In 1979, Jon Kabat-Zinn recruited chronically ill patients not responding well to traditional treatments to participate in his newly formed eight-week stress-reduction program. Now, more than 35 years later, Mindfulness-Based Stress Reduction (MBSR) and its offshoots have entered the mainstream of health care, scientific study, and public policy.
We talked to the health and well-being pioneer about why mindfulness has attracted so much attention and why it will continue to do so.
In early 2005, I met Jon Kabat-Zinn at his home in Massachusetts. I came as a meditation practitioner and journalist with a bit of skepticism about MBSR. I was curious whether the attempt to bring secular mindfulness to the broader society could be effective. In a lengthy, impassioned conversation, I began to be persuaded of its validity and power, and as a result we started down on a path of further investigation that led us to Mindful and mindful.org.
Since then, we’ve met scores of people who are bringing this approach to mindfulness into many different contexts and helping all sorts of people. And Jon and his many colleagues have just kept on going, bringing mindfulness into every corner of life. I returned to Jon’s home, on the occasion of the publication of a revised and updated edition of his groundbreaking book Full Catastrophe Living, to talk about his work. Fittingly, we began with a little bit of silence and then embarked on a stimulating conversation about the present and future of the practice he has devoted his life and heart to.
Mindful: Did you ever think the work that started in a modest clinic in a spare room of a hospital in Central Massachusetts would become so influential?
Jon Kabat-Zinn: In a word, yes. I never thought of this work as a small thing. I don’t think of myself as a big deal, but I always thought of this work as a very big deal. It wasn’t just about thinking that meditation had a modest contribution to make to Western medicine. MBSR was built on the conviction that the insights, wisdom, and compassion of the meditative traditions were equal in import and magnitude to the great discoveries about human life we’ve made in the West. If there’s an instruction manual for being human, then Western science and medicine have supplied one part of it, and the contemplative traditions have supplied another, the part that has to do with discovering and cultivating our deep interior resources.
My hope was that by starting a stress-reduction clinic based on relatively intensive training in mindfulness meditation and yoga—and their applications in everyday living—we could document how these practices might have a profound effect on the health and well-being of individuals. The larger purpose was to effect a kind of public-health intervention that would ultimately move the bell curve of the entire society.
Mindful: And it grew to the point where we now talk about mindfulness-based interventions in all sorts of areas—depression, childbirth, education, addiction, to name just a few.
JKZ: We didn’t have a specific blueprint, but I am very gratified that so many developments have been happening on so many different fronts. It’s really a matter of planting seeds. You never really know what will sprout from these seeds and how they will spread. That’s the beauty of it. It’s based on not-knowing—approaching the world inquisitively, with a fresh mind.
If we had come in with a plan, with an ideology, with all the answers, I think it would have remained small. Instead, those of us involved in this work have paid close attention to just a few essential elements. One is that mindfulness is not a special state you achieve through a trick or a technique. It is a way of being. I have a lot of faith that if people just learn how to be in the present through simple mindfulness meditation, then the practice does the work of transformation and healing. We do not need to do it for them. People are so creative and intrinsically intelligent that given a chance, they perceive the truth within their own experience. “When I get attached to something, I suffer,” they realize, “and when I don’t get attached, I don’t.”
“If there’s an instruction manual for being human, then Western science and medicine have supplied one part of it, and the contemplative traditions have supplied another—the part that has to do with discovering and cultivating our deep interior resources.”
Mindful: What else makes MBSR work?
JKZ: The eight weeks of the MBSR curriculum offer a reliable protocol that is used in many studies of the effects of mindfulness meditation practice. People who have taught it a lot have seen that it has an integrity of its own. If they try to switch things around—a little more of this, a little less of that, take this out, put this in—they find it isn’t as effective.
Yet it’s only a framework. It’s only as effective as what the teacher brings to it and how he or she “holds the space,” as we say. It simply will not work if it is scripted or formulaic. If the teacher doesn’t feel competent in one of the elements, say yoga, it doesn’t work if they bring in an outside expert. They have to get the training and embody it themselves. Everything that is taught has to be lived. Life is the curriculum.
As a teacher, you are trying to convey something that can’t be conveyed in words. Mindfulness is also heartfulness—you need poetry as much as prose. What truly makes mindfulness training work is love. If the teacher holding the class is profoundly in love with what they are doing and with the people in the class in a fundamental way, it will work. If they are not, it will peter out.
Mindful: The benefits of mindfulness go far beyond stress reduction. Why did you call your program that, and are you still satisfied with your choice?
JKZ: I wanted it to speak to universal experience. Everybody can relate to stress. It’s a common English word and a common experience. The science on stress is proving that it was a good choice. We find out more every day about the negative effects of stress on the body, on the immune system, on aging, and so on. Likewise, there is a correspondingly strong interest in how we can develop resiliency in the face of stress, which is a benefit of mindfulness practice.
Mindful: You often say that mindfulness is not about attaining benefits or fixing problems—that it’s about discovering there is more right with us than wrong with us. Yet a “stress-reduction” program can seem very benefit-oriented.
JKZ: That is an unavoidable paradox. There are tremendous benefits that arise from mindfulness practice, but it works precisely because we don’t try to attain benefit. Instead, we befriend ourselves as we are. We learn how to drop in on ourselves, visit, and hang out in awareness.
It’s essential when you’re teaching mindfulness to remember this and embody it in your own way of being. People come to a mindfulness course because they’re in pain or angry or depressed or afraid. The one thing they want is to get somewhere else, so the teacher needs to continually convey that mindfulness is not about getting anywhere. The teacher’s own practice and way of holding him- or herself communicates that, and because people are intelligent and inherently mindful, they resonate with it. At that point, it becomes ordinary common sense. People often say, “I always figured meditation was something weird and mystical. If only I had known what it really is I would have started years ago.”
Mindful: Your interest is not just working with medically defied pain, but with all of life—“the full catastrophe,” in that colorful phrase you borrowed from Zorba the Greek.
JKZ: People say, “I came to this program to deal with my pain. I didn’t realize it was about my whole life!” There was a professor I knew from my MIT days who needed a bone-marrow transplant, and he showed up at the clinic in Worcester. He said, “I want to learn how to be in relationship with my mind, so that when I’m in isolation in the transplant unit, I can survive it.” After a few MBSR classes, he said, “I feel more comfortable with these people I’ve just met than I do with the colleagues in my department.” When he asked himself why, he concluded, “This is the community of the afflicted, and we acknowledge the affliction. The faculty is also the community of the afflicted, but we don’t acknowledge our affliction at all.” Later, he was riding the subway and realized we are all “the community of the afflicted.” It made him feel extraordinarily free.
“Mindfulness is not a special state you achieve through a trick or a technique. It is a way of being.”
Mindful: If the real benefits take place in the heart and in our very way of being, why does the scientific work matter so much?
JKZ: David Black of the Mindfulness Research Guide has been gathering information on the number of scientific and medical papers per year on mindfulness, and the resulting graph is pretty telling. Something that was not on the research map at all a few decades ago is a prime area of interest now. These studies provide the evidence of effectiveness you need to be respected and adopted in key institutions in health care, education, social policy, and so on.
But ultimately we do science to understand the nature of the universe—and the nature of the one who wants to understand the nature of the universe. Research that helps us understand the capabilities of the brain and how to improve them is vitally important to how we can live well, as individuals and as a society.
The brain science has become very rigorous. A lot of credit obviously goes to Richie Davidson, in his lab at the University of Wisconsin–Madison and the Center for Investigating Healthy Minds. Their work is unique in that it focuses on both basic science and translational research, which takes place in real-life settings such as Madison’s public schools. Research on how the brain can be trained ventures into areas we wouldn’t have dreamed of years ago. For example, one of the center’s really interesting projects, funded by the Gates Foundation, is to study the effects of computer games that train children in attention and pro-social behaviors, such as recognizing others’ emotions.
Many young scientists are now taking up this field, many with the support of the Mind & Life Institute’s Varela Grants and summer research institute, where contemplative practice is integrated into a scientific meeting. Young neuroscientists and behavioral scientists are building their careers in what’s now called contemplative neuroscience. Ten years ago that may well have been a career-ending choice.
One of the Varela researchers whose work I admire is Paul Condon of Northeastern University. His group designed a study to determine what different results might arise from training in mindfulness meditation and training in meditation that emphasizes compassion. In the study, participants received eight weeks of either mindfulness or compassion training or no training at all. Afterward, the researchers set up a scenario in which a study participant was directed to sit in a waiting room with only three chairs, two of which were occupied. After a minute, a fourth person entered on crutches wincing and sighing, and the two people originally in the room pretended not to notice.
The study measured how many participants would, during a two-minute period, overcome the bystander effect—if others are ignoring something, so should I—and offer their seat to the person on crutches. The people trained in mindfulness and the people trained in compassion were both fie times more likely to give up their seat as the people in the control group. There was no difference between training in mindfulness and training in compassion.
This raises some very interesting questions, and to my mind it underscores the fact that mindfulness is compassion and vice versa. Certainly, in MBSR, where people bring every kind of pain imaginable, compassion is naturally part of the atmosphere.
Mindful: What developments outside the laboratory are you following?
JKZ: It’s exciting to see how more people in the medical world are appreciating the mind-body relationship and fostering participatory medicine, where the patient is not a passive recipient of treatment but a real partner in healing. It marks a sea change in medical education and practice. For example, Dr. Ron Epstein of the University of Rochester Medical School, with his colleagues Mick Krasner and Tim Quill, have been training primary care physicians in mindful communication. This has resulted in decreases in emotional exhaustion, depersonalization of patients, and burnout among doctors.
I can’t say enough about how the role of mindfulness-based cognitive therapy is spurring interest in mindfulness among psychologists and psychotherapists, and it has led to some very intriguing research. On another front in psychology, David Creswell has been doing work with loneliness in the elderly. All sorts of conventional interventions have been tried to reduce loneliness in the elderly, and they just never work. Have them do things in groups, form friendships, roast hot dogs—they’re still lonely. He trains them in MBSR, and their loneliness disappears. What’s that about?
Mindful: And outside of health care?
JKZ: An area where mindfulness is spreading in a truly impressive way is education. What could be more vital for our future than teachers and students sharing a mindful classroom? There’s the work of Mindful Schools and Inner Kids, to name just two of the more prominent groups. There are also federally funded test sites in several locations, where teachers are learning mindfulness along with their students.
I’m really impressed by a manual called Mindfulness in Public Schools that came out from the South Burlington Public School District in Vermont. It’s unprecedented that a whole public school system would support mindfulness to the point of developing a teaching manual modeled on its own program for students and teachers.
Another excellent project is the pilot happening in the Madison, Wisconsin, public schools, led by Lisa Flook of the Center for Investigating Healthy Minds. I was just reading the impressive results reported in the article in Mind, Brain, and Education. They adapted a form of MBSR specifically for teachers, and among other results, it decreased burnout and increased self-compassion.
In higher education, something very promising is a mindfulness-based intervention to help college students deal with anxiety and a challenging environment that has caused them in many cases to go on medication. It was developed by two psychiatrists at Duke University, Holly Rogers and Margaret Maytan, who present it in a book called Mindfulness for the Next Generation: Helping Emerging Adults Manage Stress and Lead Healthier Lives.
“There are tremendous benefits that arise from mindfulness practice, but it works precisely because we don’t try to attain benefit. Instead, we befriend ourselves as we are. We learn how to drop in on ourselves, visit, and hang out in awareness.”
Mindful: When mindfulness reaches into our institutions of higher learning, it can have broad societal effects. Where else do you see mindfulness leading to bigger changes?
JKZ: Many well-known businesses and business leaders have been bringing mindfulness into their work and leadership, and I’ve had the opportunity to meet many of them, including at the Wisdom 2.0 conference every year. Some politicians, economists, and policymakers have started practicing mindfulness and bringing it into their work. It’s not many now, but the ones who are doing it are very passionate about it. Congressman Tim Ryan, whom I met five years ago when he did a mindfulness retreat with me, has become a strong advocate for mindfulness in health care, schools, the military, and particularly for veterans. He believes that programs that develop our innate human capacity to be mindful can make a profound difference for a relatively modest investment.
When I was in England recently, I spent a whole day in Parliament and visited with Prime Minister Cameron’s advisors at 10 Downing Street. Chris Ruane, a Member of Parliament from a very poor district in North Wales, has been instrumental in bringing mindfulness into public schools there, and he’s encouraging his colleagues to consider other ways to bring mindfulness into public policy.
I also gave the keynote at a daylong conference in London called Mindfulness in Schools. What I saw there brought me to tears. Here were seven-year-olds addressing 900 people, and they were completely self-possessed talking about their mindfulness practice and what it was doing for them. You could tell it was unrehearsed. They just spontaneously said what mindfulness meant to them.
Mindful: With all of this interest from so many different quarters, are there enough qualified people to serve the growing need for mindfulness teachers?
JKZ: The price of success is that more and more people want something. But of course, mindfulness is not a something. As I said in the beginning, it’s a way of being, and you usually discover it through someone who embodies it to some degree.
Interest in mindfulness generally, and in MBSR and other mindfulness-based programs, is spreading around the world at a lightning pace. So in addition to sowing seeds we need orchards, where we are growing things in a more structured and planned way. That has not been my emphasis, but fortunately there are people paying a lot of attention to that. At the Center for Mindfulness and in professional training programs all over the world, under Saki Santorelli’s excellent direction, people are learning how to teach mindfulness in a way that allows open discovery. The program certifies that they have been well trained, but of course we can’t certify that anyone is a good teacher. Each student will always have to judge that for him- or herself.
In the future, there will need to be many different kinds of mindfulness teachers and guides for many different contexts. What’s needed for educators will differ from what’s needed for health professionals and inner city youth. Let many flowers bloom.
The spread of mindfulness into more areas of our life is a multigenerational undertaking. One of the greatest challenges is how we will work with the digital revolution and the alternate reality it has created. Many of us are spending more time online than offline. We need to navigate this mindfully or it will eat us up. The technology itself is a source of endless possibilities but also endless distraction. We’re now very good at writing code—but how good are we at knowing ourselves, loving ourselves, and making a good world together with our fellow human beings?
Almost everything we do we do for a purpose, to get something or somewhere. But in meditation this attitude can be a real obstacle. That is because meditation is different from all other human activities. Although it takes a lot of work and energy of a certain kind, ultimately meditation is a non-doing. It has no goal other than for you to be yourself. The irony is that you already are. This sounds paradoxical and a little crazy. Yet this paradox and craziness may be pointing you toward a new way of seeing yourself, one in which you are trying less and being more. This comes from intentionally cultivating the attitude of non-striving.
For example, if you sit down to meditate and you think, “I am going to be relaxed, or get enlightened, or control my pain, or become a better person,” then you have introduced an idea into your mind of where you should be, and along with it comes the notion that you are not okay right now. “If only I were calmer, or more intelligent, or a harder worker, or more this or more that, if only my heart were healthier or my knee were better, then I would be okay. But right now, I am not okay.”
This attitude undermines the cultivation of mindfulness, which involves simply paying attention to whatever is happening. If you are tense, then just pay attention to the tension. If you are in pain, then be with the pain as best you can. If you are criticizing yourself, then observe the activity of the judging mind. Just watch. We are simply allowing anything and everything that we experience from moment to moment to be here, because it already is.