While on a silent meditation retreat in 1979 these two streams of questioning resolved themselves in a ‘vision’ lasting maybe 10 seconds, which Jon describes as an instantaneous seeing of vivid, almost inevitable connections and their implications.
He recognised in that moment that the way he was working on that retreat on his own mind and mental states might have enormous benefits for the people who came to the hospital with their suffering. He saw that it might be possible to share the essence of the meditation and yoga teachings that he had been practising for the past 13 years with those who might never come to a Buddhist centre, and who would never be able to discover that essence through the words and forms that were used in such places. He resolved to try to make the practices and the language used to describe them so commonsensical that anyone might benefit from them.
Jon persuaded the hospital authorities to let him and his colleagues have some space in the basement, and there they developed what soon came to be known as the eight-week Mindfulness-Based Stress Reduction (MBSR) programme. He and his colleagues worked to develop a contemporary vocabulary that spoke to the heart of the matter without reference to the cultural aspects of the traditions out of which those practices emerged.
Jon had trained as a scientist and knew the value of research, so he and his colleagues researched the patient outcomes of their programme and, bit by bit, what is now a very considerable body of research evidence into the efficacy of the training began to emerge. At the time of writing there are many thousands of peer-reviewed scientific papers investigating the effects of mindfulness training. If you’re interested in these, you’ll find an extensive database of them at www.mindfulexperience.org.
It soon became clear that MBSR training enabled people to deal much better with chronic pain. They also became more adept at managing the various stressors that accompanied whatever issues had brought them to the hospital. The research indicates that the programme is successful at helping people deal with difficulty and, at the time of writing, more than 20,000 people have completed the eight-week course at UMass itself. More than 740 academic medical centres, hospitals, clinics and freestanding programmes offer MBSR to the public around the world, and interest in mindfulness training has continued to build as it has become increasingly apparent that it is not only stress and chronic pain that are positively affected when you learn to work with your attention in a different way.
Biological changes started to show up in the research as well. One early instance of this was the finding that, among patients who came to the hospital for treatment for psoriasis, the symptoms of those who engaged in the MBSR course alongside that treatment cleared up around 50 per cent faster than the symptoms of patients who didn’t. What this seemed to show was that what people were doing with their minds, the work they were doing with their attention, was actually changing their bodies.
The understanding of the way in which mindfulness training affects us biologically received a further boost when neuroscientists began to investigate its effects.
Part of this story goes back to 1992, when a small group of neuroscientists led by Professor Richard Davidson and helped by Alan Wallace, a Western Buddhist scholar, travelled to Dharamsala in the foothills of the Indian Himalayas on a kind of neuroscience expedition. They took with them an array of what was then cutting-edge scientific equipment: laptop computers, electroencephalographs, battery packs and a generator. They wanted to meet some of the Tibetan Buddhist hermit-meditators who lived in the hills above the town and they hoped to recruit from among them a cohort of expert meditators – people who had put in tens of thousands of hours of meditation practice. The neuroscientists wanted to study the pattern of their brain activity. They were particularly interested in the habits of thinking and feeling they exhibited when not meditating. If these demonstrated that the subjects had unusual habitual traits, these might reflect enduring functional changes that had occurred in their brains as a result of their mental training.
This first foray simply failed. To begin with, the yogis were unimpressed by what seemed to them to be the scientists’ uninformed and naïve perspectives on meditation. ‘We seemed like primitive Neanderthals to them,’ explained Alan Wallace, who helped to facilitate the encounters.
In the end the scientists got no usable data from that trip. But they’d made a start and, with the Dalai Lama’s help, in 2001 a number of maroon-robed Tibetan Buddhist monks began to make their way to Davidson’s Laboratory for Affective Neuroscience in Madison, Wisconsin, to meditate with EEG caps stuck on their already shaven heads. These were ‘Olympic-level athletes’ of meditation, with many years of intensive practice behind them. The results were astounding. The expert meditators exhibited patterns of brain activity never before measured by science. We’ll look in more detail at some of these findings in Week Three. They’re particularly interesting because from them scientists were encouraged to investigate what changes might show up in people who had no previous meditation experience and who took up an eight-week mindfulness training course. Here, they found (and research continues to find) highly significant changes in the patterns of brain activation – and even changes in the brain’s physical structure – that follow from just eight weeks of mindfulness training.
A significant event in the development of secular mindfulness training came about in 1992 when three distinguished cognitive psychologists – Zindel Segal, Mark Williams and John Teasdale – were asked by the director of a clinical psychology research network to develop a group-based therapy for the treatment of relapsing depression.
Significant depression is a highly disabling condition. Besides emotional pain and anguish, people who are depressed also experience levels of functional impairment comparable to those found in major medical illnesses – including cancer and coronary heart disease – and a World Health Organization projection suggests that of all diseases depression will impose the second-largest burden of ill health worldwide by the year 2020.
Roughly one in 10 of us in Europe and North America will experience serious depression at some point in our lives. In some parts of the population that is more like one in four. What is more, when people have had three or more serious episodes of depression there is something like a 67 per cent chance that their depression will relapse.
Back in 1992, the two treatments that seemed to be most effective in treating people with relapsing depression were one-to-one cognitive behaviour therapy (CBT) or maintenance doses of antidepressants. Both of these are relatively expensive. Not everyone is comfortable taking the drugs and they can have unwanted side effects. And not everyone can have one-to-one CBT – there is a limit to the availability of trained therapists. Coming up with an economically viable and effective group-based intervention therefore seemed urgent.
To understand the approach Segal, Williams and Teasdale took, and why they took it, it will be helpful to consider a scenario they outline in the first of their books – Mindfulness-Based Cognitive Therapy for Depression.
Mary has just come from work. She’s tired and she looks forward to spending her evening relaxing in front of the television. However, there’s a message on her answerphone. Her partner is going to be late getting back from work. She gets angry and feels disappointed and upset. Then she starts to recall other occasions that month when the same thing happened. She begins to imagine that her partner may be being unfaithful to her. She pushes that thought to one side but it comes back with even greater force when she imagines that she has heard some laughter in the background of his voicemail. Nausea comes up – and it doesn’t end there. Her mind rapidly starts to conjure up images of an unwanted future – solicitors, divorce courts, having to buy another home, living in poverty. She feels herself getting more and more upset as her anger begins to turn into depression. Her mind throws up images from the past when she was rejected and lonely. She ‘knows’ that all their mutual friends would abandon her for him. Tears