Clinical Handbook of Mindfulness (7 page)

chologies (Walsh, 1996).

The ever-growing integration between mindfulness and psychotherapy is

justified by the fact that mindfulness can be considered a trans-theoretical

construct that has been used and integrated into different Western theo-

retical and therapeutic approaches that up to only two decades ago had

few, if any, points of contact and dialogue. Today, different therapeutic

models (cognitive-behavior therapy, constructivism, evolutionary psychol-

ogy, humanist psychology, psychoanalysis, brain science, traumatology, pos-

itive psychology) now seem to have found a unifying factor and significant

shared element that will make it possible, in the future, to better understand

and develop the therapeutic factors common to all effective psychological

treatments. Indeed, it can be argued that the mechanisms of change that

form the basis of mindfulness meditation can be found in most Western psy-

chotherapeutic perspectives.

Mindfulness-based approaches also pay particular attention to the impor-

tance of personal resources and potential and to the capacity of an individ-

ual’s “system” to heal itself (or healing from within). By doing so, individuals

spontaneously reach a point (especially when properly guided and oriented)

at which they may pass from a state of imbalance and distress to a state of

greater harmony and serenity with respect to themselves with a consequent

enhanced subjective perception of well-being. Mindfulness practice (and all

of the therapeutic possibilities that may stem from its use and application) is

a discipline that unites all of the above “healing” components and provides

a point of convergence in the fertile dialogue that has arisen over the last

two decades between the East and West within the sphere of psychological

science.

The Dialogue Between Western and Eastern Psychologies

Eastern meditative traditions and Western psychology have both aspects in

common as well as significant differences. In order to better integrate the

differing scientific approaches and methods of investigation, these similari-

ties and differences must be fully understood. Western science has histori-

cally focused on the observer-independent physical world that can be stud-

ied objectively, using empirical facts and excluding subjective experience.

Western psychology, and especially neuroscience, tends to view the mind

Introduction

3

from a mechanistic perspective, in which an often used metaphor is that

of the mind as machine. From this perspective, it has been suggested

that meditation works through such psychological mechanisms as relax-

ation, exposure, desensitization, dehypnosis, deautomatization, catharsis,

and decounterconditioning (Murphy & Donovan, 1997). Other suggestions

of cognitive mechanisms include insight, self-monitoring, self-acceptance,

and self-understanding (Baer, 2003). Potential physiological mechanisms

include decreased arousal, changes in autonomic nervous system activity,

stress immunization, and hemispheric synchronization and laterality shifts

(e.g., Cahn & Polich, 2006). Some of these mechanisms have often been mis-

interpreted in a reductionistic way, leading to a limited understanding of the

processes of meditation (Wilber, 2000b). On the contrary, Eastern medita-

tive disciplines have a very different view of the mind. These traditions, and

Buddhism in particular, have focused primarily on the human mind and con-

sciousness as the primary subjects of introspective investigation, which they

see as the source of human joy and suffering, and, in general, as the source

of all phenomena (Walsh & Shapiro, 2006) to the degree that they are con-

sidered to have a tremendous impact on the understanding of the rest of the

world (Wallace, 1999).

Buddhist tradition maintains that, in the words attributed to the Bud-

dha, “All phenomena are preceded by the mind. When the mind is com-

prehended, all phenomena are comprehended,” and “by bringing the mind

under control, all things are brought under control” (Santideva, 1961, p. 68,

as cited in Wallace, 1999). This perspective differs from that of Western mod-

ern science, which assumes that the mechanistic control of the environment,

particularly the body and the brain, can alter one’s sense of well-being, com-

fort, and distress.

Another important point is that Western culture tends to be monopha-

sic, meaning that it is centered on, and conceptualized within, the usual

waking state of consciousness, whereas the culture of meditative traditions

(both Eastern and Western) is polyphasic and multistage, drawing on multi-

ple states of consciousness and multiple adult developmental stages (Laugh-

lin, McManus, & Shearer, 1992; Wilber, 2000a). As meditative practices are

studied using a Western scientific paradigm, there is a danger of “degener-

acy,” in which multiple dimensions are simplified into fewer ones, resulting

in a loss of complexity and multidimensionality (Tart, 1992).

According to Thurman (1991), scientists have more often than not con-

sidered reality to be something external to the world of human thought

in as much as reality is part of the physical world. They have thought that

the environment must be tamed, controlled, and modified in order to be

adapted to human needs. In order to understand the outside world, West-

ern science has without a doubt made extraordinary efforts and achieved

excellent results. Examples of this are the use of chemistry, pharmacology,

and surgery to cure illness, both physical and psychological. However, West-

ern science has focused solely on the study of potential cures outside the

self, introducing them into ourselves via highly advanced technologies. And

yet by doing so, it has given less importance to the positive and therapeu-

tic potential that each one of us has within ourselves. Buddhist tradition, on

the contrary, focuses on the importance of internal science and considers

the science of the mind to be the most important to the internal sciences,

4

Fabrizio Didonna

the king of all sciences. These beliefs have developed, thanks to the intense

and antique tradition based on the practice of meditation.

Another important difference between the two psychologies lies in the

methods and the means for obtaining mental health. Both systems of belief

have their own theories, but there is room for fruitful and effective collab-

oration between the two. Western psychotherapy tends to focus mainly on

the content
of the consciousness and does not try to achieve the more radi-

cal transformation proposed by Buddhist psychology, which focuses on the

process of the consciousness. The aim is to free individuals from negative

mental states by altering the perceptive and cognitive processes.

Westerners that have tried to understand and adopt these meditative prac-

tices have had the opportunity to try them out on themselves involving their

own very intense and profound sensations and emotions. Thanks to these

experiences, they have been able to develop positive psychological compe-

tences, for example, managing “destructive emotions” such as anger, mental

agitation, and attachment. In this process, they have managed to cultivate a

lifestyle that enables them to prevent what Western culture would consider

to be “mental illness”.

In the past few decades, rigorous scientific studies based on Western tech-

nologies have demonstrated that meditation practiced by experts such as

Buddhist monks can modify cerebral activity and have a positive influence

on individual’s health, both mental and physical.

The aim is to open up dialogue on the issue of therapy for mental health

between these two cultures, which differ significantly from technological,

scientific, and ideological points of view. At the same time, they both focus

on the search for human well-being in all of its components and for ways

to overcome suffering. As Engler has stated (Wilber, Engler & Brown, 1986),

when the two psychologies are combined, the result is a much more com-

plete diagram of human development. This combination makes it possible

to trace the developments that have been well founded and well studied in

Western psychology and to see, therefore, how they can be improved by

integrating the techniques of Eastern psychologies.

In many ways this book is the fruit of this fertile dialogue between the two

cultures, the two sciences, and the two psychologies that has taken place

over the past decades. It exemplifies the result of a synthesis, translated into

conceptual models and therapeutic interventions, that is the expression of

the integration of Eastern psychology with its rigorous principles dating back

thousands of years and the ability to translate scientific progress and the-

oretical advances into operational models and therapeutic techniques that

can be scientifically verified and belong, therefore, to Western psychological

cultures.

Unity of the Mind and Body

An important aspect to be emphasized in mindfulness approaches is the

considerable relevance attributed to the
unity of the mind and body
,

whereby the identification and description of bodily sensations and per-

ceptions open up a channel of information with respect to the cognitive-

emotional sphere. It should be noted that in mindfulness interventions, the

Introduction

5

conception of an individual’s relationship with the body is substantially dif-

ferent from that normally adopted in Western culture and, more specifically,

with respect to psychotherapy, in standard cognitive-behavioral approaches

(which make little effort to contemplate the physical dimension), but also

in other psychotherapeutic models that may even involve physical contact

with the patient. While these latter models lead patients to experience bod-

ily sensations and/or emotions evoked by external stimuli, the practice of

mindfulness allows patients to explore the dimension of their own physical-

ity in an autonomous, spontaneous, and decentered manner. This aspect is

found to be all the more useful if one considers that a number of patients

have difficulty expressing their thoughts and emotions through verbal com-

munication and would rather make use of the body as a metaphor of their

experiences.

This fundamental unity of mind and body has basically been lost in Western

culture. In meditative practice this union is a crucial assumption: The two

entities communicate in an active and continuous way leading to a concept

of, a whole living being that continuously interacts with its internal world.

Behind this main difference between the two cultures are a very different

understanding of the concept of mind and a different mental representation

of the idea of health and illness. The point of view of Eastern psychology

stimulates the emergence of a wider vision compared to the Western view in

as much as it recognizes this basic unity of mind and body.

The basis of this difference is a significant dichotomy that has character-

ized Western thought since the seventeenth century when Descartes intro-

duced the subdivision of the whole being into separate entities: the body and

the mind. According to Kabat-Zinn (1990), this is, at one level, an efficient

simplification, but what we often tend to forget is that the mind and the body

are only separated abstractly, from the point of view of thought. This Carte-

sian dualism of mind and body has permeated Western culture to the point

that it has nearly eliminated the entire sphere of body–mind interactions as

a legitimate field of scientific research. We can no longer think of health and

illness as entities that belong separately to the body or the mind because

they are extremely interconnected. Only recently, as the weak points of the

dualistic paradigm have become more evident, has this tendency started to

be turned upside down.

The Concept of Illness in Eastern and Western Cultures

Modern Western medicine has never given great importance to developing

an understanding of the experiences of the internal functioning of individu-

als focusing almost exclusively on external appearances (the symptom) and

concentrating, therefore, on eliminating the external manifestation rather

than the latent cause in the organism, that is, the root of the problem. There-

fore, the fact that Westerners tend to ignore the inside of the body and

its processes comes first of all from our approach to illness: The “miracle

medicines” that were developed and widely diffused in the 1930s and 1940s,

thanks to the discovery of antibiotics, took over the public imagination, and

within a very short amount of time, it was assumed that in the end science

6

Fabrizio Didonna

would be able to demonstrate that every physical problem had its cause in

invasive microorganisms and germs.

This way of dealing with health problems was even extended to mental

illness. This is demonstrated by the often overuse of pharmaceuticals that