Has mind­ful­ness been McDonald­ised or is it what we were look­ing for?

Ba­sic mind­ful­ness values are clearly at odds with as­pects of the core in­ter­ests of big cor­po­ra­tions

The Irish Times - Tuesday - Health - - Health | Mental Health - Ge­orge Win­ter

In 1979, Jon Ka­bat-Zinn, a 35-year-old doc­tor at the Univer­sity of Mas­sachusetts Med­i­cal School, in­tro­duced an eight-week mind­ful­ness-based stress re­duc­tion (MBSR) pro­gramme for chron­i­cally ill pa­tients. The pro­gramme’s suc­cess can be judged by the fact that al­most four decades later, Prof Ka­bat-Zinn is ex­ec­u­tive direc­tor of the Cen­ter for Mind­ful­ness at the univer­sity, and its web­site states that par­tic­i­pants in mind­ful­ness pro­grammes re­port a 38 per cent re­duc­tion in med­i­cal symp­toms, a 43 per cent re­duc­tion in psy­cho­log­i­cal and emo­tional dis­tress, plus a 26 per cent re­duc­tion in per­ceived stress.

And the ev­i­dence base of peer-re­viewed, con­trolled stud­ies show­ing that mind­ful­ness-based stress re­duc­tion pro­grammes im­prove di­verse con­di­tions from anx­i­ety and de­pres­sion to chronic pain and heart dis­ease is sub­stan­tial and grow­ing.

But what is mind­ful­ness? Ac­cord­ing to Ka­bat-Zinn’s book Full Catas­tro­phe Liv­ing (1990): “Sim­ply put, mind­ful­ness is mo­ment-to-mo­ment aware­ness. It is cul­ti­vated by pur­pose­fully pay­ing at­ten­tion to things we or­di­nar­ily never give a mo­ment’s thought to.”

This is ex­panded upon by Lim­er­ick-based Dr Terry Lynch, a physi­cian, psy­chother­a­pist, men­tal health ed­u­ca­tor and best-sell­ing men­tal health au­thor who ap­pre­ci­ates the value of mind­ful­ness.

Dr Lynch told The Ir­ish Times: “Con­sider the chore of wash­ing up. Viet­namese monk Thich Nhat Hanh, a global au­thor­ity on mind­ful­ness, dis­tin­guishes be­tween wash­ing dishes mind­fully – be­ing fully aware of ev­ery aspect of the process, all of our senses fully open and en­gaged as we progress through the wash­ing up – and wash­ing dishes mind­lessly – our minds flit­ting from here to there, now to the fu­ture, now to some­thing that hap­pened ear­lier to­day.”

This means, says Lynch, “that lit­tle or none of our aware­ness and at­ten­tion is fo­cused on what we’re do­ing at that time”.

MBSR be­longs to the re­cently es­tab­lished field of be­havioural medicine, which be­lieves that men­tal and emo­tional fac­tors can in­flu­ence health and our abil­ity to re­cover from ill­ness and in­jury. It suc­cess­fully blends con­tem­po­rary neu­ro­science and medicine with an aware­ness of the ori­gins of mind­ful­ness, rooted in Bud­dhist med­i­ta­tive tra­di­tions and prac­tices es­tab­lished some 2,500 years ago.

In­flu­en­tial thinkers

But some in­flu­en­tial thinkers now con­sider that the cur­rent ex­po­nen­tial growth of MBSR is sep­a­rat­ing mind­ful­ness from its spir­i­tual and eth­i­cal Bud­dhist roots.

For ex­am­ple, Prof Terry Hy­land of Dublin’s Mind­ful­ness Cen­tre (mind­ful­ness.ie) is a teacher of mind­ful­ness, and he warns against the evolution of “McMind­ful­ness” by a process of “McDonald­i­s­a­tion”. This, he says, de­rives from “the in­creas­ing tech­ni­cal ra­tio­nal­i­sa­tion and stan­dard­i­s­a­tion of more and more as­pects of so­cial, eco­nomic, po­lit­i­cal life and cul­ture”.

Prof Hy­land said that while Ka­bat-Zinn has ac­knowl­edged “op­por­tunis­tic el­e­ments” that ap­proach mind­ful­ness as a busi­ness rather than as a way of be­ing, their neg­a­tive in­flu­ence is nonethe­less un­der­es­ti­mated. “Mind­ful­ness,” ex­plains Prof Hy­land, “has be­come com­mod­i­fied; be­ing used to sell ev­ery­thing from colour­ing books to apps for mind­ful gar­den­ing, re­sult­ing in the mis­use of mind­ful­ness.”

He fur­ther cites the ex­am­ples of MBSR pro­grammes in US mil­i­tary train­ing and the cor­po­rate world as abuses of the in­ter­ven­tion: “Ba­sic mind­ful­ness values,” he says, “such as right liveli­hood, lov­ing-kind­ness, com­pas­sion and non-ma­te­ri­al­ism are clearly at odds with as­pects of the core in­ter­ests of the mil­i­tary and big cor­po­ra­tions such as Google and Ama­zon.”

Stan­dard­i­s­a­tion

Hy­land is con­cerned that just as mea­sure­ment and stan­dard­i­s­a­tion in­form the cre­ation of a cor­po­rate hamburger, re­ly­ing on par­tic­i­pant self-re­port­ing to mea­sure the suc­cess of mind­ful­ness in­ter­ven­tions, “re­moves mind­ful­ness from its eth­i­cal and at­ti­tu­di­nal foun­da­tions. In short, a ‘way of be­ing’ is not sus­cep­ti­ble to psy­cho­log­i­cal test­ing, and such test­ing con­fers lit­tle ben­e­fit on learn­ers, teach­ers or mind­ful­ness prac­ti­tion­ers.”

When it comes to cul­ti­vat­ing mind­ful­ness in the work­place, Hy­land cites the es­tab­lish­ment in 2015 of the Mind­ful­ness Ini­tia­tive in the UK by Bri­tish par­lia­men­tar­i­ans pro­mot­ing mind­ful­ness in schools, work­ing en­vi­ron­ments and the health ser­vice. Their re­port, Build­ing the Case for Mind­ful­ness in the Work­place (2016) states that “there are many anec­do­tal ac­counts of em­ploy­ees walk­ing away from toxic work­ing en­vi­ron­ments, or pur­su­ing other goals and ca­reer as­pi­ra­tions as a re­sult of hav­ing re­ceived mind­ful­ness train­ing”.

But Hy­land is un­con­vinced: “Whether mind­ful­ness pro­grammes which al­low the cul­ti­va­tion of values ques­tion­ing work­ing prac­tices and the role of work in the wider po­lit­i­cal/so­cial/cul­tural mi­lieu – al­low­ing work­ers to say ‘no’ as well as ‘yes’ to con­di­tions of ser­vice in speak­ing truth to power – could be suc­cess­fully im­ple­mented to­day is a ques­tion which can only be an­swered by the work of cur­rent and fu­ture prac­ti­tion­ers and re­searchers in the field.”

One pos­si­ble op­tion, ac­cord­ing to Hy­land, would be “to in­sist that em­ployee train­ing is con­ducted out­side of the work­place ac­cord­ing to mind­ful­ness-based in­ter­ven­tion pro­ce­dures de­signed to en­sure the in­cor­po­ra­tion of eth­i­cal values and the fos­ter­ing of crit­i­cal mind­ful­ness”.

MBSR suc­cess­fully blends con­tem­po­rary neu­ro­science and medicine with an aware­ness of the ori­gins of mind­ful­ness, rooted in Bud­dhist med­i­ta­tive tra­di­tions

Mind­ful­ness is be­ing used to sell ev­ery­thing from colour­ing books to apps for mind­ful gar­den­ing, re­sult­ing in the mis­use of mind­ful­ness

Mean­while, in Dr Terry Lynch’s work­place, where he treats pa­tients suf­fer­ing from emo­tional and men­tal health prob­lems, he ac­knowl­edges that the cul­ti­va­tion of mind­ful­ness is seen as an ef­fec­tive an­ti­dote to a wide range of life’s prob­lems: “The med­i­cal pro­fes­sion,” he says, “has adopted mind­ful­ness as a worth­while in­ter­ven­tion for stress and many other emo­tional and men­tal health is­sues in­clud­ing anx­i­ety and de­pres­sion.

Ef­fects and res­o­lu­tion

“But I’d like to see trauma – its ef­fects and its res­o­lu­tion – re­ceive the same level of so­ci­etal at­ten­tion as mind­ful­ness cur­rently at­tracts. Un­re­solved trauma oc­curs more of­ten than we think. In­deed, it’s not un­com­mon for un­re­solved trauma to in­ter­fere with our abil­ity to live mind­fully in the present, to be fully in touch with our­selves, oth­ers and the sit­u­a­tions and in­ter­ac­tions in which we en­gage as we move through daily life.

“I be­lieve that a twin fo­cus on trauma and mind­ful­ness would likely yield far greater re­sults than fo­cus­ing so sin­gu­larly on mind­ful­ness, as has been the in­creas­ing trend in devel­oped coun­tries, in­clud­ing Ire­land, in re­cent years.”

It’s clear that the cul­ti­va­tion of mind­ful­ness and the ap­pli­ca­tion of MBSR pro­grammes con­fer men­tal and phys­i­cal health ben­e­fits. To­day, al­most 40 years af­ter Ka­bat-Zinn blended an­cient Bud­dhist med­i­ta­tive and eth­i­cal prin­ci­ples with a main­stream med­i­cal ap­proach to stress re­duc­tion, ques­tions and con­cerns such as those raised by Hy­land and Lynch will shape the evolution of mind­ful­ness and how it can best be ap­plied to help un­der­stand and en­rich our lives.

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