Counter Culture became increasingly suspicious of mechanistic approaches to health and wellbeing.[7] Meditation and spiritual world views were seen by many as an antidote to the restlessness caused by an overbearing ‘technocracy’ and processes of dehumanisation.[8]
EEG test (image from Wikipedia)
Alongside the Carus-Zuzuki-Fromm confluence of psychology and traditional spiritual thought, there was a second, more scientific engagement with Eastern meditation traditions. Early accounts of the effects of meditation on the brain can be found in the electroencephalographic (EEG) literature from the 1930s.[9] The following decades were punctuated with several important peer reviewed papers from philosophical, psychoanalytical, physiological and psychological perspectives. A key breakthrough in the scientific understanding of the effects of meditation came with NN Das’s and Henri Gastaut’s research in 1955.[10] By studying brain wave activity alongside other physiological indicators, Das and Gastaut helped to establish the methodology that dominated meditation research for the following two decades.
EEG studies became much more commonplace during the 1960s. Researchers from several countries (France, Germany, India and Japan in particular) confirmed a correlation between the frequency and strength of alpha brain waves and meditative states. But in 1970, a study of Transcendental Meditation (TM) published in Science took the scientific and public interest in meditation to new levels.[11] Keith Wallace’s claims that alongside a range of potential health benefits, TM practitioners could access a novel state of consciousness, inspired meditation researchers for a decade. The 1970s saw a rapid growth in TM studies in experimental and applied settings. In the early 1970s, Wallace joined forces with the cardiologist and health researcher Herbert Benson. Using novel methodological approaches, Benson and Wallace provided further evidence that the practice of TM could lead to improved health and wellbeing.[12]
By 1974 Benson’s research had changed direction, he went on to describe the relaxation response (RR), a ‘grand theory’ that made sweeping claims for a relaxed cognitive state.[13] Benson aggregated operational elements from many different spiritual practices into four essential components that could deliver the relaxation response. Despite a successful book about the RR (written by Benson and Miriam Klipper), the science underpinning the hypothesis never received universal scientific acceptance.[14] By 1980 the scientific community had begun to evaluate‘progress’ made in the study of meditation. Deep-seated methodological and theoretical issues with TM research led to critical reviews from scientists such as Michael West.[15]
However, setbacks to the reputation of meditation research did not thoroughly dampen enthusiasm for the technology. Several new approaches were delivering positive findings, such as Vikram Patel’s combination of biofeedback and meditation to reduce stress.[16] At the start of 1980, there was a growing acceptance of the curative potential of Eastern non-positivist interventions, such as meditation (as well as yoga and acupuncture).[17] But a critical view of meditation research had raised questions about how psychology might best harness the curative potential of meditation.
When viewed from a history of science perspective, many of the strengths and weaknesses in contemporary meditation research are visible in previous ‘waves’. I acknowledge the Western-centric nature of this account. Some potentially important research originating outside of America and Britain, remains to be fully reviewed. But a clear conclusion from this brief summary is that if we don’t pay attention to reliable science from the past, we risk repeating the same mistakes and also missing important findings from earlier work.
(Based on a history of meditation paper prepared for the ERC BodyCapital conference October 2020).
Biblography
[1] Ronkin, Noa, Early Buddhist Metaphysics: The Making of a Philosophical Tradition (London: Routledge, 2005).
[2] Stephen C. Berkwitz, Buddhism in World Cultures (ABC-CLIO, 2006).
[4] Carl T. Jackson, ‘The Meeting of East and West: The Case of Paul Carus’, Journal of the History of Ideas, 29.1 (1968), 73. https://www.jstor.org/stable/2708466?seq=1
[7] Saks, Mike, ‘Medicine and the Counter Culture’, in Companion to Medicine in the Twentieth Century, ed. by Roger Cooter and John Pickstone (Abingdon: Routledge, 2003), pp. 113–24
[8] Theodore Roszak, The Making of a Counter Culture: Reflections on the Technocratic Society and Its Youthful Opposition. (Oakland: University of California Press, 1995).
[10] N Das and H Gastaut, ‘Variations in the Electrical Activity of the Brain, Heart, and Skeletal Muscles during Yogic Meditation and Trance’, Electroencephalography and Clinical Neurophysiology, 6 (1955), 211-219.
Growing challenges to the science of mindfulness is forcing a rethink in how we measure and understand the benefits of meditation.
Improving our understanding of mindfulness
Authors: Grossenbacher, P. G., & Quaglia, J. T
Year: 2017
Title: Contemplative cognition: A more integrative framework for advancing mindfulness and meditation research
Summary: The growing tide of criticism directed against the science of mindfulness, from within the scientific community, is driving a sense that something has to change. Just what that something is, remains unclear. In this paper from 2017, Grossenbacher and Quaglia proposed a new approach for understanding mindfulness and meditation as a useful first step in improving reliability in contemplative science generally.
A consensus is emerging that long-standing and evidenced problems in mindfulness research are linked to both theoretical and methodological issues, put simply what mindfulness is and how it can be understood. The authors argue that establishing an integrative theoretical framework will offer meditation scientists the tools to deliver more stable and comparable findings. Thus supporting the reliability of individual experiments and presenting greater opportunities for replication. It’s contended that by utilising the psychological constructs of attention, intention and awareness a contemplative cognitive framework (CCF) can be constructed, which would deliver an overarching view of the impact of meditation practice. Grossenbacher and Quaglia state that the CCF could
overcome discrepancies in mindfulness research (a very bold claim)
consider motivational and contextual aspects of meditation practice
create greater opportunities for epistemological plurality
deliver a common operational language, benefitting meditation and mindfulness research in general
Although falling short of a systematic review, the authors offered some welcome clarity in understanding the current limitations in this field. In addition, their discussion of the pressing need to consider the effect of motivation and context in meditation practice is particularly timely. The paper provides an exposition of attention and intention in a clear and informed manner. And I’d recommend this study to anyone wanting to know more about metacognition and meditation practice.
However one of the problems with meditation research, in general, is the failure to study traditional forms of meditation with a clear understanding of their ontologies and epistemologies. Any contemporary methods which claim a theoretical relationship with traditional practices, must include a credible understanding of what the original practices are. Only then can the modern translated meditation methods be scientifically framed, by understanding which operational components have been added or taken away. Without a clear awareness of what the original practice was, trying to reverse engineer a theoretical framework would appear to be a challenging process. Until we have a reliable phenomenological understanding of the traits practitioners cultivate in traditional mindfulness, a contemporary theoretical framework necessitates a degree of guesswork, even with the support of neural correlates.
The CCF may prove to offer a useful toolkit for new forms of meditation, unrelated to and independent from traditional methods. In could allow for hypotheses to be created and tested. But without greater certainty of the operational components of traditional practices, discussions regarding the metacognition of Buddhist or Buddhist inspired meditation is perhaps premature.
References
Grossenbacher, P. G., & Quaglia, J. T. (2017). Contemplative cognition: A more integrative framework for advancing mindfulness and meditation research. Mindfulness, 8(6), 1580-1593.
Choose happiness!
Does mind wandering inevitably lead to unhappiness?
Is mind wandering unwelcome?
Authors: Killingsworth, M. A., & Gilbert, D. T.
Year: 2010
Title: A wandering mind is an unhappy mind.
Summary: I’ve taken a step back with this study (chronologically speaking) because it predates the Jazaieri et al. paper that I recently reviewed. According to Google Scholar, this investigation has been cited by other researchers over 1500 times. If you read any scientific study linked to mind wandering since 2010 you can expect to find Killingsworth & Gilbert referenced. Three reasons why this work is so popular, firstly it was a big study, recruiting 2250 participants. Secondly, it took an innovative approach to the use of technology, using an iPhone app to track and record mind wandering in ‘real world’ scenarios. Finally, the study made some very strong statements which with hindsight, have perhaps oversimplified mind wandering. In particular, the idea that “a human mind is a wandering mind, and a wandering mind is an unhappy mind”.
The full purpose of mind wandering is not yet understood, its activity is largely observed in the Default Mode Network (DMN). The DMN is a collection of anatomically separate regions that are most active when we are not engaged in a specific externally focussed task, hence our ‘default state’. The research concludes that mind wandering is a cause of unhappiness and (staggeringly) even mind wandering to positive subjects doesn’t appear to improve self-reported happiness. Provided with this kind of context it’s no wonder that the idea of suppressive mind wandering approaches maintained popularity across experimental and clinical psychology. Killingsworth & Gilbert even supported their case by claiming that many religious and philosophical traditions link happiness to living in the here and now.
Many forms of meditation and mindfulness do work on training consciousness to rest in the present moment. But from the Tibetan Buddhist perspective to equate this with a conclusion that mind wandering is a cause of unhappiness is somewhat misleading. Traditional meditation is often set in a wider context, undertaken for the benefit of all beings (self and other). Any merit that is accumulated from resting in the present moment is typically dedicated to others, rooting the practice in the past present and future. The idea that a thought, rather than the reaction (attachment or aversion) to the thought is the cause of unhappiness isn’t supported by the theoretical frameworks of traditional meditation systems.
Abnormally high levels of mind wandering are likely to be clinically problematic, but even today we don’t know all the functions mind wandering might have. It’s considered to be linked to the narrative we make to understand ourselves in the wider world. There isn’t evidence that the process itself brings unhappiness, it may be that the quality of our self-generated narrative rather than mind-wandering per se might be the problem. For example, 1 in 4, 14-year-old girls in the UK demonstrate symptoms of depression, and that teenage depression is correlated with social media use. Can we say that mind wandering to social media content, rather than emotions linked to social media content is the root cause of any reported unhappiness?
Meditation and mindfulness may help to keep your brain young
Authors: Fotuhi, M., Lubinski, B., Trullinger, M., Hausterman, N., Riloff, T., Hadadi, M., & Raji, C. A.
Year: 2016
Title: A personalized 12‐week ” Brain Fitness Program” for improving cognitive function and increasing the volume of hippocampus in elderly with mild cognitive impairment.
Summary: The idea that brain function inevitably declines as people grow older is firmly established in both clinical and cognitive branches of psychology. This particular study is one of only a handful that I have seen to suggest, that even in retirement, people can maintain and even increase both structure and function in the brain. Participants of retirement age with a diagnosis of mild cognitive impairment (MCI) were asked to engage in a number of activities linked to brain health. They included: cognitive stimulation, Omega 3 supplements, some physical exercise, a change in diet and mindfulness meditation. Participant undertook a range of cognitive tests before the interventions and at the end of the experiment.
Results showed that 84% of participants saw an improvement in their cognitive performance. Further neuroimaging examinations revealed that a majority of a sample of the participants also demonstrated no decline or an actual increase in the volume of the hippocampus. Although this was a preliminary study with a number of methodological problems, it is suggestive that people may have a lot more control over brain structure and function than is generally assumed. This kind of ‘shotgun’ approach can support general theories but adds little to our understanding of the extent to which particular interventions (or combination of interventions) may offer benefit. It also makes the establishment of robust scientific theory a challenge, as no single theory can incorporate such a wide range of activities. For example with a new diet, can cognitive changes be attributed to the food that was no longer being eaten or the new food? Or a combination of the two? However simply to demonstrate that older adults can experience increased structure in certain brain regions is an important contribution to our understanding of the human brain.
Authors: Kieran C.R. Fox, R. Nathan Spreng, Melissa Ellamil, Jessica R. Andrews-Hanna, Kalina Christoff
Year: 2015
Title: The wandering brain: Meta-analysis of functional neuroimaging studies
of mind-wandering and related spontaneous thought processes
Summary: Thinking about the most common effects on the brain from meditation will lead you into an area that psychologists call spontaneous thoughts. These are defined as thoughts and ideas that seem to come out of nowhere and don’t necessarily have any obvious relationship to a specific task you may be undertaking. Meditation scientists have long considered that the most popular forms of secular meditation lower activity in regions of the brain known as the Default Mode Network (DMN). The DMN is strongly connected with, self-reflection, thoughts about relationships with others, memories of the past and our ability to project into the future. It is also the home to our mind wandering or drifting.
Mind wandering can increase under certain conditions and has been linked to a number of long term mental health problems including anxiety and depression. Many forms of meditation reduce activity in the parts of the DMN known to support spontaneous thoughts and mind wandering. This can be a great help to people that have problems concentrating or are troubled by negative or challenging thoughts. The research by Fox and colleagues undertook a review of 24 functional neuroimaging studies looking into mind wandering/spontaneous thought. Results confirmed that well-established centres in the DMN (medial prefrontal cortex, posterior cingulate cortex, medial temporal lobe, and bilateral inferior parietal lobule) were associated with mind wandering. However, it was evident that a number of other brain regions were also engaged. The significance of the study was that spontaneous thought cannot be regarded as universally linked to a limited number of centres in the DMN. A range of regions in different networks appears to be instrumental to spontaneous thought and mind wandering.
The implication for meditation practitioners and researchers is that the apparent act of suppression or restriction of activity in the DMN cannot be seen in a narrow context and may have a broader implication for a number of interrelated processes.
Title: Efficacy of mindfulness meditation for smoking cessation: A systematic review and meta-analysis
Summary: Although there is an enduring presumption that meditation can help people with addiction, few papers have demonstrated significant effects during randomised controlled trials. This study searched five databases in order to produce a meta-study of relevant research. Ten randomised controlled trials investigating the effect of mindfulness for tobacco smoking cessation were identified. The studies had a total of 1192 participants with individual sample sizes from 27 to 412. The studies had a balance of genders (4) or more males than females (6). The average age of participants in the studies was between from 21.5 to 45.9 years and all the research was carried out in the United States of America. The meditation interventions varied from durations of 1 day to eight weeks. Five studies used only mindfulness as the intervention (monotherapy), three used a combination of mindfulness and nicotine replacement, two studies allowed the participants to augment mindfulness therapy with nicotine replacement if desired.
The meta-review found only one study could be rated as good, four were described as fair and the remaining five adjudged to be poor. The point was made that eight of the studies did not disclose if the experimental assessors were ‘blinded’ to participant intervention. Four studies failed to report cessation outcomes and only one reported an a priori power calculation. The headline finding was that mindfulness did not offer significant increases in smoking cessation compared to other interventions. The study highlighted a number of methodological weaknesses in the reported research but acknowledged the preliminary nature of understanding in this area.
Whilst intensive meditation practice may improve cognitive function, sustained daily practice may help maintain it.
Authors: Anthony P. Zanesco, Brandon G. King, Katherine A. MacLean, Clifford D. Saron
Year: 2018
Title: Cognitive Ageing and Long-Term Maintenance of Attentional Improvements Following Meditation Training
Summary: Can meditation lead to improvements in cognitive abilities such as attention? Meditation research generally suffers from a shortage of longitudinal studies, therefore this seven-year project should be applauded. Building on their earlier work which examined the effects of a three-month meditation retreat on cognition. This investigation assessed the benefits of sustained practice in the following years. The findings appeared to demonstrate that age-related decline in reaction time was negatively correlated with the continuation of meditation practice (regular practice leading to slower decline), following the intensive three-month retreat. The research broadly concludes that the cognitive benefits achieved through periods of intensive activity may receive protection against age-related decline from regular meditation practice.
In the original retreat at least two forms of meditation were undertaken, a basic mind training and a compassion/empathy based practice, both embedded in a spiritual tradition. Inevitably it is problematic to evaluate the benefits of each of the practices or their interaction effect. As an experienced meditator I should underline that by their very nature, participants willing and able to undertake retreats of three months and sustain meditation practice over several years are probably unrepresentative of meditators generally, let alone the wider population. Limitations of ecological validity are discussed in the study. There was also insufficient information provided regarding the meditation history of participants, their levels of accomplishment, the degree of their theoretical training and information regarding secondary or special practices undertaken since the retreat.
Is contemporary mindfulness a meditation practice or something different?
Two leading researchers from contemplative science respond to a critical study of meditation and mindfulness research.
Authors: Richard J. Davidson and Cortland J. Dahl
Year: 2018
Title: Outstanding Challenges in Scientific Research on Mindfulness and Meditation
Summary: The article begins by applauding the critique of Van Dam et al. This is only to be expected, published meditation and mindfulness research often falls short of the methodological standards normally required of journal articles in cognitive psychology and neuroscience. The authors address the five points raised by the original paper in a very linear fashion, not appearing to engage with the underlying issues. The same issues that have dogged meditation research since the launch of MBSR. However to summarize the five rebuttals contained in the paper:
1 – The criticisms of meditation research reflect weakness in psychological research more generally.
2 – Contemplative practices are varied and scientific enquiry is only able to understand a few limited forms.
3 – Mindfulness and contemplative practices were not originally therapeutic in nature
4 – Research has failed to understand meditation in a relevant context.
5 – Mobile technology may be able to resolve some of the methodological issues.
Author’s Critique: It is important to note that Davidson and Dahl are leaders in this field, but if they permit I offer some observation as an experienced meditator and trained neuroscientist and cognitive psychologist.
Psychology does not appear to understand meditation in the broadest sense, the (mis)appropriation of the term mindfulness has led contemporary meditation research into a limited field of investigation without clear definitions. For example, the reduction of meditation (or mindfulness) to method alone, existing in isolation to wider cognitive processes is hard to understand in the context of traditional meditation. And it must be acknowledged that the MBSR/MBI movement uses methods ‘congruent’ with traditional meditation.
If we strip the motivation of the meditator from the meditation rationale we change the entire cognitive setting. To use a rough analogy, I can train people to kick a football but if participant A is training just for a course credit and participant B is training to play in the World Cup final we can expect the effect of the training to be different. This doesn’t just mean that comparing traditional and contemporary meditation practices is fraught with difficulty but that the current understanding of how we research meditation needs to be refined. Traditional meditation literature spanning hundreds of years indicates that two people undertaking the same practice may not experience the same effects. Their individual motivation, their capacity to meditate, external conditions such as the availability of a reliable teacher and methods can all play a part. Psychology has the instruments to consider and account for many of the factors presumed to impact on the effect of meditation, but generally, the method alone dominates the thinking of meditation scientists.
Don’t misunderstand me, the study of MBSR and related families of mindfulness are legitimate objects of clinical enquiry and experimental study. They have however unconfirmed connections with mindfulness in its many forms as practised in spiritual traditions. Buddhism is not one unified tradition, there are different approaches to what one might call mindfulness, these extend from ‘bare attention’ through to ‘shine’ as practised in Tibetan traditions. Often shine is only engaged with after many years of stable foundational practice and if approached from the Vajrayana perspective would be embedded in a context of a nondual appreciation of human consciousness.
The ability of the meditation teacher and the degree of challenge to dualistic thinking are just two factors able to meditate the impact of a meditation method. But these and other components are generally ignored by scientific studies, even strategic reviews and meta-studies. In a traditional context, a meditation master may undertake decades of practice and study to understand meditation on theoretical and experiential levels. Therefore the capacity of the meditation teacher is an established factor in the progress of traditional meditation students but this is rarely discussed in the scientific literature. The point is that the assumption that the teaching of the meditation method is not a potential variable in any experiment is probably unscientific. The Van Dam et al. study is one of the first to suggest the role of the teacher can influence the effect of meditation training on participants.
Leaving aside traditional mindfulness methods, the reliability of the term mindfulness in relation to MBSR and other contemporary practices needs some further work. Several recent studies have highlighted a lack of consistency in the way mindfulness is understood and thus operationalised. Perhaps this is the single biggest challenge meditation research faces today. If there is a weakness in the reliability over what mindfulness is, how it is understood, applied and taught, it makes experimental replication difficult. Without methodologically sound replication the building blocks to advance meditation research can’t be put in place. This I think is the main message from the Van Dam et al. review. Consider that the scientific investigation of meditation in the west is at least 45 years old, an estimated 15,000 meditation studies have been published in that time and yet experimental work is still often described as ‘preliminary’. What is the strategy to elevate meditation research to a more reliable footing?
Compassionate, loving kindness and mindfulness interventions in a palliative care setting.
Authors: Claudia Orellana-Rios, Lukas Radbruch, Martina Kern, Yesche Regel, Andreas Anton, Shane Sinclair and Stefan Schmidt
Year: 2017
Title: Mindfulness and compassion-oriented practices at work reduce distress and enhance self-care of palliative care teams: a mixed-method evaluation of an “on the job“ program
Summary: Notwithstanding the extensive body of work exploring meditation and mindfulness, there is a shortage of studies that address the potential of compassion based interventions in the workplace. A national survey of palliative care practitioners had established that for 42% of respondents, frequent patient deaths was a challenging aspect of their work. Although many people report beneficial effects from delivering compassionate care, extensive exposure to suffering can be a problem for workers. This investigation recruited participants from a palliative care centre in Bonn, Germany. Ten weeks of training in meditation combining a number of elements including, mindfulness, loving kindness and tong-len was provided. A range of mixed measures was used to establish the benefits of the practice including, a battery of self-reporting questionnaires, semi-structured interviews and a physiological measure. In conclusion, no evidence that participants experienced an increase in compassion was observed. However, improvements were reported by participants in areas including self-care and emotional regulation. The was no significant change to the cortisol levels taken as part of the trial.
Given the complex nature of introducing compassion into this particular work environment, the mixed method approach should be commended. Where compassion, loving-kindness and mindfulness are brought together as an ‘omnibus’ approach, a degree of epistemological plurality is likely to be required to gain a full understanding of the results. Reliably evaluating the effects of one approach (such as compassion) in such a trial can be a challenge in itself. However to integrate three approaches (mindfulness, compassion and loving-kindness) into a working environment, then to understand their effect individually and collectively, is making great demands of the self-reporting instruments.
It should be noted that in a recent meta-study investigating the pro-social effects of meditation, the teaching of the meditation practice by a co-author of the research was seen to be an influential factor. The precise nature of the meditation taught in this case is unclear and may, to some extent, be related to the individual approach of the teacher. The assumption that different kinds of meditation, such as compassion (tong-len), all fit within an easily replicated framework is perhaps the result of the theoretical uncertainty withing psychology towards contemplative science. There is still a shortage of data exploring how interrelated constructs such as loving-kindness and compassion might influence behaviour in the workplace. In this regard, the study provides useful information that may help the understanding of these constructs in particular working environments.
