Are you getting the full benefits of mindfulness?

Are you getting the full benefits of mindfulness?

A recent study found we may be over-reporting positive effects of mindfulness.  Reporting bias doesn’t instantly make mindfulness bad, but let’s look at what we might be missing if we don’t consider all the evidence.

Mindfulness without context can lead to problems


You may have heard reports that mindfulness can trigger anxiety. Here’s a simple example of how this could occur in a healthy person doing a simple breath awareness at the start of a yoga class:

Imagine you are aware of your breath for the first time. You’ve never really paid attention to this before so the heightened awareness makes you notice more details, like the flow of air across your upper lip, or the movement of your ribs as you inhale.

In this alert state you also start to notice that your breath is, in your opinion, quite shallow. You’ve been told by someone in the past that you should breathe deeply, and you are quite sure you are not breathing as deeply as you should.

If your teacher instructs you to practice acceptance of the breath, just as it is

you watch this apparent aberration neutrally. You don’t judge it as good or bad. Eventually the breath softens naturally, or you worry about it less.

Without understanding acceptance

you judge your breathing as bad. This makes your breath even shallower and your body tense. Both are normal, human responses to fear, but they also reinforce your belief that something is wrong.

This generalised fear of imminent but unspecified danger is what we know as anxiety.

Mindfulness was never intended as therapy

In this episode of All in the Mind researchers study Zen Buddhist meditators. They explain that mindfulness within Buddhism (or other contemplative practices) was never intended as a treatment for illness. Sure, it might help with some conditions, but the ultimate goal was as a path towards spirituality and clear understanding.

For that to happen, mindfulness is taught alongside a philosophy of practice, and other relevant instruction, such as metta (or loving kindness as it is generally translated) under guidance of a teacher.

Once someone pays attention, they will notice things, and they need a framework for making sense of that

Modern mindfulness tends to be based on Buddhism. But in the shift towards a more secular practice it is often taught without these other elements that give it context within that linage. Mindfulness has come to mean, simply, paying attention.

That can be useful, and can even feel nice. It just might not make much of a difference.

Or, you might start to notice things you are not ready to deal with on your own.

Are you giving your patients the right information about mindfulness?

Yoga, like Buddhism, is a distinct ancient philosophy, that happens to include mindfulness. A teacher will instruct you in how to meditate on the breath, mantra, sound or energy, depending on the desired effect.

As a health practitioner, you probably teach mindfulness in a secular way (and of course most yoga and a portion of Buddhism is practiced as such in western countries) but even so you need to be sure about your reasons.

For someone with anxiety or trauma, mindfulness may bring up things, sometimes in a way the person is not yet ready to deal with on their own.

Ask yourself:

  • What do I hope to achieve by encouraging mindfulness in my patient?
  • What followup support must I provide?

In Yoga for Pain, for example, we first introduce mindfulness of movement alongside skills to move better and release tension. Participants then progress to applying mindfulness to their thoughts and relationships, again with philosophical context, time to ask questions in a safe environment,  and options for professional support should they require it.

Make sure you are getting the full benefits of mindfulness

Even if you don’t feel worse as a result of your mindfulness, not appreciating the full context will limit you. Science shows that loving kindness makes you happier so, for example, you’d miss out if you practiced some parts of Buddhist mindfulness without, say, metta.

In whatever situation you practice mindfulness, be aware of your intention, and what you need to have in place for it to do its job. The right teacher might make the biggest difference.

2 Comments
  • Rex EdwardFairy
    Posted at 18:48h, 04 May Reply

    Brilliant article, Rachael. Spot on the money. I remember hearing Peter Levine interviewed last year during Diane Poole Heller’s Psychotherapy 2.0 Summit. When asked if he recommended that trauma patients use mindfulness, he surprised Diane by saying no, not necessarily, that in fact, it could have the effect of worsening some people’s anxiety and traumatic trigger response. I thought “is there nuthin about trauma this guy doesnt get?” (which of course there isn’t, he’s marvellous), but I was very relieved to hear someone say that mindfulness as its NOW generally defined isn’t necessarily a winner. It had been my experience that mindfulness (paying attention to physical sensations in the body – ie ‘paying attention’ definition), during the so-called ‘trauma-sensitive’ Nidra meditation during a ‘trauma sensitive yoga class”, did in fact cause me to experience one of the worst and most immediate flashbacks I’d ever had, 8 years after the event.

    Peter Levine’s rationale was that ‘a traumatised person needs to go very gently, very slowly when tapping into these physical sensations (which have an emotional component) in the body” and he indicated that he thought that simply taking yourself off to an experience of ‘paying attention’ mindfulness had the potential to flood a traumatised person, which is what happened with me above. It was a relief for me to hear Peter say this after my experience.

    I think your article adds even more to the topic. The fact is, yes the definition of mindfulness has changed. And simply deciding to suddenly pay attention (and unwittingly judge what you pay attention to as problematic) can have some pretty dire consequences for those new to exploring and trying to understand the trauma lodged in their bodies.

    Thanks for taking the time to share such an incisive piece.

  • Finding Yoga
    Posted at 12:07h, 09 May Reply

    Thanks for reading and such a considered addition to the discussion.

    We think it’s really important to take an inquiry-based approach to introducing mindfulness, yoga, or any practice, particularly when used as therapy.

    As you’ve suggested, it’s not just the technique, but the context, and pedagogy (or teaching principles) that determine the result for the patient or student.

    Yoga has so many techniques, within distinct lineages, and so many teachers with their own personality. Hopefully our work is helping all these teachers bring their practice into the world in the best way.

    Thanks for contributing to the conversation 🙂

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