A brief consideration of historical origins of clinically applied MM

Clinical applications of MM are primarily drawn from the Buddhist and Hindu traditions, particularly Buddhist teachings about mindfulness. Both root traditions are vast and include substantial heterogeneity across their several millennia of history, so the following review addresses some features of these two traditions that have particular relevance to psychotherapeutic applications.

Buddhist tradition

The term mindfulness, first used in English as a translation of the Pali noun sati (Bodhi 2000), denotes a state of present moment nonreactive awareness that is associated with some forms of meditation. Historically, mindfulness has been regarded in the Buddhist tradition as a foundational state of enhanced awareness that plays a pivotal role in methods to reduce suffering and achieve human liberation. The amelioration of the suffering associated with the human condition was a common aim of the Hindu and Buddhist meditation traditions from which the modern clinical use of mindfulness is derived (Eberth and Sedlmeier 2012).

Several ancient texts are central to the meditation traditions that inspired early clinical applications of mindfulness. An important work in the canonical texts of early Buddhism, the Satipatthana Sutta (foundations of mindfulness) (Walshe 1987) is especially instructive in the present discussion. The Satipatthana Sutta explained that mindfulness is a method for the elimination of suffering and outlined four focal points for mindfulness: Breathing, feeling, consciousness, and mental objects. The mental objects include negative emotions (e.g. anger); perceptual processes with which the mind identifies; sensory stimuli; positive emotions conducive to spiritual development (such as tranquility, equanimity, and concentration); and the Four Noble Truths (the reality of suffering, the link between suffering and clinging, the possibility of relinquishing clinging, and the method used to do so). The importance placed on FA in MMBI is reflected in breath-focused Buddhist meditative techniques.

Other early texts where the Four Noble Truths are explained in depth, for example the Mahasatipattana Sutta (greater discourse on the foundations of mindfulness), emphasized the inherently transient nature of existence, the inevitability of hardship, the compounded nature of all phenomena including the self, and the use of meditation to develop increasingly refined states of consciousness predicated on foundational awareness of the reality of suffering (Walshe 1987). That is, mindfulness is an awareness technique, but the texts were also quite specific about broader psychological and existential themes beyond the breath to which this enhanced awareness should be subjected, including the necessity of ethical behavior and insights regarding the interdependence of the self with all phenomena (Williams 2000). A later Buddhist movement, the Mahayana, emphasized the necessity of compassionate behavior as integral to this enhancement of awareness, which in turn was supported by the practitioner’s acquisition of a non-clinging attitude (Williams 2009). Scrutiny of the contemplative traditions from which mindfulness derives suggests that meditation can induce states of awareness that extend upon a spectrum that is not adequately captured by the FA/OM taxonomy or the term mindfulness. For example, an early Buddhist text, the Ariyapariyesana Sutta, outlines a spectrum of meditative development that begins with mindfulness and equanimity, and then proceeds via a series of increasingly refined absorptions (jhanas) to a dimension of consciousness in which all mental activity and self-awareness cease altogether (Walshe 1987), a state sometimes described as NDA (Dunne 2011). In these Buddhist texts the development of awareness takes place alongside insights into the nature of existence and the necessity for compassionate and ethical conduct. Despite the fact that secular writing has emphasized mindfulness as a hallmark of Buddhist meditation, a review indicates that in the Buddha’s original teachings, mindfulness serves the purpose of regulating attention on the object of meditation (Van Gordon et al. 2015). Thus, in the Buddhist canon at least, it may not be accurate to make a sharp distinction between concentrative and mindfulness meditation.

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