Mindfulness in Buddhism & Psychology

Christopher K. Germer, PhD is a clinical instructor in psychology at Harvard Medical

School and a founding member of the Institute for Meditation and Psychotherapy. He is the
author of The Mindful Path to Self-Compassion, and co-editor of Mindfulness and
Psychotherapy and Wisdom and Compassion in Psychotherapy.

He taught Training Compassion: From the Buddha to Modern Psychology, with Mu

Soeng, at BCBS September 7-9, 2012.

Insight Journal asked Germer to talk about some key aspects of the growing overlap of
Buddhist ideas and practices with Western psychotherapy.

Insight Journal: Western psychology has had a couple of decades now, at least, in which
the insights into human psychology in Buddhism have had a significant and broadening
impact. Just how great has that impact been? Are there still doubters who think this is a fad
of some kind that will pass?

Christopher Germer: There will always be doubters but they seem to be disappearing
fast. In our culture, for better or worse, the scientific method is a major arbiter of truth
and the sheer volume of psychological research is growing fast. For example, in 2005 there
were only about 350 peer-reviewed articles on mindfulness in the psychological
literature and now that number is almost 1800. Mindfulness, considered the heart of
Buddhist psychology, has been integrated into every school of psychotherapy and has
become a major treatment paradigm in its own right, with proven effectiveness for treating
depression, anxiety, irritable bowel, chronic pain, smoking, insomnia, hot flashes and many
other conditions. The military even conducts mindfulness-based mental fitness programs
to reduce the incidence of post-traumatic stress.

The use of neuroimagingobjective measures of how the brain changes through mind
traininghas helped to remove doubts about the effectiveness of Buddhist meditation. In
the future, imaging will probably be used clinically to identify maladaptive brain patterns
associated with mental illness, and when that happens, techniques such as meditation will
be tapped to alter how the brain functions. I believe that interest in Buddhist ideas and
practices will only grow over the coming decades.

Positive psychology, which focuses on human flourishing rather than mental illness, is also
learning a lot from Buddhism, particularly how mindfulness and compassion can enhance
wellbeing. This has been the domain of Buddhism for the past two millennia and were just
adding a scientific perspective.

I think modern psychology has just begun to scratch the surface of Buddhist psychology.
Mindfulness was a fledgling science in 1985 and now its mainstream, but new vistas are
emerging. For example, as social scientists and psychotherapists deepen their
understanding of Buddhist psychology, theyre developing the new science of compassion,
the science of wisdom, exploring the impact of refined states of consciousness on the brain
and behavior, investigating the health benefits of ethical, pro-social behavior, and theyre
developing a range of innovative treatment strategies for hard-to-treat mental conditions.

IJ: Do you worry that important parts of the Dhamma are being lost in translation, if you
will, as they are applied in as part of a broader therapeutic approach?

CG: Probably not as much as I should. Thanks to Jon Kabat-Zinn and the Mindfulness-
Based Stress Reduction program, therapists understand the importance of personal
practice. That opens the door to new and interesting aspects of the Dhamma. However, we
need to accept that most therapists will only skim the surface of the Dhamma. Even in
Buddhist countries like Thailand, only a small minority of the population has the time or
interest to meditate or read Buddhist texts.

I think the Dhamma is beneficial to people to whatever extent theyre willing to engage it.
For example, theres no harm in learning mindful walking or mindful eating and teaching it
to others, and the power of these simple practices often triggers curiosity and leads to
further inquiry and practice. We all have to start somewhere.

The notion of insightinsight into suffering, impermanence, and no-selfare still

seldom discussed in clinical circles. Over the years, I suspect that more and more therapists
will experience the transformative potential of insight when they go on retreats and bring
that knowledge back into the professional conversation. Some colleagues are already
taking a deep plunge such as Boston psychotherapists Bill and Susan Morgan who are on a
three-year retreat at the Forest Refuge. The experience of insight is a valuable asset to
therapists. For example, the insight that the severity of our suffering depends largely on our
attitude toward it provides hope and emotional freedom in the midst of seemingly
unbearable suffering.
IJ: What are the most important insights for Western mental health professionals to
understand; to put it another way, which of these insights most radically transforms what
the Western psychological tradition has taken as given?

CG: I think the insight I just mentioned is very importantour relationship to emotional
pain is a key factor in how much we suffer. For example, the latest wave of cognitive
behavior therapy understands that trying to directly change our thoughts is less effective
than creating a wide, openhearted space for our experiencea less resistant, less avoidant
relationship to our thoughts and feelings. This view is expressed in the mindfulness-based
cognitive therapy maxim: Thoughts are thoughts, not facts. Psychoanalytic
psychotherapy is also embracing the notion that shifting our relationship to childhood
experience is more important than remembering all the details.

Another insight is the importance of intention. Until now, scientific psychology has been
primarily concerned with thoughts, feelings, and behaviors. Since the advent of
mindfulness and acceptance-based therapy, were noticing that progress in therapy can be
measured by a shift in intentionmoving from resistance and aversion to acceptance.
Everyone who comes to therapy is resisting emotional pain, perhaps anxiety or depression.
As psychologist Steven Hayes says, Control is the problem, not the solution. The path
toward acceptance in therapy seems to occur in stages: (1) curiosity, (2) tolerance, (3)
willingness, and finally (4) friendship. Full acceptance, or the ability to embrace the pain in
our lives, may seem like a tall order, especially when a person is panicking or
overwhelmed with grief, but getting there is the art of psychotherapy.

Yet another contribution of Buddhism to western psychology is that capacities such as

attention, compassion and empathy are skills that can be learned, rather than simply a
product of good genes or a fortunate childhood. Believe it or not, this is a new
understanding. Sigmund Freud recommended evenly hovering attention as the optimal
state of mind for an analyst, but he didnt offer any suggestions for how to achieve that
frame of mind (besides a personal analysis). Now we know that the skills of mindfulness
meditationfocused awareness, open monitoring, and loving-kindnesscan be practiced
on the cushion and even during the therapy hour itself. The latter practicerelational
mindfulnessis a relatively new interest for both American Buddhists and
psychotherapists.

A fascinating new field of psychology that is co-emerging with Buddhist psychology in the
West is social neuroscience or interpersonal neurobiology. Social neuroscience
explores how human interactions shape our brains, and researchers such as Dan Siegel at
UCLA have discovered that emotionally attuned interactions activate similar brain areas as
mindfulness and compassion meditation. Therefore, our ability to pay attention with
empathy and compassion can be developed when we sit in solitary meditation; skills that
are essential to a therapeutic relationship and effective treatment in general. Graduate
programs in clinical and counseling psychology around the country are starting to
recommend and teach mindfulness meditation to their students.

Mindfulness is also being taught to clinicians for self-care and to alleviate compassion
fatigue. Traditionally, self-care involves taking time off from work to recharge ones
batteries, but this approach doesnt teach therapists to thrive during stressful situations
themselves. Self-care keeps caregivers from drowning, as physician Michael Kearney
suggests, but self-care with mindfulness is like learning to breathe under water.
Compassion training, especially self-compassion, is also a protection against compassion
fatigue. As neuroscientist Tanya Singer suggests, compassion fatigue is really empathy
fatigue. Compassion is a positive attitudeclosely related to loving-kindnessand is
more energizing than depleting. Empathy alone, without the warmth of compassion, can be
truly exhausting.

These are just a few ways that Buddhist theory and practice are affecting mental health
care. The meeting of Buddhist and modern psychology is like a rising tide that is lifting a
lot of boats.
IJ: Where would you say Western psychology is on the timeline of its evolution? If we use
the metaphor of a human life, is it an infant, in grade school, adolescence, adult?

CG: Id say grade school. I met a retired diplomat in India who accompanied Carl Jung on
his first visit to Benares, and he quoted Carl Jung as saying that compared to India,
western psychology is in its infancy. In the early 1900s, William James at Harvard
University said that everyone would be studying Buddhist psychology in about 25 years.
That time has finally come, almost a century later. Mostly in the last 10 years, were
witnessing a remarkable convergence of the ancient, introspective wisdom of the East with
western, objective scientific psychology, yielding a more comprehensive understanding of
the human psyche. Neuroimaging helps a lot to validate contemplative practicenow we
can even measure changes in the connective tissue of the brain with 11 hours of
meditation. I think well go even further when we have the technology to measure energy
in the bodychi. And neurofeedbackknowing when were generating beneficial brain
patterns in meditationmay shorten the time we need to match our brain states to those of
advanced meditators. I doubt that these scientific advances will ever replace the need for
insight into the nature of the mind and abiding self-mastery, but recent discoveries in
clinical and neuroscience are inspiring people throughout the world to take to the path of
inner transformation. I recently visited Korea and China, and found that psychology
colleagues (and monastics in Korea) were thrilled to see their ancient wisdom corroborated
by modern science. That can only be a good thing for global evolution.

IJ: Looking at this from the other side, what are the most important findings of Western
psychology that those of us trying to learn and practice Buddhism should know about? Im
thinking, for example, of the idea that meditation practice can be very helpful, but it can
also provide a means of avoiding psychological issues that should be surfaced and dealt
with.

CG: I see contemplative practice and psychotherapy as twin paths to emotional healing.
Its true that meditation can be misused as an emotional bypass, but usually not forever.
Our unresolved conflicts slip into our lives sooner or later, either on the cushion or in
relational conflict. Most emotional suffering originated in relationships and healing
relationships can go a long way toward alleviating it. Therefore, therapy is often a useful
adjunct to meditative practice, especially if the therapist shares a common model of how
suffering is created and alleviated.

As adults, though, the days are long gone when other people can provide all our emotional
needsnot the best therapist, the perfect spouse, a loving parent, or the ideal friend can
satisfy our adult need for connection and validation. Practicing loving-kindness meditation,
especially for ourselves, is an important vehicle for giving ourselves the affection we may
not have received in childhood or yearn to receive in our daily lives. I believe my wife
would agree that I require less maintenance since I stated practicing mett meditation, and I
feel a lot happier, too.
I think that Western psychologists are helping to put Buddhist ideas into modern language
and concepts, which may help dharma teachers and meditators in their practices.
Psychologists actively trying to figure out what works in mindfulness meditationthe
mechanisms of actionand for whom. For example, they are exploring in great detail the
different kinds of attention (focused attention, open monitoring) and qualities of attention
(compassion, loving-kindness) from neurological, physiological, and cognitive
perspectives. Weve recently discovered that focused attention practice is probably more
effective than loving-kindness to disengage from obsessional thinking. When the Dalai
Lama is asked what meditation is good for what problem, he often says that we need more
research. It may be cheeky to say this, but I believe a new Abhidhamma is currently being
written by these very discerning scientist-practitioners who are teasing out the different
elements of Buddhist theory and practice.

IJ: Are there specific Buddhist texts that speak to you more than others, as a mental health
professional? Do you find there is consensus about these among you and other
professionals who are familiar with the texts?

CG: Id say the Satipahna Sutta and the npnasati Sutta get top honors among my
colleagues. Im also inspired by the Bodhicaryavatara, or The Way of the Bodhisattva by
Shantideva. However, most mental health professionals derive their inspiration from
meditation practice and commentaries by meditation teachers rather than texts. This is a
gap that BCBS is uniquely positioned and actively engaged in filling. For example, Andy
Olendzki has very popular courses on early Buddhist psychology and the Abhidhamma that
offer continuing education credit to therapists.

IJ: How do you see the role of self-compassion, both in terms of Buddhism and Western
psychology?

CG: Some Buddhist practitioners worry that the notion of self-compassion subtly reifies
the self and leads to greater suffering. I think thats true when our suffering is rather mild,
but when our sense of self is engulfed in intense and disturbing emotions, such as grief,
shame or despair, we need to rescue the observerthe experiencerbefore we can pay
attention to our experience. Giving ourselves the same warmth and kindness that wed give
to a loved one reduces our mental chatter, opens our awareness, reconnects us with others
and the world.

Over the past eight years, a considerable body of research has shown that self-compassion
is a core mechanism of emotional healing. Its the implicit attitude of mindfulness, but it
helps to explicitly practice self-compassion when we suffer, fail, or feel inadequate. For
example, when were meditating and there is no comfort in paying attention to the breath
or body sensation, we can simply put our hands over the heart and feel the warmth of our
hands, the gentle pressure of the hands on the chest, and the rhythmic movement of the
breath under our hands. That simple act reminds us that were not only paying attention,
but were paying loving attention, to our moment-to-moment experience.

Self-compassion is often the only way that people can stop beating up on themselves (and
fighting their experience) when things go wrong in their lives. Personally, I had debilitating
public speaking anxiety for decades and mett meditation finally gave me the strength to
just be anxious during a speech and let the anxiety play itself out. The practice of loving-
kindness meditation is currently a hot research topic and its the core practice in the eight-
week Mindful Self-Compassion training program that Kristin Neff, a psychology professor
at the University of Texas, and I have been developing and researching for the past two
years.

IJ: How would helping others, as opposed to helping oneself, be seen as a therapeutic tool,
in both contexts? Would it be seen similarly in both, or differently?

CG: There is a growing literature in positive psychology on the psychological benefits of

compassion for others, gratitude and other pro-social emotions. I asked a pioneer in the
field, Christopher Peterson, to sum up positive psychology in a few words, and he said,
other people. Just like the bodhisattva vow, attending to the welfare of others is a
prescription for happiness. It liberates us from the illusory prison of individuality. Both
Buddhism and positive psychology are on the same page in regard to compassion for
others.

In clinical practice, however, self-compassion is usually the starting point and is a more
effective way of alleviating suffering. Once we have rediscovered the loveliness in
ourselves, then we can see the loveliness in others. Its impossible to embrace others when
we notice and reject qualities in others that we despise in ourselves. The Dalai Lama
echoed this view when he said:

For someone to develop genuine compassion towards others, first he or she must have a
basis upon which to cultivate compassion, and that basis is the ability to connect to ones
own feelings and to care for ones own welfareCaring for others requires caring for
oneself.

Ironically, in 2012, self-compassion can no longer be assumed. People dont necessarily

know how to be kind or compassionate toward themselves. Especially when we experience
overwhelming emotional pain, most of us kick in negative core beliefs such as Im
unlovable, Im stupid, and Im defective. So the path to loving ourselves is often
through others. A new research study has shown this as well. In loving-kindness
meditation, we learn to evoke loving states of mind by first thinking of a living being who
naturally makes us smile, such as a dear dog or cat, and then we tuck ourselves into that
circle of compassion. May you and I be safe and free from suffering.
Practicing compassion for others, including altruistic action, occurs naturally when we feel
more comfortable in our own skin. Historically speaking, this has been the starting point of
most Buddhist practiceordinary unhappiness, but we basically like ourselvesand then
we progress toward to the abode of the gods, the Brahmaviharas.