The relationship between mindfulness and meditation therapy

Mindfulness is one of the most commonly used core techniques of meditation therapy, but the two are by no means subordinate or equivalent - meditation therapy is a collection of psychotherapy techniques that are incorporated into an evidence-based practice system and have clear clinical intervention goals. It can include mindfulness exercises or other non-mindfulness meditation techniques; mindfulness itself is a state of mind that is "conscious, non-judgmental and aware of the present moment". It can be used as a therapeutic tool in clinical settings, or it can exist completely independently in daily practice and life scenes, and is not necessarily related to psychotherapy.

In the past three years that I have been following up in the psychology department of a general hospital, at least 70% of the patients who came into contact with meditation intervention for the first time asked as soon as they sat down: "Doctor, I have been practicing mindfulness with the APP for half a year, does it mean that I have received meditation therapy? Why is my anxiety not getting better?" This misunderstanding is too common. Many popular science contents always tie mindfulness and meditation therapy together, making everyone assume that the two are the same thing, but in fact they are far from each other. To put it bluntly, the relationship between the two is a bit like the relationship between Pu'er and lipid-lowering diet therapy - Pu'er is one of the most commonly used ingredients in lipid-lowering diet therapy, but if you drink Pu'er at home every day, it does not mean that you are doing a standard diet therapy, nor can it be said that Pu'er is equal to the lipid-lowering therapy itself.

Interestingly, there is actually no unified conclusion on the relationship between the two in the industry, and therapists with different orientations have very different opinions. For example, the CBT-oriented supervisor I studied with before has always regarded mindfulness as a "tool" that is no different from breathing relaxation and muscle relaxation. When he did meditation therapy, he did not ask the visitors to cross their legs or close their eyes. He even asked the visitors to take out the throat lozenges in their bags and smell them for 30 seconds while waiting for the subway, and concentrate on feeling the changes in the cool and sweet taste of mint. This was considered a therapeutic mindfulness exercise. In his framework, mindfulness is just a tool to help clients quickly withdraw from rumination, and it has no necessary connection with the core of meditation therapy.

But humanistic and transpersonal therapists don’t see it that way at all. Last year, I attended a meditation workshop focused on trauma intervention. The teacher who taught it has been doing transpersonal psychotherapy for more than 20 years. He repeatedly emphasized that "mindfulness is the soul of meditation therapy" and even required all participants to sit in static meditation for more than 40 minutes. Only when you are completely in a state of non-judgmental awareness and can live with your own trauma without escaping, can this meditation therapy really be effective. If you just follow two breaths casually, it can only be regarded as a relaxation exercise, and it cannot be considered a treatment at all.

Both statements are actually supported by clinical data, and there is no right or wrong in themselves. After all, the boundary between the two is fluid. For example, one of my previous visitors had severe test anxiety. When I was practicing mindfulness at home, I would always impose requirements on myself: "There must be no distracting thoughts throughout the process." Whenever I thought about the test, I would scold myself for being useless. The more I practiced, the more nervous I became, and I couldn't sleep all night. Later, when we gave him meditation therapy, we used mindfulness techniques to specifically tell him, "It's okay to think about the exam. Just see the thought drift by and don't blame yourself." We even allowed him to open his eyes and look at the trees outside the window when his mind wandered, without forcing himself to focus. After three weeks of practicing this way, his anxiety scale score dropped by 40%. You see, it is also a mindfulness practice. In daily settings, you may add a bunch of "must-do" rules to yourself. In a treatment setting, it is flexibly adjusted according to your intervention goals. This is the core reason why mindfulness cannot be directly equated with meditation therapy.

What many people don’t know is that there are already many meditation therapies that do not use mindfulness techniques at all. For example, some mantra meditation interventions for attention deficit disorder only require visitors to repeatedly recite a meaningless syllable silently. They do not require you to be aware of your own thoughts at all. You only need to follow the recitation, which can also have the effect of improving concentration. In turn, mindfulness has long been out of the meditation scene. Nowadays, many Internet companies are promoting mindful lunches and mindful walks, which ask everyone not to check their mobile phones while eating and focus on feeling the taste of food. When walking, don’t think about work and focus on feeling the touch of your feet on the ground. These are all mindfulness exercises, but they have nothing to do with meditation or psychotherapy.

In fact, for ordinary people, there is no need to worry about the relationship between the two. If you just want to relax, it is perfectly fine to practice mindfulness meditation with the APP for 10 minutes. If you really have anxiety, depression and other problems that need intervention, don't practice blindly and adjust it by yourself according to the methods on the Internet. The only thing is to find a therapist who has received standard training - after all, whether it is mindfulness or meditation therapy, if it can help you solve the problem, it is a good thing.