Mindfulness Matters

Mindfulness Matters

Selling Water by the River: The Deceptive Simplicity of Learning Mindfulness

posted by Dr. Arnie Kozak

AA021036The proliferation of all things mindfulness is mind boggling (does that make one more or less mindful, I wonder?). Research, teachers, books, blogs, and applications continue to grow. It may be safe to say, mindfulness has become a fad. There could certainly be worse things to generate a bandwagon effect. I am certainly pleased to be a part of this movement and play my small role.

The title of this blog entry comes from a saying in the mindfulness teaching community. Teaching mindfulness is like selling water by the river. The students could just go down the river themselves and drink this water. Mindfulness is a native skill; why do you need a teacher? The reason is that while mindfulness is simple in concept it can be quite challenging to figure out how to insinuate it into your life. This is where a teacher becomes indispensable.

Unless you can be self-motivated, the structure of a class really helps. NICABM (National institute for the Application of Behavioral Medicine) offers online courses with prominent teachers. Recently, Tara Brach taught a program on relationships and now Jack Kornfield will be teaching a course on the power of mindfulness. You can watch some preview videos here.

Jack is one of the preeminent mindfulness teachers. He is the author of many books, including the spiritual favorite: After The Ecstasy, The Laundry.

I’ve had the pleasure of sitting with him once very briefly and I’ve read his books and listened to his talks. He is a gentle and intelligent soul that can bring mindfulness teachings to life.

Sometimes, when the stresses of life start to build, it’s easy to get frustrated and feel like there’s no way to slow down.

Jack will be teaching an online course through  Mindfulness can help us to slow down and bring presence to our busy days.

You can check out some course preview videos. Learn more here:

 

The Science of Mindfulness

posted by Dr. Arnie Kozak

BS16096A recent analysis of mindfulness research studies (known as a meta-analysis) was published by the Association for Health and Research Quality (AHRQ). This government agency does major reviews of various therapies.

The good news is that mindfulness has come of age to attract such a review. The bad news, if you will, is that the modest results appear to run counter to the current wild enthusiasm for mindfulness. How can we understand this apparent incongruity?

The main reason is methodology. AHRQ reviews only include studies that meet stringent criteria. The vast majority of mindfulness studies did not meet these criteria. In fact, only .2 percent were included. Not all of these excluded studies focused on mindfulness, many implemented transcendental meditation.

Peer review versus gold standard. Grant supported versus Many of the mindfulness studies published over the last thirty-five years have appeared in peer-reviewed journals. However, peer review is not the most stringent criteria. The AHRQ study concludes:

After reviewing 18 753 citations, we included 47 trials with 3515 participants. Mindfulness meditation programs had moderate evidence of improved anxiety (effect size, 0.38 at 8 weeks and 0.22  at 3-6 months), depression 0.30 at 8 weeks and 0.23 at 3-6 month, and pain (0.33) and low evidence of improved stress/distress and mental health–related quality of life. We found low evidence of no effect or insufficient evidence of any effect of meditation programs on positive mood, attention, substance use, eating habits, sleep, and weight. We found no evidence that meditation programs were better than any active treatment (ie, drugs, exercise, and other behavioral therapies).

Understanding this study is part understanding scientific literacy, part philosophy of science, and part epistemology.For more on research methodology read the interview with Willoughby Britton, a neuroscience researcher at Brown University Medical School.

The popular consumption of science contains much misunderstanding. If you read that something has been “proven” be careful. It is very difficult to prove anything. What science can do, with well constructed studies, is disprove things. This is the principle of falsifiability.

If a study gets a positive result that is evidence that supports the hypothesis that this treatment, let’s say, works better than chance. But you never know when future evidence may contradict what you’ve found. Accumulated evidence is good but it is not definitive. A study that finds a negative result may be more definitive if the methodology of the study is robust enough to support that claim. this is known as “power” in statistics and a study must have a sufficient number of subjects and other design characteristics before you conclude that the difference between the treatment group and the non-treatment group (placebo) were no different than chance variations. If scientists replicate such studies and consistently find a non-result, it is reasonable to conclude that the treatment offers nothing beyond a placebo response.

With mindfulness, we simply don’t know enough yet. There is much to encourage that with sufficient methodological rigor, mindfulness intervention studies will continue to demonstrate benefit. There are many other effective forms of treatment, such as cognitive behavioral therapies. Mindfulness may not be superior to these other forms of treatment and this does not mean that it not effective, just not incrementally more effective. Studies study groups and the results of a study report group averages. Individual results will vary.

Efficacy is not the same as effectiveness and a placebo response is always part of a positive result. Studies attempt to remove sources of variability and create a controlled labaroatory envireonment. These conditions do not replicate real life. There is a difference between participating in a research study on stress and being referred by your physician to a mindfulness-based stress reduction group in the community.

The small mindfulness database does not mean that mindfulness does not work. It means that there is not enough rigorous scientific studies yet. It costs more to run a high level study. It requires more subjects and an active control group. this adds complexity and expense. Mindfulness studies are just now getting funded.

In the “real” world outside the laboratory, when people seek treatment, they bring with them a set of expectations for response. This is the power of the placebo response and it is active in almost every treatment, including drug treatments (and especially with drugs that treat anxiety and depression). The goal in clinical practice is not to eliminate the placebo effect. In fact, the opposite. What you don’t want is a treatment that works only via placebo. The results of the AHRQ study suggest this not the case for mindfulness, but more research needs to be done. When people undergo mindfulness-based interventions, they receive benefit.

10 Percent Happier Courtesy of Mindfulness, Of Course

posted by Dr. Arnie Kozak

10percent

Greetings faithful readers. I have been busy finishing up the final draft of my forthcoming book The Awakened Introvert: A Practical Mindfulness Skills to Help you Maximize Your Strengths and Thrive in a Loud and Crazy World (New Harbinger, Spring 2015). I had a chance to read the conversation between the Harris’s and it got me thinking about dualism versus non-dualism. I’ve excerpted some quotes from that dialog and see my commentary below.

Dan Harris, author of 10 Percent Happier: How I Tamed the Voice in My Head, Reduced Stress Without Losing My Edge, and Found Self-Help That Actually Works—A True Story, talked with Sam Harris (no relation) author of The End of Faith, on his blog Taming the Mind.

Dan: “It’s this thunderous truism: We all know on some level that we are thinking all the time, that we have this voice in our heads, and the nature of this voice is mostly negative. It’s also repetitive and ceaselessly self-referential. We walk around in this fog of memory about the past and anticipation of a future that may or may not arrive in the form in which we imagine it.”

Sam: “And this is why training the mind through meditation makes sense—because it’s the most direct way to influence the mechanics of your own experience. To remain unaware of this machinery—in particular, the automaticity of thought—is to simply be propelled by it into one situation after another in which you struggle to find lasting fulfillment amid conditions that can’t provide it. So there is a point to meditation after all—but it isn’t a goal-oriented one. In each moment of real meditation, the self is already transcended. 

“When you turn attention upon itself and look for the thinker of your thoughts, the absence of any center to consciousness can be glimpsed immediately. It can’t be found by going deeper. To go deep—into the breath or any other phenomenon you can notice—is to start looking out the window at the trees. “It simply doesn’t matter what the contents of consciousness are. The self is an illusion in any case.

I liked the analogy of looking at the glass. You can see your reflection or you can look through to the world. By following the breath out there in the world, you will eventually, reach back to the reflection. All the techniques are like scaffolding (or the raft image the Buddha used; once you use the raft to cross the river, you don’t carry it on your back). Once you have gotten far enough along with the project of getting to know yourself as a human becoming (notice I didn’t say “being”) you don’t need the scaffolding anymore and you can dismantle it. In other words, technique is a transition to a less formal place. That is where you’ll find your reflection, as it were.

The goal reinforces the self that tries to reach the goal. The major work of the practice is to keep showing up and try to be open to what is happening.

A lot of what they discussed is covered by the Third Noble Truth. Self is a construction, it is fabricated when we project a sense of ownership onto our experience. When we can stop doing that, we are nirvana. We are not adding anything to the experience of consciousness. S. Harris is talking about looking at the source of that construction. When we can turn attention to that source that construction, seemingly solid otherwise, becomes flimsy and may collapse. When it collapse the duality disappears, if momentarily. I’m not sure if the Buddha used the language of non duality, but the cessation of nirvana is the same thing.

The question of wanting leads us to the constructedness of self. Remember the exercise of asking what is it that I am seeking when my attention moves away from now? These departures from the moment are in the service of this constructed self. In fact, these desires are what keeps that building up. When the desires stop, the construction collapses and there you are in consciousness without a subject and object.

Sam: “The non-dual truth is that consciousness is already free of this thing we think we have in our heads—the ego, the thinker of thoughts, the grumpy homunculus. And the intrinsic selflessness of consciousness can be recognized, right now, before you make any effort to be free of the self through goal-oriented practice. Once you have recognized the way consciousness already is, there is still practice to do, but it’s not the same as just logging your miles of mindfulness on the breath or any other object of perception.” 

Yes. It is all available to anyone in any instant. However, the more you practice, the more opportunity you’ll have to experience it. It is like what Ben Hogan (I think) said about luck, “The more I practice, the luckier I get.” When I was on retreat, the teacher Rodney Smith talked a lot about presence. I think this was his term for the non-dual awareness. We get to presence by relinquishing all secondary agendas. Easier said than done but that presence IS available always but it not reached for as much as revealed.

Sam: “Technically, it’s not true mindfulness at that point, but even when one is really balanced with one’s attention, there is still the feeling that one is patiently contemplating one’s own neurosis. It is another thing entirely to recognize that there is no self at the center of this storm in the first place.

I have written about the issue of mindfulness within the current frame of self versus mindfulness as a radical technology for change. 

Sam: “But I’ve learned, as a result of my humbling encounters with my own mind, to charitably discount everyone else’s psychopathology. I like this statement and it reminds me of one of the more salient fruits of practice—that humility. When you know how complex the brain is and how we are actively involved in constructing our experience and how the self doesn’t exist as we think, it leads to a certain skepticism about our own mind and the mind of others. It’s a daunting process and, again, our job is to keep showing up and make the effort.”

Being the host of ABC’s Nightline gave Dan Harris a great platform for promoting mindfulness and his book:

YouTube Preview Image

Mud Season: The Way Beyond is (Still) Through

posted by Dr. Arnie Kozak

Mud_1Below is a repost of a post on mud season from last year. It’s that time of year again, except that it has come much later this year, several weeks later, almost a month.

Mud season has arrived early in mid-march. Warm days and sunshine are melting the snowpack and the ground is thawing, partially in places and yielding to soft pools of mud in many spots. A sign at the nature preserve near my house has a sign encouraging hikers to walk through the mud and not around the puddles. To do so will help the ground to heal and will not prolong the proliferation of mud by extending the vulnerability of the trails by foot traffic.

In our emotional life we might heed the same advise. To heal we need to walk through the mud and not seek to go around it. The classic wisdom urges: the way beyond is through. When we avoid our difficult situations we prolong the muck. Healing happens through courageous exposure to the painful situations of our life. There is an old Buddhist saying: “Hot Buddha sweats; cold Buddha shivers.” To this we can end “Buddha walking in mud season gets wet and muddy feet!” That’s the reality of walking through the mud, our feet get wet and mud gets between our toes. That is what is so.

But we might add something to this — a resistance to this simple moist and cool reality. We don’t “want” to get our feet wet and we are willing to walk around the puddles to avoid this. In the process of doing so we damage the trail, prolong its “healing.” And what is this wanting all about? What’s wrong with wet feet? What’s the big issue with muddy toes? We typically don’t reflect on these questions and go directly to a conditioned response of aversion. And this aversion can lead to avoidance. And this avoidance can lead to an inability to heal from the situations that confront us, if we take the metaphorical suggestion of the trail to its logical conclusion. Behavioral psychology has shown us that avoidance prolongs fear conditioning.

Our natural tendency is to avoid situations that make us anxious. The avoids relieves that sense of anxiety and thereby becomes a potent reinforcement (negative reinforcement in this case). Therefore, the next time anxiety arises we are more likely to avoid it again, engaging the behavior that has been reinforced. This avoidance can become a habit, even a way of life. So the best counsel is to take a straight line path through the mud.

Notice how the mud feels, its coolness, its dampness, its texture, and so forth. If we are open to noticing in this way we might even remember the pleasure of playing in the mud as a child, long before we insisted on things being just so. There was a freedom we once had and have now lost when we impose so many conditions on the conditions we confront. To realize our Buddha nature we just need to feel the mud between our toes. If we can do so with interest and a smile we are well on our way to recapturing that lost freedom

Read more: http://www.beliefnet.com/columnists/mindfulnessmatters/2010/03/mud-season-the-way-beyond-is-through.html#ixzz3071Daog3

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