Book Review January 15, 2012

Teaching Mindfulness: A Practical Guide for Clinicians and Educators

Judith R. Milner, MD, MEd, SpecEd

J Clin Psychiatry 2012;73(1):131

Article Abstract

From our regular book review column.

Because this piece does not have an abstract, we have provided for your benefit the first 3 sentences of the full text.

This is a very timely and practical work, perhaps the first of its kind. In a culture in which mindfulness is increasingly touted as apsychotherapeutic tool, if not an entire way of being in the world, itis helpful to have a book describing how to teach and usemindfulness-based techniques. In a Foreword, Jon Kabat-Zinn recountsthat, for years, mindfulness-based stress reduction (MBSR) techniqueshave been used in hospitals predominantly with evidence-based reductionof pain and suffering, enhanced immune response, and improved emotionalregulation.’ ‹

Teaching Mindfulness: A Practical Guide for Clinicians and Educators

edited by Donald McCown, Diane Reibel, and Marc S. Micozzi. Foreword by Jon Kabat-Zinn. Springer, New York, NY, 2010, 250 pages, $159.00 (hardback).

This is a very timely and practical work, perhaps the first of its kind. In a culture in which mindfulness is increasingly touted as a psychotherapeutic tool, if not an entire way of being in the world, it is helpful to have a book describing how to teach and use mindfulness-based techniques. In a Foreword, Jon Kabat-Zinn recounts that, for years, mindfulness-based stress reduction (MBSR) techniques have been used in hospitals predominantly with evidence-based reduction of pain and suffering, enhanced immune response, and improved emotional regulation. At this juncture in time, however, it is interesting that MBSR begins to emerge as a scientific tool, with deep roots in what has traditionally been viewed as the spiritual, most commonly Buddhist, practice of meditation. The book is timely because there is a rapidly growing interest in and demand for the teaching of mindfulness to a much broader level within many of society’s institutions. "Why now?" one might ask. As Kabat-Zinn so articulately states,

In part, I would say, because the world and its institutions and denizens are literally and metaphorically starving for authentic ways to live and to be and to act in the world. We long for some degree of effective balance and wisdom that supports meaningful, embodied, and significant work—the work of making a difference in the world, of adding value and beauty, of individually and collectively waking up to the full range of human intelligences and capacities we share for wisdom, ease of being and kindness. (p xiii)

In the Preface, the editors define mindfulness as "the capacity to be with and in the constant flow of awareness." They describe it as an inherent ability we all share and further speak to the issue of mutual transformation—of both teacher and student—in the gift of teaching mindfulness. So, potential teachers of mindfulness come, yes, from the helping professions, but where prerequisites are viewed from the perspective of one’s attitude and own preexistent level of mindfulness practice, the net is cast much wider indeed.

The book is structured in 3 parts. Part I provides an overview of contemporary mindfulness-based interventions (MBIs) in medicine and mental health care; places those interventions in the wider historical and cultural context of the meeting of East and West; suggests the ripple effect of cultural diffusion and the expanding openness to contemplative practices in general and mindfulness in particular, especially in North America; and attempts to offer a pragmatic definition and felt understanding of mindfulness that will be useful for a teacher when inquiring about either one’s own practice or the practice of one’s students. Part II elucidates what is required in the practice of teaching and how one may further develop their own practice of mindfulness. More concretely, it outlines the skills of teaching, describes how and when they come into play, and offers clinical vignettes. Part III provides a schematic for teaching. The process of teaching and learning within MBIs is laid out, whether it be with individuals or groups. "Gestures" that may be used for suggestion and for teaching are described, identified, and illustrated. Also, scripts and step-by-step descriptions of activities and practices that can be used in the learning environment are provided, as well as an Appendix rich with resources for personal and curriculum development.

The editors introduce us to some contemporary MBIs such as Kabat-Zinn’s MBSR, Segal’s mindfulness-based cognitive therapy, Linehan’s dialectical behavior therapy, and Hayes’s acceptance and commitment therapy, including references to the more practiced approaches of Freud, Jung, and psychoanalyst Erich Fromm. In a rich and entertaining discourse, they trace the historical influence of Eastern thought on Western experience back to the days of Alexander the Great; quoting such notables as Thoreau and Emerson; providing a brief description of Morita Therapy; introducing us to Zen scholar, D. T. Suzuki; and tracking the growth, definition, and ultimate secularization of Buddhism in America. Concomitant with the secularization of Buddhism has been the widespread acceptance and gaining popularity of the concept of mindfulness, no discussion of which would be complete without mention of Thich Nhat Hanh and Jack Kornfield, in addition to Kabat-Zinn. Nor would it be complete without descriptions of neurobiological and neuroanatomical correlates of mindfulness and subsequent empathy—mirror neurons.

Part II is aptly entitled "Authenticity, Authority, and Friendship." These are the qualities the teacher brings to the group. The 4 skill sets that seem to be shared among teachers in the MBIs are stewardship of the group; homiletics, or the delivery of didactic material; guidance of formal practices and informal group experiences; and inquiry into participants’ direct experiences. Part III is entitled "Toward an ‘ Empty’ Curriculum." "Empty" though it may be, very specific directives are provided in this section for the teaching and conduction of core formal mindfulness practices, including body scan, sitting meditation, and mindful hatha yoga. The MBSR template course program is offered. Variations, such as the "3 lesson module," a MBSR mini-course, are made available.

The book is comprehensive, well written, informative, and entertaining. It would be a valuable source of information to any person interested in teaching MBIs or in deepening his or her own practice of mindfulness. The Appendix provides extensive information on additional training resources.

Judith R. Milner, MD, MEd, SpecEd

[email protected]

Author affiliation: Private Practice of Psychiatry, Everett, Washington. Potential conflicts of interest: None reported.