However, training in mindfulness (defined in terms of non-reactive attention and meta-awareness) is most likely insufficient in producing strong health-conducive changes in emotion regulation and well-being. For such effects to emerge, mindfulness practice needs to be applied together with, or as part of, practices targeting development of acceptance, adaptive emotion regulation strategies and emotion qualities of loving kindness, compassion, rejoicing and equanimity. This is supported by findings from studies mentioned above which applied training in mindfulness without other elements such as group therapy, practices of acceptance, inquiry into mental habits, education about stress or cultivation of decentring which are present in MBSR and MBCT. Indeed, the studies on selective effects of mindfulness (Moore et al., 2012; Malinowski et al., 2015) found improvements in orienting and attention control of practitioners, but they did not find enhancements in their well-being or emotion regulation. Such effects are further supported by findings from clinical research which reported that both mindfulness and self-compassion mediated outcomes in recurrently depressed participants who trained in MBCT, and self-compassion particularly mediated the decoupling between reactivity of depressive thinking and poor patient outcomes (Kuyken et al., 2010). This highlights the importance of not equating the effects of mindfulness with the effects of MBSR or MBCT since mindfulness practice may not be solely responsible for the health and well-being enhancing effects of these interventions.
A similar point can be made about the relationship between mindfulness and MEA. The stability and control of non-reactive attention together with meta-awareness as the core components of MSRC developed in mindfulness practice can be considered essential pre-requisites for shifts in MEA. However, mindfulness cannot be equated with these changes in existential awareness which arise as a result of multiple factors including the development of mindfulness, motivation/intention for practice, development of emotional qualities of loving kindness, compassion, rejoicing and equanimity together with targeted experiential exploration of the mind in the process of inquiry. Interestingly, cultivation of decentring, which is one of the initial shifts in MEA, is considered the core mechanism underlying the beneficial effects of MBSR and MBCT on anxiety and depression (Bieling et al., 2012; Hoge et al., 2015). Yet again, this is likely the result of complex training in MBSR and MBCT, not mindfulness practices as such.
Hence, an essential task of future research on mindfulness seems to be in disentangling the contribution of mindfulness and other elements of training in MBSR and MBCT to the well-being supporting effects of these interventions. This would enable us to better understand the complex interplay between mindfulness as a core meditation practice enhancing attention stability, attention control and meta-awareness and other meditation practices. Based on such understanding, we might be better able to tailor meditation-based training to enhance the health and well-being of people with varied pre-existing propensities and conditions. This finer-grained approach to mindfulness research and application may lead to further understanding of the role mindfulness plays in long-term effects of meditation, both in terms of its supportive effects and limitations.
A day of mindfulness practice
The preceding discussion shows how both traditional and modern accounts of mindfulness consider mindfulness a part of any meditation practice. Therefore, development of mindfulness is integral to the myriad of different meditation practices and is often considered one of the first steps in meditation training. Accordingly, mindfulness can be developed in many different ways, breath-focus being a common approach in secular meditation-based programmes and Theravada Buddhist schools. Other approaches include visualizations-based practices and mantra recitation, focusing on a visual object (either sacred object or any neural object such as a point on the ground or a pebble), focusing on sounds etc. Mindfulness can also be developed in more discursive meditation practices, for example, in focused contemplation on a certain topic (e.g., preciousness of human life or nature of suffering) as long as the contemplations involve elements of sustained attention on the topic, monitoring of distraction and non-reactive control of attention which helps return attention back to the topic of meditation. However, discursive mindfulness meditation of this type is unlikely to lead to high levels of stability described in the Shamatha training due to elaborative verbal (even if silent speech) nature of these practices.
Mindfulness practice can be embedded into our everyday activities to support the connection between the effects of our formal practice and everyday functioning and to increase the quantity and quality of our mindfulness practice. Exploring ways to spend a usual day mindfully, we can start in the morning right after we wake up by remembering the motivation/intention for the day. This is particularly important in the Buddhist context where motivation/intention gives direction to all meditation practice. After setting the motivation for the day, we can do a brief mindfulness practice which can take on different forms depending on the context of our practice. In the secular context, the practice might simply involve attending to the sensations in our body, for instance by doing a brief body scan as we are still lying in the bed or as we sit up. In the Tibetan Buddhist context, the mindfulness practice might be a set of visualization and mantra practices, often those focusing on taking refuge and cultivating compassion for all beings. The meditations can also include brief contemplations on topics such as impermanence, opportunities of the day to develop our meditation practice and reminders about different forms of suffering and a path towards liberation from suffering. Some practitioners may prefer, and be able to engage in, a longer and more formal meditation session on the cushion. Whatever the duration of this initial morning practice, whether 5 minutes or 1 hour, developing a regular routine of waking up in a more settled meditative way may contribute to our well-being.
The initial more formal mindfulness practice right after we wake up may be followed by informal practices while we are engaging in the morning routines. Almost any of these activities can be turned into a mindfulness practice if we stay in the present moment focusing on the activity at hand while regularly monitoring sensations, emotions and thoughts in our mind and body. This would involve noticing when we are getting tense and feel pressed for time and pausing for a moment, or noticing moments of contentment and savouring those. It might be helpful to select a couple of activities from the morning routines during which we engage in mindfulness – it might be tooth brushing, making a tea or coffee, having breakfast or getting dressed. Meditators practicing in the Buddhist context may apply a slightly different approach, where, for example, they use everyday routines as reminders of contemplative topics such as impermanence or motivation for the day, or they can recite silently a mantra or do visualizations during some of the morning activities. They may also mindfully engage in loving kindness and compassion practices which we will discuss in the next chapter.
These practices can continue while commuting to work and can become a useful way to turn a dull everyday activity into a refreshing mental practice. At work, mindfulness can be practiced while working by staying present with the task at hand and reducing distractions if possible. Some of the distractions may be inevitable, other distractions are self-initiated – for example, many of us repetitively check e-mails while engaging in a task even when it is not necessary. We can also practice meta-awareness by noticing when we start to ruminate about past or future activities which are not relevant to the task at hand, and then gently return our attention back to the task. A Buddhist practitioner can also use moments of distraction as a reminder of some aspect of their practice, whether it is a contemplative topic such as loving kindness or impermanence or devotional practice. It can also be particularly helpful to build in a brief break every hour, or at any other regular interval that is possible, and use these breaks for short 2–5-minute meditation practices. These could involve mindful stretching, mindful attention to the breath or the body, listening mindfully to sounds or, in the Buddhist context, doing a brief visualiz
ation or compassion practice. The key element of mindfulness practice here is to remember these little meditation breaks, staying present while doing the meditations and monitoring for distractions.
Lunch break can be another opportunity to practice mindfulness, from walking mindfully while getting the meal, to eating the meal mindfully instead of multi-tasking while eating or eating the food while planning the tasks for the afternoon. Depending on what is possible, lunchtime might be also an opportunity to engage in a short practice of 3–10 minutes which might be refreshing and help us engage our attention during the afternoon in a more balanced and less tense and exhausting way. During the afternoon, we can apply the same principles as in the morning: staying present on tasks, reducing distractions and introducing short mindfulness practice breaks. For example, we can use a coffee break for a brief mindfulness practice – start by walking down the corridor while noticing the movement of our body and placement of our feet, staying present while making the tea, noticing the smell and taste of the tea while drinking etc. We can also try to include brief afternoon breaks to check for tension in our body and relax or stretch if needed. A meditator practicing in a traditional meditation context can use the tea break for gratitude practice or to do focused practice on a sacred object, mantra or visualization.
The commute from work can again be used to settle the mind and body, perhaps returning to the mind and body in the present moment after a busy afternoon. Or it can be an opportunity to do other calm abiding practices on the go, by focusing on sounds or any neutral visual object in the environment. Buddhist practitioners can use the time to refocus on contemplative topics of their practice, do devotional practices or visualizations. After returning home, preparation of an evening meal and talking with family can also be opportunities to stay in the moment and practice mindfulness without the need to ruminate about what happened at work or plan for the next day. Engaging with a family in a mindful way may simply mean giving them full attention and being aware of our responses and their feelings, thoughts, expressions etc. Meal time can again be an opportunity to practice focus on the senses and also being fully present with others. In the Buddhist context the meal time can be also an opportunity for practicing generosity, gratitude, loving kindness and compassion together with a brief visualization meditation.
In the evening, mindful approach can enable us to be more aware of our choices of spending the time. We may notice that we have a habit of watching TV programmes or doing some activities which are not necessary or helpful to our well-being. We may change our choices instead. We can also choose to do further formal meditation practice, a brief one or longer one, according to what is possible and how we want to engage with our meditation practice. It might be that mindfulness practice helps us to get to sleep in the evening or it might be that we practice for spiritual reasons and the formal practice in the evening is an opportunity to reflect and to do a deeper meditation practice. A Buddhist practitioner would typically end the day by reflecting on her practice during the day and dedicating virtue accumulated during the day for further progress on the path and for liberation of all beings from suffering.
Mindfulness from a long-term practice perspective
M indfulness is currently the most popular and most investigated meditation practice. Yet, interpretation of cumulative findings from studies on mindfulness is greatly undermined by the lack of differentiation between mindfulness and other contemplative practices, in addition to the lack of distinction between effects of secular mindfulness-based approaches which have many therapeutic elements and effects of mindfulness practice as such. In neuroscience research, review studies often combine results from secular MBSR and MBCT training with findings from meditators trained in various Buddhist schools. This makes the conclusions of such studies about overarching brain patterns associated with mindfulness problematic. Nevertheless, findings from research which tried to dissociate effects of mindfulness practice from other contributory factors documented improvements in attention control, orienting of attention and efficient use of attention resources in general. However, such training restricted to mindfulness practice did not result in significant improvements in emotion regulation and well-being. This suggests that not only mindfulness but also other practices and factors contribute to the health-enhancing effects of MBSR and MBCT or traditional meditation training.
From the perspective of the framework proposed in Chapter 1, mindfulness could be considered an essential element of any meditation practice and training in mindfulness particularly targets the development of non-reactive attention and meta-awareness. However, mindfulness is not to be equated with MEA such as decentring which arise only if mindfulness is practiced together with training in other qualities including compassion combined with the development of motivation/intention and contemplative inquiry. According to this framework, future research needs to carefully distinguish between the outcomes of mindfulness practice and outcomes of mindfulness-based approaches which include many other therapeutic elements. Such refinement of our theoretical understanding of mindfulness may support more focused research on mindfulness and other practices. It may also support development of methods and approaches which support long-term meditation practice with implications for how meditation-based techniques are applied in healthcare, education and other areas.
Summary
Chapter 3 is the first to consider a specific meditation practice from the perspective of developing long-term meditation practice embedded in everyday activities. Mindfulness, as a necessary pre-requisite for other meditation practices, is the most suitable starting point for cultivating long-term meditation. The chapter considers the similarities and differences between secular and Buddhist notions of mindfulness and particularly focuses on questions about long-term meditation practice resulting from secular training in mindfulness-based approaches. It is highlighted that different conceptualizations of mindfulness may also be linked to different neurocognitive underpinnings of the practices. Finally, the chapter discusses how the new framework of contemplative psychology outlined in Chapter 1 could provide the necessary theoretical grounding for conceptualizing therapeutic effects of long-term mindfulness practice, leading to new possibilities for contemplative psychotherapy.
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