Mindfulness meditation: Lotus therapy

The patient sat with his eyes closed, submerged in the rhythm of his own breathing, and after a while noticed that he was thinking about his troubled relationship with his father.

"I was able to be there, present for the pain," he said, when the meditation session ended. "To just let it be what it was, without thinking it through."

The therapist nodded.

"Acceptance is what it was," he continued. "Just letting it be. Not trying to change anything."

"That's it," the therapist said. "That's it, and that's big."

This exercise in focused awareness and mental catch-and-release of emotions has become perhaps the most popular new psychotherapy technique of the past decade. Mindfulness meditation, as it is called, is rooted in the teachings of a fifth-century BC Indian prince, Siddhartha Gautama, later known as the Buddha. It is catching the attention of talk therapists of all stripes, including academic researchers, Freudian analysts in private practice and skeptics who see all the hallmarks of another fad.

For years, psychotherapists have worked to relieve suffering by reframing the content of patients' thoughts, directly altering behavior or helping people gain insight into the subconscious sources of their despair and anxiety. The promise of mindfulness meditation is that it can help patients endure flash floods of emotion during the therapeutic process — and ultimately alter reactions to daily experience at a level that words cannot reach. "The interest in this has just taken off," said Zindel Segal, a psychologist at the Center of Addiction and Mental Health in Toronto, where the above group therapy session was taped. "And I think a big part of it is that more and more therapists are practicing some form of contemplation themselves and want to bring that into therapy."

At workshops and conferences across the country, students, counselors and psychologists in private practice throng lectures on mindfulness. The National Institutes of Health is financing more than 50 studies testing mindfulness techniques, up from 3 in 2000, to help relieve stress, soothe addictive cravings, improve attention, lift despair and reduce hot flashes.

Some proponents say Buddha's arrival in psychotherapy signals a broader opening in the culture at large — a way to access deeper healing, a hidden path revealed.

Yet so far, the evidence that mindfulness meditation helps relieve psychiatric symptoms is thin, and in some cases, it may make people worse, some studies suggest. Many researchers now worry that the enthusiasm for Buddhist practice will run so far ahead of the science that this promising psychological tool could turn into another fad.

"I'm very open to the possibility that this approach could be effective, and it certainly should be studied," said Scott Lilienfeld, a psychology professor at Emory. "What concerns me is the hype, the talk about changing the world, this allure of the guru that the field of psychotherapy has a tendency to cultivate."

Buddhist meditation came to psychotherapy from mainstream academic medicine. In the 1970s, a graduate student in molecular biology, Jon Kabat-Zinn, intrigued by Buddhist ideas, adapted a version of its meditative practice that could be easily learned and studied. It was by design a secular version, extracted like a gemstone from the many-layered foundation of Buddhist teaching, which has sprouted a wide variety of sects and spiritual practices and attracted 350 million adherents worldwide.

In transcendental meditation and other types of meditation, practitioners seek to transcend or "lose" themselves. The goal of mindfulness meditation was different, to foster an awareness of every sensation as it unfolds in the moment.

Kabat-Zinn taught the practice to people suffering from chronic pain at the University of Massachusetts medical school. In the 1980s he published a series of studies demonstrating that two-hour courses, given once a week for eight weeks, reduced chronic pain more effectively than treatment as usual.

Word spread, discreetly at first. "I think that back then, other researchers had to be very careful when they talked about this, because they didn't want to be seen as New Age weirdos," Kabat-Zinn, now a professor emeritus of medicine at the University of Massachusetts, said in an interview. "So they didn't call it mindfulness or meditation. "After a while, we put enough studies out there that people became more comfortable with it."

One person who noticed early on was Marsha Linehan, a psychologist at the University of Washington who was trying to treat deeply troubled patients with histories of suicidal behavior. "Trying to treat these patients with some change-based behavior therapy just made them worse, not better," Linehan said in an interview. "With the really hard stuff, you need something else, something that allows people to tolerate these very strong emotions."

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