Mindfulness and meditation therapy

Mindfulness and meditation therapy are neither equivalent nor completely separated. Mindfulness is the most widely used core technology carrier of meditation therapy, while meditation therapy is a clinical psychological intervention system that includes mindfulness, transcendental meditation, guided imagination and other technical paths.； At the same time, daily mindfulness practice in non-clinical settings does not essentially fall into the category of therapy.

The first time I had a real sense of this difference was when I received my first client with panic disorder three years ago. The girl was 27 years old at the time and worked as an Internet operator. She had been having attacks at least once a week for three consecutive months. She was breathless and her hands were numb. She had checked her heart several times and found nothing wrong. When she came, she still had a wrinkled meditation clock in her pocket that she had practiced with the blogger for half a year. “I practice mindfulness meditation for 20 minutes every day, why is it still not working? ”she asked me. I looked through the content of the exercises she followed. It was the kind of traditional meditation that focuses on "clearing the brain and entering deep calm." The whole process of guidance asked her to "get rid of all the thoughts in the mind." It was completely opposite to the mindfulness technology we use clinically. The mindfulness we teach is that if you find that your thoughts have drifted to next week's weekly report, it doesn't matter. You don't have to scold yourself for wandering, just gently bring your attention back to your breathing. There is no need to "empty" at all.

Mindfulness-based stress reduction therapy (MBSR) and mindfulness-based cognitive therapy (MBCT), which are most commonly used in clinical practice, are essentially branches of meditation therapy with mindfulness technology as the core. It is even said that meditation therapy has been included in the mainstream evidence-based psychological intervention system in the past 20 years, and 80% of the research data comes from mindfulness-related intervention studies. Last year, I conducted a pre-exam anxiety group intervention for high school seniors. I used the three-minute breathing space mindfulness technique, which is a type of short-term meditation therapy. After each intervention, I could see their state anxiety scale scores drop by an average of seven or eight points, and the effect was visible to the naked eye.

It’s interesting to say that when I attended an industry forum two years ago, I saw two groups of people quarreling over the boundaries of these two concepts. Teachers of traditional Theravada Vipassana believe that mindfulness is originally the core practice method of traditional meditation. Now the clinical academic community has taken it out of the religious and spiritual context and only used it to treat insomnia and reduce anxiety. This is using mindfulness in a "shallow" way, and even eliminating its original meaning. The senior sister sitting next to me who is doing evidence-based research directly dumped the meta-analysis data from 2022, saying that the intervention effect of standardized and adjusted mindfulness meditation therapy on generalized anxiety is equivalent to that of a moderate dose of sertraline. For the vast majority of ordinary people who are just troubled by daily emotions, there is no need to pursue any kind of "enlightenment". It is enough to solve the current pain, and there is no need to raise the threshold so high.

In fact, to use an inappropriate analogy, the relationship between mindfulness and meditation therapy is a bit like the relationship between glutinous rice and zongzi. Glutinous rice is the core ingredient of Zongzi. It is used in most mainstream sweet and salty Zongzi. However, you cannot say that glutinous rice is Zongzi. After all, glutinous rice can also be used to cook porridge and make glutinous rice cakes. It is just like taking a minute to do breathing awareness during your daily break from work. It is just a daily mindfulness practice and not a therapy at all. ； On the other hand, not all rice dumplings must be made of glutinous rice. Nowadays, there are also rice dumplings made of grains. Just like some meditation therapies such as transcendental meditation, which use the technique of silently reciting mantras, which is completely different from the core logic of mindfulness of "awareness without judgment", they also belong to the serious branch of meditation therapy.

To be honest, many meditation-related products on the market now like to bundle these two concepts together. A friend of mine spent 399 on a "21-Day Mindfulness Meditation Healing Course" some time ago. He went in and listened to two classes. Half of the class taught you how to "connect with the energy of the universe", and the other half of the class was about home feng shui, which is pure IQ tax. In fact, ordinary people don’t need to struggle with concepts. If you just want to have a good night’s sleep, just practice 10 minutes of mindfulness-guided sleep meditation with a regular APP. It will be useful. ； If you have been troubled by depression or anxiety for two or three months, and your normal life has been affected, then don’t expect to get better just by following the short videos. Finding a therapist with registration system qualifications and doing structured meditation therapy intervention will definitely be much more efficient than practicing blindly on your own.

I have been doing clinical practice for so long, and I rarely define concepts with my clients. After all, whether it is mindfulness practice or meditation therapy, they are essentially tools to help you get along well with your emotions. There are not so many ups and downs, and there are not so many mysterious statements. If it can be used and useful, it is better than anything else.