A great deal has happened on so many fronts since this book first appeared in 1990. For one, the Stress Reduction Clinic described here, since the year 2000 under the direction of my longtime colleague and friend Dr. Saki Santorelli, has continued to thrive at UMass for another thirteen years, thanks in large measure to his remarkable leadership and vision and skill in negotiating the waters during a very turbulent and trying time in medicine. In September 2013 the clinic celebrated its thirty-fourth year in continual operation. More than twenty thousand medical patients have completed the eight-week MBSR program. The present teachers and staff of the clinic are unsurpassed in their devotion to articulating the practice of mindfulness effectively, in the quality of the work they do, and in the profound effects they have on the people who take the program in helping them to know themselves better and grow more fully into themselves to whatever degree might be possible. As a community, we share a deep gratitude for all the past MBSR instructors and staff who contributed to the successes of the program over the years—they are listed in the Acknowledgments.
In the past twenty years, the work described in this book, in the form of MBSR and other mindfulness-based programs, has spread around the world. While from one perspective this may have seemed improbable, from another perspective it makes a lot of sense, and can be seen as a very positive development, perhaps arriving at just the perfect moment for the world to take note of the power of mindfulness and harness its transformative and healing potential. At first it happened relatively slowly, and then increasingly rapidly. It spread to hospitals, medical centers, clinics, and a range of other institutions such as schools, businesses, prisons, the military, and beyond. It part, this was propelled by the work of the Stress Reduction Clinic having been featured in the 1993 public television special Healing and the Mind, with Bill Moyers, seen by more than forty million viewers over the years. Since the entire forty-five-minute segment was crafted as a guided meditation in its own right by the talented producer David Grubin and by the editors—a very unusual use of television—it had a profound impact on the viewers, entraining them right into the process and practice of mindfulness along with the patients who were taking the class.
Our work in the clinic has also been featured in many other television news programs and articles in the media over the years, and now, increasingly, in the foreign media as well.
The development of mindfulness-based cognitive therapy, with its powerful theoretical rationale and its well-designed and executed clinical trials demonstrating and confirming its efficacy, also played a major role in the spread of interest in mindfulness in psychological circles and in psychotherapy. So has the development of self-report instruments that purport to “measure mindfulness” and have given rise to a rich and growing body of research. Studies on the effects of MBSR and other forms of meditation practice on both brain activity and brain structure and connectivity have also accelerated work in this growing area of neuroscience, now known as contemplative neuroscience. Many of these studies have been conducted on monks and other practitioners with tens of thousands of hours of meditation practice and training. Richard Davidson and his collaborators at the University of Wisconsin in the Laboratory of Affective Neuroscience and the Center for Investigating Healthy Minds have been pioneers in this area. The University of Wisconsin has its own Center for Mindfulness and a fine team of MBSR instructors, led by its founder, Katherine Bonus.
The Mind and Life Institute and its annual Summer Research Institute have catalyzed a growing community of young scientists and clinicians at the highest levels. It has also made it much more acceptable as a career path to do research in this area, by making strategic funding available for young investigators through Varela Research Grants (named after the late Francisco Varela—the co-founder of the Mind and Life Institute, a polymath neuroscientist, philosopher, and highly committed meditation practitioner) as well as larger grants for senor investigators.
In 1995 we inaugurated an umbrella institute, known as the Center for Mindfulness in Medicine, Health Care, and Society (CFM), to house not only the Stress Reduction Clinic but the wellspring of initiatives and projects that were emerging out of our work by that time, well beyond the work in the clinic itself. The CFM now offers mindfulness-based programs of all kinds in schools and businesses in addition to its work with medical patients. It also houses an institute, Oasis, for educating and training interested health professionals and others in the intricacies of mindfulness practice and its delivery in a range of different institutional settings. Oasis offers an MBSR instructor certification program that professionals are participating in from around the world.
The CFM also collaborates with other institutions in a range of ongoing research projects, and hosts an annual international mindfulness conference that, in 2013, is in its eleventh year. Hundreds of scientists, clinicians, and educators from around the world attend these meetings and share their initiatives and studies with each other—a beautiful and growing global community. Many of these mindfulness teachers are now writing both professional and trade books to express their own unique perspectives on mindfulness, MBSR, MBCT, and other mindfulness-based interventions. They are also studying and writing about meditation practices which cultivate lovingkindness and compassion, as well as the cultivation of what some psychologists are calling virtuous human qualities, such as generosity, forgiveness, gratitude, and kindness.
All these efforts from different groups around the world are driving and deepening the growing interest and understanding of mindfulness as an actual practice, and not merely as a philosophy or good idea. The field of mindfulness-based interventions is increasingly multifaceted. MBSR programs and other programs modeled on it are even being offered now by Buddhist meditation centers such as InsightLA.
From 1992 to 1999, we ran a free MBSR clinic in the inner city in Worcester, with free on-site mindful child care, free transportation, and in which classes were taught in Spanish as well as in English. This clinic and the hundreds of people it served demonstrated the universality of MBSR and its adaptability to multicultural settings. We also conducted a four-year program for inmates and staff of the Massachusetts Department of Corrections, and demonstrated an ability to reach large numbers of inmates with MBSR and reduce measures of hostility and stress. One of our colleagues, George Mumford, who co-led our inner city clinic, also trained both the Chicago Bulls and then the Los Angeles Lakers in mindfulness during their championship seasons.
You can find out more about the CFM and the Stress Reduction Clinic, its professional training opportunities, and where MBSR programs that we know about are located around the world by visiting the CFM’s website at www.umassmed.edu/cfm.
In his Preface, Thich Nhat Hanh describes this book as “a door opening both on the dharma (from the side of the world) and on the world (from the side of the dharma).” Although you will not find the word dharma in this book, other than in this paragraph, in the Preface, and in two other places, I would say that we need it in our vocabulary, as there is no way to translate it. For many years, I was hesitant to use it at all, and there is certainly no need for it in the teaching of MBSR, nor do we ever use it in that context. Still, it is necessary in the training of MBSR teachers, because, as Thich Nhat Hanh saw, MBSR is deeply rooted in dharma. If prospective MBSR teachers think that mindfulness is just another cognitive-behavioral “technique” developed within the intellectual framework of Western clinical psychology, they would be sorely mistaken. That would be a profound misunderstanding of the origins of mindfulness and of MBSR, and the depths of its healing and transformative potential. For obvious reasons, one cannot teach what one does not understand, and mindfulness cannot be understood outside of its embodied cultivation through practice without attachment to any outcomes, however desireable. For anybody who is interested in this subject in any detail, I have written an extended piece entitled “Some Reflections on the Origins of MBSR, Skillful Means, and the Trouble with Maps.” It can be found in the book Mindfulness: Diverse Perspectives on Its Meaning, Origins, and Applications, co-edited by Mark Williams of the Oxford University Mindfulness Centre and myself. You may also want to consult a chapter called “Dharma” that I wrote for Coming to Our Senses. These attempts to use the word and locate it within the field of mindfulness-based interventions are meant to give more explicit background to those who care to understand the traditions out of which MBSR emerged and upon which its practices are based. MBSR was meant from the beginning to be an experiment to see whether mainstream America and American medicine and health care would be receptive to this transformative and liberative dharma perspective, if framed in a universal vocabulary and within an easily accessible and commonsensical format and idiom. MBSR and its “cousins” are expressions, however limited they may be in some regards, of the deep wisdom stemming from practices discovered and refined long ago in India and kept alive and refined further over millennia by multiple traditions—mostly but not exclusively Buddhism—in all the civilizations of Asia.
May mindfulness in its most universal expression prove valuable in your life and in all your relationships, both inner and outer. May your mindfulness practice continue to grow and flower and nourish your life and work from moment to moment and from day to day. And may the world benefit from this potentially boundless flowering within your own heart.