Is It Mindfulness or Meditation?

I get asked that question a lot, and the answer is, yes, and . . .

Yes, mindfulness is a form of meditation practice. Other names for such meditation are insight and Vipassana. Mindfulness was popularized thirty years ago by Jon Kabat-Zinn with his Mindfulness-Based Stress Reduction. The genius of Jon Kabat-Zinn has been to make this ancient form of meditation accessible to the mainstream. Mindfulness meditation is now taught in a wide range of settings including hospitals, clinics, schools, prisons, businesses, and other venues all other the U.S. and the rest of the world. It is the form of meditation that has been the subject of much attention from neuroscience research. It is the practice I teach in my Mindfulness-Based Dementia Care and other mindfulness-based programs for caregivers. Mindfulness as commonly taught these days, draws its roots from the most ancient tradition of Buddhism know as Theravada. It has been stripped of all its religious context, and only the methods for de-stressing the brain have been kept, thereby making it accessible to all, independent of their religious orientation. It is important to stress that contemporary mindfulness practice is completely agnostic. 

Other forms of meditation include zen, Tibetan, transcendental meditation (TM), Christian centering prayer, Sufism, and yoga meditation. 

How Much Meditation?

Ask around how long to sit each day, and you are likely to get many different answers. Some believe, the longer the better. Others like Mingyur Rinpoche, advocate 'short times, many times'. At Zen Hospice, short 5 to 10 minutes mindful checkins before each shift appear to have a significant impact on the well-being of the volunteers and their ability to provide mindful, compassionate care. It certainly did for me. Yet others advocate a middle road. The standard length at IMC is 45 minutes, same as in Mindfulness-Based Stress Reduction training. Ayya Khema recommends a minimum of 30 minutes every day. Intuitively, and also from personal experience, it seems that the mind needs a minimum amount of time in order to settle, and also that the longer, the more settling is to be expected, as in the case during retreats for instance. I make it a point to sit at least 30 minutes every morning. I also do shorter sittings throughout the day, and once in a while, I will do 45 minutes sittings, mostly when I sit with the IMC sangha. 

Turning to neuroscience research, there does not seem to be any conclusive answers, or at least not yet. 

An important question that deserves more investigation, it seems . . . 

5 Tips For Wannabe Mindfulness Teachers

From being a student, and also a teacher of mindfulness, I have learned a few things that I would like to pass along to 'wannabe' teachers:

1. Have integrity as a teacher

Learn from a reputable teacher. Sit every day for 30 minutes at least, and go on a long silent retreat at least once a year. Do not follow someone else's script. Instead let the words flow from your in-the-moment experience and your own practice. If not able, better have your 'student' listen to a recording of a more experienced teacher.

2. Do not add to the moment

Mindfulness practice is simply about being aware of what is. It is not about visualizing what is not there, or forcing your breath into a different rhythm. Those techniques belong to other types of meditation practices with a different goal.

3. Stay away from 'I' and 'You'

Instead go for 'we' statements, or even better, action oriented instructions without personal pronouns, e.g. "body sitting still, being breathed", or, "turning our attention to the experience of hearing sounds", etc. This way, the possibility of experiencing not self gets introduced.

4. Leave the space open for the wide range of possible experiences

Do not impose your idea of what the now ought to be. During body scan, make room for possibility not just of sensations but also of no sensations. During mindfulness of emotions, give examples of many emotions, and also possibility of not knowing. Also, do not tell people that they should not think - such a common misconception, that get unfortunately passed on by so many untrained 'teachers'!

5. Talk, but not too much

Guiding means you need to use verbal guidance throughout the meditation to hold students' experience. It does not mean placating the whole time with non stop talking. You want to give students a chance to take in your instructions, and then experience for themselves. 

With deep gratitude to those teachers from which I learned much about the art of teaching mindfulness: Gil Fronsdal, Bob Stahl, Jon Kabat-Zinn

The Direct Connection Between Mindfulness Practice and Beneficial Changes in the Brain

From the lab of Harvard researcher, Sara Lazar, comes the most conclusive study to date, linking mindfulness practice with sustained beneficial changes in areas of the brain associated with learning, memory, self-awareness, compassion, introspection, and stress response. 

As reported earlier this year in the Harvard Gazette:

Participating in an eight-week mindfulness meditation program appears to make measurable changes in brain regions associated with memory, sense of self, empathy, and stress. In a study that will appear in the Jan. 30 issue of Psychiatry Research: Neuroimaging, a team led by Harvard-affiliated researchers at Massachusetts General Hospital (MGH) reported the results of their study, the first to document meditation-produced changes over time in the brain’s gray matter.

“Although the practice of meditation is associated with a sense of peacefulness and physical relaxation, practitioners have long claimed that meditation also provides cognitive and psychological benefits that persist throughout the day,” says study senior author Sara Lazar of the MGHPsychiatric Neuroimaging Research Program and a Harvard Medical Schoolinstructor in psychology. “This study demonstrates that changes in brain structure may underlie some of these reported improvements and that people are not just feeling better because they are spending time relaxing.”

Previous studies from Lazar’s group and others found structural differences between the brains of experienced meditation practitioners and individuals with no history of meditation, observing thickening of the cerebral cortex in areas associated with attention and emotional integration. But those investigations could not document that those differences were actually produced by meditation.

For the current study, magnetic resonance (MR) images were taken of the brain structure of 16 study participants two weeks before and after they took part in the eight-week Mindfulness-Based Stress Reduction (MBSR) Program at the University of Massachusetts Center for Mindfulness. In addition to weekly meetings that included practice of mindfulness meditation — which focuses on nonjudgmental awareness of sensations, feelings, and state of mind — participants received audio recordings for guided meditation practice and were asked to keep track of how much time they practiced each day. A set of MR brain images was also taken of a control group of nonmeditators over a similar time interval.

Meditation group participants reported spending an average of 27 minutes each day practicing mindfulness exercises, and their responses to a mindfulness questionnaire indicated significant improvements compared with pre-participation responses. The analysis of MR images, which focused on areas where meditation-associated differences were seen in earlier studies, found increased gray-matter density in the hippocampus, known to be important for learning and memory, and in structures associated with self-awareness, compassion, and introspection.

Participant-reported reductions in stress also were correlated with decreased gray-matter density in the amygdala, which is known to play an important role in anxiety and stress. Although no change was seen in a self-awareness-associated structure called the insula, which had been identified in earlier studies, the authors suggest that longer-term meditation practice might be needed to produce changes in that area. None of these changes were seen in the control group, indicating that they had not resulted merely from the passage of time.

This study is scientifically proving what all meditators know from experience, i.e. the long lasting effect of meditation not just during formal mindfulness practice, but more importantly, afterward, throughout the day. 

Another good reason to start each day with a 30 minute sitting! 

Revisiting the Mindfulness and Stress Reduction Connection

While preparing a training for professional caregivers, I was  looking for a simple explanation of the connection between mindfulness practice and stress reduction. What happens during the intimate process of practice that makes it possible to reduce one's stress level? Also, what do we mean by stress?

Floating in my mind were memories of explanations I had read about dukkha - sometimes translated as stress - in the Buddhist teachings, lectures from Jon Kabat-Zinn on MBSR, and scientific interpretations from neuroscientists like Philippe Goldin or Richard Davidson. Nothing that quite captured what I was after, though.

True to the spirit of mindfulness practice, I turned inside and this is what I found:

Stress happens when there is tensing against the flow of life - against the ending of what felt good, against the arising of unpleasant experiences, or in anticipation of their imagined occurrence. It manifests as tensions in the body, and tightness in the mind.

Mindfulness is an iterative process, about becoming aware of these tensions, and relaxing them slowly. Going back and forth between seeing, and relaxing, seeing and relaxing. Insight, or wise understanding facilitates the process of relaxing. Also important is bringing an attitude of relaxed alertness to the practice, so as to not further compound the stress, the tension. 

This is my experience of how mindfulness practice leads to stress reduction.

A Well Trained Teacher

The Huffington Post just published my article on the 13 Essential Tips for Dementia Caregivers, a summary for lay people about the main principles of the Presence Care approach. Here is an excerpt of the post, regarding the mindfulness practice part of the Presence Care training:

1. Start your day with a few minutes of sitting mindfulness practice, and end the same way.

Mindfulness practice, even for a few minutes a day, can reduce stress. It is also a good way to start your day from a calm, centered place, which is what your loved one needs most from you. If you're not sure how to practice, simply find a quiet place, close your eyes, sit in an alert yet relaxed posture, take a few minutes to check in with yourself and then turn your attention to your breath. Let your body breathe, and simply watch the in and out flow of your breath. You will notice thoughts and sounds coming and going. That is a normal part of the experience. When that happens, simply return to observing the breath. Sit like this for a few minutes.

2. Incorporate mindfulness into your routines: walking, doing chores, caring for loved one, etc.

The same way you were observing your breath while sitting, you can also pay attention to the sensations of your feet on the ground while walking. You can practice while walking alone or with your loved one -- the slower the better. While washing your hands, you can become aware of the sensations of the water running over your hands. While assisting your loved one with dinner, you can focus on the experience of filling up the spoon, bringing it to the person's mouth and their experience of eating. Remember, it is about being present for the experience in the moment, all of it and regardless of what it is. You may do this as often as you want throughout the day.

3. Practice recognizing and being with your emotions, including difficult ones.

When caring for someone with dementia, you are bound to experience many -- and sometimes difficult -- emotions: grief, anger, boredom, tiredness, fear, anxiety, frustration. A very powerful and simple practice is to simply acknowledge the emotion and its physical manifestations in your body. Where am I feeling it? How does it feel? What are the sensations? Also, recognize whether it is pleasant or unpleasant and feel the whole extent of the pleasantness or the unpleasantness. And when you need a break, focus your attention on the breath and watch it come and go. Lastly, identify the thoughts that come with the emotion and see where you are getting caught. Are there changes you can make in the outside world, or do you need to change your attitude?

4. Practice loving kindness for yourself, and also for your loved one.

When the fear or the anger get to be too much, mitigate with some kind energy of your own. Think about someone, something or a place that is very dear to you. Feel the love and kindness emanating from your heart and send it to yourself. While you may not "believe" in it at first, trust that it will make its way through to you eventually. You are working on rewiring your brain, and it takes time! Quietly say something like this to yourself: "May I be at peace, may I be at ease," and repeat a few times, wishing you well. You may then send that same kind energy to your loved one, this time repeating the words, "May you be at peace, may you be at ease," wishing him or her well. This is a simple yet very powerful practice if you do it often.

[ . . .  ]

What I did not mention in the article was the importance of having a teacher well trained in mindfulness practice in order for students to properly learn and integrate these practices.  With the popularity of mindfulness-based classes of all sorts growing, the risk of being taught by persons with a wrong or superficial  understanding of practice is also on the rise. For instance, the fact that an MBSR teacher has undergone the MBSR teacher practicum is no guarantee that that person has properly understood practice. I have met quite a few people who have come out of an MBSR program with a false impression of what it's like to do sitting meditation.