Meditation as Medicine: A Critique

Abstract

Meditation as Medicine: A Critique Wakoh Shannon Hickey Twenty‐seven adults are arrayed at the front of a large, sloping lecture hall: some lying on their backs, some upright in free‐standing chairs, some in the tiers of seats bolted to the floor. Most appear to range in age from mid‐forties to mid‐fifties. The lights are dim, most eyes are closed, and except for occasional fidgeting, everyone is silent and still. The instructor, a kindly psychiatrist who bears a striking resemblance to Santa Claus, has instructed everyone to focus attention on the ebb and flow of the breath, counting exhalations from one to eight, then returning to one. Each time the mind wanders off, the meditator should begin counting again at one: the point is not to get to eight, but to continually refocus attention on the breath. Toward the end of the evening, participants gather on chairs in a circle, each speaking in turn about her or his experience. One woman says she hates meditating, because her mind wanders constantly, and her thoughts are full of “mean” commentary about herself. A Vietnam veteran remarks that for thirty years he feared that “if I allowed myself to have the memories they’d kill me, so I fought them off like I fought the war.” Meditation has helped him to see that his thoughts will not kill him, and that facing the painful memories relieves the depression and anxiety caused by his avoidance. Another woman’s voice breaks as she remarks that part of her resistance to meditation emerges from a belief that “I don’t deserve happiness.” Scenes like this are being repeated in hundreds, perhaps thousands, of settings around the United States. They are part of a program called Mindfulness‐Based Stress Reduction (MBSR), which molecular biologist Jon Kabat‐Zinn, Ph.D., developed at the University of Massachusetts Medical Center in 1971. During the eight‐week MBSR program, participants attend a two‐and‐a‐half hour class each week. They learn various forms of sitting and walking meditation, do visualizations to cultivate lovingkindness, and practice simple yoga postures. They also agree to complete daily homework assignments: to meditate and do yoga for forty‐five minutes each day, and to keep a journal recording these practices and the practitioners’ responses to stressful situations. Other therapeutic protocols employing mindfulness practice have been developed specifically for dealing with psychological problems. Mindfulness‐Based Cognitive Therapy (MBCT) has adapted the MBSR program for people suffering from depression.1 Dialectical Behavioral Therapy (DBT) is a protocol for treating Borderline Personality Disorder developed by psychotherapist Marsha Linehan, Ph.D. It includes a form of mindfulness derived from Zen meditation and seems to be effective for addressing a disorder that is notoriously difficult to treat.2 For simplicity’s sake, this article will focus on MBSR, the largest of the programs. Meditation as medicine: the scope The precise scope of MBSR is unknown, because the program is not centrally controlled. In 1996, fifteen years after MBSR was launched in Massachusetts, approximately 120 programs were operating in the U.S., and “a few” in other countries. A year later, the number had more than doubled.3 As of April 2010, a database hosted by the Center for Mindfulness in Medicine, Healthcare, and Society, which Kabat‐Zinn founded, listed 553 MBSR programs around the world. The Center estimates that “tens of thousands” of people worldwide have completed the program.4 A slew of medical studies on MBSR have linked it to faster recovery from psoriasis outbreaks, improved cardiac health, fewer post‐chemotherapy symptoms among cancer patients, greater immune responses to flu vaccine, and increased activity—possibly even neural growth—in areas of the brain associated with positive mood.5 I have no doubt that mindfulness can be very helpful to people in a variety of ways. I have practiced it myself for more than twenty‐five years and have taught it to others, and I have both experienced and observed its beneficial effects. Yet I have a number of concerns about the way mindfulness practice has become commodified in recent years. I find some of the recent clinical research on meditation very intriguing. Yet I have some...