Sahanika Ratnayake was raised a Buddhist in Sri Lanka and New Zealand but had no interest in meditation before going to Cambridge. Clinical psychologists were exploring the therapeutic potential of mindfulness and, like many other students, Ratnayake learned to practice mindfulness meditation to help her cope with the stress of student life. Mindfulness helped her “to be calmer, more relaxed, and better able to step away from any overwhelming feelings,” but she “also became troubled by a cluster of feelings that [she] couldn’t quite identify.” She “could no longer make sense of [her] emotions and thoughts,” she wrote in a July article for Aeon

In a Medium article the following month, Jamie Bristow, director of the UK-based Mindfulness Initiative, which teaches meditation to politicians, expressed his sympathy for “the troubled feelings and confusion that [Ratnayake] attributes to undertaking mindfulness training.” But, he explained, “No psychological intervention is without risks. Like exercise or pharmaceuticals, we must develop our understanding of how to deploy them skillfully so as to reduce the chance of harm, but we can never eliminate the possibility. Not because harm is intrinsic in the instance of mindfulness practice, but because of the latent vulnerabilities that it may trigger or potential misunderstandings about how it is intended to be practiced (edit August 20, 2019).” 

Does Ratnayake represent a vulnerable population susceptible to side-effects of mindfulness? Is she misrepresenting mindfulness, or is Bristow, while meaning well, pathologizing Ratnayake to discredit the way she makes sense of her experience? Alternatively, could Bristow believe that Ratnayake does not understand how mindfulness is intended to be practiced?

As well as being raised a Buddhist, Ratnayake gained a PhD in the philosophy of contemporary psychotherapy. Her account is critical of the nature of mindfulness practice both in its Buddhist as well as therapeutic incarnations. After practicing mindfulness, she no longer knew which thoughts or feelings to trust. Should she use mindfulness to register and dismiss her worrying thoughts and anxious feelings? How could she know which ones were real and which ones were imaginary?

In spite of clinicians’ attempts to cloak mindfulness in a cognitive smokescreen, Ratnayake does not believe her concerns have anything to do with her personal vulnerabilities. While mindfulness has migrated from Buddhism into a clinical context, it is taught to teachers by Buddhists who are well aware that it is designed to develop insight into tenets of Buddhist doctrine: impermanence, suffering, and no-self.

The instructions for mindfulness meditation are simple. Typically, the practitioner learns to disengage attention from thinking and to focus on body-based sensations. Maintaining one’s focus on body-based sensations, thoughts and feelings become transient phenomena passing through the mind. This does enable people to disengage from worry, rumination, and self-critical thinking. However, as Ratnayake points out, changing the way we experience thoughts and feelings raises profound existential and philosophical questions—as voiced by one participant in a Mindfulness-Based Cognitive Therapy course that I observed while training to teach: “If I am not my thoughts, what am I?”

As in Buddhism, mindfulness courses teach a calming method of concentration that disengages attention from troublesome thinking. When existential questions are raised in therapeutic mindfulness courses (and certain modern hybrid forms of Buddhism that have been influential in the development of mindfulness), these questions are also objectified, registered, and dismissed as “thinking.” Nonjudgmental awareness of thoughts, feelings, and sensations arising from moment to moment becomes a refuge. This can lead to devaluing and avoiding critical thinking.

A natural intelligence led Ratnayake to explore existential questions and may be responsible for Ratanayake’s all too real and distressing experience. It is farfetched to describe this as a “vulnerability” to mindfulness. If the potential for entertaining existential concerns is a clinical contra-indication to mindfulness, this has serious implications. Ron Purser, author of McMindfulness: How Mindfulness Became the New Capitalist Spirituality (Repeater, 2019), goes further: “Through the reductive explanatory narratives of psychologism or biologism, psychic and mental disturbances are depoliticized. What remains is an individualistic view of human distress, with the underlying premise that those who suffer are dysfunctional.”

Ratnayake agrees. “In spite of a growing literature probing the root causes of mental-health issues, policymakers tend to rely on low-cost, supposedly all-encompassing solutions for a broad base of clients,” she wrote in her article. “The focus tends to be solely on the contents of an individual’s mind and the alleviation of their distress, rather than on interrogating the deeper socioeconomic and political conditions that give rise to the distress in the first place.” 

This is true of all evidence-based cognitive psychological and pharmaceutical therapies because clinical trials are primarily concerned with quantifying the way therapy reduces emotional distress. The social and economic causes of that stress are typically outside the scope of therapy

Bristow, in his response, recognized that “our cultural histories will inevitably color our experience”; however, he continued, “as mindfulness is a way of being aware, we can bring it to bear within and upon whatever frameworks shape our world.” 

But the notion of mindful awareness is, in fact, loaded with metaphysical assumptions and beliefs about the nature of self and reality. It cannot be stripped of its cultural context despite Bristow’s claim.

Two-and-a-half thousand years ago, the lives people led and the beliefs they held were very different from those of today. The Buddha dismantled the illusion of an eternal soul as a means to escape the suffering of endless rebirth as a sentient being. In the social context of his time, this empowered individuals to seek their own salvation and dispossessed the priestly caste of their magical power. Whether it was his intention or not, the Buddha’s message may well have been a threat to the social order of his day.

Like every tradition, Buddhism, morphs to fit different cultures. Existential and philosophical questions are carefully examined in traditional forms of Buddhism to dispel the myth of a permanent essence of self that Hindus believe is reborn from one life to the next.

Today, the function we attribute to mindfulness as therapy is to reduce the impact of stress on health and well-being. This psychological form of Buddhism is built on a series of assumptions about the nature of self: the way we relate to thoughts and feelings is the subjective source of suffering. We can escape this suffering if we are accepting of it and we apply curiosity to understand the psychological processes that cause us to react to uncomfortable feelings.

Mindfulness as self-help may help us to be more self-accepting, think more clearly, make better decisions, and even be more aware of the way others feel. Psychological Buddhism, however, is inseparable from the assumptions upon which it is based. It is inseparable from the meaning and purpose we attribute to it. It is inseparable from the cultural context in which it is practiced. It is packaged in a particular contemporary worldview, even if we are not aware of it—and few of us are likely to become so unless it is pointed out.

More than ever before, we need to examine existential questions into the nature of self, not to escape rebirth but to find purpose in our lives, engage in meaningful activity, and make a positive contribution to society. Ratnayake concludes: “To look for richer explanations about why you think and feel the way you do, you need to see yourself as a distinct individual, operating within a certain context. You need to have some account of the self, as this demarcates what is a response to your context, and what flows from yourself.”

We need to develop better ways of teaching mindfulness that recognize that the awareness we cultivate is shaped by what we believe, and what we believe is as much a product of our own thinking as it is of common beliefs of society. Purser proposes a “social mindfulness” that “starts with the widest possible lens, focusing attention on the structural causes of suffering.” He continues: “Liberating mindfulness requires us to face our own delusion. Although this is sometimes a solitary process, it isn’t a retreat from the outside world. Instead, it can deepen our sense of connection, provided we see beyond clinging to the illusory separateness of self.” 

Often, we can do little on our own. If we think we are independent actors, we are more likely to accept things as they are. We need to see that we have to work together to make a more compassionate society—and safeguard the future for generations to come. We need to construct a more inclusive and interconnected sense of identity to do this.

In the absence of social rituals and human intimacy that make us feel safe and connected to others in community, attentional training can regulate self-defeating thinking. If this is all mindfulness can do, then it is no more than a self-administered anesthetic to the distress we experience as a result of modern working life. We are loving, caring, crying beings, and at the same time, we are capable of unimaginable acts of cruelty and stupidity.

The claim that clinical mindfulness can be value-neutral does not hold water. Some smell a rat when they are told to apply nonjudgmental awareness to thoughts and feelings. As a human socio-biological function, mindfulness always comes with a subtext that can have very different effects, individually and collectively. In the current context, psychological Buddhism is often irresponsibly deployed, making individuals feel responsible for their own suffering while pathologizing the critical thinking that we must address the social and material causes of distress in our society.

We need to design mindfulness programs that recognize that we need to work together to make a better world. There is little we can do alone. The human mind cannot be broken down and reconstructed from its parts like Frankenstein’s monster. Our approach to mindfulness has to include an understanding that our sense of identity, beliefs, and feelings are social as well as individual constructions. To dismiss existential questions as signs of pathology and depoliticize mindfulness by making it a value-neutral psychological intervention risks making it a form of social control. It is either ill-informed to argue, or dishonest to pretend otherwise.

Further reading: If you enjoyed this article, you may also be interested in our Tricycle Talks interview with McMindfulness author Ron Purser, Rande Brown’s essay on why mindfulness is not a substitute for therapy, and our online course on the history (and practice) of mindfulness

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