Buddhist Mindfulness Vs Third Wave CBT Conceptualisations

So recently I have found myself reflecting about some of the epistemological overlaps between some of the psychological approaches which I find the most valuable personally and professionally as a trainee clinical psychologist and a person practicing Buddhism. I would like to explore these and start a dialogue with you if possible. These thoughts have mainly been surrounding Buddhist and Medical conceptualisations of Mindfulness; Collectivist Narrative approaches (including techniques such as The Tree of Life), and liberation and community psychology praxis derived from the work of Ignacio Martin-Baró who drew heavily on the work of Paulo Freire.

Before I explore these differences in future blog posts, I thought it might be useful to first of all start with one, and share some Buddhist conceptualisations of Mindfulness from my practice over the last 5 years through the London Buddhist Centre and Buddhist retreats. These afforded me to be able to learn more myself through teaching a Meditation class for a whole year after work for the staff at at a stressed service I was working for who were hit badly by the NHS cuts.

I will then outline some reflections on how I have noticed Mindfulness to be used within the more medical-dominated helping professions. I would love to hear your reflections.

The Model of Buddhist Mindfulness: Beautiful Depth Lost in Translation?

In Mindfulness my meditation teacher attempts to explain and interpret some Pali words which can easily be lost in translations as well as modern conceptualisations of Mindfulness particularly ‘third wave’ Cognitive Behavioural Therapy within the medical model. I will now outline some of these, which derive from the Buddha who talked about a model for Mindfulness as captured in the albeit imperfect Honeyball Sutta, which of course was created at a time much different to modern society, as a way to come back to the here and now or ‘primary experience’.

Primary Experience

The Buddha broke down ‘experience’ into several beautiful nuances. The first one is Vedanā  which is kind of like a texture of your experience, one which can be somewhere on a sensation spectrum between pleasant unpleasant or even neutral, it is a general feeling sense but not an emotion with a word per se. A major skill in mindfulness is to repeatedly bring awareness to where your experience is on this spectrum. A pleasant experience might take you away from the present by craving another pleasant experience, such as wanting another bite of brownie before savouring the bite in your mouth before it is all gone without tasting it at all or realising you now feel sick. An unpleasant experience might be extra important to notice since pushing an experience away makes it worse, for example if you had a headache this might be unpleasant and absent-mindedly cause you to frown and get frustrated, increasing its intensity and add frustrated feelings to the mix. Two ‘shades’ of Vedanā if you like, are Sanjna which is simple a basic knowing or idea of what you are doing for instance that you are sat on the tube; and Sparśa or a basic sense of contact between your sense organs and your experience, which is slightly different to simply the ability to sense; for example if you are absorbed in this awesome blog and someone says your name but you don’t hear them, this is… sparse Sparśa!

These first parts of an experience seem to lead to Vitaka or divided reasoning, which could come into intelligence and common sense and can be utilised as a way to come back to Vedanā. For example if you are late for a train and you tend to somehow reassure yourself that you are not going to be late to your destination.

Also within your primary experience, but as I will go on to outline will be coloured by secondary experiences, are two subtleties: Alesaya or underlying tendencies, for example this may include social conditioning such as gender, influences from childhood, and perhaps to some extent genetics; and also under this category is Sanskara, similar to habits for example the constructions of habitual optimism or pessimism, introversion or extraversion might be considered to be differentiated in this way.

Vedana

 Secondary Experience

Sometimes staying in the here and now can be difficult. The Buddha breaks down what is happening naming it a secondary experience. He outlines how although this form of common sense (Vitaka) can bring you back to the texture of your experience (Vedanā) it can also sometimes take you away from it. In this case it can lead to Prapanca or mental proliferation which is when we create stories about our primary experiences in the here and now. For instance if you are standing at the platform after your train, this would be your primary experience, but you might add a secondary experience by thinking ‘This is always happening to me I’m an idiot’ which eventually leads to Prapanca-Sanja-Sanska’ (yes… guzuntide!) which loosely translates into more fixed, habitual or automatic assumptions such as constructions or prejudice including expectations theories or views. My teacher reminds us about the quote from Karl Popper “People fitting things into pre-conscious theories”. I am reminded about how challenging it can be to try to talk to someone who you have been told by a friend is a difficult person and how this colours your view of that person and your responses to them. Another example I can think of from my clinical work might be speaking to someone of the same minority difference as yourself and assuming that they have had the same experiences as you, which closes down curiosity.

In this way you can see how these resulting distortions more firmly shaped the formation of past underlying tendencies (Alesaya) and habits (Sanskara) which now form part of a persons primary experience. These then colour and  in some ways distort the here and now primary experience. For example messages from the general media, such as heterosexism in TV shows, or implicit racism in the ‘daily mail’, which may have been also part of a family culture and the society which the person exists within.

The image I bring to mind is one of a lake with a leaf on the surface blowing in the wind making ripples. Trying to fish the leaf out would make larger ripples. this would cause drips and splashes. Letting the leaf eventually pass however, allows the lake to have a still calm surface, like a still mind.

Honeyball sutta

Widening the Gap

Therefore on one hand can be a vicious cycle of ‘reacting’ or being on ‘auto pilot’; whilst on the other hand, coming back to the primary experience, can create an ever widening gap which allows for creative space. Mindfulness is a means by which this can be done and there are both formal practices such as The Mindfulness of Breathing Meditation and informal practices, such as everyday Mindfulness. These feed into each other like water being filtered and re-filtered over and over again: your life becomes clearer and richer and meditating within this context becomes easier and more of a priority, as does living with the effects of Mindful meditation such as creativity and awareness.

An example of being creative rather than reactive in social situations might be described by family therapist Barry Mason as ‘safe uncertainty’, which I understand as being in the here and now bringing awareness to the potential unpleasant texture of not-knowing an answer, say in a challenging interview or other social interaction such as speaking with someone from a different religion. It is getting out of your comfort zone and bringing in a creative pause and awareness of what might be happening.

The tricky part is remembering to be Mindful informally especially if you don’t have a formal practice. I posted here about how to set up very useful Mindful Anchors to prompt you to bring you back to your primary experience by using Vitaka and also here is a post about a Mindfulness bead project called ‘thought on a thread’.

Widening The Creative Gap

The Buddhist Collectivist (Sangha) Vs The Individualistic ‘Third Wave’ CBT

You might say that Mindfulness is a human faculty that does not belong to anyone, but can be expressed to people in more skilful and less skilful ways.

Mindfulness in Contexts

I think it is interesting to place the different conceptualisations of Mindfulness in social and historical context. The Honey Ball Sutta outlined above emerged in a particular ancient social and historical context, which valued spoken word over written texts and sharing experiences with one another. I personally feel the Buddhist model of Mindfulness is ever relevant in modern society particularly in the ‘west’, and as a useful counterbalance for the booming technological advances moving quicker than we can keep up with. Multi-tasking and productivity are highly valued in western cultures, and technology is reflecting this. Whatsmore, in many ‘western’ cultures people tend to have a greater emphasis on the self and personality rather than collective identity; and also many people here also find themselves with a sense that something deeper is lacking from their lives, a connection to someone or something.

Not surprisingly then, more and more, Mindfulness seems to be being comodified and fetishised and has been absorbed by osmosis-like powers in the helping professions by the integrated therapy of ‘Cognitive Behavioural Therapy’ (CBT) being framed as a wave of CBT which has not first or second but third alluding to it as being hot off the research press. I find it useful to remind myself that the Behavioural school of psychology emerged in the context of the industrial revolution where doing and reacting were most required by that society, and Cognitive school of psychology grew during the emergence of the computer era; before they were brought together most recently spurred on my Lord Richard Layard in a return financial investment packaged as ‘Improving Access to Psychological Therapies’ (IAPT) sold as a means to get people out of their mental distressing situations and back to work. It was proposed that this would thereby repay the financial investment, controversially resources were taken from more established services, contributing to long waiting lists, a medicalised view of distress which arguably worsened access to help.

Mindfulness Skill Forming and Sharing

I am forever experiencing Mindfulness as a skill or an art, as it unfolds new layers and although cheesy to say, depth. You do not have to practice Buddhism to learn these skills, it is true, as Buddhism is essentially learning about ones own mind and learning the subtle pitfalls and areas for particular practice outlined above. The word ‘Mindful’ is unsurprisingly used as a synonym for ‘aware’ or other psychological constructs such as ‘Mentalizing’: “I am just Mindful of the time” – said whilst getting anxious at the realisation that a meeting has overrun. The language we use shapes the way in which Mindfulness is taken into action, as explained by George Lakoff and Mark Johnson in their article ‘Metaphors we live by’.

The Nature of Everyones Mind

Mindfulness in the helping professions is often used within the Medical Model and offered as a cure for fixed, hereditary and essential mental ‘illnesses’ which seems to be a far cry from coming back to ones own moment by moment multi-textured experience! The result is thereby ‘othering’ people who will most benefit from it and allowing professionals to preserve a false aura of perfection.

However from the Buddhist perspective there is a huge emphasis on normalising the nature of the human ‘monkey’ mind in seeing shiny things to run off towards, which tends to be lost in helping professions because of issues of boundaries and professionals who have not experienced, failed and continued with mindfulness formally or informally.

Compassion as Wisdom

Personally the more I have culminated periods of being more Mindful, the more compassion including from others, I have found I have needed in order to deal with what I have found lurking within a broad array of experiences! Unlike within collectivist practice, compassion might have less emphasis within Medical conceptualisations of third-wave-CBT and I have noticed in my limited experience so far, is often left out completely. There can be danger of misunderstanding Mindfulness to reduce unwanted symptoms rather than to live harmoniously with what is there. This poses a challenge for capturing the ‘evidence’ that Mindfulness is ‘working’ as it involves changing the perspectives of stakeholders in positions of power.

Indeed, Buddhist Mindfulness practices seemed to lead me to notice how unethical the contexts of Third Wave CBT has become in the wider context of informing cherry picked ‘gold standard’ but reductive research for unhelpful psychiatric diagnosis labels (chosen by government ministers). Often these function as masking idiosyncratic meanings for a persons experience and the way in which others experience them.

Locating Difficulties

The other major critique of the way in which CBT and Third Wave CBT has been applied in psychological therapies is how it implicitly locates problems within the individual and has less emphasis on social influences. Whatsmore, it has sometimes been used as a means to reduce specific difficulties but are viewed within a reductive medical model, one which is not always culturally appropriate. In the context of an quality-eroding and bullied NHS it has inevitably ignored many aspects of Mindfulness which are inclusive of other people and the collective.

The Honey Ball Sutta was however a model for Society. As Mark Williams says “Mindfulness means knowing directly what is going on inside and outside ourselves, moment by moment”. At the Buddhist Centre I attend, a great emphasis is put on developing deeper connections with others, or the Sangha (spiritual community including others approaching and curious about Buddhist teachings).

Ironically Third Wave CBT conceptualisations of Mindfulness which operate in individualistic and culturally inapproapriate medical models, which seek people to engage with them, instead of the other way around, might be, as the Buddha might have highlighted, the upshot of ‘reacting’ rather than ‘creativity’.

I hope to continue this exploration in exploring the similarities and differences in Narrative practices, and also Liberation Psychology Praxis which aim to thicken subjugated stories for the liberation of marginalised groups in society, both which pique my curiosity when compared to moving away from proliferation of experiences.

Useful references…

I would like to thank my meditation teacher Maitreyabandhu for his amazing wisdom, his youtube talks on the Honeyball Sutta can be viewed here.

Lakoff, G., & Johnson, M. (2008). Metaphors we live by. University of Chicago press.

Mason, B. (1993). Towards positions of safe uncertainty. Human Systems4(3-4), 189-200.

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The Typewriter Poem

I have been experimenting with writing after meditation, bringing mindfulness into writing. Lots of writers are now opting for apps which switch off the internet for you, preventing distractions and even wordpress blog has a minimalism function now. The way I tend to write essays for university is by free-writing, turning off spellcheck and maximising the screen from all boarders and buttons.

This is a poem I wrote about this creative process, using the metaphor and also instrument of an old typewriter, one which has no delete button, but a certain process and stream of mindfulness is required.

The Typewriter Poem

 

Typerwriter

Antonio Carluccio, Mushroom Hunt Photo-shoot

Here are some photos from a photo shoot I was lucky enough to do in Autumn for the legendary Antonio Carluccio, for a wild Mushroom Hunt in a beautiful forrest. Over dinner Antonio was horrified to learn that I was a vegetarian, but I made the excuse that it meant I could have extra Mushrooms. My favourite Mushroom was the violet coloured Amethyst deceiver which change shade depending on if it has rained. We made a delicious Mushroom tagliatelle with these gems!

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My Creative Alter Ego

I recently decided to paint my creative ‘alter ego’, Mr.Taurus, an image based on an old photo of me in the studio of when I was feeling really inspired. Mr.Taurus is a nom de plume I have used since collage when I recognised I had a superstitious side, and in a collage horoscope Mr.Taurus was referred to with bizarre specificity. I found that many qualities held by typical Taureans, such as compassion and ecological connections seemed to map onto themes in my artwork, writing and also a slightly spiritual side which I was exploring at the time.

For this painting I had in mind the Narrative Psychology ideas of externalisation in strengthening and envisioning how this side of me would look (not to externalise it then burn it as a friend joked about!). This painting was made quickly and at the time I really had to cling to Mindfulness as I was super busy with writing the first “doctorate level” essay of my life while juggling a new work-placement. This was significant because for me this is a time in my life I need to be in touch with creativity the most, and I was afraid I may lose this side of me.

In fact I found that this part of me, the part I named Mr.Taurus, seemed to really want to come out to play when I have been doing non creative things. It was almost as if I had not let him speak or have his say, so he burst out at a really unexpected time. Rufus May, a Clinical Psychologist interested in the phenomenon of Hearing Voices describes how we can have many useful parts of ourselves which can sometimes need good team management, almost like our own internal family therapy. He talks about how it is important to create a dialogue with these aspects of our selfs and to learn from what they might mean for us by giving them awareness and kindness.

I have also been struck by Elizabeth Gilbert’s TED Talk on elusive creative energies, ones which seem to have a mind of their own, popping up to say hello at the most inconvenient moments, like a line for a poem in our mind when busy driving, seemingly coming from the ether. The Eat Pray Love author talks about these archetypal spirits as muses or genies historically thought to hide in the walls of creative art studios.

I agree that there is a danger of putting creative responsibility on your own individual shoulders is that if it goes wrong, messy or not how you first intended, you get the consequences. It reminds me of the barrier of perfectionism, often seen when buying a beautiful new Moleskine notebook which is too perfect to make errors in, deterring writing or drawing. Perhaps we need imperfect notebooks and canvases so to speak, ones which invite beautiful and honest mistakes. This is one thing I really like about blogging, there is no demand for high quality. Perhaps this idea is like our selves, we need a part of us to create an imaginary friend with, to take the brunt from our own inner critic and to put out the doormat to welcome exhilarating creative freedom.

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Lose Your Mind

I wanted to share something from a meditation class I went to this week where I learnt a new meditation technique. With this technique you put your attention in the belly area as you are breathing and the sensations here as you breathe as normal. It is particularly useful for getting ‘out of your head’. When our minds wonder it is a case of noticing it and not getting annoyed at it by practicing bringing the awareness back to the belly area. Our bodies are not thoughts and so we process our bodies in a different part of the brain associated with relaxation.

Sometimes our minds can feel as busy as this photo (which I took in Huddersfield’s Byram Arcade recently) or as my meditation teacher calls ‘the YouTube channel of our mind’ where, after watching the same types of clips over and over we get a choice of eight more associated clips to watch. These tend to be the same kind of clips: clips about conflict, work, shopping, conversations, dates and so on.

I hope that technology begins to reflect more mindfulness qualities, like the great minimalist writing applications which are available now, and less like brain-tweets.

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If Attention Was Light

I hope this little doodle I made helps to clarify why Mindfulness is not actually just doing one thing. Yet how practicing that way can help afterwards.

If attention was light:

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MINDFUL ANCHORS

My meditation teacher Maitreyabandhu says that Mindfulness is easy to do, but difficult to remember to do. My Cat snapped my ‘Thought in a thread’ which was one of my reminders, just after posting about it recently. So whilst I find a new mindfulness bracelet, I’ve decided to also make some Mindful Anchors.

Mindful Anchors are prompts throughout the day. To do this you take 10 minutes to make a small list of everyday ques which you charge to will act as a helpful prompt to be present in a Mindful way. The trick is to make a list of things you will firstly remember and secondly see at least a few times a week, and some everyday. I’m trying to chose them from indoors and outdoors and places I might need Mindfulness such as commuting and at work. The tricky thing is choosing anchors which are not so common that they will wear off over time with desensitisation, so a range of Anchors ensure you will experience them frequently.

With mine I have decide to try to incorporate the 5 senses so smells and sights and sounds and so on. I have tried to think of the different rooms of a building and things you might find in each.

The idea is that when you see them it is simply a case of feeling your weight on the floor, noticing your breathing and the quality of it, observing the thoughts occurring in that moment, just noticing any tension in the shoulders and hands, and tuning into your mood state. Taking mindfulness further you can learn to notice the “feeling quality” of the moment: is the general experience pleasant, unpleasant or on the neutral spectrum. This helps because we can begin to stop clinging to pleasant and averting unpleasant because these both take us away from the present moment which is ever-changing. Therefore avoiding distress. Learning the beauty of the imperfect.

Remember – when being mindful, you don’t really have to add anything to your experience or change it, you can be Mindful whilst running for the last train or even when multitasking. It is simply about switching off autopilot and becoming more aware. Letting automatic google-brain thoughts pass by.

Here some examples of my Mindfulness Anchors:

– A Crow
– Sunflowers
– Tartan pattern
– People with Dreadlocks
– Kiwi fruit
– Teaspoons
– Soap
– Croissant
– The number 10
– Big Ben
– Fire Engines
– The Birmingham Accent
– The smell of aftershave/perfume
– The taste of Citron
– Odd socks

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