Clinical Handbook of Mindfulness (8 page)

influence the mind and emotions. Attention was taken away from internal

states to focus on the external world. As Thurman (1991) states, in the West

our ability to influence the external reality has by far surpassed the power

we have over ourselves. Today we are at a point at which illness is seen as

something that invades us and as such must be fought against using external

means that are often, unfortunately, just as invasive.

As Goleman (2003) has clearly pointed out, in the West, medicines have

become the most common solution to dealing with destructive emotions,

that is, those that create significant suffering for ourselves and others. With-

out questioning the fact that pharmaceuticals that alter and stabilize mood

have helped millions of persons, it is possible to point out alternative ways to

control the mind. Differently from modern science, which has concentrated

on developing ingenious chemical compounds to help people overcome the

most intoxicating emotions, Buddhist psychology offers more difficult paths

to recover involving a series of methods aimed at training the mind through

the practice of meditation.

From a Western point of view, mental health is defined by defect as

absence of psychiatric pathologies, that is, in the West normalcy is the aim.

However, in Buddhist psychology, for example, normalcy is only the starting

point for practicing the principles that lead to freedom from suffering and

mental uneasiness.

Tibetan Buddhism has a very refined psychology that has been practiced

for more than 2,000 years as well as a model of well-being that extends our

concept of mental health. Buddhist psychology has developed an elaborate

model of the mind that, as is the case for every complete psychological sys-

tem, describes how perception, motivation, cognition, and emotions work

in detail and analyzes both the causes of human suffering (etiology) and the

ways out of this suffering (therapy). It has developed its own representation

of the mind and how it works as well as its own definition of mental health.

Over the centuries, it has defined a precise map of how changes in the mind

and body have a reciprocal influence on one another and has developed a

series of techniques aimed a voluntarily controlling these changes.

This psychology allows Westerners to have a complementary vision and

perspective with regard to some of the more central questions of modern

psychology: the possibility to cultivate mental health, the nature of the mind,

the limits of the growth potential of human beings, and the tools and meth-

ods needed to enact changes on the psyche.

Negative and Positive Mental Factors

In the Buddhist model of the mind and mental health, the measurement used

is a single moment of the mind characterized by several mental factors. The

concept of “mental factor” partially corresponds to the Western concept of

Introduction

7

“emotion,” but this is not the appropriate term since some of the factors are

cognitive or perceptive (Goleman, 1991).

Every mental factor has unique properties that influence our perception of

reality and our subjective experience moment after moment. For this reason,

the primary cause of changes in experience should not be attributed to exter-

nal realities, to objects, but rather to the properties of that specific moment

in our mind and conscience. It is also well known in Western psychology

that any fact in our life can be considered pleasant or unpleasant depending

on the situation we find ourselves in and the “lenses” we wear to examine it.

Every mental state, every moment of the mind, is made up of a changeable

variety of properties that can be combined in order to determine a particular

mental state and its tone (Goleman, 1991). Abidharma, one of the branches

of Buddhist psychology, takes about 50 mental factors into consideration,

half of which are considered to be negative or harmful in as much as they

distort one’s perception of reality, and the others are considered to be posi-

tive and beneficial. The rule of mental health in this system is very “simple”

and direct because it is based on experience: Negative or harmful states are

those that do not lead to calmness, tranquillity, balance, and meditation. This

is the basic rule in this psychological system: If a mental factor supports

and promotes balance, then it is to be considered positive and beneficial

(Goleman, 1991).

The basic negative mental factors are
illusion
or
ignorance, attachment

or
desire
, and
aversion
or
hostility. Illusion
or
ignorance
is to be understood as a perceptive defect, a fogging up of the mind that inhibits individuals from

seeing things clearly and without making any sort of judgment.
Attachment

or
desire
is expressed as a selfish longing for gratification, which tends to

overestimate the quality of what one is desiring (idealization) and distorts

reality in as much as it leads the person to remain anchored to an object

or thought, creating a sort of fixation that is difficult to break away from.

Aversion
and
hostility
are to be understood as intense anger that leads to

a distortion of reality, but in the opposite direction of attachment, and that

makes a person see everything in a negative way (see also Chapters 1 and 2 of

this volume). Combinations of these factors lead to various types of distress.

For example, anger can lead to fury, revenge, contempt, and envy, while

attachment brings about phenomena such as avarice, futility, various forms

of dependency and addictions, excitement, and mental agitation. Accord-

ing to the Abidharma, excitement often influences people’s mind because it

sets the mind up for uncontrollable and useless fantasies. Basically we prefer

the flow of awareness: a normal and habitual condition of excitement and

agitation. It is this very agitated and destructive “mental state,” which dis-

rupts a person’s overall well-being, that meditation aims to relax and heal

(Goleman, 1991).

Each negative mental factor is countered by a health factor that is dia-

metrically opposed to it and that can replace it through a mechanism simi-

lar to “reciprocal inhibition,” which is used in systematic desensitization in

cognitive-behavioral techniques. For example, relaxation inhibits its physio-

logical opposite, which is tension (Goleman, 1988). In other words, for every

negative mental factor, there is a corresponding positive one that can dom-

inate it (e.g., penetration, mindfulness, non-attachment, impartiality), and

8

Fabrizio Didonna

when a positive health factor is present in a mental state, the harmful one

it is suppressing cannot reappear.

When one factor or a group of specific factors frequently inhabit the men-

tal state of an individual, it becomes one of that individual’s personality

traits: The sum total of a person’s mental factors determines his/her type of

personality.

The issue of motivation is closely related to mental factors. Mental states

are what push a person to look for one thing and avoid another. If a mind is

dominated by greed, this will become the predominant motivational factor

and the individual’s behavior will be influenced as a consequence, that is, by

seeking to conquer the object of his/her desire.

Mindfulness Meditation, Cognitive Processes,

and Mental Suffering

One of the main factors that causes and maintains mental suffering

(e.g., depression, anxiety) is the relationship that people have learned to acti-

vate in relation to their own private experience. An important aspect of this

relationship is people’s tendency to let themselves be overcome and dom-

inated by thoughts that start from far away, deep in our minds, and slowly

spread out to a point in which they can no longer be controlled and taken

over. During meditation the same thing happens and we become aware of it.

People become aware, maybe for the first time, of the fact that we are contin-

uously immersed in an uninterrupted flow of thoughts that come regardless

of our will to have them or not, one after the other, in very rapid succes-

sion. Indeed this is simply the nature of our mind, intrinsically transient and

fluctuating. Therefore, the problem is not to eliminate the thoughts that are

generated, but rather to disidentify oneself from them. One of the most valu-

able teachings and principles mindfulness-based programmes are based on

(e.g., MBSR, Kabat-Zinn, 1990, and MBCT, Segal, Williams & Teasdale, 2002)

is this idea of
not being your own thoughts
.

Patanjali (1989) speaks about this “process of identification,” but broad-

ens the concept as it is understood by modern psychology, which maintains

that the ego identifies itself in objects and people, that is, stimuli coming

from the outside world. Patanjali suggests that there is something that lies

beneath even the smallest thought, and this is when we identify with this,

without being aware of it, that we believe we are the thoughts we are think-

ing. Patanjali claims something that is radically different from the Western

concept of “I think, therefore I am,” basically assuming that we are differ-

ent from our thoughts. As the mind becomes less and less identified with

the content of our thoughts, the greater our ability to concentrate and the

greater the resulting sense of calm.

Meditation seems to function not by changing the contents of our mind,

but rather our identification with these contents through a “seeing” that

is more accepting, intuitive, and immediate, thanks to which the coercive

power of some cognitive-affective contents progressively decreases until it

eventually disappears. Consequently, the central theme of psychopathol-

ogy seems to focus on automating our cognitive and emotional processes,

and crystallizing thought configurations, memories, emotions, and bodily

Introduction

9

reactions that become automatic beyond our awareness of them and will to

control them (Segal, Williams & Teasdale, 2002). In some ways mindfulness

works in the opposite direction. As will be carefully explained in various

chapters in this book, the processes of
decentering
and
disidentification
,

which in standard cognitive therapy are considered a means for achieving

the end (i.e., changing the contents of a though), are actually the end itself of

therapy based on mindfulness. Non-attachment and non-identification with

what we take to be real is the basis of mindfulness-based approaches.

Rumination is one of the major cognitive processes in many psychological

illnesses. When people worry or ruminate about their problems, even if it

seems to them that they are facing the difficulty, they are actually moving

further away from a direct perception of the nature of the difficulty. This

happens because ruminating always involves making a judgment about the

experience. Meditation techniques based on mindfulness work in exactly

the opposite direction favoring a “letting-go” attitude toward one’s own

thoughts. This is an indispensable skill for people’s psychological and phys-

ical health since it helps them avoid getting stuck once again in harmful

vicious cycles. The worst damage caused by depressive rumination is the fact

that the ruminative thought feeds itself continuously. This process generates

thoughts and, therefore, emotions that become more and more intense and

far from the actual situation, such that over time it becomes more and more

difficult to differentiate reality from one’s judgment of it. For this reason,

according to mindfulness, it is extremely important that patients learn how

to disidentify themselves from their thoughts.

Mindfulness-based programs seem to be able to directly intervene on

several aspects of ruminative thoughts by exploiting the repetitive way

these thoughts work. The possibility to disidentify ourselves from our own

thoughts can free us up from one of the strongest and most deeply rooted

attachments: the attachment to thinking for the sake of thinking, that is,

being dependent on the incessant mental conversation that goes on in our

minds. There seems to be a unique fascination with this attachment since

we only feel normal when our minds are thinking a lot and since we think

that the solution to all of our problems can come solely from thoughts as

if we had a sort of blind faith in the presumed magical power of thinking

and re-thinking. Mindfulness offers a passage through which thoughts can

be stripped of the importance we attribute to them. When we realize that

our thoughts are non-concrete and have no substance, that their true nature

does not necessarily have anything to do with reality, we have overcome the

obstacle of attachment and the possibility that it will degenerate into the

negative effects of rumination.

Through diligently practicing the ability to detach ourselves from our own