Jon Kabat-Zinn was one of the first scientists to produce evidence that meditation is good for you. Here he talks about the Mindfulness-Based Stress Reduction programme that he founded, and explains why he believes mindfulness has such a crucial role to play in the modern world.

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Jon Kabat-Zinn is explaining how he first began his pioneering work to introduce meditation into the mainstream of medicine and society. When he was growing up, he recalls, meditation was "considered to be somewhere in the spectrum of the lunatic fringe—beyond the counterculture... There were sex, drugs, rock and roll, meditation and yoga, and they were all way, way out there. That was my generation."

A meditation-based career was therefore not the most logical choice for a respectable young American who had studied under a Nobel laureate and graduated with a Ph.D. in molecular biology from the prestigious Massachusetts Institute of Technology (MIT).

But Kabat-Zinn's thirteen years of Buddhist practice had convinced him that meditation could be used as a potent tool to help people cope with stress, anxiety, pain and illness.

Having studied with teachers from the Zen and Theravada traditions, he decided to draw upon his own experience in order to help those who were, as he puts it, falling through the cracks in the healthcare system.

"There were lots of people who were just not getting satisfaction from the medical system in 1979," he says. "So I went around and started talking to doctors and asked them, 'If we set up some kind of meditation-based stress reduction programme, even if you think meditation is crazy, would you send us patients?'

"A lot of the doctors said to me, 'I could think of a hundred people off the top of my head who are not getting better with what I'm doing. Maybe you could do something more'."

As soon as the doctors saw what was happening with their patients, they sent more patients

"It was obvious almost immediately that if you emphasize the cultivation of attention and the awareness that comes out of that kind of non-judgemental, moment-to-moment, non-reactive attending, then anybody can do it," he says.

"If you don't weight it with a lot of cultural, spiritual or ideological baggage, people who have had a lot of experience with pain and suffering in their bodies will try anything.

"In our case, they were being referred by anaesthesiologists, by the pain clinic, by orthopaedic surgeons, primary care physicians and neurologists; and they were being referred to a clinic in the hospital that was training them in Buddhist meditation without the Buddhism...

"As soon as the doctors saw what was happening with their patients, they sent more patients." And so Mindfulness-Based Stress Reduction was born.

Kabat-Zinn is quick to point out that the 'M' in MBSR does not directly correspond to any traditional Buddhist definition of mindfulness.

It is, he says, "a big umbrella term for Dharma, for awareness, for compassion, because if we had to make the kinds of distinctions that are made in the Abhidharma or in any kind of Buddhist philosophy about the nature of mind, MBSR would never have gotten off the ground.

"Everybody would have run out of the room saying 'this doesn't relate to me'. But people can relate to the present moment."

He adds: "I never shied away from the word 'meditation', but it just didn't seem relevant to feature that it was Buddhist. I would say if people asked me where it was from, but it just didn't seem relevant to emphasize that.

"The important thing was to be empirical about it—try it, see how you feel when you start to cultivate what we call mindfulness. See what happens.

"What happened was that people started to experience shifts in their pain and shifts in their relationship to their pain, even when the pain didn't shift. And those shifts were in the direction of moments of freedom, of liberation, of realizing 'my pain is not me'."

Medical and scientific research

Jon Kabat-Zinn's training as a scientist had taught him that MBSR would only gain wider acceptance if he was able to measure and document the results that his patients had been reporting. Having cut his teeth experimenting on bacterial viruses, he now set about devising studies for real human beings.

He did it on a shoestring at first, as it was impossible to secure funding for randomized clinical trials in a field that, as far as the medical profession was concerned, did not even exist.

In 1982, Kabat-Zinn put a group of fifty-one people suffering from chronic pain through an eight-week course featuring one two-hour session of mindfulness per week.

The research, published in the Journal of the American Medical Association, showed that the level of pain experienced by the subjects had reduced significantly-with half of them reporting a fifty per cent reduction or more.

More studies followed and in 1993, mindfulness hit the mainstream in a big way when forty million Americans tuned in to watch a TV documentary called Healing and the Mind, made by the veteran journalist Bill Moyers.

The programme was filmed while Kabat-Zinn and his team were conducting research on patients receiving ultraviolet light treatment for the skin disease psoriasis. One group was given just the light treatment, and the other listened to guided mindfulness tapes as they stood in the lightbox. It was found that the meditators healed at about four times the rate of the non-meditators.

In 1997, Kabat-Zinn teamed up with the neuroscientist Dr. Richard Davidson to test how ordinary office workers would respond to mindfulness training.

Kabat-Zinn and Davidson have both been key figures in the development of the Mind and Life Institute, which—with the guidance and inspiration of His Holiness the Dalai Lama—is an important forum for scientific research into the benefits of meditation.

Their 1997 study took place at a biotech company in Madison, Wisconsin. Over an eight-week period, a group of scientists, marketing executives, lab technicians and managers gathered regularly in one of the company conference rooms to practise meditation.

Measurements of their brain activity taken before and after the course showed significant increases in activity in several parts of the left prefrontal cortex—an area of the brain associated with positive emotions.

This heightened activity persisted for at least four months, and the results backed up the workers' statements that the mindfulness training had left them feeling less stressed and happier in their jobs.

After the course, the employees were given an influenza vaccine. A follow-up after nine weeks found that the meditators had a significantly stronger immune response to the vaccine than the non-meditators, suggesting that immune response is related to how we process emotions, particularly in times of stress.

The spread of mindfulness

As more studies produced evidence that mindfulness could be effective in a variety of different settings, the first MBSR offshoots began to emerge. Mindfulness-Based Cognitive Therapy, for example, was developed to help people suffering from repeated bouts of depression.

In 2000, a group of researchers, including the clinical scientists Zindel Segal, Mark Williams and John Teasdale, published a study that found that eight weekly sessions of mindfulness halved the rate of relapse in people with three or more episodes of depression.

MBSR is now used in over 200 medical centres across the USA and beyond. Over the past thirty years, more than 18,000 patients have been through the Stress Reduction Clinic alone, and Jon Kabat-Zinn has given mindfulness training to thousands of medical professionals. Papers on the clinical application and the neuroscience of mindfulness are growing exponentially.

"They are now funding mindfulness research to the tune of hundreds of millions of dollars a year," says Kabat-Zinn. "From the 1979 perspective, it was more likely that the universe would have suddenly stopped expanding and started collapsing.

Kabat-Zinn has introduced mindfulness to people from all walks of life-from prisoners and the homeless to business leaders, lawyers and Olympic athletes.

In the 1990s, his former colleague George Mumford taught mindfulness to basketball legend Michael Jordan and his all-conquering Chicago Bulls team. Under coach Phil Jackson, the Bulls won three NBA titles in a row, and when Jackson moved on to the Los Angeles Lakers, he took Mumford with him—and won three more titles.

"Is that why they won so many championships?" Kabat-Zinn asks of the players' mindfulness training. "Of course. They grew two inches by meditating!"

In 2008, Kabat-Zinn was asked by the US army to help train its soldiers in mindfulness, to enable them to cope better with the stress of combat and its psychological after-effects.

"We've got nineteen and twenty-year-olds coming home and they are experiencing Post Traumatic Stress Disorder from seeing and experiencing and contributing to all sorts of horrific, unthinkable, unspeakable things," he says. "They are taking it out on their wife and kids, or their husband and kids, and the army is actually asking for mindfulness training."

A programme called Mindfulness-Based Mental Fitness Training has been specifically developed for the US army, and soldiers returning from the wars in Iraq and Afghanistan are now receiving MBSR training at veterans hospitals across the United States.

Thinking is the most powerful force in the human repertoire—except for awareness. Thinking is trained in school, awareness never gets any training at all

"It's a fantastic flowering. The risk is that it's also becoming a very smart career move for psychologists to get into mindfulness this, mindfulness that, and to think of mindfulness like a concept—'Oh yeah, be in the present moment, a little non-judgemental, I've always done that'—and not understanding, this is not a concept, it is a way of being."

He adds: "We emphasize for the teachers: if you're not living this, then it's not mindfulness, and you should never ask one of your patients or students to do anything that you are not doing at least as much of yourself, every single day.

"If you're asking them to practise forty-five minutes a day, six days a week, then you had better be practising forty-five minutes a day, six days a week."

Doing what is appropriate

Jon Kabat-Zinn's aim when he founded the Stress Reduction Clinic in 1979 was to alleviate the suffering of his patients. But it is impossible, he says, for an individual to practise mindfulness genuinely without also opening up to a more ethical, altruistic and compassionate approach to life.

"My own view is that when you don't judge anything, then you automatically move into acceptance. Because acceptance isn't possible unless you stop judging, and accepting means seeing things as they are, which means seeing the interconnectedness of all things. As soon there is interconnectedness, then loving kindness and connection arises naturally.

"We do train people in metta meditation and loving kindness practice, but my own feeling has always been that it's better to embody loving kindness and compassion than to talk about it."

The ultimate practice, he says, "is not sitting in full lotus posture, but everyday life-living life as if it mattered, moment by moment by moment, and doing what is appropriate in the present moment, which would of course be ethical.

"Look at how many people get into trouble doing things they know are not right to do. They choose a path—whether it's alcohol, drugs or sex, whatever it is—because they are feeling lonely, hurt, confused or whatever, and it seems like there will be a little bit of pleasure from this particular moment.

"What they don't see is that behind this little moment of pleasure is an infinite field of pain, for themselves and whoever else they are in touch with, all the people in their lives that they may have betrayed by betraying themselves.

"If you are really present then you don't need some kind of big moral compass, because from moment to moment the seeing will protect you, naturally. We find this with our patients. They come in and they tell us that they are seeing differently and they are acting differently, and they are not reacting in the old ways.

"They are learning how to respond rather than to react—how to go in the direction of a greater sense of humour and to take themselves less seriously."

Lessons in awareness

Ultimately, Jon Kabat-Zinn hopes that the growing acceptance of the value of meditation could help to spark what he calls a renaissance in consciousness, and ultimately lead to a more mindful, caring society in which children learn mindfulness and awareness from a young age.

"Thinking is the most powerful force in the human repertoire—except for awareness. Thinking is trained in school, awareness never gets any training at all.

"So if you really want to balance the thinking mind, which is very beautiful at some times and very horrible at others, the only thing that can balance it is awareness. It should be taught to children in kindergarten, but in a way that they can hear—it's not about trying to turn them into Buddhists.

"We can fantasize a little bit about what it would mean for humanity and the planet if what we've learned through science and the application of thinking, and through the cultivation of the heart in Dharma, were to come together so that we understood what the true interest of all sentient beings was, and did not betray that for our own smaller self-interest.

"Why not have laws that regulate to some degree the level of greed or wealth that was possible in the world..? I think there is a possibility, with the lightest of touches, of bringing wisdom more into our institutions, so that they supported life, rather than greed, hatred and delusion.

"Universities have always done that to a degree, and to another degree they have also been gigantic houses of ego, where 'my work is better than your work'. Of course that's true in all professions.

"If each one of us took responsibility, then you could say that all of us are cells of the one body and we contribute our own hearts, our own minds and our own views and our own fears to this larger body. But the more we can modulate our contribution with awareness and kindness, the healthier the body is going to be.

"Non-harming, what they call ahimsa in Sanskrit, is the absolute cardinal principle of the Dharma, and it's also the cardinal principle of the Hippocratic Oath in medicine. First do no harm.

"In order to do no harm, you have to be mindful. Without awareness, you are going to do harm right and left, because you will not be able to see what effect you are having on others."

Interview by Andy Fraser

Links

University of Massachusetts Medical School

International Forum on Buddhism and Medicine