Qualified guidance of a mindfulness teacher is important in the context of secular meditation training as well. With the fast growing interest in mindfulness-based approaches, training and proper qualifications of mindfulness teachers are of increasing importance. There are several established mindfulness training organizations based at universities in the UK and the USA. In the UK, there is a framework of recommendations to guide teacher training and continuous development (Crane et al., 2012); however, there is no formal regulatory body to safeguard mindfulness training standards. So the burden of ensuring that practitioners receive training from a qualified mindfulness teacher remains on practitioners themselves in the form of questioning the teacher’s meditation background and mindfulness training history. In this process basic familiarity with the typical training requirements might be helpful; for example, standard academic training in mindfulness-based approaches at UK institutions would require at least two years of study and practice preceded by at least one year of personal mindfulness practice combined with continuous mindfulness practice and regular mindfulness teaching supervision.
Several avenues of secular mindfulness teacher training seem to require further development from the perspective of supporting mindfulness practitioners in cultivating long-term meditation practice. One of these pertains to qualifications of mindfulness teachers to guide practitioners beyond the eight-week course towards not only sustaining but also further development of their meditation skills. It is possible that the expansion of meditation practice beyond standard MBSR and MBCT training may require a transition into practicing in an established traditional contemplative system. There is currently no clear guidance on how secular mindfulness teachers could handle requests for longer-term mindfulness practice guidance from their course attendees. Another aspect of secular mindfulness teaching which needs further development relates to the adverse experiences in meditation which are more likely to arise with long-term practice. Currently, the application process for attendance of MBSR and MBCT courses involves pre-screening of participants for history of mental illness or current difficulties which could exacerbate as a result of attending MBSR or MBCT training. Further research will be needed to enhance our understanding of the interactions between history of mental health problems and risk of adverse experiences during secular mindfulness training. Both within and outside of the clinical context, support of long-term practitioners of secular mindfulness will require development of clear guidance on dealing with adverse meditation experiences linked to long-term practice in the secular context. It also remains an open question whether secular mindfulness practice which is not strongly grounded in traditional contemplative approaches and motivational/intentional qualities can lead to progression into advanced stages of Shamatha and Vipassana or whether stagnation in practice is inevitable after a certain stage.
Neuroscience of mindfulness
Even though neuroscience research on mindfulness produced interesting findings and some converging evidence over the last decade, inferences from the research results to neurocognitive mechanisms of mindfulness are in many studies problematic. This is because in a lot of cases the term ‘mindfulness’ is used without distinction for a broad range of meditation studies investigating both secular and Buddhist meditation. For example, a latest review article on neuroscience of mindfulness (Tang, Hölzel and Posner, 2015) combined findings from studies on mindfulness-based approaches with results of studies with Zen meditators, Insight meditators and Tibetan Buddhist Dzogchen practitioners. The review concluded that there is some overlap in brain activation across these studies in regions such as anterior cingulate cortex or anterior insular cortex – this overlap was attributed to the effects of mindfulness. However, such inferences are questionable given the vast differences in types of practices and length of meditation training participants underwent across the different traditions. And even if we look at modulations in brain function and structure in studies which only investigated mindfulness-based approaches, we could not be sure that any overarching pattern of findings is solely due to mindfulness. The reason for this is that the effects of mindfulness in these studies are inseparable from other therapeutic elements of mindfulness courses such as development of self-compassion or decentring. Nevertheless, it is possible to partially bypass these difficulties by zooming in onto studies which investigated the core elements of mindfulness related to different facets of attention.
One of the first studies to investigate neurocognitive changes in attention resulting from MBSR training specifically focused on three attention networks: orienting, alerting and conflict monitoring (Jha, Krompinger and Baime, 2007). Orienting relates to the ability to direct attention and selectively attend to relevant information in the environment; alerting is linked to the ability to sustain a state of vigilance and detect changes in that state; and conflict monitoring prioritizes amongst competing information and tasks. The three networks are associated with different neural substrates (Petersen and Posner, 2012). The findings of the study on the effects of MBSR on the three networks showed improvements in orienting of attention from before to after the MBSR course, suggesting that secular mindfulness training can improve the ability to guide attention and focus more narrowly on the object of meditation (Jha, Krompinger and Baime, 2007).
The same study (Jha, Krompinger and Baime, 2007) also included evaluations in a group of experienced meditators from before to after a one-month retreat during which they trained mostly in focused attention. In contrast to the MBSR course participants, the experienced meditators showed improvements in the alerting network from before to after the retreat. This finding indicated that longer meditation training may further enhance both sustained attention and the ability to notice distractions while focusing on a meditative object. The differential effects in the MBSR group and the experienced meditator group also suggest that improvements in attention abilities may follow a specific pattern of changes with orienting of attention enhanced before alerting attention. Interestingly, this lends partial support to the traditional accounts of Shamatha training where the initial stages of training require repeated redirecting of attention and narrowing of attention focus which could be associated with orienting attention, whereas further progression in Shamatha training targets more subtle abilities of noticing distraction to meditation focus.
In line with these findings, a study which focused on assessment of attention changes in meditators from before to after retreat in Shamatha reported improvements in sustained attention (MacLean et al., 2010). Specifically, the participants were meditators who participated in a three-month retreat during which they trained in breath-focus meditation and also in visualization-based practices and meditations developing loving kindness and compassion. Improvements in their attention were assessed in a reaction-time task before and after the three-month retreat and also compared with a control group of matched meditators not training in a retreat. The findings suggested that the retreat participants were able to perform better on a sustained attention task which required subtle perceptual discrimination, possibly due to enhanced abilities of vigilance and clarity in perceptual discrimination. These findings suggest that the retreat training may have particularly improved the metacognitive element of attention cultivated in Shamatha which would be expected in the more advanced stages of Shamatha training.
However, a study on the effects of MBCT on attention changes in recurrently depressed patients showed that even secular mindfulness training might improve sustained attention abilities (Bostanov et al., 2012). This would contradict the pattern of progression in attention training with meditation proposed in the two previous studies we have discussed (Jha, Krompinger and Baime, 2007; MacLean et al., 2010). Yet, closer investigation of the experimental task used in the study on MBCT reveals that the effects obtained may be better described in terms of improvements in attention orienting and focused attention than sustained attention. Specifically, the study evaluated ERP brain responses (late contingent negat
ive variation (CNV) component) to distractor white noise sounds while participants were asked to practice a breath-focus meditation. The findings revealed negative CNV after MBCT training which indicated that the MBCT participants were less distracted by the white noise than before MBCT training and also in comparison to control participants who did not receive MBCT training. Even though the researchers interpreted the findings in terms of sustained attention and concentration abilities, the task seems to have primarily engaged orienting attention supporting selective attention to the breath and was perhaps less demanding on vigilance and metacognitive awareness. So the results might be actually aligned with the expected progression of improvements in attention skills expected in Shamatha training.
Findings in all the studies we have mentioned in this section so far may have, however, been impacted by several factors. One of the factors is the actual motivation and effort to perform well after meditation training; this pertains both to training in the secular and traditional meditation context. In other words, those who receive meditation training may expect that their attention improves with meditation training and as a result may ‘try harder’ during the testing session after meditation training. The contribution of increased effort to results reporting improvements in attention after mindfulness/meditation training was partially supported in a study which tried to manipulate the motivation of participants to perform better (Jensen et al., 2012). While one group of participants was tested before and after eight weeks of standard MBSR training, the control group, which did not receive meditation training, was tested at the same two time points but further divided into two control subgroups at the second time point (post-test). One of the control subgroups was told that if they showed improved performance at the second time point they would receive a financial reward. The other control subgroup was not offered any financial reward. Comparisons of results in reaction time-based attention tasks between the MBSR group and control participants who received financial reward did not reveal any significant differences in performance. Both the MBSR group and the reward control subgroup performed better than the control subgroup which did not receive a financial reward. These findings indicated that the motivation to perform better might be a significant contributing factor to results reporting improvements in attention after meditation training.
Another possible factor which could have impacted on the findings in the studies we have discussed relates to the multifaceted nature of training in mindfulness-based approaches which involves not only training in mindfulness and metacognitive awareness, but also in acceptance and self-compassion, and in the case of MBCT also in decentring. The same point can also apply in many cases to Buddhist retreat training; for example, the study on the three-month Shamatha retreat mentioned that the meditation training also involved visualization practices and practices developing loving kindness and compassion (MacLean et al., 2010). So it is difficult to infer with certainty whether the attention effects reported in these studies were mostly due to the attention training which is at the core of mindfulness and metacognitive awareness skills or also due to other elements of the mindfulness/meditation training.
To dissociate the effects of the other practices from actual training in mindfulness and meta-awareness, Moore et al. (2012) conducted a study which involved only 3-hours of initial instruction in mindfulness followed by daily 10-minute-long practice of breath-focus for 16 weeks. With the exception of the initial session, the study did not involve regular group meetings and in this way eliminated group practice and sharing of experience in a group as contributing factors to possible changes in attention. The study also only provided instructions on the practice of breath-focus (practiced with an attitude of non-reactivity), thus eliminating possible impact of other meditation practices on the results. Changes in attention were evaluated using ERPs in an established task (Stroop task) which assesses attention control. While there were no significant effects after eight weeks of practice, differences between the meditation and control groups emerged at 16 weeks. The meditation group showed significantly more negative amplitudes of ERP responses associated with focused attention and also reduced responses indexed by an ERP component (P3b) sensitive to allocation of attention resources. Together these findings suggested that the brief daily meditation training improved focused attention and attention control abilities of the participants. This result is noteworthy both given the selective training in breath-focus (and no other meditation practice) and given the short amount of daily practice participants were asked to do. In addition, attention effort was less likely to contribute to the findings since no effects were obtained at eight weeks and no differences in behavioural (reaction time and accuracy) performance of the meditation and control group participants were found at any of the three time points.
Looking closer at the attention mechanisms involved in mindfulness and meta-awareness training, one model described a cycle of attention processes including sustaining attention on a meditation object, distraction, noticing of distraction and shifting attention back to the meditation object (Hasenkamp et al., 2012). This progression of attention processes was supported by an fMRI investigation in which experienced meditators practiced a breath-focus meditation and reported moments when they got distracted. The researchers analyzed brief time sequences preceding and following the distraction reports. The analyses revealed a distinct pattern of brain activation associated with sustained attention on the breath, distraction and noticing distraction plus shifting of attention back to the breath (Hasenkamp et al., 2012).
Another model proposed further elaboration of these stages by disengaging from the distraction. The model also suggested that each of the stages can be associated with activation of a specific attention network, progressing respectively from alerting network to default mode network, salience network, executive network and orienting network (Malinowski, 2013). We have described the orienting, alerting and executive (conflict-monitoring) networks earlier in this section; the default mode network is usually activated during moments of distraction (off-task activity) and the salience network supports monitoring for and noticing distraction. However, none of the networks work in complete separation from the other networks and there is also certain neural overlap between them. There is particularly extensive discussion about the overlap and differences between the executive, orienting and salience networks without a broad agreement amongst researchers.
As we have seen in this section, research in neuroscience of mindfulness produced many interesting findings over the last decade and a half. The main tasks for future research in this area are entangled with the definitional challenges of the concept of mindfulness. If mindfulness is defined in terms of attention, meta-awareness and non-reactivity, such research should primarily focus on investigating these aspects of mindfulness. If mindfulness is defined more broadly, including intention and a range of emotional qualities such as acceptance, kindness etc., the investigations become more complex and it also becomes more difficult to distinguish between contributions of the different dimensions of mindfulness to the outcomes. For instance, one of the recent reviews on neural mechanisms of mindfulness included factors such as exposure, memory mechanisms (extinction and reconsolidation of memories), reappraisal (changes in ways we think about experience) and perspective on the self (Hölzel et al., 2011). These seem to be possible mechanisms mediating outcomes of mindfulness-based approaches and other types of meditation training which include mindfulness. However, it is not straightforward to link the mechanism to the development of mindfulness as such, without other practices or aspects of training in MBSR, MBCT or different aspects of more traditional training. Accordingly, clarifying the construct of mindfulness together with other contributing factors and practices in the varied contexts in which it is applied would greatly facilitate further research in the neuroscience of mindfulness.
Mindfulness, self-regulation and existential well-being
Chapter 1 introduced a framework for further resea
rch on meditation which suggested that meditation practice modifies the metacognitive self-regulatory capacity (MSRC) of the mind and modes of existential awareness (MEA). Both the MSRC and MEA are further modulated by the motivation/intention we bring to meditation practice and by the context of meditation practice (secular or religious, monastic or other ordained, informal or retreat etc.). Within this framework, mindfulness would be considered a practice targeting the development of MSRC, particularly attention and meta-awareness skills together with an attitude of non-reactivity (Dorjee, 2016). Such characterization of mindfulness is more narrow than the conceptualizations of mindfulness in MBSR or MBCT because it does not equate mindfulness with intention of meditation practice, a mode of awareness or a range of emotion qualities such as acceptance, kindness etc. The definition of mindfulness in terms of changes in non-reactive attention and metacognition as the core processes of MSRCis at the same time broader than some Buddhist accounts of mindfulness (mentioned earlier in this chapter) which single out meta-awareness as a separate mental faculty.
If mindfulness is defined in terms of non-reactive attention and meta-awareness, this highlights the essential contribution of mindfulness to any meditation practice. At the same time, such a definition points to the central role of mindfulness in the development of self-regulation as one of the two core pillars of well-being. Indeed, mindfulness is indispensable in both Shamatha practices, which aim to develop attention stability and control, and in Vipassana practices, which apply refined non-reactive attention and metacognition abilities in examining the nature of self, mind and reality. Research findings suggest that training targeting mindfulness as such (non-reactive breath-focus without other elements included in MBSR and MBCT) can enhance core capacities of attention orienting and attention control as would be expected (Moore et al., 2012; Malinowski et al., 2015), whilst the current evidence on the effects of MBSR and MBCT on core attention-related self-regulatory skills is currently mixed (Lao et al., 2016).
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