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Mindfulness for Just About Everything

by Paramabandhu

Mindfulness for Just About Everything
by Paramabandhu

Audio available at: http://www.freebuddhistaudio.com/talks/details?num=OM778

Talk given at San Francisco Buddhist Center, 2006

First of all, I'd just like to say it is a real pleasure to be here. It's twenty-five years since I
was last in San Francisco, and I wasn't at the Buddhist Center there on that occasion, so it
is lovely to be here.

I am going to talk a bit about mindfulness and various health-related issues. The short
title is: 'Mindfulness for Just About Everything' – which sums it up.

Certainly in the UK there has been a great surge of interest in mindfulness, although I
suspect actually we might be a bit behind the US, because I think over here there has
been a longer history of interest in mindfulness for health-related issues. In the UK it has
been taken up pretty widely for stress, pain, anxiety, depression, personality disorder and
addiction, and we have been running courses at our Centre in London for the last two
years.

So what I want to do in this talk is have a look at this phenomenon of mindfulness and
how it is applied to various health-related conditions, and particularly look at its
relationship to the Buddhist tradition – where it comes out of, how it relates to the
Buddhist tradition. Over the weekend (for those of you coming on the weekend) it will be
much more practical. This is a much more conceptual background to mindfulness for
health-related conditions, and where it comes out of the Buddhist tradition.

I am going to start with a bit of therapeutic history of meditation and Buddhism – this is
not comprehensive, but I just want to draw out a few strands.

Meditation first became popular in the West in the 1960's when initially it was seen as
something of a cure-all. People started doing studies in the ‘70s and ‘80s on meditation,
particularly meditation with an emphasis on concentration and relaxation – particularly a
lot of transcendental meditation studies. These studies showed that T.M. (transcendental
meditation) was beneficial for anxiety, for high blood pressure, for cannabis addiction
and for general well-being.

There were some problems, though, with these early studies. When you did a comparison
it showed there actually wasn't much difference between just sitting quietly and other
forms of relaxation. In other words, although there was some benefit it wasn't very
specific to the meditation.

Then there was another strand which looked at the Buddhist suttas, and looked at how the
Buddha behaved as a therapist. Somebody looked at how you could see him, in effect,
doing behaviour therapy.

There are a couple of stories to give you examples of this. There is a story of a particular
king who had a problem: his problem was that he slept a lot and he couldn't get up.
Eventually it got so bad that he... well, I was going to say he went to see the Buddha but
of course he couldn't go to see the Buddha because he couldn't get up!... [LAUGHTER]
...but he got the Buddha to come and see him, and the Buddha diagnosed his problem as
over-eating (which of course, with the modern epidemic of obesity, is relevant today
perhaps...).

What the Buddha did is he gave a little prescription for the king, which was that when he
was served his food he wasn't allowed to eat the last mouthful. He was supervised by the
prince, and when the prince was supervising this, just as the king was going to – you
know – elbow in and get that last mouthful, the Buddha gave him a verse to remind him
of why he was not to have that last mouthful.

So each day he had a little bit less food, and in time of course he became lean and healthy
and had no problems with sleep, and he could get up.

Seen from a modern point of view, that would be a bit of behaviour therapy: the Buddha
examined the king's behaviour, diagnosed his behavioural problem, and gave a treatment.

There's another story which is probably better known: the story of Kisa Gotami. Kisa
Gotami suffered from what we might think of today as a pathological grief reaction. She
was a lady who had had quite a difficult background. She become married – and in those
days in India when you were married you went to the husband's family, and as a woman
you were at the bottom of the pile: you were a bit of a skivvy, you were pushed about...
that is, until you gave birth to a child. And, particularly if the child was a son, then your
social status was raised.

So she gave birth to a son and she was very happy and of course very attached to her son.
Unfortunately, when her son wasn't very old he died... one account says he was bitten by
a snake... and she was grief-stricken; she just couldn't believe that this had happened to
her. And she went around not believing that her baby was dead, asking people for
medicine for her baby to make him well again.

Eventually someone said, 'go and see the Buddha', and the Buddha said, 'yes, I can give
you medicine for your baby; the medicine is a mustard seed – however, the mustard seed
must come from a house where nobody has died.'

So Kisa Gotami was very happy; she went rushing off, and she went to house after house
after house... Everywhere people were very happy to give her a mustard seed, but at each
house she came to an uncle had died, a daughter had died, a husband had died...
somebody had died.

And eventually she realised, of course, that death happens – it's inevitable. And she
realised her own son was, of course, dead – couldn't be brought back to life. And she
became a disciple of the Buddha and, according to tradition, became enlightened.

So, coming from our particular perspective, again you could see that as a behavioural
experiment which, in this case, was very efficacious for Kisa Gotami understanding what
was going on.

There has been a whole line of thought like this, looking at the suttas in terms of the
Buddha acting like a behaviour therapist, and it has been suggested that – particularly if
you are working with people from an ethnic Buddhist background – that could be quite
useful.

I haven't seen anybody, though, who has applied it in another way, to Westerners – but it
is an interesting line of thought.

Then another line, which is more the topic that we're looking at today, is mindfulness.
Mindfulness was particularly taken up, first of all, by John Kabat-Zinn in Massachusetts.
He set up a 'stress clinic', as it was called, but what he predominantly took was people
with chronic pain. He took people who had pain that Western doctors couldn't do
anything for any more; any sort of pain. So in a way they didn't have anything to lose by
going to see Kabat-Zinn.

What he set up was an eight-week mindfulness meditation course, with some yoga
exercises in it and a one-day retreat during the course of it. And what he found was that
two-thirds of the people benefited from this, and, even more remarkably, four years later
when they did a follow-up people were still benefiting from it, particularly if they had
continued with the meditation, or even if they had continued with informal practice
(which I will refer to later).

He also did work with anxiety and then later other conditions, like psoriasis, and this
came to be called 'mindfulness-based stress reduction'.

So in a way Kabat-Zinn started this off, and then mindfulness started being used much
more in other things; it started being used as part of other sorts of therapy. It is used in
'acceptance and commitment therapy' which is being developed by someone called
Steven Hayes, in Utah (I think!), and he has found that helpful for depression and anxiety
and for some other conditions. It is also being used in 'dialectical behaviour therapy'
(D.B.T.) which was developed by Marsha Linehan particularly for working with people
with borderline personality disorder, although it has also been adapted for use in
substance use.

In these things, mindfulness is just one component of the therapy. More recently there's
something called 'mindfulness-based cognitive therapy' (M.B.C.T.) which is for recurrent
depression, and this is really built on Kabat-Zinn's work and is shown to be effective for
people who have had more than three episodes of depression – people with recurrent
depression.

In Britain, we have this thing called the 'N.I.C.E. Guidelines' from the National Institute
of Clinical Excellence, which says what are the effective treatments, and recently
M.B.C.T. has been put into the N.I.C.E. Guidelines for the treatment of recurrent
depression.

So, that's M.B.C.T... and then there is M.B.R.P. – 'mindfulness-based relapse prevention'
– which is using the same sort of stuff for preventing relapse into addictive disorders.
There have been some theoretical papers written about this, and here and there people are
starting to do work with it... I started running courses on it at the Centre where I teach
and in the Health Service where I work as well, basically adapting the mindfulness-based
cognitive therapy ...

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