Mindfulness Means Nothing: Lose the Word, Find a Habit

Mindfulness is the ability to live life more fully aware of what's going on both around us and in our minds. Through that awareness, we become more familiar with our ongoing mental habits.
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A woman doing yoga on the beach at sunset.More yoga images:
A woman doing yoga on the beach at sunset.More yoga images:

I am on my way to a Mets game and my friend Ken asks, "What is mindfulness?" It's not an uncommon question for me. It's in my writing, my medical practice, the classes I lead, and my everyday life. So you'd think I'd have a pithy answer that perhaps would last less than the hour we'll be stuck in ballpark traffic, but I don't. Mindfulness has become harder and harder for me to define the more I know about it.

I often say that if mindfulness seems odd or inaccessible, I've done a poor job explaining it. I generally start with Dr. Jon Kabat-Zinn's definition, since he created the original mindfulness program in the 1970s. He has said mindfulness is "paying attention on purpose, in the present moment, and nonjudgmentally, to the unfolding of experience moment to moment."

That sentence is accurate, but fails my Bronx test. If I ask any average person on the street what that means, I'd be at risk for a dismissive shrug. And who wants to be nonjudgmental anyway? Dr. Kabat-Zinn's definition starts the discussion, but does not necessarily reveal enough about tangible, day-to-day value. That's because mindfulness is a word trying to translate an experience, something common sense and accessible but not easy to encapsulate.

Mindfulness: A Dictionary Definition
Mindfulness According to Oxford:
The quality or state of being conscious or aware of something

Dr. Kabat-Zinn created his "mindfulness-based stress reduction" (MBSR) program to introduce centuries-old Buddhist concepts into the secular West. Mindfulness is not a spiritual practice unless you want it to be. Whether you're an intense business leader, an inner-city kid from Baltimore or living on a mountaintop in Tibet, mindfulness builds skills and perspectives that cultivate a larger sense of equilibrium around basic facts of life such as everything is always changing, nothing stands still, and uncertainty rules.

The concept behind the entire MBSR program can be unintentionally misleading. Give us eight weeks and we can fix your stress problem. It can sound very... advertising driven. As any MBSR teacher would say, in reality stress is going to continue whatever we do. And even when your stress level does improve (as research suggests it may), MBSR does not immediately alter anything for some people or eliminate stress forever for anyone; it is not cure-all or a quick fix.

The eight-week program is an introduction to a lifelong training. Stick to it, even when practice is difficult and not much seems to happen, and your experience changes. Mindfulness is more analogous to long term physical fitness than anything more immediate such as knee surgery or a dose of antibiotics.

The Language of Mindfulness
Mindfulness According to Grandma:
Learning how to "be in the moment" and familiar with what you are experiencing so that you become more focused and less reactive in your behavior.

There's often confusion about the relationship between various related concepts such as "mindfulness" and "mindfulness meditation" and "mindfulness-based stress reduction." Are they all the same or different? Do they all depend on each other? If I take a mindfulness class do I have to sit quietly for hours on end and pretend to be happy about it?

First, what is meditation? Mindfulness meditation is a particular type of meditation that breaks a habit. We all live much of life distracted and not quite paying attention to what's actually going on. We exist on autopilot, generally relying on habitual and often reactive behaviors. Through meditation we aim to build a capacity to attend fully to real life, as it is, for better or worse, without any escapism or striving for a totally still mind. Not only can you meditate if you have a busy mind, it's expected that you'll have one.

How does the MBSR program relate to mindfulness? Dr. Kabat-Zinn's center has created guidelines for MBSR instruction, with the intention that only teachers following the plan call their classes by that name. To attend an MBSR class means someone follows this protocol. Many other programs and interventions formally or informally (but validly) integrate mindfulness.

Mindfulness refers to the whole package, a particular set of cognitive skills we develop that help manage our lives. Mindfulness doesn't require meditation, but it's built through meditation. It does not require a particular program. You can practice mindfulness at any time through the day, bringing your full attention to whatever you're doing, with a particular attitude of openness and acceptance (whatever that means). So mindfulness is not mindfulness based stress reduction is not meditation.

Mindfulness is more than attention training.

Mindfulness According to Siri:
The trait of staying aware
(of paying close attention) to your responsibilities.

Stress results when real life does not fit our idea of what should be. Which might mean something as huge as "I imagined I'd be in a happy marriage forever but now I'm getting divorced" or as simple as "I had my heart set on a cheeseburger but they are out of cheese." Recently back from vacation we may feel particularly magnanimous, accept our disappointment, and move forward. After an awful night sleep and a fight with our boss the no-cheese experience causes a meltdown. A lot of the time, if not all the time, our perspective matters.

When we discuss paying full attention to our immediate experience, it means not only to external forces (no cheese today) but all our internal chatter (this kind of thing always happens to me, what idiot failed to order cheese at a burger joint, my life sucks, why can't I be more mindful and accepting instead of getting angry again). We cannot expect to be happy in any situation, but we increase suffering when fueling our mental fires with self-recrimination (I shouldn't make such a big deal over a missing dairy product), rumination (if only I could stick to vegetarianism this kind of thing wouldn't happen to me), prognosticating (nothing will ever change) or any other common tinder.

Mindfulness may be a proactive version of the traditional serenity prayer, without the God reference. Being open and curious means acknowledging the reality of the moment, however we feel, without excessive wrestling. Equanimity, a sense of peace and ease, often follows. May I develop for myself the ability to change the things I can, to accept the things I cannot, and the wisdom always to see the difference.

Mindfulness is a skill set.
Mindfulness According to Dr. G, Pediatrician/MBSR participant:
Mindfulness is a state where one accepts the past as unchangeable and the future as theoretical, where thoughts are just thoughts
and the present moment is all there is.

So what is mindfulness already? Mindfulness is the ability to live life more fully aware of what's going on both around us and in our minds. Through that awareness, we become more familiar with our ongoing mental habits. That awareness increases our ability to pick and choose (without expecting total success) which ones to continue and from which we might step back at any moment.

We also build a general trait of responsiveness over reactivity. We create a little more space between our experience (no cheese) and whatever we elect to do next. Or maybe for once we allow ourselves to do or say nothing at all, dropping any rumination, planning or compulsion to fix everything. I'm disappointed, I don't have time to go elsewhere, what else can I order today?

Putting our existence under a microscope is not the goal; we instead balance a more gentle focus with a measure of acceptance. We recognize our own cognitive tendencies without self-abuse. We cultivate a sense of compassion for ourselves and others, a recognition than once we pause and attend we may notice that we're all trying to find some peace and happiness in life, even when we appear to be making a mess of it.

Mindfulness for a healthy brain.

Mindfulness According to basketball coach Phil Jackson:
The trick is to experience each moment with a clear mind and open heart. When you do that, the game -- and life -- will take care of itself.

I don't work out because I want stronger lungs or legs or arms in particular. I want my body as a whole to stay in shape. And I don't practice mindfulness because I expect better focus or less stress or more responsiveness in isolation. I support a general state of mental well-being through ongoing effort. That hopefully improves life not just for me, but for my family and anyone else who deals with me day to day.

As a doctor trained in Western medicine, the science matters a lot to me. Among people practicing mindfulness studies have shown physical changes in the brain including ones potentially related to focus and emotional control. Other research reveals physical and psychological benefits. The brain is malleable, responding to our experience and whatever we mentally practice with concrete, physical growth. So if it clicks for you, feel free to define mindfulness as cognitive fitness training.

In a line or two then, what is mindfulness and why do it? Mindfulness is a word, and a less than perfect one at defining anything in particular. The concepts behind mindfulness matter far more. Try it and find out.

For more by Mark Bertin, M.D., click here.

For more on mindfulness, click here.