NOETIC SCIENCES REVIEW # 35, PAGE 14
AUTUMN 1995

Large Pear Drawing #1 by Martha Alf © 1988, courtesy of Newspace gallery, Los Angeles
THE CONTEMPLATIVE MIND IN SOCIETY

By Jon Kabat-Zinn

Editor's Note: For 16 years, Jon Kabat-Zinn has combined his knowledge and practice of Buddhist meditation with his role as a leader in social and medical applications of psychospiritual disciplines. In 1979, he founded the Stress Reduction Clinic at the University of Massachusetts Medical Center. As a result of his experience in practical meditation, be has developed ideas for designing and implementing "mindfulness programs" which would affect a broad range of arenas such as medicine, health care, education, work, family life, leisure time, and sports.

Kabat-Zinn expresses the view that virtually any waking human activity would be richer, its spiritual aspects more apparent and meaningful, and one's own ego and attachments less blinding and interfering if it were held in a spacious and situation-appropriate field of mindfulness. Widespread adoption of this practice, be believes, could bring about a momentous change in society.

The telephone, the transistor, and the home computer transformed the society by quantum leaps, driven by the extraordinary power of the enhanced connectedness made possible through the controlled channeling of electric current, and by the market forces such possibilities generated. Before that, it was the steam engine, the railroad, and the automobile, the harnessing of chemical and mechanical power.

The transformative effects on society of large numbers of people purposefully cultivating a more mindful and contemplative life are potentially as powerful if not more so than such technological advances in power and connectivity and the capabilities they give rise to.

However, widespread adoption of contemplative "technologies" and their associated shifts in worldview will be very different, given their inner orientation and use of more subtle energies. For one thing, they offer scant opportunities for economic exploitation, which would be highly undesirable in any event. This does not mean that a widespread adoption of contemplative values and practices would not have profound economic and political benefits. I believe it certainly would.

In the past 150 years, human beings have learned to interface comfortably with machines and, in the past decade or so, with emerging information/digital technology. Many people are becoming "computer literate" on an operational level and this skill is now being taught in the schools as fundamental to economic survival in the job market.

But we have yet, as a society or a culture, to come to grips with the profound and irreversible implications of such technological changes and their effects on the pace of life, the rate, amount and quality of information and images that human beings, even children, have to "process" in a day. We have yet to fully appreciate the impact of these technologies on the quality of our individual and family lives, the meaning and quality of our work lives and environments, as well as on our greater political and cultural goals and social values—to say nothing of our tremendous capacity for self- and eco-destruction. All this technology, although itself potentially enhancing of connectivity and communication, is also alienating, intrusive, and isolating.

I would suggest that it is now time for society to turn attention to developing what we may call "inner technologies". The untapped potential of the human mind for individual and collective creativity and wisdom has to be intentionally cultivated. It needs training of a certain kind (for example, as found in many contemporary consciousness disciplines) if it is to keep up with the precocious challenges of our technological advances without losing all sense of value and meaning in our individual and collective lives.

An inner "technology", of which meditation in its most generic sense and most basic form (mindfulness) is the cardinal element, has the capacity to elevate our consciousness up to and beyond the challenges posed by our technological advances, and to harness them as well as the power of the mind for the greater good and harmony of all people and the planet. This capacity is built in to a "universal grammar" of human psychology, I believe, just as our capacity for speech is built in to our brain structure through a universal grammar/language instinct. Just as with language development, it needs exposure and some training to fully develop this capacity. What is involved is basically a deep familiarity and intimacy with the activity and reactivity of one's own mind, and some competency in navigating through our mind and emotions with equanimity, clarity, and commitment.

From my work in the field over the past 16 years, I see that more and more people are taking up or coming back to the practice of meditation and making it an integral part of their daily lives in a non-mechanical way. As they do this, and as they communicate about it more freely, they tend to develop a deepening understanding of its potential uses and transformative value, grounded in their own direct experience. Personal values tend to change subtly or not so subtly, as well as behaviors, each in uniquely personal but describable ways. I see this inner process as an expanding view of what it means to be fully human and a planetary adult—both as an individual and embedded within a collectively shared, conscious, and continually interacting network (society, sangha).

In what follows, I paint an optimistic if somewhat radical scenario of the transformative possibilities for our era. I like to think that we are facing and are already unwittingly engaged in a very real opportunity for seeding a second Italian/European Renaissance in the United States, if not worldwide. I believe we need to at least attempt to formulate a large vision of the possible and then work toward it incrementally; we should be careful, however, not to delude ourselves about potential problems with ambition or power, or about the potential resistance to any efforts to further a contemplative orientation in our society and its institutions. A collective, continuously evolving vision of what we think we are doing, and why, will serve us well as a resource of deepening clarity and motivation. Then, by paying careful attention to the details and making sure that our efforts reflect the wisdom and compassion the topic of the contemplative mind represents in the first place, we will be building the inner counterparts of the telephone/ transistor/computer. I believe that the rest will, in some profound way, take care of itself.

POTENTIAL FOR A SECOND RENAISSANCE

As I see it, a profound social/cultural revolution, or what I prefer to think of as a second Renaissance, is possible, at least in first- and second-world countries, if not globally. It is driven by strong currents of desire for greater meaning and fulfillment, health and well-being, leisure and comfort, and the expectation of relative longevity that the past several centuries of technological progress in first-world countries has generated. The power of this strong inward longing in our society for well-being, meaning, and connectedness should not be underestimated.

The Italian Renaissance emerged out of a thousand years of relative cultural and social "darkness", fueled by a renewed appreciation for the sacred and a strong desire to integrate it into the domain of the human through new forms of art and architecture. And, of course, it was fueled by a scientific method based on confidence that careful direct observation and measurement could help elucidate the mystery of the work of God, as well as by explorations to discover new worlds (for plunder, trade, subjugation and religious imperialism). On the artistic and architectural side, it was driven in large measure by the creative impulse and genius of individuals such as DaVinci and Michelangelo, whose work was well-funded by a small number of wealthy and enlightened patrons.

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CONTEMPLATION AND CHANGE

What do we mean by "contemplation" or "meditation"? For most purposes, the two terms are interchangeable: They refer to methods of disciplining the mind by focusing on a specific object of thought or by completely letting go of all thoughts and emotions, and Just simply watching or witnessing whatever arises in consciousness. Such practice usually results in a growing awareness of nonattachment to the contents of our mind, with an increasing ability to exercise choice in how we use our mind. In practical terms, this usually brings about a greater sense of self-mastery, well-being, equanimity and reduced stress.

One might argue that for centuries, even millennia, the human mind has not developed significantly, nor has it been fundamentally affected by any of the technological breakthroughs of the past. It still functions at a relatively unsophisticated level of self-knowledge, awareness, and motivation, following a kind of lawfulness or universal grammar described by the Buddha and Buddhist psychology, the Upanishads and the Bhagavad Gita, and some Jewish, Christian, Muslim, and Taoist teachings. Transformational change in terms of awareness and nonself-oriented, ecological motivation is possible, according to these teachings, but takes a certain kind of inner work which involves training, and in some ways taming the mind through contemplation—the systematic cultivation of awareness and compassion. Generically, these teachings and their methods of training the mind are known as consciousness disciplines.

—Jon Kabat-Zinn

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One might argue that conditions are ripe, at least in the United States, for the beginning of a new and more enlightened and broad-based Renaissance, one which may well last more than a few hundred years, and whose emergence may be far more rapid than its predecessor of 500 years ago, given the time acceleration of our day, driven by our speed-of-light communications technology. The question for us now is how to further the emergence of such a profound and complex cultural transformation, which in some ways is already unfolding.

We will also need to ask, since the contemplative and the sacred have always been undercurrents of life in our society, why it is that such an emergence has not happened before. We will need to think about and anticipate what present and future obstacles to such an undertaking might be. These are large historical questions that no one person can give complete answers to. However, refining our thinking about them through dialogue which honors the work of scholarship but goes beyond the scholarly will be essential to developing new models for social learning and social action along contemplative lines.

Up to this time, the subject of how to live consciously (or religiously, in the old terminology) has been an arcane, age-old scholarly debate. The challenge, I believe, is to make it real within the conduct of our own lives through personal engagement and experimentation. It will also be important not to hide our personal involvement but to let our efforts become known and resonate in larger circles of the society on all levels. In order to do this, our vocabulary and our thinking and our efforts must transcend religion as we know it, with its historically parochial and sometimes evangelical and messianic interests, ideologies and hierarchies so as to be a truly universal expression of the direct experience of the numinous, the sacred, the tao, god, the divine, nature, silence, in all aspects of life and not conflict with our healthy affirmation of the need to keep Church and State separate, given what both Church and State represent.

Moreover, strange as it may sound, such a movement needs to avoid the human impulse to let this come about through the emergence of one particular person who takes on the role of avatar, savior, messiah, charismatic leader, spokesperson, tempting as this is for many people. This has been the historical pathway by which the mega-emergences of the path of the sacred have manifested, through the major world religions and various cults. But the framing of a single person as the encapsulation of our understanding takes it out of the domain of direct experience and inevitably introduces a dualism and a lack of personal responsibility and engagement which creates more problems than it solves. The same is true for the predominance of a single idea, ideal, belief system, or view of truth, or an us/them, enlightened/unenlightened, meditator/non-meditator mentality.

NEXT STEPS IN FULFILLING THE VISION

In January, this year, we established the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical Center. The mission of the new Mindfulness Center is to serve as an effective vehicle for furthering the exploration and dissemination of mindfulness in mainstream channels in medicine and medical education, in health care, and in society at large.

In addition to forming an advisory board of senior personnel from within U Mass and the outside community, the Mindfulness Center's plans include establishing four major umbrella functions: Clinical, Educational, Research, and Outreach/Network. We are also raising funds for a mindfully designed, ecologically sensitive building. It will embody the principles of mindfulness in its architecture, atmosphere and relationship to the entire medical center. An important element of the construction project is to create a rock garden close to the main hospital building, modeled on the one at Ryoanji Temple in Kyoto.

The garden will serve the entire workforce of the medical center—as well as patients and their families and visitors—and be a place for quiet reflection, contemplation, and re-minding. It will anchor in space and time the spaceless and the timeless, wordlessly bringing the power of the contemplative mind and the principles of the "Tao of Work" right into the hospital/medical school environment.

We have already begun a project to develop a communication and support network among all professionals delivering mindfulness-based stress reduction. As well as publishing a newsletter, Indra's Net: The Bulletin of the Mindfulness Network, we will eventually set up a network web site for sharing information via the Internet. This communications project will provide information and support for all people working in the field of mindfulness-based stress reduction and its offshoots, and encourage others to enter this growing field.

We will continue ongoing and planned research goals of the Stress Reduction Clinic, including research, particularly into breast cancer, and mind-in-healing approaches to psoriasis.

Throughout, in the spirit of mindfulness, a major mission of the new center is to be alert to and to pursue unpredictable opportunities as they emerge from the synergy of the work itself.

A BLUEPRINT FOR ACTION

The expression of the contemplative mind in society and an appreciation for the sacred can be found by nourishing the growth and dissemination of non-dual meditation in society in a context that is universal, nonsectarian, scientific, mainstream, and fun (in the sense of interesting, and as a compelling adventure or life quest).

It is important to point out that there should and can be no fixed form for this to happen. Meditative pathways, teachers, and programs cannot be cloned, although effective models might be adapted and modified, as has been the case in medical and educational settings with mindfulness-based stress reduction (see sidebar "Meditation in Action"). Appropriate forms and vehicles could be developed out of personal contemplative experiences and meditation practices. These forms would interface in appropriate ways with the social terrain and be sensitive to professional, institutional, generational, and ethnic cultures and their values.

Such work would be well served by establishing a small number of centers throughout North America for the in-depth training of a new breed of inventive and creative meditation teachers: for the most part, people who are already professionals in a particular area, hold other jobs, and who wish to introduce the meditative/contemplative dimension into their work and into their places of work. Of course, the deeper their grounding and commitment to mindfulness practice before they undergo such specialized training, the better. Such centers could also conduct research and offer programs of various kinds, depending on their contexts and missions.

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CULTURAL IMPACT OF MEDITATION

It is interesting to note that meditation is a cornerstone, if not the entire foundation, for Buddhism in all its forms, Christianity (Christ's 40 days in the wilderness alone), and Judaism. It is also a fundamental ingredient In the Ornish program, the Commonweal Cancer Help Program, and our work in the U Mass Stress Reduction Clinic. Even Spiegel's breast cancer replication study (and the original) has an element of it under a different name.

From a cultural/artistic perspective, meditation, primarily its Buddhist formulation, underlies the work of the beat generation of poets and its ongoing, broad based aftermath in America. Gary Snyder heads his own Zen Center and has been a student of Zen since before 1956, Allen Ginsberg practices Tibetan Buddhism, and Jack Kerouac wrote a book on the life of the Buddha and was profoundly influenced by Buddha dharma, to name Just a few (see Beneath a Single Moon, Buddhism in Contemporary American Poetry, Shambhala, 1991). Alan Watts played an important role in the emergence and translation of Eastern understanding in the West.

—Jon Kabat-Zinn

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Individuals who have received adequate training in such centers, and others who appear spontaneously, might then establish second-generation centers from which programs, scholarship, and diverse applications of the contemplative perspective to the lives of real people would emanate and spread further. Ideally, these centers would be located for the most part within existing mainstream institutions such as universities, hospitals, clinics, medical schools, retirement and nursing homes (a very large and growing, receptive and in-need portion of our population), primary and secondary schools, college campuses, work environments (particularly large corporations and factories), prisons, shelters, and churches of all denominations that are receptive to this message.

These centers of mindfulness development would be "seeded" through spontaneous and chaotic pathways. I believe this process will take care of itself if the proper conditions are met. For one, we might note that there are many natural resources already in existence in our society and its institutions that can be built on and which already have an orientation which shares elements if not total perspective and motivation with a contemplative perspective. Examples would be any programs that emphasize the value of relaxation and of the mind-body connection, such as the natural childbirth movement, physical education and health programs in the schools, the parenting movement, the death and dying movement including hospice work, sports at all levels including world-class amateur and professional athletics, corporate stress reduction programs, Alcoholics Anonymous and other spiritually based 12-step self-help programs, and in the medical arena, cardiac rehabilitation, occupational rehabilitation, physical therapy, and university health services, to name a few.

Schools of nursing and schools of social work already have such an orientation to a large degree, and constitute a very rich environment for further development and mainstreaming of contemplative practices. "Holistic education centers" such as Omega, Interface, The Open Center, Esalen, Hollyhock, and The Learning Annex could serve as complementary, less mainstream, venues and vehicles for the contemplative vision and its practices to spread, in arts and music as well as in other areas. They are already playing a key role in this regard in the society, as are more traditional and tradition-specific meditation centers across North America, such as Zen centers, vipassana centers, Tibetan Buddhist centers, yoga centers, ashrams, and classes, Christian retreat centers and adult education centers.

These efforts will need to be developed in tandem with well-conceived and well-funded research programs to evaluate various forms, approaches, environments, and short- and long-term outcomes of such efforts with specific populations of people. Funding would come primarily from private foundations and individuals who are committed to furthering the vision by supporting centers, projects, and related research.

The media can play a critical role in the dissemination of meditative practices and the understanding and acceptance of them. Different kinds of contemplative programming, such as live, real-time, interactive (phone-in) meditation practice sessions/classes on radio, network television (including PBS) and cable, and development of CD-ROMs designed to deepen meditation practice and an understanding of contemplation and the meaning and role of the sacred in real life are feasible, marketable (if form and substance are appropriate), and timely.

Having debated versions of a big vision of what we mean by "The Contemplative Mind in Society" and what we think we are doing, we should also espouse the small-is-beautiful ethic, and work within a manageable operational framework, letting the catalytic aspects of the work take care of themselves—with judicious introduction of the paddle into the current at key moments. All efforts should aim at embodying the principles we espouse in our personal and professional lives, and for implementing the "Tao of Work" within our efforts.

MEDITATION IN ACTION

When we established the Stress Reduction Clinic at the University of Massachusetts Medical Center (UMMC) in 1979, we saw this as a conscious attempt to introduce the essence of Buddhist mindfulness meditation practice and hatha yoga to patients with chronic medical problems in a university medical center within the mainstream of medicine and health care. We chose to position it as a part of "clinical behavioral medicine" and to structure it as a clinic in the form of a course designed to train patients in mindfulness and its applications in everyday life, including coping with stress, pain, and chronic illness. However, its basic mission was orthogonal from the start—that is, we saw it as operating within a paradigm and consciousness "at right angles to" the larger institution within which it was embedded.

From the outside, it looks like a clinic, bills like a clinic, operates like a clinic, but once inside, one gradually discovers that it is "rotated in consciousness". For instance, it includes a model for the sacred quality of the encounter between a person as patient and his/her physician and health care team. Thus the principle that all patients referred to the clinic are encountered as full human beings and are listened to and spoken to from the heart by the interviewer. In other words, the encounter itself is held in mindfulness and part of the work of the staff is to make their work part of their meditation practice and their meditation practice part of their work.

Some of what we have learned in the past 16 years:

  • Large numbers of people with a wide range of chronic medical problems, diseases, and pain conditions are willing to undergo relatively intensive, experiential training in mindfulness meditation and its applications in daily life, and to practice meditation regularly over the short and long run. More than 7,000 people have completed our eight-week clinic at UMMC, with approximately 85 percent referred by their physicians. Doctors are willing to send patients to such programs and are by and large very satisfied with the results.
  • Poor, inner city, minority individuals under severe psychosocial/economic stress are also willing to undergo such training and respond enthusiastically to it when the program is presented and supported in commonsensical ways (that is, free of charge, with on-site day care and free transportation when necessary). The program can be successfully delivered entirely in Spanish to non-English speaking Latinos.
  • Hospitals and medical centers are ready to accept the meditation/contemplative model when it is presented as "mindfulness-based stress reduction". In the case of our medical center, we have extensive and vital research, clinical, teaching collaborations with many different departments. Such interfaces further a gradual but inexorable shift in the overall culture of the institution and its mission in terms of both accepting and incorporating aspects of mindfulness into the practice of medicine and health care. It is now important for such models to establish themselves in hospitals and medical centers throughout the country.
  • Bill Moyers helped enormously in the dissemination of our approach throughout North America. Television captured the feeling heart of the work, and people apparently resonated with it in large numbers. Full Catastrophe Living (1990) and Wherever You Go, There You Are (1994) also functioned and continue to function catalytically to expand and deepen people's understanding and acceptance of the relevance and importance of formal and informal mindfulness meditation practice in their lives. They also support people who wish to undertake mindfulness as a daily discipline, and people are doing this in large and growing numbers without the aid of formal institution-based programs.
  • Health professionals in large numbers feel a degree of emptiness or limitation in their work and are turning toward mindfulness as the ingredient which is missing. As with lay people, they are coming to it through the media, through books, and through word of mouth. They are now coming in large numbers (200 at a time plus long waiting lists) to our professional training programs through the Omega Institute and are going back to their institutions and setting up similar clinics in hospitals and medical centers, as well as bringing the principles and practice of mindfulness into their own clinical work with patients and clients.
  • Some physicians in private practice have taken to putting patients of their own into groups and teaching such programs themselves as an expanded element of what it means to practice medicine, recapturing the old (Latin) meaning of doctor as teacher. Research is built into many of these clinical programs. In Utah, it has already resulted in a successful doctoral thesis; at Newton-Wellesley Hospital, in two published papers on fibromyalgia pain and mindfulness-based stress reduction; and in an article in a British medical journal on the importance of mindfulness in relapse prevention in depression.
  • Medical students are receptive to training in mindfulness based stress reduction. We have had a program for first- and second-year medical students in place for eight years.
  • It is possible to successfully introduce mindfulness based stress reduction within a state corrections system, both for inmates and for corrections personnel, from superintendents to corrections officers. Short- and long-term outcome studies, including effects on addictive behaviors, impulse control, hostility and violence, and recidivism are currently underway.
  • It has been possible for an elementary school teacher to introduce mindfulness-based stress reduction within a public school system in Mormon, Utah, and have it be accepted, integrated, supported, and adopted by other teachers and parents to an extraordinary degree. Her experience became the basis for offering a whole new class of training programs for elementary and secondary school teachers. The pilot effort in April this year, in Cambridge, Massachusetts, attracted 120 teachers.
  • Perhaps most important, we are learning to work together as a team and to embody the principles and practices of mindfulness in all aspects of our work and in our communications with the medical center and the medical community. We call this the "Tao of Work", and we are intent upon letting our efforts flow more and more from such an orientation and redefine our general understanding of the place and function of "work" in our lives. This includes appreciating and tapping the unique inner resources of each individual team member, keeping work life in balance with other pursuits including family and contemplative practices, letting the work become one's meditation practice and vice versa, helping each other see and work on our rough edges and blind spots, and working with whatever comes up mindfully and compassionately.

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Places that have established clinics on the U Mass model, offering mindfulness-based stress reduction, include:

  • Brigham Women's Hospital (Boston)
  • Kaiser Permanente (several locations + clinical trial of efficacy)
  • El Camino Hospital (Mountain View, California)
  • LDS Hospital (Salt Lake City)
  • Newton-Wellesley (Massachusetts)
  • Pittsburgh Rehabilitation Institute (Pennsylvania)
  • Yale University Health Service and Inner City Programs (Connecticut)
  • Barnard College Health Service (New York)
  • Cook County Hospital (Chicago)
  • Texas Tech University Health Sciences Center (Lubbock)
  • Abbott Northwestern Hospital (Minneapolis)
  • Santa Cruz Medical Clinic (California)
  • San Diego Medical Center (California)
  • St. Mary's Hospital (San Francisco)
  • San Francisco General Hospital (California)
  • Sequoia Hospital (Redwood City, California)
  • Hill Park Clinic (Petaluma, California)
  • Cancer Support Community (San Francisco)
  • Holy Name Hospital (Teaneck, New Jersey)
  • Hackensack Medical Center (New Jersey)
  • Arizona University Health Sciences Center (Tucson)
  • SUNY Syracuse Medical Center (New York)
  • Bedford VA Hospital (Massachusetts)
  • The Clarke Institute (Toronto, Canada)
  • Cambridge University, Applied Psychology Unit (UK)
  • University College of North Wales (UK)

Manly of these programs are beaded by physicians who trained with us. Several of these doctors are actually subspecialists in cardiology or pulmonology with a deep interest and personal commitment to meditation practice. Most are in internal medicine and primary care. Other program beads are nurses, social workers, and clinical psychologists.

Many other programs and classes in mindfulness-based stress reduction are in existence outside hospitals, in private clinics and through private practices across North America.

—Jon Kabat-Zinn

RETURN TO SIDEBAR 1 "CONTEMPLATION AND CHANGE"
RETURN TO SIDEBAR 2 "CULTURAL IMPACT OF MEDITATION"

This article was originally written for a conference on contemplative practices and their relevance to society, sponsored by the Nathan Cummings Foundation and the Fetzer Institute. The Fetzer Institute is an organization committed to mind-body health and healing, and is a long-term strategic partner of IONS.

Jon Kabat-Zinn is the founder and director of the Stress Reduction Clinic at the University of Massachusetts Medical Center, Associate Professor of Medicine in the Division of Preventive and Behavioral Medicine, and Executive Director of the newly established UMMC Center for Mindfulness in Medicine, Health Care, and Society. He is the author of Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain and Illness, and Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life.

Read other articles from issue # 35

Large Pear Drawing #1 by Martha Alf © 1988, courtesy of Newspace gallery, Los Angeles

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