The Refugees of Mindfulness: Rethinking Psychology’s Experiment with Meditation

“Jill” is 32 and works as a lawyer in the southwest. She wrote to me explaining that during her meditation she sometimes feels a panic attack coming on and has disturbing mental images. She cannot control it and does not know what she is doing wrong. When we talk for the first time I ask her when it began. “It started a few months after my therapist taught me mindfulness…”

file000351809409Third wave Cognitive-Behavioral Therapy (CBT) is the marriage of modern psychology and ancient buddhist meditation. It has grown rapidly in the past decade, and many psychologists and meditation teachers are enthusiastic about the development, seeing it as a blend of the very best of eastern wisdom with western psychological science. Third wave CBT goes under a variety of names such as Mindfulness-Based CBT (MBCBT), Dialectical Behavior Therapy (DBT), Acceptance and Commitment Therapy (ACT) and Mindfulness-Based Stress Reduction (MBSR). There are also less structured approaches and informal sitting groups springing up in clinics across the country. It is the rare hospital or clinic that does not have a meditation group these days. This has resulted in a historically unique situation. Psychologists, medical doctors, social workers and counselors are rapidly becoming the vanguard of meditation in the west, introducing people who may have never meditated to the practice.

All these approaches have the common elements of CBT (recognizing and challenging maladaptive thoughts) and a version of meditation that goes under the moniker “mindfulness meditation” or sometimes just “mindfulness.” A review of the treatment manuals for DBT, ACT, MBSR and MBCBT suggest that “mindfulness meditation” is something close to a “soft-vipassana.” The person doing meditation in these treatment protocols is instructed to watch thoughts and feelings come and go on their own without judgment. This leads to the insight that one does not need to believe in, or act on, thoughts or feelings. This is perfect for CBT, which emphasizes the importance of thoughts and beliefs as the drivers of mood disorders. I call mindfulness meditation a “soft” version of vipassana because it stops short of instructing the person to see that everything in awareness is coming and going and is not owned. It also does not emphasize the kind of intense or rapid momentary concentration that marks some vipassana techniques. Instead, clinical mindfulness focuses on relaxation and gentleness (but not samadhi) and points the person to watch thinking and emotional reactions. I would argue that these differences are a very good thing because, despite popular opinion, traditional vipassana would be terrible medicine for a person who is emotionally distraught, unstable, and unable to cope.

That last sentence may be a bit shocking to some. If you are like most people, you associate meditation, all types of meditation, with happiness, relaxation, and maybe even bliss. The idea that it could produce difficulty is not only counter intuitive, it is anathema to how meditation is presented in the west. If anything difficult does occur during the meditation the meditator is likely to feel that they are doing something wrong. If he or she goes to a meditation teacher the advice will likely be to just “let it go,” “drop it,” or my favorite, “thank your mind for it.” This is patronizing. It gives the false impression that if anything distressing does occur during meditation, the problem is one of technique or reactivity on behalf of the meditator. In reality difficult experiences in meditation, ones that are remarkably similar to the symptoms of many mood disorders, are so normal that the most ancient surviving meditation manuals in Buddhism go into great detail about them, categorizing them into six distinct types that occur in a specific order. Far from being a sign of poor meditation, they are actually described as a sign of deepening insight. In other words, the most ancient manuals not only affirm that difficult experiences occur during serious meditation, they posit that these experiences are supposed to happen. They are a definite sign of one’s movement along what the famous Burmese meditation master Mahasi Sayadaw coined The Progress of Insight, and are known as the “dukkha nanas” or “insights into suffering.” This might sound bad, but the good news is that these more distressing insights only occur when one is well on the way and down the path. Meditators usually have to go through a lot of sitting time, develop strong concentration, and become very equanimous before they can enter into the later insights. For this reason it is unlikely that a soft-vipassana approach can get one very far beyond the initial insights and into the dukkha nanas. So in a clinical setting if you stick to the instructions and don’t overdo it, nothing unsettling is likely to occur. I do not believe mindfulness meditation is intentionally designed for this, but if it was it would be a damn clever modification of traditional vipassana.

Despite the limits of mindfulness meditation, there is a problem. A small number of people in clinical settings are unexpectedly good at meditation. With the barest instruction, some people are able to launch themselves deep into the rabbit hole of insights that vipassana is intended to produce. It is an experience that can be troubling and even destabilizing, particularly if one has no idea that it is coming. As third wave CBT has boomed in the past decade these people have become a significant minority in the meditation community. Introduced to meditation through therapy, they find themselves on an emotional ride to which they never agreed, encountering upheavals and difficult truths at the very moment in their lives when they are least able to handle them. That is bad enough, but much worse is that many of the well-intentioned clinicians who teach these techniques have no idea that anything troubling could occur.

Many of the developers of these approaches received their training in meditation through Zen, which eschews the more old fashioned stage-models of insight, and therefore does not formally recognize the predictable difficulties that arise (though every Zen teacher I’ve met is cognizant of them and is well-prepared to handle them). Additionally, for reasons too complex to go into here, traditional vipassana teachers in the west have elected to present the practice without much emphasis on the traditional stages of insight. And so, without intending to, they often leave the simplistic impression that there are no difficulties associated with insight, and that more meditation equals more happiness. The inspired psychologists who learn from these teachers come away greatly impressed with meditation, but with little to no knowledge of the dukkha nanas. They return to their clinics, offices and hospitals and find novel ways to integrate meditation into the treatments of unstable people. Most of these people get great benefit. Some have a different experience, one that is unsettling. And while many meditators may object to this characterization, pointing out that their own experience of dukkha nanas was not so difficult, I would argue that most people who go through it with little trouble are not in the midst of therapy or suicidal.

file1151340932146People who have had this unexpected experience are growing in numbers and are starting to share with each other and with more traditional meditators. They have come to call the dukkha nanas the “dark night” after the Christian experience (some teachers believe they may be in the same mystical family if not the same thing). They are sharing and seeking advice on internet forums and in settings such as the Cheetah House and Dark Night Project where they feel they will not be told to simply “drop it” but will be supported in gaining understanding. They are an unseen, and as yet unrecognized, growing minority of western meditators. Many have no sangha, no formal teacher, no texts or canon, no philosophy or anything resembling “faith.” They are frequently alone, searching the Internet for anyone like themselves, trying to sift through the overwhelmingly positive pitch for meditation for some nugget of information that can illuminate their experience. Like refugees with no home, they do not understand what is happening to them or why, and they often do not know what to do or where to go for help.

This issue is not abstract for me and perhaps my own experience will shed light on why I care so much. Two years ago I received the green light from my teacher to begin teaching insight meditation. I put up a website, told those who knew me what I was up to, and waited to see who would be interested.  While I made an effort to write in my own voice, which can be irreverent, what I presented was right down the middle vipassana. However, I did do one thing that was unusual and for which I am very grateful. I went against the common practice of downplaying the insight stages and instead put them front-and-center on the site. I did this because my teacher was clear about them with me, so I followed suit and was candid about them in my teaching. I made sure to include a rich description of the dukkha nanas and cautions to those who may be about to plunge into them. Unbeknownst to me this one gesture of understanding came to define my experience of teaching for the next two years, as the great majority of people who contacted me, and continue to contact me, are in the dark night. Most got into it through formal practice (amazingly, it doesn’t seem to matter much which technique or tradition). But I was alarmed when it seemed that a significant number, perhaps a third, learned to meditate from their therapist or from a group in a clinical setting. Sometimes they were actively suicidal at the time they learned to meditate. Interestingly, the majority never discussed their negative experiences while they were in therapy. Like the therapists themselves, they wanted to believe that meditation was helping, and so they dismissed what was occurring or blamed it on the thing that brought them to therapy in the first place.

As a psychologist this is more than a bit embarrassing, it is troubling. It is one of the ethical principles of psychology that no intervention is done without fully explaining the risks and benefits of the treatment. If an intervention could possibly cause distress, even mild distress, psychologists are ethically obligated to inform the person of this possibility and gain their informed consent before proceeding. Psychologists are not doing this when it comes to mindfulness meditation, chiefly because they do not know there are risks. But more and more people who have participated in it know that there are. This is not a situation created by malice, but by ignorance. Psychologists simply were not told this could ever happen, and were given the impression that the results of meditation were exclusively happiness, calm, and increased wellbeing. They are not to be blamed for this situation, as they have merely borrowed a problem that already existed in the way meditation was being taught to students in the west. It is a problem that continues and in some ways defines what “mainstream” meditation teaching is in the west.

While this is not psychology’s fault, it is only a matter of time before the consequences lay squarely on the shoulders of psychologists who teach mindfulness meditation. Sooner or later, those who teach it will learn about the progress of insight and the dark night. Either from writings like this or from patients themselves. When they do they will face an ethical dilemma about whether to continue teaching meditation in clinical settings. While meditation teachers can essentially “get away” with not telling people about the dark night, psychologists do not have this luxury. Ethically, we are obligated to acknowledge the risks and be cautious. This is not happening yet, but it is my sincere hope that those enamored of third wave CBT will examine not only the manuals and the studies, but look deeply into the descriptions of insight in the pali cannon. Even better, talk with meditators who have experienced a dark night, researchers who study it, or best of all dive into it and see what it is like. Psychologists might benefit most from going beyond mindfulness meditation, breaking loose of the manual, and seeing how far this practice can go. Then there might be more respect for the powerful, and sometimes life-shaking, changes that vipassana can create in the heart and mind. It is my hope that psychology will soon lose its infatuation with meditation, and begin to evaluate it as a tool for change in a more mature light, seeing both the promise and the dilemmas. Until this happens I expect the community of mindfulness meditation refugees to grow.

About Ron

To learn meditation, no matter where you are in the world, just send an email to: alohadharma@gmail.com

Posted on July 23, 2013, in buddhism, Meditation, Mindfulness, psychology, Uncategorized, vipassana and tagged , , , , , , , , , , , , , , . Bookmark the permalink. 54 Comments.

  1. Reblogged this on Beyond Meds and commented:
    I talk about this stuff quite a lot…though I don’t think it should dissuade anyone from practicing meditation…people need to be aware…

    See my archive collection on the topic here: Meditation, not all bliss and roses.

  2. Thanks Ron,
    I think it was Atcha Chan who said something to the effect of until you have shed a tear, your meditation truly hasnt begun. Dr. Elisabeth Targ also wrote about this issue.
    Jim.

    • Jim – i loves AC’s candor. Reading his talks is always an inspiration and shows just how one can be both profound and down to earth. I’ll check out Dr. Targ – thanks for that lead.

  3. This could also be a sign of other things – what I have found personally is that if you have unresolved ‘stuff’ especially stuff that is from trauma, the energy from meditation (esp after crossing A&P) can often move around until it finds a trigger point in the body for the trauma and keep triggering it over and over. I’m starting to think that meditation should be step 2 or 3 in the average person’s path of growth, with Psychotherapy, Somatic Experiencing and possibly in the future neurofeedback therapy (like zengar), just so people can be ‘ready’ to meditate. We can’t avoid problems but I would like to think we could help prevent some issues.

  4. Thank you for writing about this situation. I know from personal experience that even the best and most wonderful spiritual techniques can be fraught with danger for some.

  5. Reblogged this on Social Work Unplugged.

  6. Har-Prakash Khalsa

    Great article Ron.

    So what would you suggest to the average person who is considering meditation classes, or going to an intensive re what to look for re when meditation might be contraindicated? Should there be a kind of standardized intake form that people should fill out before venturing into meditation? What kinds of meditation approaches seem to be contraindicated and should be tagged as buyer beware for what kinds of people?

    This Leigh Brasington interview starting at 2:11 https://vimeo.com/61893225 begins to address the issue “at the start of every retreat I teach I warn students that if you have unresolved psychological issues…”

    Thanks for taking on these important issues.

    • Hi Har-Prakash,

      I’ve thought a bit about what a “best practice” would look like for both psychologists and for meditation teachers, and it would be something along the lines of what you are suggesting. It would suffice for teachers to give a warning (like Brasington’s) and as part of it point out that certain problems are not a good match with vipassana, including ongoing moderate to severe depression and panic disorder. Encourage students to seek you out for a private consultation if anything like that is currently going on for them or if anything unusually distressing comes up while meditating. Teachers should also do a bit of screening on retreats, and they do for Goenka retreats, but people often are not truthful because of stigma. It is best to simply ask students in private if you suspect anything. Psychologists on the other hand need to be a bit more detailed about the situation. At the beginning of therapy there is always a point at which the therapist goes through a standard set of disclosures and warnings, explaining what the treatment entails, what the commitment means for the person, and if there are any risks what they are and actions to take if they arise. I imagine a day when psychologists include the meditation component in this section, explaining that, for a small but undetermined number of people mindfulness meditation can not only create calm but can evoke the following… and give the person a handout describing the progress of insight that you go over together.

      But really it all has to start with psychologists and other mental health providers simply being aware that this is real and should be a consideration. At this point they don’t take it seriously. I’ve given several presentations to groups of psychologists and psychiatrists. All of them were fascinated with the information, thought it was thought-provoking, and a month later not a single one had made a change to their practice. Taking it seriously is the first step. That is why W. Briton’s research is so important.

      I would also stress that I’m really only talking about vipassana or vipassana-related meditations here, that is, those that are aimed at disrupting the normal process of identification with the flow of of thoughts, emotions and sensations. Concentration practices seem to be more stabilizing, as a contrast (though some teachers may disagree).

  7. Paradigms shift slowly, unless they shift violently.
    If the teacher cant understand the lesson, how can they educate?

  8. Thank you for this, I am pleased to have found your blog. As someone who spent many years working through my own dark night and who has struggled with meditation and mindfulness I have learnt alot about myself through the practice over the years but it has not been an easy, peaceful path – in fact at many times I have met my own anger, fear, confusion and it has been a terribly frightening experience…..I had to seek out information myself and felt quite isolated and alone in doing so. It then concerns me that so many people I work with (as a mental health support worker) have been “taught” in 3 easy steps how to do this by well meaning? but inexperienced pysch professionals who have no idea of the potential for extremely frightening outcomes for unwell people attempting this. There is a huge difference between practice in well people and those like myself with problematic psyches.

  9. excellent article, Ron! here’s to hardcore dharma! :)

  10. Reblogged this on unclouding and commented:
    This was so good and dead-on that I have to reblog it.

  11. Here is an example of how a wonderfully competent teacher handles this situation: http://youtu.be/BQ5B70ac_9M

  12. HI Ron,

    I just discovered your site thanks to a friend on FB who posted this article. As a trauma survivor, I’ve spent much of my life in and out of therapy and have attempted to work with many modalities from both eastern and western traditions. I’m also the ED of a non-profit that provides healing support for male survivors of sexual violence.

    I am very grateful for your post here, because it speaks about a common problem that many trauma survivors experience. The process of mindfulness meditation as a CBT tool can be very helpful to help break cycles of repetitive and/or obsessive thought, but it is not in and of itself a solution to the problem for most people who battle PTSD, or trauma related anxiety and depression. And for some people, it can seriously destabilize someone who has not built up a strong enough foundation of self-regulation, trust, and safety in their own day to day experiences.

    Many of the survivors that I speak with have shared with me that sitting meditation is very difficult for them, precisely because it can open them up to recall of awful memories and emotional places. (This is one argument in favor of EMDR and other modalities that incorporate techniques to “break up” our focus on traumatic emotions and memories through artificial physical stimuli.) However, many times the therapist/practitioner/leader who is incorporating mindfulness techniques is not cognizant of the depth of the pain that can be unleashed and can be unprepared for this if they are not well trained in trauma informed practice.

    I passionately feel that survivors need permission and encouragement to shape practices to their own specific needs. For example, recently (after watching Andy Puddicombe’s TED talk) I’ve taken to juggling for 10 minutes a day as a part of my self-care routine. For me, this is proving to be a very effective way to practice mindfulness meditation within a limited context, and it has the added benefit of being a source of “fun”, and physical activity. While I certainly recognize and acknowledge this is not “traditional” meditation, it does enforce a milder type of focus and mindfulness of the present moment. It’s also a great way to focus on one thing (the juggling), which frees me up to let all other thoughts and emotions “flow” through me. I also recognize that this is a great tool for me, and while I think it’s possible that there may be other people who could benefit from juggling as a form of “lite-meditiation”, I’m not in any way suggesting this is a panacea for all survivors.

    Chris Anderson
    Malesurvivor.org

  13. Thank you. I was assaulted by 41 men between the ages of 11 and 17. I used to meditate quite regularly, but had been doing a physical relaxation technique for most of my adult life prior to, and during the doing of meditation. Perhaps that relaxation allowed me to meditate deeply, but I’ve always been able to “let go” physically. Unfortunately, I found that after only a short time doing meditation, all of the pictures of the facts of these men’s behaviors came flooding back into my mind like a never-ending movie in 3D. I stopped meditating just because of that. I occasionally do a little meditation, but only after not sleeping: just to refresh energy. And I only do it if no pictures and memories come up. It is just too depressing to pretend that this activity will make me happier or help me get over the fears. Seeing it again and again just reaffirms the horror of their actions against my body and soul. Forgetting is a stupid notion anyway; but constant reminders is possibly more stupid.

  14. Good day! Would you mind if I share your blog with my facebook group?
    There’s a lot of folks that I think would really appreciate your content. Please let me know. Thanks

  15. I realize I am joining this conversation somewhat lately, but your article struck a chord for me, although almost certainly not the chord you intended. I have personally practiced Zen mediation for over 25 years, and have also worked in clinical mental health settings for about 15. I’m also pursuing an advanced degree in contemplative psychotherapy. I lay this out at the start, just so that it’s clear; I know from experience a little of what is being discussed here.

    While it is true that some might experience developing insight as a potentially unsettling or distressing experience, this is always a transient phase that a skillful therapist or teacher will guide a student through. It is necessary. It is not, however, inevitable. Many, if not most people who use mindfulness techniques also experience a tremendous sense of relief as insight develops. This only stands to reason. As it becomes increasingly clear that the internal dialogue that our culture has convinced us is the “self” is not REALLY coming from a “self”, but rather conditioned thoughts, feelings, and behaviors, a person become LESS distressed.

    All psychotherapy carries the risk that a person will learn something about themselves, or their world view that shakes up deeply ingrained beliefs and maladaptive behaviors… that is precisely what psychotherapy is designed to do. A warning label may be an ethical necessity, but if so, this extends to everything a therapist does, not just a specific technique that an individual practitioner specializes in. The idea that mindfulness practices are any more dangerous than other psychotherapeutic technique seems highly suspect to me. It certainly should be supported by some empirical study.

    • Thanks for the thoughts. I understand where you are coming from, in that this is a position that I came to reluctantly. Initially I embraced MBCBT and similar approaches. I love meditation and I love therapy. They are both big parts of my life. What could be better than the two together? I wish it were different.

      For the record, I don’t think that meditation should be removed from psychotherapy. Instead, there needs to be a broad recognition that the dukkha nanas are real, a profession-wide conversation about what that means for therapists and clients using these techniques, and some standard of best practice for how to address them in treatment if they were to arise.

      I simply disagree that skillful therapists could guide someone through the dukkha nanas and into the higher insights of equanimity, path, and fruit, where relief can be experienced. Therapists, for the most part, do not even know that “stages” of insight exist, and if they did they would not be qualified to guide someone through them. Claiming to have this competency as a psychologist would be unethical. I think with the training you are pursuing, you would be qualified. But that is rare compared to the many psychologists and other professionals teaching meditation.

      I also disagree that these insight stages, as they are described in the Visuddhimagga, are anything like the “insights” one gets in therapy. They are the same word, but that is just about all they have in common. It is like equating the mouth of a river to the mouth of a person. Equating the dukkha nanas with the kind of distress that comes up when examining one’s life in therapy is a very common view, but it is very inaccurate. Meditative “insights” (nanas) and psychological insights are worlds apart. The sooner this view can be adopted by the profession at large, the sooner a more thoughtful approach is possible.

  16. Hi Ron-
    Great article, really nicely put.
    There are a bunch of resources on this topic at http://www.cheetahhouse.org, as well as a description of the “Varieties of Contemplative Experience” research study.

  17. I really value this exposition: it’s so important to draw back the Pollyanna veils where we can.

    But I’m puzzled as to how a therapist committed to Buddhism would avoid a tautological loop here. The dukkha nanas are posited as existentially inevitable. At what point does the meditator’s awareness of this positing begin to needlessly produce the anticipated results? When we make claims like “Disgust is a clear insight into the unsatisfactoriness of the body and mind” (taken from your description of the dukkha nanas), how are we sure that the disgust isn’t a product of the *idea* of the unsatisifactoriness of the body and mind — an idea that permeates the entire discourse? What leads us to call it “disgust” instead of “shame”, besides the history of translation of the Pali, which itself is a translation from early Buddhist oral culture?

    Simply put: could the Dark Night not be at times a meta-state? How would we know?

    • Thanks for your feedback – it is really valuable. Let me clarify that I am not religiously Buddhist. I try to make that clear on the site as much as I can, but I still get confused with religious teachers. I teach only one thing – awakening through insight. Buddhism has the best technology for that, but if there were a better way I would jump to it in a second. My commitment to Buddhism is out of pragmatism, not piousness.

      The only way to know for sure whether you are actually experiencing a nana or simply scripting it is to work with a teacher and check in weekly or biweekly (daily is optimal if you are in retreat). Teachers can tell the difference in the same way that a person who has hiked the appalachian trail can tell whether you actually hiked a section, or simply read about it, by talking about it with you. There are a lot of things, small things, that aren’t in the descriptions that make it crystal clear. If you are just doing it on your own, and self-diagnosing, then yes, you’re likely to script or get lost in some idea. These things are not ideas anymore than catching a cold is an idea. If you are experiencing it at the moment and describe it, then someone who has been through it can tell.

  18. Hi Ron,

    Thanks for the article. The public and therapists def need more education on this. One step in the right direction will be to start disattaching mindfulness from the 3rd wave CBT models. CBT is only one very limited form of therapy and “mindfulness-based therapy” might be a better fit in some of the models that take suffering and tragedy head on and don’t merely try to avoid/eliminate them.

    For the record, I’m a therapist and meditator and don’t consider myself in the realm of the 3rd wave CBT models. I have no problem with them, and know they help a lot of people reduce suffering. I just think we need to broaden the scope of how therapy and mindfulness can interact and in doing so we’d naturally come to deeper insights (as a field) about the very real issues you’re discussing. Keep up the good dialogue.

    Sam

    • Hi Sam,

      Thanks for the encouragement. I’m a CBT therapist and so I’m most familiar with those models, but I have heard from colleagues of mine that work in other frameworks that mindfulness is coming into vogue in a trans-theoretical way. I’ll be very curious to see how it all turns out. In the meantime, those who know about the vipassana insights and are working in the psychological community need to be vocal and urge more caution and thoughtful engagement.

      Ron

  19. I think it is important to use the best treatment for the patient, not the one most used by the therapist. There are many other meditations that use a gentler entry that are beneficial to psychotherapy. Counting meditation, walking meditation, loveingkindness meditation, etc.. Sometimes there needs to be a focus, a concentration to the mediation. Then a transition to a more in-depth mediation could be handled. Those who are new to meditation have difficulty with free-flowing thoughts, you don’t have to have a mental illness for this to occur. As someone who suffers from PTDS and as a Buddhist, I had to bring back my meditation to a simpler state or I wouldn’t have made it through 2 minutes.

    • I strongly agree with you James. The issue I’m raising here applies specifically to the kind of meditation that is going under the label “mindfulness meditation” in clinical settings. Concentration meditation and metta meditation do not have the same effect and I have yet to learn of anyone experiencing anything like a dukkha nana when doing those kinds of meditation. I recommend those meditations to everyone and often recommend metta to patients of mine who are struggling with depression.

      I was recently interviewed about this very issue and had an interesting discussion about how different kinds of meditation are better suited to different issues. The full interview can be found here:

  20. Ron,
    I have learned in my practice that the unconscious will come in during the process of meditation. The issue for me is to learn to trust the process that Ggod has in store for me.
    I mistrust any process that seeks to teach anyone how to ‘look’ at their own mind in any sort of formal structured way.
    Thanks for bringing this issue to us.
    Jim

  21. Hi Ron,
    I currently wonder if all those problems would be solved if ‘mindfulness meditation’ in these contexts would be exchanged with the practice of Metta. Do you think that would work, or does it have similar dangers?

    • I think it would not have the same problems associated with it because the main ingredient of vipassana (deidentification with things that are coming and going in the mind and body) would be missing.

      In my capacity as a psychologist I have taught people metta meditation and am very pleased with the results. It seems like a good alternative.

  22. “Many of the well-intentioned clinicians who teach these techniques have no idea that anything troubling could occur?” – That’s simply not true. The opposite is true. Therapy is there in order to help people allowing to feel negative feelings and then learn to live with them. It’s the exact purpose of the therapeutical setting that they should feel what’s troubling them.

    • The problem seems to be you think from a Buddhist paradigm, speaking about ‘nana’s’ etc., which apparently are part of your belief system. Psychology and mindfulness sees only suffering, no nana’s and ‘deeper’ or ‘higher’ kinds of suffering. – Third generation of CBT doesn’t have buddhist metaphysics at its core. It uses awareness, which is auniversally human capacity. Awareness can be rather disturbing for those who are mentally ill or have major issues and are confronted with what’s going on inside. This has nothing to do with metaphysical dangers.

    • Hi Bernd – I meant that the therapists have no idea that anything troubling could occur from the meditation itself. I am a psychologist, and we are always aware that talking about distressing things can be…well…distressing. But when therapists get training in mindfulness-based techniques, they are not, as a general rule, told that the meditation itself can be distressing. Most believe that more meditation equals more peace and contentment. It just isn’t so.

      When you point out that psychology doesn’t see things like “nanas” (which is just the pali word for “insight” or “knowledge”), you are pointing to exactly the problem. Nanas are not things that one believes in, they are states that come up when you do vipassana. They come up whether you know they exist or not, and have nothing to do with anything personal about the individual or their particular story or trauma, anymore than getting an elevated heart rate while running has anything to do with one’s personal story. They are just a natural development that people go through when they meditate in this way. So talking about them as a belief system is a bit strange to me. I don’t have a belief system in nanas anymore than I have a belief system in common colds or adolescence. They are descriptions of something, not beliefs.

      The problem is that they seem so strange and foreign, and so they are not discussed and psychologists are largely unaware of them. Teachers avoid talking about them for a number of reasons, but it leads to a kind of blackout on this very important information. Part of what I’m trying to do is raise awareness about them and the fact that they are real, and help people start to consider the implications for therapy.

  23. Ron – thanks for beginning a dialogue on this (evidently divisive!) subject.

    I am not involved in any formal capacity with the psychotherapies or meditation practices, but I have extensive experience of the former as a “patient”; and, tellingly, have always instinctively balked at formal meditation practice, precisely because I am aware – and was aware very early on – of its potential to kindle unmanageable experiences.

    Indeed, I am a “non-religious seeker” who is engaged with life on two levels (which are really one): Firstly, from the perspective of trying to resolve “trauma” via some therapeutic means (generally psychotherapy, which I have now eschewed entirely – could write an essay on my reasons); and, secondly, from a wider “Truth seeking” perspective.

    The latter has always been coloured by and provoked elements of the former; and the former depends upon – and I am totally convinced of this – the latter. Let me elaborate…

    If a person REALLY wants to completely resolve extremely overwhelming trauma, they aren’t going to do it by healing a rift in the phenomenological self. Trauma at this level is usually caused by the self being almost wholly overwhelmed or “short-circuited” at some time; and we all know that the one thing the self is hell bent on is remaining in charge.

    Long term meditation – even something as “benign” as mindfulness – aims at the eventual detachment from the self; or the Realisation that one is not the self and never was – that one is ******* (insert your own word for the indescribable). This is what every form of meditative practice was developed to induce, as far as I am aware. The idea of it being an END – a thing which resolves a dysfunctional self into a functional one – is an entirely Western idea, and has led to the very problem you describe. It is much the same as the Western psychotherapeutic idea of “self-realisation” being the realisation of the “true” phenomenological self – a self that one never was in the first place! Self-Realisation is actually another Eastern tradition, and if one reads descriptions of the Self to be realised in the Vedic texts, for example, it is clear that it is not a more integrated version of the ego-self!

    So – taking into account the fact that traditional meditation is designed to gradually undermine the identification with the ego-self, and then add to this fact the probability that people with unconsciously repressed massive trauma have already had a shocking introduction to the possibility of the ego-self being shattered, and you have a recipe for some serious problems.

    However, as I believe you are trying to point out, it is only really a problem due to a lack of awareness of how quickly and how deeply one can be immersed in the deepest recesses of the psyche; and let’s not forget that we have inherited millions of years of “psychology”, from survival needs to bonding needs. Any challenge to the structure is going to be felt as traumatic, I would suggest. But these need not be seen as problems if it is understood that such potentially massive and long lasting issues (and another Western problem is the down-playing of the severity of the “Dark Night” – my God, have you read St John’s descriptions!? It’s not an episode of the existential blues!!!) may actually be a type of passage, then more may done to provide the support and space for such a passage, instead of it being met with terror, impatience, pathologising diagnoses, or a compulsion to medicate.

    So – to conclude – I guess I’m saying that if a therapist aims to help someone to rebuild a functional or more adaptive phenomenological self, then dealing with people for whom this is impossible (as I know is the case for myself) is potentially going to worsen their problems, as eventually they will either encounter a worsening of their “symptoms”, or – if not managed correctly – they will become hopeless and disillusioned as yet another “helper” fails to understand what is happening to them.

    I sincerely hope your message is heard loudly and clearly so that there may be safe, resourceful (and well-resourced…) havens for such genuinely troubled – and potentially very fortunate – people…

  24. Hello my name is khemin, and I have been a consistent meditator for thirty years, and have been on many retreats and lived and worked in a retreat centre for many years,
    I am currently teaching meditation in india and Sri Lanka. ( a little bit about this energy i call me)
    I read what you had to say about meditation, and of course you are absolutely correct, the main focus of meditation is enlightenment, that is crystal clear, it’s not about, feeling good or some sort of temporary happiness,and I thin meditation has been somewhat hijacked by the “lets all feel soft and lovely”which of course is ok, but it is self deceiving and does not have much basis on reality, and does not last.
    The language of meditation has become soft , like a cuddly toy, we forget the Buddha came from a warrior caste and meditation is a courageous thing to do, it’s not a soft option.

    After saying all that, I do believe that all we can do in meditation is to set up conditions for something to arise, we cannot force anything to happen and that usually comes from a very relaxed opening up and a gentle persistent effort, and sometimes the effort of just letting go.
    So I can see why we have meandered down this road, of softly softly.

    I have not really experienced the dark night, , I am sure it is like that for some people, but I believe if you have a good grounding in Samatha meditation and not in such a hurry to get on to vipassana ! ( and of course insight is the real way forward ) think the dark nights are much more less disruptive. The change is more gentle, the tortoise instead of the hare.
    I can only speak from my own experience, I have changed enormously over the years, ( not how I always wanted it to go) but I look in my rear view mirror, over many years and I have more compassion and I am more content, and of course I feel uncomfortable at times, if we are moving out of our comfort zone it is inevitable.
    Thanks for your comments khemin.

    • I agree totally with this! If one has good concentration meditation then vipassana is much smoother. The joyous nanas are full of less craving and the suffering nanas are full of less aversion. There is more equanimity overall, and greater peace.

      That being said, some people struggle for years (sometimes decades) with developing concentration, and the question we much ask ourselves as teachers is this: how much is enough? How long do we encourage concentration and forestall vipassana? It is not an easy call to make, I think, and it needs to be assessed on a case by case basis.

      The bigger issue is that very few people in the mindfulness movement is even aware that these distinctions exist, and do not understand how difficult and life-changing these practices can be.

  25. I haven’t read all the discussions but you make a good point in the blog Ron.

    My dissatisfaction with secular mindfulness interventions overlaps and is probably complementary. I don’t think mindfulness on its own “works”. It is Insight that heals and you need all 8 parts of the path to develop that. You can’t really talk about things like Right View or Right Livelihood in a secular clinical setting. It is inappropriate.

    This is also a bias of internet discussions. People tend to only talk about meditation. The Buddha didn’t say go meditate he said go follow the 8 fold path. All traditions also contain the 5 training precepts but these are conveniently forgotten when we get secular! Our economy is built on stealing, killing, lying, fornicating and boozing to a greater or lesser extent. How popular would mindfulness be if we mentioned these? You can forget the dark nights putting people off ;)

    I like Thich Nhat Hanh’s “interbeing” as a way to start dealing with Right View and leading on to ethical conduct and mindfulness. It is inspired.

    These two blogs may be of interest in relation to this secular stuff:

    http://www.hyam.net/blog/archives/1419

    http://www.hyam.net/blog/archives/2000

  26. Good article; I’ve often wondered about people like myself whose deeper meditations have led them not to bliss but to an even darker night.
    I’ve been concerned about the widespread use of CBT in the UK for depression, both unipolar and bi-polar, when my own experience of using my own explorations have led me to greater distress and not relief. In the UK, there seems to be little true support for those who experience the dark night, and an overall emphasis that you’re not doing it right.

  27. ethan davidson

    It is highly nieve to think that meditation will not bring up underlying sufferering. After all, the Buddha’s first teaching is that “all life contains suffering” and meditation was intended to help people realize that on a very deep level. That one eventually becomes happyer for knowing this does not mean that there will not be pain along the way.
    I went an eight week vipasana retreit. I had experienced blissful states in meditation, but the vipasana instruction to keep coming back to my body seemed to block me from having more. What came up instead was trauma. The highly painful experiaanced experences I had had remained lodged in my body, and once my concentration increased sufficeintly, I was forced to relive them. In the course of things, I developed more compassion, because I saw that other people also had tramas lodged in their bodies and that causing them pain created more. I evetulally did experience bliss. But that dosn’t mean that I can always go back to it. Another Buddhist teaching is that bliss states arising from meditation are temporary, are just another example of impermanence.
    But yes, one sometimes aproaches the doors of madness, and you have to be relativly well wrapped to undertake the journey. And if you fell that any suffering you experiecne is your own fault, you not only will increase your suffering, you will have enitrely missed the point. Which is that it is nobody’s fault. It just is.

  28. Hi Ron,

    Thank you for this interesting and thought-provoking article! I am a bit confused abut a couple of points, and hoping you could clarify things for me.

    First, is Samatha aka Zazen aka mindfullness meditation not qualitatively different from the contemplative practices of Vipassana? I ask this as a Zen practitioner who has no direct experience with Vipassana. As I understand it, Samatha is meant to calm the mind, expand awareness, and create the conditions necessary for the development of wisdom and insight; whereas Vipassana uses specific contemplations meant to generate insights into the nature of existence.

    As I understand it, the dukkha nanas described in the Visuddhimagga can be expected to occur as one engages in Vipassana practices. But is it not a bit of a jump think that they (the dukkha nanas) would also be expected to occur for practitioners who choose Samatha / mindfulness meditation / Zazen as their primary practice?

    Just to be clear – I agree with the premise of your article: that painful, disturbing thoughts and images will arise during the course of one’s meditation. And it goes without saying that the more fragile, vulnerable, or unstable a person is, the more thrown off they will become when the difficult stuff arises. Furthermore, I think that there are certain conditions (such as psychotic disorders and severe PTSD) which would contraindicate the practice of mindfulness meditation altogether. I’m just not quite sure that the dukkha nanas should be considered unavoidable to those practicing Samatha/ mindfulness meditation / Zazen. What do you think?

    My second question has to do with the dukkha nanas themselves. Are they described in any texts directly attributable to the Buddha? I was not able to find any description of these in the anthology I have (“In the Buddha’s Words: An Anthology of Discourses from the Pali Canon,” Bhikkhu Bodhi ed.) Is the Visuddhimagga the only text where the dukkha nanas are described and explored?

    Thank you for your thoughts and insights!

    Greg

    • Hi Greg – I don’t go into the Zen or concentration practices in the article because it would have gone from an essay to a book if I had gone there, that is why it isn’t covered. But you are right. The effects of those kinds of meditation are very different from vipassana. If you use the analogy of medicine, each type of meditation is like a different medicine that has very different effects. If you do concentration, the effects are that you feel tranquil and focused. If you do vipassana, things get sped up quite a bit, and it feels far more turbulent.

      The problem with what is being called “mindfulness meditation” is that we just made it up out of thin air in this country. You won’t find it anywhere in any tradition. It pulls elements of vipassana, concentration, and other stuff and jumbles them together. And depending on what program you learn it from it could be mostly concentration (you feel really calm) or mostly vipassana (here come the nanas!). It’s actually a big mess.

      As far as the doctrinal question, you are right again. The Buddha said nothing about the nanas. Some people look at that and go – right, they’re bunk! But the problem is that he also didn’t mention a lot of things that are found in Zen, Tibetan Buddhism, Chan, etc. But yet people flourish and awaken with those practices and those teachings. My view is that it is not very healthy to be too strict about whether an awakening practice was taught by a religious figure or not, by a founder or not, etc. Not that you are doing that at all – but a lot of people I talk to do exactly that. I consider it analogous to ignoring Hubble deep space data because it wasn’t discovered by Galileo.

      I hope that helps to clear thing up, or at least share in the confusion.

      Ron

  29. Ron

    I just came across your post on MBSR and the mindfulness based therapies Great stuff! Its very refreshing to hear from someone experienced in practice, who also has an understanding of need for a psychological understanding of mindfulness. And of course an awareness of the issues you have raised is important for those involved in trying to teach mindfulness in the context of therapy, or as a self help approach. Thanks.

    I occasionally run brief workshops on mindfulness for therapists and have had people approach me asking about strange experiences they have had when on retreats. What is really worrying about this is that the people running those retreats didn’t seem to have any idea about what was happening, or how to offer some reassurance. Your bringing up this topic is certainly valuable.

    I hope you don’t mind if I make a few comments on some aspects of your post that I think could do with some clarification. Ok, I may be just a wee bit pedantic about this stuff.

    I fully agree that a “soft vipassana” approach is generally taken in practice by many therapists. I don’t think this is not necessarily due to the requirements of, or theoretical basis of the different therapies, but rather reflects the cultural influences on those the therapists. Often this is because of the predominate vipassana/insight influence on those involved in MBSR, and MBCT, and the fact that a lot of writing by those with interests in, or initial training in those approaches gets disseminated under the term mindfulness. I also suspect, as you have suggested, that this approach reflects the level of knowledge and experience of traditional mindfulness training of many trainers of mindfulness teachers.

    I think that another strong influence is that fact that most therapists using these approaches are trained as cognitive therapists. It is hard to shake off the common sense model of therapy which assumes the primacy of thought, and the importance of thought control. An exception is ACT of course, which has a theoretical rationale for not using thought control techniques, and as the name implies encourages a full acceptance of (i.e. fully experiencing) many unchangeable aspects of experience. I think it is important to note that ACT does not typically involve the challenging of thoughts as the other CBT therapies tend to. This marks it as unique among the modern extensions of CBT.

    I know your post was a general one, nevertheless I think it is important to be aware that not all therapists, and certainly not all therapies follow the “let it go” or “drop it” approach to dealing with experiences that come up. Again, I think this relates to therapists own experiences of meditation, and the theoretical model they are coming from. One of my own concerns around the widespread use of mindfulness is that, at least in my experience, many therapists don’t really embed mindfulness in a coherent theory of practice. Therefore it can get a bit waffly. It isn’t dharma, and often it isn’t really psychology either.

    I was surprised at your comment that many of the developers of the mindfulness based therapies had their meditation training in Zen. My understanding is that this isn’t so. I understand that Jon Kabat-Zin was initially a Zen student, but also was involved in Vipassana style practice prior to starting MBSR. In his writings he has said that he asked his Vipassana teacher for permission to teach mindfulness in a course for the public which suggests a big influence there. In addition, I believe that the American “insight” approach is very evident in the methods of teaching of most MBSR teachers. I once asked a senior MBSR teacher and researcher why this was, and why the Zen influence was not more evident in MBSR (I was assuming that JKZ had been a Zen student). They attributed this to the influence of the Barre Centre (insight meditation), which was “just down the road”, and that basically that was all the MBSR people knew.

    Of all the other mindfulness based therapies I am aware of only Marsha Linehan, the main developer of DBT, as having had and significant Zen training. Apart from the underlying theme of holding the dialectic which may have been influenced by Zen practice, I see little of Zen in the DBT programme. DBT, like MBSR, was developed quite some time ago. I suspect that Dr Linehan, and Dr Kabat-Zinn were quite young practitioners at the time they developed their programmes. It would only be natural that their practice would have matured over the years. For example, Dr Linehan is now recognised as a teacher in Zen tradition. Ten years or more can represent a considerable amount of time in the training of a Zen student. I have wondered from time to time, given the extra years of practice, and the advances in the literature what Dr Linehan, or Dr Kabat-Zinn might come up with if they were to develop their programmes now.

    I have raised the points above not to quibble, but because I think that a clear history and analysis of mindfulness based practices, and where they came from is necessary for the development of a good psychology. There is more than enough myth and confusion over these issues at the moment, and you have pointed out some of these. Anything we can do to reduce the confusion will hopefully lead to a more helpful, and evidence based approach to what can be a very useful, and possibly even liberating practice. :)

    Thanks for the very interesting blog, and website. I look forward to reading more.

    Jim Hegarty

    PS I was just reading your response to Greg, and Zen meditation isn’t a concentration practice. I don’t know why people keep saying that.

  30. Ron,

    I am a psychologist who has done meditation on and off for more than 25 years. I have been fortunate to have good teachers so I am very familiar with the Dark Night. Recently, I have become interested in third-wave therapies such as ACT and DBT. I do not have the impression that ACT actually involves extensive meditation practice and that ACT can handle the stuff that comes up. I do not know much about M-CBT, however. Your thoughts?

    • My understanding is that ACT involves numerous “mindfulness exercises” some of which look a lot like the beginning instructions for vipassana (essentially – calm down, watch what is happening, stop identifying with it). However, there is no emphasis on establishing a formal meditation practice per se, one is instructed to use the exercises to de-identify with thinking, a process called “de-fusion” in their manuals. The iterations on CBT are different in that they seem to more deliberately incorporate formal meditation practices. For example in “The Mindful Way Through Depression” there is a CD of guided meditations and the person is recommended to engage in these practices regularly. My impression is that there is more of a risk of running into DN if someone takes such instructions and engages in them diligently for lengthy periods. Unfortunately, there is no mention of the progress of insight in the book.

      • Ron,

        I agree with your assessment of mindfulness in ACT. Good point about MBCBT.

        DBT involves a lot of face and phone time so it seems to work out okay. Would you agree?

        Maybe the DN risk is mostly associated with MBCBT, not with other third wave psychotherapies. Your thoughts?

        Craig

        • My impression from the folks that I have worked with who were taught mindfulness in therapy and got into the DN is that although it can happen during treatment, more often it tends to happen after treatment has ended. These people keep meditating, doing the practices on their own, and after a long enough time getting better with the practice, the insights start arising. Then they are without a therapist and often without a teacher.

          You are right about DBT. It is an excellent treatment in that it gives the person a lot of support and good skills (I often refer people to DBT therapists), but it would be great if there were some kind of warm hand-off to an insight teacher for those folks who choose to keep meditating after treatment ends. That way if things get disturbing there is someone who can guide the person.

          Let me clarify that I do not think that mindfulness should be removed from the treatment options that people have. What I’m advocating for is a broader recognition among therapists (and ultimately patients) that these techniques were originally intended to be used in such a way that they create state changes that are predictable, repeatable and well-documented, and that the states are sometimes disturbing and contraindicated for the person in treatment.

          I think there are good reasons to continue using mindfulness in treatments, but the current problem (as I see it) is that it is not very well informed by all the the thousands of years of carefully documented experience and explanation. Those who pioneered these techniques left us an amazing wealth of information on what they do and how they impact the psychology of people over time, it is a shame that so little of that information is being used in clinical settings. However, it is my opinion that a change is starting to happen.

  1. Pingback: Refugees of Mindfulness | Meditation Los Angeles

  2. Pingback: ‘Opiate of the masses’ and other criticisms of mindfulness

  3. Pingback: The Dangers of Meditation. Advice for Meditators. An interview with Leigh Brasington by Willoughby Britton. – Tibetan Buddhism :: Struggling With Diffi·Cult Issues

  4. Pingback: Overcome These Five Obstacles to Your Mindfulness Meditation Practice – PsychCentral.com (blog) | whatsmindfulness

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

Follow

Get every new post delivered to your Inbox.

Join 400 other followers

%d bloggers like this: