Meditation is a practice that helps us to learn wise and skillful ways to harness the ordinary power of our minds. Mindfulness, the paying of bare or direct attention to each moment of our lives, is the most crucial aspect of meditation practice. Mindfulness may be used as a vehicle for change, healing, and stress reduction. This approach is based on a pioneering program developed more than 20 years ago by Dr. Jon Kabat-Zinn at the University of Massachusetts Medical Center in Worcester, Massachusetts.
Hippocrates said, "It is the job of the physician to help the patient find the healing power within himself." Mindfulness is the simple and attainable practice of potentially unlocking these powers by cultivating the healing potential of a mind that sees clearly and is focused. Mindfulness has been studied extensively during the last decade, and we are now beginning to understand its true utility.
Life View
How we view life determines, to a large degree, how much stress we have, as well as how anxious and depressed we become. We know that stress, anxiety, and depression—especially chronic stress, anxiety, and depression—can weaken the body and certainly may worsen many chronic medical and psychological conditions. Mindfulness may not only diminish stress, anxiety and depression, but may also transform a person's actual approach to life itself.
Mindfulness Overview
Two years ago, a 44-year-old physician in my community, who was known by his colleagues to be fairly bright, but also intimidating and short-tempered, began a program of mindfulness-based stress reduction. He had high blood pressure and was willing to try anything before resorting to medications to control his condition. A few weeks after the completion of his program, he wrote to me that his blood pressure had fallen from a high of 160/100 to normal values around 120/80. His blood pressure has remained at these normal levels for more than three years. He also wrote, "my life feels so dramatically changed and transformed. My all too frequent experiences of tension and sense of constant urgency, irritability, frustration, and outright anger have given way to an overall calm and equilibrium I could not have foreseen. I feel a sense of peace and ease I have never been able to attain [before]. And I feel like a kinder man."
Another client, a 55-year-old department head of a major college had suffered chronic anxiety, depression, and persistent insomnia for which he had engaged in long periods of psychotherapy and psychopharmacology. Six months after his program, he wrote, "My years of insomnia and depression have diminished so radically it's almost hard to believe they were so much a part of my daily life. This treatment course has opened up a renewed sense of joy in living and celebrating life and its diversity once again. It is the most powerful healing experience I've ever had."
What was it that was so instrumental in helping these people change? Mindfulness—the practice of simply paying attention with an open and non-judging attitude to things just as they are, moment to moment. This simple, but rich and complex practice of being awake to or aware of the moments of our lives can be of deep value, but is itself a very radical idea in our culture, particularly in medicine and psychiatry. We as individuals in this society are always on the move, always doing. We're focused on getting somewhere, on being more successful, on acquiring something else, on avoiding discomfort, no matter what the price. And although we focus on an incessant and relentless "busyness," we have little time or use for something like mindfulness, which actually seems like doing nothing.
Our minds are racing all the time; we have great difficulty in sitting still and simply being at rest. We are either off in the future, planning, scheming, projecting, worrying, or we're lost in the past, lamenting, daydreaming, caught up in memories, or berating ourselves. "If only I did this. If only I did that." We ruminate over all that should have or could have been. Even in the present, our minds are distracted—thinking, thinking, thinking. "If only I could figure this out, if only I could get there—wherever 'there' is, then I'll be okay, then I'll be comfortable." Like the White Rabbit in Alice in Wonderland, we're always racing off, never pausing long enough to be where we are.
Health
The Root of the Problem
Of course we are very uncomfortable remaining still when we feel disconnected, overloaded, stressed out, and when we feel a nagging undercurrent that something is wrong. This sense of unease may manifest itself both physically and psychologically - clients may have depression and anxiety; they may develop physical ailments and suffer from burnout; they may have difficulties with intimacy and interpersonal relationships. And while drug companies, physicians, and psychiatrists seek more efficient ways to approach and manage our symptoms, they may not more adequately address the central question: What is the cause of all these problems in the first place? What exactly is going on here? In order to see the forest for the trees we have to step back and step outside the usual treatment paradigm and open up to a wider way of thinking. This is the approach of mindfulness.
What is Mindfulness?
As I stated earlier, mindfulness is the practice of purposefully paying attention to each moment. Until you begin to try keeping the mind focused in the present, you have no idea how infrequently your mind is "here." And as a sign in Las Vegas states, "You have to be present to win." We need to learn to pay bare attention, as if we were looking through a camera viewer—we simply see what's there, unadorned by our theories and opinions. As a wise Zen Master said, "Stop seeking the truth; seek to let go of your opinions." Or, as Sergeant Joe Friday said on the Dragnet TV series: "Just the facts, ma'am." We only get to live our lives moment by moment; either we are here for them, or we're not. If we're not, life will simply slip away. We experience this detached feeling as a loss of control, a loss of grounding. We get anxious and afraid and may feel life is slipping away. We get stressed from the threat of a life that has no meaning or is out of control. We hurry about and urgently try to catch up on things. We hurry and worry so much, we miss the life we are living. We're afraid to let go and slow down. In a way, mindfulness is also the teaching of letting go.
Experiencing Pleasure
In one session of a mindfulness program, clients were instructed to pay close attention to pleasant experiences during periods of meditation. They were asked to record in a journal what they experienced in their bodies and to notice their moods, thoughts, and feelings during pleasant experiences. One student, a 43-year-old man, who was referred for treatment after several hospitalizations for stress-related chest pain and overwhelming anxiety, reported in class, "I didn't have one pleasant experience all week." "Do you shower before work?" I asked. He replied, "Every day." When I inquired as to whether he enjoyed showering, he said, "Very much." "So you do have pleasant experiences every day right off the bat," I said. His reply, sad but true, was, "You mean those little experiences count?"
If we miss these small moments of pleasure, as we often do, we cannot get them back. If we let our "moments slip away, unnoticed and unused," as Martha Graham said, there is no refund. We are missing our lives, we are disconnected, and that sense of disconnection is often at the heart of many maladaptive coping styles and at the core of our suffering. Mindfulness is the practice of reconnecting on an inner level to whom we are and reconnecting on an outer level in a compassionate way to the world around us. So mindfulness is a practice, a tool, and a way of living with an open mind and an open heart.
Openness
The experience of this "openness" is in itself healing. And since we really don't have to "do" anything to be aware, except to pay attention, mindfulness is really "non-doing," which again, is a radical shift in a culture that is always on the go. It is also a major shift from most therapy, which focuses on the past, on getting somewhere, or on improving self-image. Mindfulness is the belief that clear seeing and understanding will free us. Free us from what? From so much of our self-created suffering, from being stuck in patterns and self-images that keep us from knowing and accepting ourselves, our spouses, our children, and life itself. So mindfulness is not just about relaxing or feeling good. It's about waking up to this human life with all its joys and sorrows, pleasures and struggles, pains and beauty, in a very real and immediate way.
How is Mindfulness of Value in Treating Stress and Other Psychological and Medical Conditions?
Let me outline a brief view of stress. Stress is a total mind/body response to a perceived threat. The threat may be real or unreal, external or internal; it makes no difference. Life has stressors of all types: physical (think of the toll gravity itself takes on the body), social, financial, political, biological, to name just a few. The very nature of life (aging, change, illness, dying) is stressful, especially if we resist it. But much of our stress comes from ignorance from fighting against life's natural conditions. In a way, stress is resistance. Much stress comes from imagined threats, from catastrophizing, like Chicken Little believing the sky is falling. What would help Chicken Little? To simply look at what he is afraid of, to pay close attention to the sky. As the spiritual dictum goes, "the truth shall set you free." So to begin to see, to open up and pay attention not to our thoughts or ideas about things, but to life as it is—this is the antidote to stress. If ignorance causes suffering, and if to ignore is the root of ignorance, then paying close attention is what dispels our ignorance. A simple but profound truth.
The more closed our minds, the more rigid we are in our world view, the more frightening and stressful anything that doesn't fit our idea of "normal" is. We have built an intellectual fortress to protect ourselves from the enemy, but our fortress has become our prison, and the enemy is our own rigidity, which we hold onto for dear life. These are what we call patterns, behaviors that might once have kept us safe but now keep us stuck. We are trapped in our limited and habitual ways of seeing and thinking.
Our perceived threats touch off a chain of events called a stress reaction, involving the central nervous system and endocrine system, with the release of stress-causing chemicals such as cortisol, epinephrine, and norepinephrine. These chemicals put the mind/body into a state of alert hyperarousal. Let's say you're flying along in an airplane, relaxed, daydreaming, and all of a sudden there is considerable turbulence. "Uh oh," the mind thinks. "I don't like this. I wish this would stop. How long will it go on? What was that noise?" The emotion of fear arises and the mind reacts by increasing its fear-based thinking. Also, our bodies begin to respond to the stress reaction; our heart rates increase, hands get clammy, we might get lightheaded, our mouths feel dry, breathing becomes shallow, and we feel queasy. Our sense of physical discomfort intensifies our fear. We look out and check the shakiness of the wings and think, "this doesn't feel safe." We recall reading about precipitous plunges, about planes disintegrating and crashing. Soon we imagine ourselves dying.
Hiding from discomfort
Of course, all that has happened is "bumpiness," and even that passes in due time. What happens is that most of us want to try and repress, suppress, or get away from our discomfort. We try to hide from our fear or anxiety. This is where the problem begins—when we try to push away awareness, disconnect from our feelings, we bottle things up. This is not of much importance in a single incident, but since life is full of turbulence (think of how many "bumps" there are in an ordinary day), and we constantly push discomfort down, we often end up in a state of chronic hyperarousal or chronic stress that manifests itself in high blood pressure, depression, headache, backaches, insomnia, and so forth. One way we try to keep away from our discomfort is to become busier. To get away from the discomfort we can do something to make things better or we can develop addictive dependencies to food, sex, drugs, or alcohol to take the edge off. But these maladaptive behaviors simply add to our stress, in our minds, bodies, social lives, and families. As the stress cycle continues, it spins on and on until we burn out or break down. This stress measurably undermines the health of our minds and bodies - the cardiovascular system, nervous system, musculoskeletal system, gastrointestinal system, and, of course, the immune system. This is how stress can make us sick. It's not only that stress may kill us, but it also robs us of the quality of our lives and destroys our peace of mind. This can be demonstrated in medical literature.
So how does mindfulness free us from this cycle of stress and the self-destructive and self-limiting patterns and behavior in which we are stuck? By seeing and knowing directly what we are experiencing, and by having, through the practice of mindfulness, gained an ability to have some equanimity and balance in the midst of difficult experiences, we can act clearly and wisely because we are fully alert to whatever it is that is really happening. For example, if you had to confront an assailant, an illness, the loss of a spouse, or even an idea you don't want to accept, what good will it do you to stick your head in the sand, or to react with anger, condescension, or depression? None! So if we clearly see what we are up against, stay fully aware of exactly what's happening, then we can evaluate each situation and take appropriate action to find a solution. We can deal with excessive emotional reactions. We recognize turbulence for what it really is. We can respond more appropriately if we can see, or be mindful of the "old" reactions. We can break the old patterns. Of course we will experience some stress. But the intensity and duration will be reduced, and, because nothing is pushed under the rug, those feelings of stress will pass, and no chronic stress condition will begin. It is not acute stress that does the damage, it is the chronic stress. Seeing clearly is the beginning of freedom, but as the freed slave and great statesman Frederick Douglas said, "To be free we must strike the first blow." For us, that blow is mindful awareness. Mindful awareness gives us the ability to make truly informed choices, and helps us let things pass without holding on and dragging our past into every moment. It gives us back the moment in which we live.
Mindfulness Meditation
Let me explain a bit, on a practical level, how we do mindfulness meditation or how we practice it. Remember that mindfulness meditation is an experience and not a philosophy. It does not offer concepts of life, but is a direct way of seeing and knowing life. This is not knowing through a veil of thinking and opinion, but a deep and direct knowing. For example, you don't have a philosophical discussion about seeing someone swimming—the person is swimming; it is an observed fact. Mindfulness is a lifetime journey to be where we already are, but fully awake. So we don't have to strain, or push ourselves, or try too hard. Rather, the spirit and heart of this practice is a gentleness or kindness toward ourselves and life. We pay attention not to judge what we see, but simply to just see. We open the mind and open the heart and pay attention. If you're angry, you observe what anger is in the mind (the thoughts and moods), and in the body (the tightening and constricting; the energy flow.) We come to know and see anger; not to be the anger, not to react to the anger (unless we are in a truly threatening situation). We see thoughts, emotions and our constant opinions about everything, but we just see them for what they are—events in consciousness that come and go. We see thoughts such as "I don't like this, I don't like that," and most frequently, "I don't like me," to have no particular truth; they are just opinions.
The best attitudes you can bring to the following simple exercises that will give you a taste of the practice, are patience, acceptance of whatever arises, a nonjudgmental, genuine curiosity, clear seeing, and willingness. Let go of any ideas of where this will get you or of how it will fix you. Just be present. Trust in your ability to handle what's there, and trust in life's moments.
Body Scan
Lie down in a relatively quiet place where you won't be disturbed. Lie on your back with your legs outstretched and your arms at your sides. Feel the alignment of your body as a whole, and feel the floor support your body. It is important not to try to relax, not to try to achieve anything. Just pay close attention with an open and receptive mind. Notice sensations as precisely as you can, but remember that you're not for or against whatever you experience. There is no right or wrong thing to feel. Bring your attention to the toes of your left foot. Be aware of any sensations that are there, such as temperature, touch, moisture, or air currents. Let your attention rest there about 30 seconds. Then, as you inhale, let go of the toes and bring attention to the bottom of the foot. After 30 seconds, to the top of the foot, then to the ankle, then the lower leg. Follow all the way to the left hip and then start with the toes of the right leg. Scan the whole body in this way. Do not try to create sensation. If there's no sensation, be comfortable with that. When you're done, congratulate yourself for taking the time to be with yourself.
Sitting Meditation With Awareness of Breath
What's nice about using the breath as a focus for mindfulness is that it is portable, always available to our attention, and is a natural rhythm of the body. So find a comfortable chair or cushion to sit on. Take a basically dignified posture that honors your body. Sit erect, but relaxed and not rigid. Let your shoulders be at ease and place your hands on your thighs or folded in your lap. Close your eyes or leave them partially open. Let your belly be soft. Now bring your attention to your belly. Notice the belly fill with the intake of breath, and then fall when you exhale. Just pay attention to the sensations of the breath coming and going, the rising and falling of the belly. Let your awareness ride the wave of breathing, moment by moment, staying with the sensations of the breath coming and going. Do not try to alter your breathing in any way. Just be with it as it is. There is no right or wrong way of breathing.
When your mind wanders, which it will, over and over, and you realize you're no longer with the breath, but caught up in thinking, just make a conscious mental note that you're thinking (to remind yourself where your mind has gone) and come back to the breath. This is all you have to do, over and over. There is nothing to "achieve" no "good" or "bad" meditation; there is just awareness moment to moment. Return to this moment whenever you realize you've drifted away.
Mindfulness in Daily Life
We also practice mindfulness in the most ordinary situations. It is the quality of our attention that is most important—so you can brush your teeth mindfully, being aware of smell, taste, texture, touch, and movement. Be fully present. Pay attention. Notice how alive an ordinary moment can be.
Be mindful of walking your dog, of petting or feeding your pet, of simply watching them closely. Really be present. Try just looking at your child, at your spouse. Really pay attention. Learn to stand still a moment and look around you. See a leaf, a shadow, a bird, a moth, a wall. See stillness. See motion, color, light. Whenever you're caught evaluating what you see, just note "thinking" and come back to seeing, seeing with bare attention, being present to each unique moment.
Listen. Just be still and be attentive to sound. Let sound in, hearing sounds as they are. Don't judge what you hear. There's no right or wrong sound. Just listen; a dog barks, a refrigerator compressor kicks on, a faucet drips, our intestines gurgle, birds sing, a car passes, a moment of silence occurs, a phone rings. This is the symphony of life. Be here, know what life sounds like. Experience the richness of being connected, even for a moment. You don't have to go anywhere special to find life. It's all right here in this moment. Pay attention.
Practice mindfulness. See for yourself. Use these simple practices anywhere, even for a few moments. Begin to feel what it's like to be more and more awake, fully present, mindful.
