Dear Editor,
Mindfulness is a new relaxation technique currently being endorsed by the ICGP and promoted as a stress reduction method to avoid burnout in general practice. Whilst the altruism and intention is certainly admirable, it should be noted that mindfulness is ‘an Eastern meditative technique adopted directly from Buddhism’.
Mindfulness is more than a meditative practice; it is an outlook on life and reality that is designed to cultivate detachment. Detachment is necessary in Buddhism because Buddhism teaches that attachment to this world, to your thinking, your desires and indeed to your identity as an individual or self keeps you in the cycle of rebirth.
Mindfulness is the method of detachment through which one ultimately becomes liberated, achieving a state of complete detachment or Nirvana. This process of detachment or mindfulness is often defined as a “moment-by-moment non-judgmental awareness of the present”.
Given that we cannot in reality detach ourselves from rational informed reasoning whilst maintaining effectiveness in consultations, this form of relaxation therapy is disturbing as it undermines the activity of active listening, cognitive reasoning and expressed empathy in the consultation.
In Buddhism, the mind is perceived as being a barrier to grasping ultimate reality and truth; therefore the mind must be bypassed. Mindfulness is designed to do just this — bypass the faculty of the mind. But is it common sense to detach the rational mind from the reality it encounters on a momentary basis?
The concept of mindfulness is becoming more widely accepted in the Irish healthcare community and therefore deserves some critical appraisal. We must be careful to assess what becomes generally accepted in everyday medical practice. If one practises mindfulness meditation on a regular basis, one endorses and eventually may adopt the world view behind it, accepting that the process of detachment is helpful to us and useful for our patients. However, if we accept that the self is actually real, there can be no true detachment from it; the conscious and active pursuit of liberation from self must be seriously questioned.
Whilst mindfulness focuses on the processes of detachment from self, it actually involves doing the exact opposite. Being mindful means basically concentrating on yourself. The techniques of mindfulness meditation may lead one to enter an altered psychological state similar to that of self-hypnosis. In this state, the practitioner’s critical thinking and judgment are suspended, leaving the mind open to virtually anything.
The consultation is an active engagement in a very meaningful, relational interaction between two very existent and important people. The consultation is the process that needs to be strongly supported and protected by our profession for the good of our patients. Mindfulness, in my view, has the potential to undermine the unique dialogue and relationship which we engage in daily as GPs.
Dr Richard Gavin,
Cornerstone Medical Practice, Drogheda.
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Dr Gavin is (deliberately?) misunderstanding what mindfulness is about. Far from detachment (in the negative manner described), being mindful is about becoming more aware, more focused and more present with the task one is currently working on.
Mindfulness in a consultation would mean putting aside any residual thoughts about the past or the future in order to focus fully on the needs of the patient in front of you. This is especially important if we are to avoid residual thoughts and feelings about a previous patients spilling over into this consultation.
Also, far from detaching from your rational mind during a consultation, being mindful would be to seek to engage it fully in order to arrive at the best assessment or diagnosis.
“Putting aside any residual thoughts about the past or the future in order to focus fully on the needs of the patient in front of you.”
The patient needs a scientist who will use the past in the present to help make the patient’s future better.
It appears Dr Gavin understands mindfulness in a different way than most mindfulness practitioners. Practicing mindfulness increases one’s awareness of self and surroundings. In one respect, it helps exercise mental focus and attentiveness. I would not say mindfulness distracts an individual from practicing basic consultation skills, but can actually enhance attentiveness.
I can see one criticise mindfulness as being another form of relaxation. It is that, but it also increases one’s tolerance for pain (psychological and physical) by reducing the psychological suffering that happens from mindlessness.
I have to ask: is this a joke?
If not, Dr Gavin does his reputation a great disservice with this article.
This is not the Onion news report, is it?
I’m with Tim.
All that was missing from the good doctor’s critique was a reference too the ‘cult’ of Buddhism.
Mindfulness provides a way of using your mind more effectively. Nothing to fear: everything to gain.
The article is a great example of the process of coming to a conclusion about something without having experienced it or understood it. It seems to be reflecting fear of meditation based on the idea that mindfulness makes you stupid and numb. It also claims (incorrectly) that all Buddhist practices are about renunciation (detachment).
I am actually grateful for this article. The other day I attended a conference called ‘Mindfulness in the Workplace’ and one participant asked the presenter the following: ‘In the current time of mindfulness becoming so popular, with research showing how beneficial it is, what are the sceptics saying, what are the obstacles for mindfulness becoming a mainstream tool for working with stress?’ Well, here is the answer.
May insight and understanding overcome close-mindedness.
Mindfulness practitioners are training a more attentive state [and are] more open and aware in the moment with the patient.
See The Inner Consultation, a mindful approach (awareness centred), promoted by R Neighbour.
Mindlessness is best avoided, an absent doctor unaware is a “responder” and less an “observer”, in Neighbour’s language.
Mindfulness is not what you think.
It is being more aware in the present moment, being aware of thought emotion and sensation in a more expanded awareness strengthened by mindfulness practice. It is not a religion. It is a way of life that brings wisdom, kindness, and forgiveness through attention to one’s own thoughts, emotions and sensations.
Try Mindfulness For Dummies or see Jon Kabat-Zinn on YouTube talking about mindfulness to Google employees.
This is a shocking piece of writing. It is also an irresponsible and harmful one too. Mindfulness meditation has the potential to offer people relief from unnecessary suffering and this article misrepresents not only the practise itself but also Buddhism as a whole.
Firstly, mindfulness meditation is NOT a relaxation technique. It is a way of cultivating focused attention and awareness. Relaxation can be an offshoot of this but often that is not the case. Like most training, it requires hard work and consistent application.
Secondly – the term ‘detachment’ or ‘non-attachment’ (the latter being a better translation from the Pali) is not a state of renunciation but a non-attachment to a fixed view of reality. Too often we expect the world to stay the way we want it to or we want it to be other than it is. Our desire for things to be this way leads to suffering – the Buddha teaches us to let go of this false view and embrace change. He asks us not to deny the world but to see it as it really is! Mindfulness is a practise that helps us to notice these changes and the flux of reality and helps us to accept and cultivate awareness of this changing reality. In doing so we can better understand how we can make the world a better place for ourselves and others.
This is to embrace life, not to turn our backs on it! Nirvana is the stopping of craving for things to be other than they are and an embracing of a productive and positive interaction with reality. In this way we are not reborn into cycles of unwholesome and destructive activity. This is a minute-to-minute process and not specifically between lifetimes.
Thirdly – the belief in no-self or non-self is not some sort of denial of existence but a recognition that the self is not a fixed entity that is unchanging. The self is a process and cannot be pinned down so to believe that we can identify it as a distinct object is simply an act of faith. Mindfulness allows us to appreciate more what makes up this shifting, moving and changing process that we call human experience. Further to this the idea that somehow mindfulness is only a focus on ‘yourself’ is the most disturbing part of this letter and belies a very shallow understanding of experience. How is it possible to only experience ‘yourself” unless you believe in some form of solipsism? This is impossible as we cannot disassociate ourselves from the world around us – I challenge Doctor Gavin to tell us where the dividing line exists between our experience of ourselves and that of the world. For example, Mindfulness is at its most fruitful when it is brought to bear on our relationships with others and how we act and feel in their presence. Sitting meditation practise is only a part of mindfulness and as I mentioned above, is a from of training of our attention so that we can be more PRESENT to others.
I am also intrigued as to what is suggested by the idea of the mind being open to virtually anything – surely the mind is more susceptible to subliminal suggestion when we are distracted or lacking in awareness (the exact opposite of mindfulness practise) – unless the writer is suggesting demonic possession!
Mindfulness as a practise has so much to offer and does not deserve such a shallow critique.
So where has joined-up thinking gone?
There are too many logic-jumps in this argument to make any sense.
I’m with Dan, and started with Miro but he’s lost me. I think maybe I need more mindfulness.
A