Edel Maex
In the foreword to Jon Kabat-Zinn’s ‘Full Catastrophe Living’ Thich Nhat Hanh describes the book as a door from the dharma to the world as well as from the world to the dharma. Jon Kabat-Zinn in his book skilfully succeeds in translating traditional Buddhist concepts in modern everyday language so as to make them accessible to the West. Had it not been for Thich Nhat Hanh’s foreword the Buddhist origin of them might have gone unnoticed to many readers. Thich Nhat Hanh is one of the foremost Buddhist teachers in the West and his few words certainly attracted many Buddhist practitioners to this book and to the application of mindfulness in clinical practice. This work gave rise to a first generation of mindfulness teachers.
Jon Kabat-Zinn not only tapped on Buddhist tradition but equally on the scientific tradition he was trained in, thus creating acceptability for his work in the world of science and medicine. This attracted many prominent researchers into the field of mindfulness and exciting results came from that research. What we see now is a second generation of mindfulness teachers, many of which do not have a background in Buddhism at all, but with a very sincere personal practice.
We started to call it the hourglass model: MBSR/CT deriving from both the Buddhist and the scientific tradition. Many questions that arise in mindfulness research today already have a long history in the Buddhist literature as a topic of discussion and experimentation. To give an example: in the Lotus Sutra a nine year old girl without any meditation experience at all suddenly attains full awakening. This passage certainly puts on the agenda the question of how much formal practice is necessary (and at that time severely criticised a male chauvinistic monastic attitude).
Some of these texts are very precise using philosophical language, such as large parts of the Pali-Canon. Other texts, such as the Lotus Sutra or the Tibetan Book of the Death, look very magical and obscure and it is hard to imagine that they contain the roots of mindfulness training.
This article aims at retranslating some mindfulness concepts to basic Buddhist concepts (in a movement opposite to Jon Kabat-Zinn’s first move) to make Buddhist literature more accessible to mindfulness teachers that are less familiar with the Buddhist tradition and to allow us reconnect with the treasures that are present in our roots.
Upaya
What Jon Kabat-Zinn did, is in line with a long-standing Buddhist approach called upaya, usually translated as ‘skill in means’. Buddhism is not dogmatic, it is not a creed. It is a practice to be learned and when you read the oldest texts, closest to the historical Buddha, you see that he was an excellent teacher. The Buddha always addresses the person he is talking to in the language and the frame of reference of that person. This yields an extremely rich literature in which the same message is restated in many different ways.
Buddhist teachers after the Buddha have continued that way so you see Chinese Buddhism explained in a very Chinese way and Tibetan Buddhism in a Tibetan style. This accounts for a proliferation of styles, texts and colours.
Jon Kabat-Zinn has done nothing else but continue that tradition and restate the teaching in a way that makes it acceptable to the medical an the scientific world. The development of MBCT again continues the same tradition in reformulating the very same teaching in the language of CBT and adapting it to the sufferings of people with recurrent depression. Further developments will do the same. All this is, very traditionally Buddhist, the product of upaya.
Upaya is an important theme in the Lotus Sutra. It tells the story of a rich man, whose children have a lot of toys to play with. At a sudden moment he realises that the house is on fire and that his children are inside, playing. He calls: fire, fire, but the children think he is just being playful and continue with their toys. In the end the father says: Come outside quickly, I bought you some very exciting new toys. The children run out and are saved form the fire. This text compares some of the teaching of the Buddha as skilful means (upaya) intended to save us form suffering without any further intrinsic meaning. It criticises a tendency at that time to become doctrinal and to loose the real point of the practice.
Research hypotheses are not randomly generated. They always start from an educated guess. For a guess to be educated it can better draw from scientific, clinical and Buddhist resources. This can help us in our research to generate hypotheses that are meaningful and useful and not losing ourselves in studying toys that are intrinsically meaningless.
Four noble Truths
In the Kalama Sutta in the Pali-Canon the Buddha is asked the question: ‘There are so many teachers around, who are we to believe?’ He answers: ‘Do not rely on tradition, scripture, authority or philosophy. Only when you see for yourself that a practice leads to suffering or to wellbeing then you should either reject or accept it.’
This text illustrates that suffering is at the core of it all. The dharma (the Buddhist teaching) is about suffering and nothing else. No wonder we use it in clinical practise.
This is called the first noble truth: the observation that there is suffering. It is not a dogma. It doesn’t say that all is suffering. It just states the observable fact of suffering.
That also explains why it is generic: it is not about chronic pain, not about depression, not about eating disorders but about suffering. So it is meant to be helpful in all conditions that entail suffering. But of course upaya teaches us to tailor it to the concrete situation of this concrete suffering individual.
Another interesting aspect of this passage in the Kalama Sutta is that the Buddha explicitly presents the dharma as a testable hypothesis. No wonder scientists feel attracted to it.
The second noble truth is about the origin of suffering and the third about the ending of suffering due to the ending of its origin. The origin is defined as ‘thirst’. Thirst in turn originates from feeling. The link between feeling and thirst is not absolute. Feeling can be prevented from becoming thirst.
To give an example: suppose I fall in love with my neighbour’s wife. In a way nothing is wrong with that, until the moment I definitely want to possess her, when I start to see my life as worthless without her, when I am ready to do anything to …. That is when feeling becomes thirst. Rest assured that a lot of suffering will follow. It is part of the chain of events that led to many a suicide or murder. The same goes for thoughts, feelings, actions. The moment I identify with them, the moment I react from them, suffering entails.
The field of mindfulness has some very beautiful language to describe this. We speak of stress reactivity and stress response. Reactivity is when thirst takes over, responding is possible as long as a feeling or a thought remains a feeling or a thought and we can remain aware of that without automatically reacting to it. We also call this metacognitive awareness. Research has shown it to be the key element for mindfulness training to be successful.
How do we learn that? There is a path, a method. The fourth noble truth is the path leading to the cessation of suffering. The path is known as the eightfold path.
The eightfold path
The eight elements of the eightfold path are not just a simple sequence. They are mutually inclusive. They are called ‘right’ but the Sanskrit term derives from music theory and actually means harmonic. They are right in the sense of being attuned to each other to form a scale or chord. Since eight elements are hard to memorize they are often summarized into three groups: understanding, virtue and meditation.
Understanding (Prajna) is the entry into the path. People will not engage in MBSR/CT if there is not some understanding and a certain trust as to why they should do this and why it should be helpful.
Virtue (Shila) is the element we are probably least at ease with. Isn’t science to be value-free? Mindfulness definitely is not. It is unthinkable without kindness, respect and dignity. These virtues are as well a prerequisite, an element and a consequence of the path. Ethics in Buddhism is completely different from what we are used to in the West in that it is defined in function of suffering. Wholesome is what leads to wellbeing, unwholesome is what leads to suffering. Even ethics is a testable hypothesis.
Meditation (Samadhi) is the third group. Meditation is a lot more popular in the West than it is in the East. We tend to favour it so much that the attuning to the other elements of the path risks to get lost.
Buddhist meditation is an interplay of shamata and vipashyana. Shamata is stopping, calming. It refers to the act of stopping our habitual activities and to bring our attention to something simple. It is Benson’s relaxation response. The next step is vipashyana: looking. Relaxation in Mindfulness training is not an end in itself but it is a step towards looking, toward (metacognitive) awareness. Meditation is the laboratory situation. It is the place where we see our mind at work and learn not to react to what presents itself but to mindfully hold it.
Right mindfulness (sama sati) finds its place here but the meaning of the term mindfulness has expanded in recent years beyond its original meaning.
It is clear that the whole thing does not end on the cushion. From what you discover in meditation grows understanding. From this understanding grows kindness, this in turns motivates and sustains your meditation practice, which leads to a deepening of understanding, which leads to … The circle is endless.
karma
The hot topic of debate at the time of the Buddha was karma. The word karma means intentional action, behaviour. According to the classic texts karma can be done by way of body, speech, and thought. Doesn’t that sound familiar to a cognitive therapist! The discussion at the time was about the consequences of behaviour. There was among others a nihilistic faction that denied that behaviour had any consequences at all and that life was more or less random. Others were materialistic saying that behaviour only had material consequences and no psychological or ethical consequences at all. The Buddha’s statement was very clear: "'I am the owner of my actions (karma), heir to my actions, born of my actions, related through my actions, and have my actions as my arbitrator. Whatever I do, for good or for evil, to that will I fall heir’ (AN V.57) The Buddha held a performative view of self. We are what we do.
The four noble truths thus are a theory of karma. They state that there is a problem and that something can be done about it. Our actions do matter. The formula ends with explaining what there is to be done.
For this reason a criterion for participating in MBSR/CT is at least some control over your behaviour and the understanding that your situation is not solely dependent on outside conditions but that you can take responsibility for it yourself.
Prajna-karuna
We came to know the beneficial effects of meditation (Samadhi), we are acquiring a growing understanding (Prajna) into the mechanisms that underlie it. What is least articulated in the field of mindfulness is Shila, virtue. That does not mean it is not present. It cannot be absent.
In Buddhism the fruit of the practice is often designated as prajna-karuna (karuna meaning compassion). Prajna and karuna are not two. They are one. The cognitive and the ethical element form an inseparable whole. Understanding and compassion are related to each other as the flame and the heat, one being the function of the other. Compassion naturally flows from understanding. Without compassion no understanding is possible.
How can we put that in more familiar ‘mindfulness-terms’? Metacognitive awareness is a modern rendering of prajna. What is the ethical consequence of metacognitive awareness? I cannot be metacognitively aware of my feelings of sadness, without bringing a lot kindness to my feeling and myself. I have to stop judging myself, stop reproaching myself for my thoughts and feelings. There is no way around. What happens when I become more metacognitively aware? Suppose I am very very angry, so angry that I might kill someone. When I can see my anger and hold it without acting on it impulsively, when can I see my thinking and judging at work without taking it to be reality, what will happen? The murder probably will not take place. Instead of it will come a larger awareness of the situation and a feeling of compassion for all involved.
It is logical that cognitive researchers approach the field from the cognitive side. It might be wonderful if we also found a way to better conceptualize and investigate the compassionate aspects of mindfulness.
Teaching
As with many aspects of the teaching, the different Buddhist traditions have adapted their model of student–teacher relationship to the culture where it is taught. In MBSR/CT this relationship is modelled after the client-therapist relationship, but not without adapting it to the specific needs of mindfulness training.
The common element in these traditions is that teaching, as in the teaching of any skill, is seen as an interaction between the skill in itself, the skilfulness of the teacher and the skilfulness of the student.
It is very hard to teach someone a skill that you have not mastered yourself to some extent. That’s why it all starts from your own practise. But that is not enough. The teaching must be skilfully tailored to the abilities of the student. The student himself is an equally defining element. However hard you try to teach someone, the result will also depend on the cooperation and commitment of the student.
Three jewels
At the centre of all Buddhist traditions are what is called the Three Jewels: Buddha, Dharma and Sangha.
Buddha is originally stands for the historical person. In later years the meaning shifted from the person to what he stands for. Jon Kabat-Zinn used to say showing a large Buddha statue: This is not a picture of a person but of a state of mind. We call this state of mind mindfulness.
Dharma is the teaching, the practice. As the history of Buddhism (up till the development of MBSR/CT) shows, it is in a process of continuing reformulation in accordance with the present needs of those in front of us.
Sangha is the community, originally meaning the community of monks and extending to all involved. There is a strong feeling that this is not an individual thing. The group is important. We support each other in our practice. That is why we teach mindfulness in groups.
There is also the community of mindfulness teachers and researchers. We often refer to ourselves as a sangha. So I want to end this text, as an offering to the sangha, with this beautiful dialogue between the Buddha and Ananda:
‘Ananda said to the Blessed One, "This is half of the holy life, lord: admirable friendship, admirable companionship, admirable camaraderie."
"Don't say that, Ananda. Don't say that. Admirable friendship, admirable companionship, admirable camaraderie is actually the whole of the holy life. When a monk has admirable people as friends, companions, & comrades, he can be expected to develop & pursue the noble eightfold path.’ SN XLV.2