Origins and Common Confusions
Mindfulness has a double meaning in the English language. The online Oxford English Dictionary defines mindfulness in its common meaning outside the meditative context as âThe quality or state of being conscious or aware of something.â As you can imagine, this can lead to all sorts of misinterpretations of the term when trying to apply it to the Buddhist teaching of mindfulness. In modern day Western psychology, mindfulness has progressively become an umbrella term related to purposeful sustained attention in the present moment. This understanding is not only inaccurate, but it also misleads newcomers to mindfulness training. For example, a cat sitting attentively in front of a mousehole, ready to jump on its prey, sustains attention from moment to moment; however, it is not a mindful cat. Similarly, a sniper paying purposeful attention in the present moment, ready to kill in the context of following orders without making judgments, is attentive but not mindful. Unfortunately, this initial misunderstanding of the construct engenders low construct validity in both mindfulness measurement tools and the studies that use them, but a discussion on these issues is beyond the scope of this chapter.
In the Buddhist psychological context, the term âmindfulnessâ is a translation of the Pali term sati. Pali was the common language used in northern India during the time of the Buddha, over 25 centuries ago. Sati has been interpreted by various monastic and lay teachers as âawarenessâ (Goenka, 2000, p. 135), âmindfulness or awarenessâ (Narada, 1988, p. 183; Rahula, 1974, p. 48), and as âremembering or bearing in mindâ (Rhys Davids, 1881, p. 107; Sharf, 2014, p. 942;). The British Buddhist scholar Rupert Gethin explains that sati should be understood as that which allows us to be aware of the full range and extent of phenomenaâas an awareness of phenomena and their relative valueâand is therefore what causes the mindfulness practitioner to ârememberâ that any experience exists in relation to a whole variety of experiences that may be skillful or unskillful, wholesome or unwholesome, ethical or unethical (Gethin, 1992). The traditional purpose of mindfulness practice, since its origination in Buddhist teaching, is to develop wisdom and reduce suffering.
Unlike some of the current Western teaching models, the traditional approach teaches mindfulness as a quality of mind to be cultivated at all levels of experience. In particular, it involves developing our mindfulness skills across four modalities so that mindfulness permeates through all domains of functioning. This encompasses âthe constant mindfulness with regard to body (kĂĄyĂĄnupassanĂĄ), feelings (vedanĂĄnupassanĂĄ), thoughts (cittĂĄnupassanĂĄ), and mind objects (dhammĂĄnupassanĂĄ)â (Narada, 1988, p. 182). Note that âfeelingâ (vedana) is meant to signify âinteroceptionâ and the associated pleasant, unpleasant or neutral hedonic tone, and is frequently used interchangeably with âbody sensationsâ in the literature (e.g., Rahula, 1974, p. 48). Hence, vedana has more to do with âfeelingâ (the verb) than with âfeelingsâ (the noun). Although it is not necessary to explain these details to clients, it is helpful for therapists to know the original purpose of mindfulness training and understand clearly the definition of mindfulness, as some clients will ask about it.
In particular, it is important that clients understand the differences between attentiveness, awareness and mindfulness. In brief, we understand attention to be the mental effort that directs awareness to an object or stimulus and awareness is the action of conscious apprehension of the object. While mindfulness requires both attentional effort and awareness of what is occurring in the present moment, it must be free from any bias, such as liking or disliking what we attend to, and the propensity to desire or resent the object. The attentive cat in the aforementioned example craves the appearance of the mouse, and the sniper may resent the target or crave a successful shot. Mindfulness meditation needs to be understood as a training in unbiased attention to our ongoing experience, preventing any personal interpretation or interference with the object of observation. Mindfulness must, therefore, include a sense of detachment from, and nonâidentification with, the object that we attend to.
For this reason, mindfulness practice must be accompanied by equanimity (upekkha in Pali), which is a detached, neutral and balanced mental state that is neither elated nor depressed, which enables a nonâreactive attitude irrespective of the type of experience being encountered. Researchers are starting to express the importance of equanimity in mindfulness practice (e.g., Desbordes et al., 2015). Mindfulness practice requires mental neutrality, which allows us to investigate safely, objectively and with a healthy curiosity. Hence, to use the term mindfulness accurately, it must be understood as a tool, not as a goal. As we progressively acquire the ability to stabilize attention, our observation deepens and we notice that all things change, including our thoughts, emotions, physical body and the entire world around usânothing remains the same, including what we call âthe self.â Thus, mindfulness is a tool for both selfâinvestigation and âselfâdesensitizationâ through direct exposure to whatever we call âI,â âmy,â or âmineâ while preventing the reinforcement of a sense of self, as is discussed in the next chapter and revisited in Part 2 as we implement the stages of MiCBT.
Operational Definition
Most teachers agree that mindfulness practice requires paying attention to our present experience, without adding or subtracting any aspect to the experience, while preventing biased judgment, reactivity and identification with the experience. When gathering the essence of traditional and modern descriptions of mindfulness, we can summarize a mindful mental state as a heightened sensory and metacognitive awareness of the presentâmoment experience, free from reactivity, biased personal values and selfâreferential evaluation. Training in mindfulness meditation requires deliberate sustained attention to sensory and cognitive processes with unconditional acceptance of the experience. This necessitates a deliberate effort to inhibit oneâs learned reactions (craving and aversion) and develop greater objectivity, acceptance and detachment with each experience.
MiCBT applies mindfulness training in the Vipassana tradition of the Burmese teachers lineage of Ledi Sayadaw, Saya Tetgyi, Sayagyi U Ba Khin and, later, S. N. Goenka. Accordingly, MiCBT may be defined as a theoretically congruent and technically complementary integration of traditional mindfulness training and CBT, which provides a transdiagnostic approach to address emotional distress across a wide range of disorders.
