The past two decades have seen much criticism of the psychiatric approach to mental disorder. Robert Whittaker (Anatomy of an Epidemic), Joanna Moncrief (The Bitterest Pills), Peter Goetzsche (Deadly Psychiatry and Organised Denial), James Davies (Cracked). These are just a few of the authors speaking out against the medicalisation of mental distress, criticising the current approach as a “one-size fits all” solution to mental illness and calling for a reduction in the use of medicine to treat it. While several leading psychiatrists have defended these modern practices, many others would like to see a reduction in drug-centred solutions and the use of a wider variety of therapies.
One such practice that has swept the western world is mindfulness meditation. Preached as an ancient Eastern solution to a modern problem, it is cited as having its roots in Buddhist tradition. Jon Kabat-Zinn describes mindfulness as “paying attention in a particular way; on purpose, in the present moment, and non-judgmentally.”. When used in meditation, the practitioner aims to “center themselves” on the present, and ignore the distractions from their past and future.
The amazing thing is: it works. Studies have shown that, as a treatment, mindfulness seems just as effective as Cognitive Behavioural Therapy. So what, then, is the problem?
In his paper, “Is Mindfulness Buddhist”, Robert H. Sharf argues that the western approach to mindfulness is far removed from its Buddhist origins. Perhaps most interestingly, Sharf discusses similarities between the American depressive and the mindset central to Buddhist thought. Quoting a paper by Brown and Harris from 1978 describing depressive disorders, Sharf characterises depression as “thoughts about the hopelessness of one’s life in general. It is such generalization of hopelessness that we believe forms the central core of depressive disorder”. This sort of understanding, Sharf says, is a central aspect of Buddhism, which teaches that “to live is to suffer” and that “escape requires, among other things, abandoning hope that happiness in this world is possible.” He goes on to point out this is very much contrary to our western understanding of Buddhism:
“Yet today Buddhist insight is touted as the very antithesis of depression. Rather than cultivating a desire to abandon the world, Buddhism is seen as a science of happiness—a way of easing the pain of existence. Buddhist practice is reduced to meditation, and meditation, in turn, is reduced to mindfulness, which is touted as a therapeutic practice that leads to an emotionally fulfilling and rewarding life. Mindfulness is promoted as a cure-all for anxiety, affective disorders including post-traumatic stress, alcoholism, drug dependency, attention-deficit disorder, anti-social and criminal behavior, and for the commonplace strain of modern urban life”.
Sharf’s paper doesn’t claim that mindfulness has no therapeutic value. Rather, it seeks to recognise the false claim that the practise is based in centuries of Buddhist tradition. In reality, Sharf asserts mindfulness is more like a modified “Protestant” version of Buddhism” that originated in the early twentieth century.
But is there any harm in our appropriation of mindfulness? Even if it’s origins may not be founded in Eastern practice, as many would like to believe, does that damage the integrity of the practice? Surely the legitimacy of a treatment lies in its effectiveness, not in its origins.
One argument is that Eastern origins are simply used to generate interest in mindfulness as a solution to all forms of stress. This makes for a convenient corporate selling point as it is increasingly brought into the workplace. Described by critics as “McMindfulness”, Professor Ron Pursur argues “Rather than applying mindfulness as a means to awaken individuals and organizations from the unwholesome roots of greed, ill will and delusion, it is usually being refashioned into a banal, therapeutic, self-help technique that can actually reinforce those roots.”. Instead of aiming to improve quality of life, these schemes are made in an effort to reduce workplace costs by decreasing sick leave.
Jay Watts agrees that mindfulness in the workplace and corporate interest are become increasingly intertwined. As mindfulness is slowly co-opted under the umbrella of treatments known as Cognitive Behavioural Therapy (CBT), it is provided under the guise of helping the employee to deal with the stress of the modern world. This not only seeks to increase the productivity of the worker, but places the blame on the individual if they fail to improve. With such an effective treatment provided free-of-charge, it absolves the company of the responsibility of said person’s discomfort in the workplace.
Not only are these motives insidious, but researchers are becoming increasingly aware that, as with most treatments, mindfulness isn’t without its negative side effects. Kate Williams, a researcher at the University of Massachusetts, is quoted in the Guardian as describing two of these harmful effects.
The first is a reaction to the process of self-exploration, and the emotions that this brings with it. While some experiences may be positive, this process naturally can bring about negative feelings as well. Repressed past traumas, buried emotions and unrealised self-perceptions are rarely easy to feel and should be tackled only with the awareness that the process may bring grief and distress with it.
The second, however, lies more in feeling than in thoughts. “Experiences can be quite extreme, to the extent of inducing paranoia, delusions, confusion, mania or depression”, says Williams. Miguel Farias and Catherine Wikholm tackle this little known aspect in their book “The Buddha Pill” and have sought to explore all aspects of mindfulness as a treatment. In their blog post on The Conversation, they use the following analogy:
“For some, penicillin is life saving; for others, it induces a harmful reaction. Just because your friend or family member responds to a pill a certain way, does not mean you will respond in the same way. The same is also true with mindfulness: for some, it may be very effective or it may not work at all, for others, there may be harmful effects.”
In his criticism of the overabundant use of psychiatric drugs, James Davies concludes, “I believe that psychiatry is not the enemy; that the people I have disagreed with are not the enemy. No, I believe the only enemy is anything that actively tries to conceal the inconvenient facts.”.
While Davies was campaigning for increasing alternative solutions such as mindfulness, his lense of scepticism must be applied to any and all treatments we consider using. Citing false claims of eastern tradition should not excuse mindfulness from the scrutiny of the medical community. Instead it is the responsibility of practitioners to find the treatment most suitable for themselves and their patients. Just as there is no “one-size fits all”medicine, an awareness of the limitations of mindfulness must accompany its addition to our repertoire of treatments.
Illustration: Maha Sultan