I don’t need to spend much time setting up the present day picture concerning mindfulness and the enhancing of mental, emotional and physical well-being. Not a day goes by it would seem without an announcement of research findings advocating the use of this ancient practice. As a mindfulness instructor with a background in empirical science I have concerns about just how far we can take the promising findings and making them ‘true’. But is there a deeper cause for concern?
A good proportion of people who have found mindfulness meditation in the past decade have come from through the yoga root or from participation on courses such as the popular programmes of Mindfulness Based Stress Reduction or Mindfulness Based Cognitive Therapy. One of the first (and it has to be said foundational practices even as one becomes an experienced meditator) is that of a breath awareness practice. The instruction is to sit and place attention on the breath: the in breath, the out breath. As a novice, this training the mind toward one object takes much effort, and one soon learns that the mind has a tendency to drift away. Often, meditators lose heart at this stage – it requires a good teacher to help the student learn that thinking in itself is NOT a bad thing: we do not meditate to stop thinking. If we can stay on this path of practice, over time we learn that rather the idea is to simply catch ourselves thinking, note it and come back to the present moment (in the shape and form of the breath). If we stay on the path even longer, we can take on the instruction to ‘just sit’, and watch the mind’s activity – like a stream carrying leaves, or trains pulling in and out of the station: the key being we don’t ourselves jump in the stream nor board any of the trains – we simply observe the comings and goings with no agenda.
The initial mindfulness work is therefore building the capacity to watch one’s experience. Mark Epstein, one of my favourite authors on the interface between Buddhism and psychotherapy, describes how this sets up a situation in which the individual becomes both subject and object, the observer and observed, and provides a ‘therapeutic splitting of the ego’. The use of the word ‘therapeutic’ implies this is a good thing right? Well yes….but often no. The meditator becomes witness to the rapidly changing nature of experience, and this disrupts the self-concept. How one handles this disruption will depend on the background of the meditator (one could say, the preceding ‘ego-strength’), and also the frame within which they are practicing. Let’s take the latter point first…
There is a growing concern from Western Buddhist teachers (many trained in clinical psychology and psychotherapy) regarding the how mindfulness-meditation is being pulled from its Buddhist roots. Mindfulness as a ‘technique’ omits the ethical and philosophical preparation needed to integrate experiences during meditation. From the Buddhist teachings, the aim of the meditation practice is one of reaching ‘egolessness’. Contrary to a lay understanding of this, it does not mean losing one’s person-hood or annihilation of the ‘self’, but rather addressing the “I-ness” of experience. Buddhist teachings explain that we are not as solid nor as separate as we tend to think we are (and I for one have many everyday experiences where I notice how tightly I try to defend my ‘self-ness’!). Watching our minds, feeling sensations, experiencing emotions in meditation helps us see that we are the sum of moment by moment experience, we are constantly in flux, in process. There is not one solid entity to defend at all! Only study and understanding of egolessness can provide the meditator with the ground* upon which to hold a stripping back of the self-concept.
Meditating outside of a Buddhist path therefore requires a careful approach, and here I call upon fellow mindfulness teachers and colleagues in the psychotherapeutic world to give some careful consideration as to how they approach meditation. John Welwood, another Buddhist psychology hero of mine (I am fortunate enough to be studying with him in New York this summer), writes extensively about a pitfall he describes as ‘spiritual bypassing’. I encourage any practitioner in the mental health field to read his work and to understand the trap people in psychological distress (perhaps those we could describe as having insufficient ego-strength) can fall in to if they take up meditation as a way to ease their pain. The deconstruction of the “I” through meditation risks ego disintegration in a way that creates, rather than alleviates primal anxiety: In essence, the ‘self’ loses control of mental life.
So, although this depersonalisation is seen as an essential part of the Buddhist path, it challenges one’s identity leaving the meditator groundless and fragile. A consequence may be to experience ‘The dark night of the soul’. This was the metaphor used by St. John-of-the-Cross in the 16th Century when chronicling his journey through ‘loss, abandonment and transformation’ on the path toward union with God. Recently, it has been adopted more widely across spiritual traditions, and in discussing meditation-induced fragmentation of the self. According to Willoughby Britton, Assistant Professor of Psychiatry and Human Behaviour at Brown University Medical School, there are four types of effects associated with meditation induced ‘dark night’ experiences:
Cognitive effect: sensory overload, and disturbances to the sense-of-self and time
Affect: increases in emotions such as fear and anxiety; and severe mood shifts from euphoria and grandiosity to severe depression and nihilism
Perceptional changes: hallucinations and lights
Physiological responses: inexplicable musculoskeletal pain, and headaches.
Other research similarly reports confusion, anxiety, mood swings, hallucinations, hearing voices, feeling vibrations, narcolepsy, uncomfortable kinaesthetic sensations, mild dissociation, grandiosity, feelings of defencelessness and guilt – all symptoms that would lead to a diagnosis of psychosis if using the DSM-5 (the 5th edition of the Diagnostic and statistical manual of mental disorders).
Now, it may seem odd that an advocate of mindfulness is painting such a pessimistic picture. Indeed, it may not be a sound marketing effort on my part! My intention is not to scare people off the practice – far from it: I believe in the power of this practice…
…it just requires fore-thought: preparation of the ground, explanation of the process, clear objectives and expectations (especially what it can do and cannot do)…and most importantly, a skilled practitioner / teacher to guide the meditator through the ups and downs along the path. I share the view of Willoughby Britton – we have rushed in to grab a practice from the East without truly appreciating and understanding the context from whence it came. Research needs to be carried out, and long term effects need to be monitored.
One point worthy of explicit mention is concerning deep retreat experiences. I think each retreat I have participated on, there is at least one person who is there as a first-time meditator. Whilst one may admire such courage (and what I am about to say is not taking this away nor condemning the choice), I do wonder about the risks. I imagine we have heard stories of people dropping their everyday lives to leave for an Ashram or enter a long term retreat ‘to find oneself’. Without wanting to appear I am generalising nor stereotyping here (I will leave that to books and films that do so!), one might consider the existential questioning and associated psychological pain underneath leaping in to a retreat as a first experience of meditation. Certainly, there is a growing body of research pointing to meditation-induced psychosis on intensive-retreat experiences. Again, stepping in to underline I am not scare-mongering here – just asking people who host retreats to consider the criteria for admission.
To live more mindfully is a fine aspiration, and meditation practice is the best way to practice and enhance this way-of-being. However, whether we are working in the health professions, an instructor on a Mindfulness-Based Stress Reduction or Cognitive Therapy course, a yoga teacher, or a counsellor / therapist surely we have a duty of care to safeguard mental health: to understand ALL aspects of this practice, to give it respect in the same way we would consider contra-implications of prescription medicine. We also need to encourage people to see this practice as one of longevity NOT as a quick, deep cleanse**.
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*deliberately I choose this term, as anyone who has been meditating long enough will know that there IS NO ground. Confidence comes when we realise that not only are we falling, the rock we are trying to hold on to is also falling too. The good news is, according to Chogyam Trungpa Ripoche “there is no ground to break our fall” 🙂
**the Buddhist path of meditation is considered as a gradual path toward enlightenment, or in Western terms, “fully functioning”. Given the many years of building up unhelpful habitual patterns and the neuroscience work that points to “neurons that fire together, wire together”, keep in mind it takes time to undo and unravel our programming.