Mindfulness and meditation therapy

Mindfulness is one of the core application technologies of contemporary meditation therapy, but the two are neither subordinate nor equivalent concepts, but two independent systems that have the same origin, overlap and have boundaries. To put it bluntly, you can understand the two as "golden partners" who share the same cultural source and often work together, but each has its own career map.

Two months ago, when I was leading an eight-week mindfulness-based stress reduction group at a community mental health service station, three students raised their hands in the first class and asked the same question: "Are we going to learn mindfulness or meditation today?" Do you have to sit cross-legged and meditate? If I can’t sit still, will it mean I can’t practice? ” In fact, it is normal to have such doubts. After all, most of the meditation apps on the market now package "mindfulness meditation" as the same concept and sell it. It is really difficult for ordinary people to distinguish the boundaries.

Both were originally born out of the Zen practice tradition in South Asia, but have taken completely different development routes since the mid-to-late 20th century: Meditation therapy first took the path of clinical verification. Transcendental Meditation first entered the American clinical research system in the 1960s to assist in lowering blood pressure and improving chronic sleep disorders. At this time, there was almost no concept of "mindfulness" in meditation therapy, and the core of the practice was to calm thoughts by silently chanting specific mantras. It wasn't until Dr. Kabat-Zinn launched Mindfulness-Based Stress Reduction (MBSR) in 1979, and deliberately separated the core of "mindfulness" - that is, "awareness of the present moment without judgment" from the religious context and turned it into a quantifiable and repeatable clinical technology. Mindfulness was officially bound to meditation therapy and became the most out-of-the-box component of the latter.

Interestingly, there is no unified conclusion on the relationship between the two in clinical circles. Practitioners from different schools have very different opinions: For example, consultants who practice traditional psychoanalysis or dynamic orientation mostly think that meditation therapy is an "emotional regulation toolkit" that includes a variety of techniques. Mindfulness is just a small tool used to anchor attention and quickly calm emotions. It has similar positioning to breathing regulation and progressive muscle relaxation. There is no need to elevate it separately.； However, counselors who engage in the third wave of cognitive behavioral therapy, such as me who usually do Acceptance and Commitment Therapy (ACT), will feel that mindfulness is the core, and meditation is just one of the forms of practice that carries mindfulness - after all, you don’t have to sit cross-legged to meditate. Feel the temperature of the water flowing through the back of your hands when washing dishes, chew 20 times while eating to appreciate the taste of food. These are all mindfulness exercises and do not need to be linked to meditation at all.

A previous visit I had from a 17-year-old high school senior illustrates this boundary well. She suffered from severe anxiety accompanied by panic attacks. She took medication as prescribed by her doctor and received psychological counseling at the same time. In the most severe cases, she could not sit quietly for 5 minutes. Whenever she closed her eyes, her mind was filled with mock test rankings and her parents' talk. She could not do a regular 15-minute mindfulness meditation. I didn't arrange any meditation exercises for her at that time. I only taught her two small mindfulness methods that "have nothing to do with meditation": one is to eat a mint candy every morning before self-study, chew it slowly, and feel the coolness of the mint spreading in your throat. If you get distracted, pull it back. Don't blame yourself. ； The other is when I walk home from school for 10 minutes every day, I just count my steps, left foot 1, right foot 2. If I make a mistake, I start over. After practicing like this for three weeks, her frequency of panic attacks dropped from three times a week to once every half month, and her SAS (Self-Rating Anxiety Scale) score dropped directly from 72 to 48. She later joked with me and said, "It turns out that I was deceived before. Who said that mindfulness requires meditation?" ”

Don’t think that only mindfulness can exist apart from meditation. There are many categories of meditation therapy that have nothing to do with mindfulness. For example, the currently popular compassion meditation, inner child meditation, and vision meditation. The core of these exercises is to guide you to mobilize your imagination and trigger specific emotions. They are completely different from the requirements of mindfulness of "no judgment, no deduction, and just awareness of the present moment." They are essentially another branch of meditation therapy.

I have been practicing mindfulness for almost 6 years. To be honest, ordinary learners do not need to worry about which definition of the two includes which. As long as it can help you get rid of the thoughts of "regret for the past and anxiety about the future" and return to the present moment, whether it is sitting down to meditate for 10 minutes or standing by the window and feeling the temperature of the wind for 30 seconds, it is useful. However, if you want to apply it clinically, you still have to clear this boundary: for example, during a severe depressive episode or with severe dissociative symptoms, you cannot practice mindfulness meditation casually. On the contrary, it may trigger an emotional breakdown. At this time, you would rather use gentler exercise adjustment rather than forcefully practice it.

Not long ago, I had dinner with a senior who has been practicing transcendental meditation for more than ten years. I think what he said is particularly appropriate: "The relationship between the two is like tea and teapot. Many people use teapots to brew mindfulness tea, but teapots can also brew other teas. If you want to dryly chew tea, no one will stop you. You don't have to worry about the container, as long as you can taste the flavor you want." ”

Oh yes, a final reminder: If you are a newbie and want to try it, don’t just buy thousands of mindfulness meditation classes. Try a free 10-minute body scan first. If you can sit still, continue practicing. If you can’t sit still, try counting steps while walking. Whatever suits you is more effective than any "professional orthodoxy".