Germinal Mindfulness

Abstract

Mindfulness has become a household word in the research and treatment of mental disorders. The term with Buddhist origins is associated in our culture with purposeful, non-judgmental, present-centered attention, and carries the promise of many therapeutic benefits. In this essay, a more detailed description of the term is offered: the one described in one of the books that inspired the mindfulness movement of the West, The Heart of Buddhist Meditation: The Buddha’s Way of Mindfulness, by the Buddhist monk of the Theravada sect from Sri Lanka, Nyanaponika Thera (1901-1994). The effectiveness of mindfulness in relatively mild mental disorders is well-documented, but not so much in serious disorders like schizophrenia, usually called psychosis. An overview of schizophrenia includes basic concepts of psychology, psychiatry, and neurology of related importance, as well as the name changes of the disease that have recently occurred in some countries of the Far East. Germinal Mindfulness is specified as the primordial, indispensable, and around-the-clock event of human cognition: Germinal Mindfulness is hypothesized to be seriously impaired in schizophrenia. Possible therapeutic benefits of meditation are outlined. It is hoped that a more in-depth understanding of the term mindfulness may contribute to treatments for schizophrenia and other mental disorders, that could include meditative practices.

by Lucas Peluffo

Schizophrenia survivor, meditator, biologist (B.A., 1984, The University of Vermont—Burlington, Vermont, USA). Contact: lucaspeluffo@icloud.com

Published: 2020. Revised; paragraphs, notes, and web links added: 2023.

Mindfulness: Introduction and Overview

The word mindfulness¹ is a translation from the Pali (an ancient liturgical Indian language used in Buddhist scriptures) word sati. Many scholars assert that one exact translation is lacking and that the word roughly means “awareness,” or “attention.” As Right Mindfulness, it is the seventh step to be followed in the Buddhist Noble Eightfold Path (the path being Buddhism’s Fourth Noble Truth). Mindfulness is also a factor of Buddhist enlightenment and one of the traditional mental faculties.  Paradoxically, for many students, the word sati was originally related to memory, or remembrance, even though in Buddhist scriptures and popular usage, it mostly emphasizes attention to present experiences. An approach to partly solve the paradox may include remarking that words and their meanings evolve, and also wandering around the fact that the hypothetical “present” is almost always tainted with some form of memory. Sati could describe an awareness of the interdependence of phenomena, and also the mind’s capacity to not forget or turn away from a meditation object. Some have translated sati as “memory of the present.”

In popular usage, mindfulness may refer to meditation in general, even though a large variety of meditation methods exist. The exact definition and use of mindfulness may vary among different Buddhist sects. Mindfulness is also an important and analogous term in the jargon of Yoga, the Hindu practice that includes meditation. Modern neuroscience has focused more on mindfulness among all meditation forms, contributing greatly to its popularity with abundant discoveries.

Buddhism, the Indian meditative tradition where mindfulness has its roots, includes sophisticated psychology where calming the mind is of paramount importance. The religious aspects of Buddhism include abundant mystical concepts, but the ancient belief system that venerates personal meditation like no other is, perhaps, consequently, the most empirical one. Accordingly, it is common knowledge among intellectuals that some of Buddhism’s tenets do not contradict modern scientific findings.

Perhaps the most widely quoted definition of mindfulness comes from pioneer Jon Kabat-Zinn (USA, 1944-), the molecular biologist who, turned a psychologist, created the successful Mindfulness-Based Stress Reduction (MBSR) program: “Mindfulness is awareness that arises through paying attention, on purpose, in the present moment, non-judgmentally.”² Mindfulness is directed to both mental and bodily processes. In a nutshell, on top of the proven benefits of non-reactive, present-centered attention, the therapeutic success of practicing mindfulness is often attributed to an emphasis on being aware of the transient and even insubstantial nature of thoughts and feelings, especially the distressing and painful ones.

The popularization of the typical Western definition of mindfulness as just nonjudgmental awareness is often criticized by Buddhists more immersed in their tradition. For them, nonjudgmental awareness is a step toward the active study and discrimination of an extensive list of psychological elements considered as causes of suffering and happiness, with lasting happiness being naturally the goal. In Buddhist doctrine, mindfulness refers frequently to a kind of attentiveness with the connotation of being good, skillful, or right—and therefore requiring some memory for its effectiveness. As such, it functions as a tool to reach key insights into mystical concepts such as the illusory nature of the self, the consequent impersonality of phenomena, and the ending of suffering through the realization of Nirvana: the extinction of greed, hatred, and delusion in this life or others.

The most important scientist to popularize the therapeutic benefits of mindfulness within secular medicine is Kabat-Zinn. Kabat-Zinn once defined mindfulness as a discipline of attention, with attention understood as the natural human capacity that the practice is meant to build. Mindfulness is gaining popularity as a proven scientific practice, not tied to its ancient religious roots, and it has expanded worldwide. In 1979, Kabat-Zinn founded the Mindfulness-Based Stress Reduction (MBSR) program at the University of Massachusetts to treat the chronically ill. MBSR and similar programs targeting stress, anxiety, depression, and pain have been applied in hospitals, schools, veterans centers, and prisons. A couple of more specific therapies have appeared since that include mindfulness. Mindfulness-Based Cognitive Therapy (MBCT) is a successful psychotherapy originally targeting depression, and it is partially based on MBSR. MBCT started in the 1990s through psychologists John Teasdale, Philip Barnard, Zindel Seagal, and Mark Williams. MBCT uses Cognitive Behavioral Therapy (CBT) in collaboration with mindfulness. Dialectical Behavior Therapy (DBT), the brainchild of psychologist Marsha Linehan (herself once controversially diagnosed with schizophrenia at 17, decades before her groundbreaking publications in full lucidity), combines mindfulness with group classes and a sense of community. DBT was originally developed to treat suicidal behaviors and later became the gold-standard treatment for borderline personality disorders. Many other mindfulness-based therapies also exist around the world.

Schizophrenia: Overview

Schizophrenia is a chronic and heterogeneous mental health disorder that is thought to affect about one percent of the world’s population. When the disease is in progress, the psychotic symptoms include delusions and hallucinations. Troubles with thinking and concentration also appear, and erratic movements and speech may also occur. Psychotic symptoms may result in severe distortions of reality, and a person is diagnosed with schizophrenia when those symptoms—along with others—persist over some time.  Auditory verbal hallucinations (“hearing voices”) are the most common symptom of schizophrenia: these are often tied to paranoid delusions of persecution. Complementing traditional psychology, scientists are unraveling the disease by studying genetics, conducting behavioral research, and using advanced imaging to look at the brain’s structure and function.

Experts have traditionally grouped the symptoms of schizophrenia as “positive” or “negative.” It is generally believed that these symptoms interact mysteriously, embodying the schizophrenic personality. The positive symptoms are active but abnormal traits, such as psychotic delusions and hallucinations, as well as erratic speech and bodily movements. The negative symptoms, on the other hand, refer to qualities that are lacking; they include affective flattening, deficits in interest, motivation, and communication, as well as poor cognition. Recently, the cognitive deficits have been grouped into a unique category. Although schizophrenia can generally—and in this essay—be called psychosis,³ specialists should explain that schizophrenia is a psychiatric disease associated especially with psychotic symptoms; and that the disease also includes those symptoms that are not psychotic and are also an important part of the diagnosis, such as affective flattening and the other negative symptoms. Other diseases considered as psychoses include bipolar disorder and schizoaffective disorder.

Arguably, given the potential disorders of the unleashed human mind, the positive symptoms of schizophrenia are the ones to be feared most. This would be in spite of the fact that the negative symptoms can evidently disrupt a person’s entire lifestyle.

The exact causes of schizophrenia remain a mystery, but the general opinion includes a genetic predisposition, developmental and environmental factors, including stressful events, as well as the alteration of chemical substances and the structure of the brain. Most scientists believe that the disease is incurable, but that through treatment and support, people diagnosed with schizophrenia gain the possibility of living active and meaningful lives. Medications have been directly successful in treating the positive symptoms of schizophrenia, while the negative symptoms tend to remain under the more mysterious and often ineffective umbrella of psychotherapy.

Mindfulness-based treatments for schizophrenia have begun recently. It is fair to assert that the data shows promise, but that most experts are waiting for more convincing results. It is also fair to mention that some clinicians do consider mindfulness to be harmful to psychotics, especially when applied within prolonged esoteric and mystical settings. Mindfulness treatments do not aim to cure the symptoms of psychosis, but aim to foster acceptance and insight into those symptoms. However, by helping to reduce distress, these treatments should help to alleviate the symptoms as well. The success of mindfulness-based treatments in milder mental disorders suggests that they may also help to improve the overall mental health of individuals with psychosis. Some optimistic clinicians and patients see mindfulness-based treatments as a possible complement or even an alternative to the medication-based approaches that have been well-perfected in modern times.

The Heart of Buddhist Meditation

According to Kabat-Zinn, the seminal book of the mindfulness movement of the West may just be The Heart of Buddhist Meditation: The Buddha’s Way of Mindfulness, by the German-born Buddhist monk of the Theravada sect from Sri Lanka, Nyanaponika Thera (1901-1994): “The book that started it all”—writes Kabat-Zinn himself on the cover of the book’s edition found in the bibliography. Thera’s scholarship centered on the practice and theory of meditation, and he emphasized that the training of attention may be considered the very heart of Buddhism. In the book, Thera fleshes out the Buddhist practice in detail from the perspective of his sect. In the first two chapters, he starts by defining and separating mindfulness into two specific aspects: Bare Attention and Clear Comprehension. Bare Attention refers to mindfulness within a purely receptive state of mind, and Clear Comprehension refers to mindfulness when activity applies, including mental activity. Both aspects are considered to be important by Buddhists, acknowledging that Clear Comprehension applies to the greater part of our time. The Clear Comprehension of activities would result from the successful application of Bare Attention. The term that I will touch on in more detail in this essay is Bare Attention, which is intimately associated with silent, sitting meditation. 

One aim of Bare Attention would be to allow the objects of perception to be seen as for the first time, not distorted or labeled by memory or imagination. Meditators are trained to maintain the corresponding purely receptive state of mind for as long as their concentration permits. Traditionally, Bare Attention is perfected by meditators concentrating on each sense door independently. Bare Attention then refers to a rawer, sense-centered version of “just” attention.⁴ Furthermore, Right Mindfulness is described in the book as a more ambitious and sophisticated version of just mindfulness. Right Mindfulness would be a developed faculty of experienced meditators, promising a high level of mental clarity, including ethical and other philosophical thought. Thought including concepts such as impersonality, imperturbability, and the overcoming of greed and grief concerning the world. Thera calls the most basic form of mindfulness Germinal Mindfulness (a term that I chose to put in this essay with capital letters as specific) in the following paragraph of his famous book:

“Mindfulness, though so highly praised and capable of such great achievements, is not at all a ‘mystical’ state, beyond the ken and reach of the average person. It is, on the contrary, something quite simple and common, and very familiar to us. In its elementary manifestation, known under the term ‘attention,’ it is one of the cardinal functions of consciousness without which there cannot be a perception of any object at all. If a sense stimulus exercises a stimulus that is sufficiently strong, attention is roused in its basic form as an initial ‘taking notice’ of the object, as the first ‘turning towards’ it. Because of this, consciousness breaks through the dark stream of subconsciousness (a function that, according to the Abhidharma—Buddhist psychology—is performed innumerable times during each second of waking life). This function of Germinal Mindfulness [emphasis and capitalizations added], or initial attention, is still a rather primitive process, but it is of decisive importance, being the first emergence of consciousness from its unconscious subsoil” (Thera, 2014, pp. 9-10).

In Thera’s meditative scheme, an object refers to any sensation, memory, image, word…anything that the mind may receive, perceive, or produce. Germinal Mindfulness is the very first phase of every perceptual process and the primordial event of our general cognition, appearing before associative and the very human abstract thought. The term Germinal Mindfulness is only mentioned once in the book: in the last paragraph quoted. From then on, the specific term seems to be forgotten…except that it appears to fall under the domain of Bare Attention if both terms are interpreted as synonyms describing a purely receptive mindset, or even a state of mind without any thoughts. Germinal Mindfulness is detected by, is intimately related to, and is intuitively included within Bare Attention. But what is the exact relationship between the two terms? Are they really synonyms? How fine would the line between them be? Unlike Germinal Mindfulness, Bare Attention is aroused willfully at particular times. Besides, it is often directed toward specific meditation objects: within its typical definition as choiceless awareness, a paradox? As I see it, in the primordial conscious mind, both concepts may coexist and be synonyms fleetingly … but Bare Attention then takes off within complex mental functions as a mental muscle and method in its own right. Isn’t Germinal Mindfulness something concrete and Bare Attention, as a method, its abstraction with therapeutic ambitions? One therapeutic ambition is to cleanse perceptions from the contaminations of conceptual thought.

Thera proposes an elegant synthesis of human consciousness, developing or “growing” from Germinal Mindfulness toward the ambitious Right Mindfulness through an increase in the intensity and quality of attention, or mindfulness. Of course, many other models of perception and attention exist in Buddhism—and obviously elsewhere—of much greater complexity and sophistication.

Right Mindfulness can then become the developed faculty used by meditators in the traditional Four Foundations of Mindfulness, common and crucial in all the Buddhist sects. Attention is therefore extended to (1) Body, (2) Feelings, (3) State of Mind, and (4) Mental Contents. In the mindfulness movements of the West, mindfulness of the body is considered basic and is by far the most common, sometimes referred to as Mindfulness of the Breathing Body.  Right Mindfulness then includes, generally, the development of the Four Foundations of Mindfulness, as well as the aforementioned two-fold division into Bare Attention and Clear Comprehension.

In the following three paragraphs, Thera describes the essential process of the cultivation and strengthening of Germinal Mindfulness:

“… Just as detrimental consequences must result from an unstable and carelessly laid foundation, so the blessings of a solid and reliable one will extend far into the future.

“Therefore, Right Mindfulness starts at the beginning. In employing the method of Bare Attention, it goes back to the seed state of things. Applied to the activity of the mind this means: observation reverts to the very first phase of the process of perception when mind is in a purely receptive state, and when attention is restricted to a bare noticing of the object [see paragraph quoted before: Ibid., pp.9-10]. That phase is of a very short and hardly perceptible duration, and, as we have said, it furnishes a superficial, incomplete, and often faulty picture of the object. It is the task of the next perceptual phase to correct and to supplement that first impression, but this is not always done. Often the first impression is taken for granted, and even new distortions, characteristic of the more complex mental functions of the second stage, are added.

“Here starts the work of Bare Attention, being a deliberate cultivation and strengthening of that first receptive state of mind, giving it a longer chance to fulfill its important task in the process of cognition. Bare Attention proves the thoroughness of its procedure by cleansing and preparing the ground carefully for all subsequent mental processes. By that cleansing function, it serves the high purpose of the entire Method set forth in the Discourse: ‘for the purification of beings…’ which, in the Commentary, is explained as the purification, or cleansing, of mind” (Ibid., p.19).⁵

We get a direct glimpse here of mindfulness of the mind or metacognition, a crucial and perfectible aim of mindfulness. In the light of Bare Attention, the seemingly uniform act of perception appears as a sequence of quick and differentiated single phases. The basic differentiation of the perceptual process includes the primordial and bare sense-data and the subsequent phase of interpreting and evaluating them. The complex mental functions of the mentioned second stage lump together the detection of more detail, the relation to the observer (subjectivity), and the development of associative and abstract thought.

One can conclude from Thera’s book that even expert meditators find it very difficult to free their Bare Attention completely from memory and associative thought. One reason why even the earliest sense impressions are tinged with associative thought and memory is likely that the workings of the speedy, reading human mind (presumably unlike the animal’s) demand urgent coordination of symbols, concepts, and experiences.

In this scheme, it is evident that neither those relatively complex mental functions nor the more ambitious Right Mindfulness (defined as a third stage and final goal by Thera) could develop well without a solid Germinal Mindfulness. It is my hypothesis that serious troubles with Germinal Mindfulness should, therefore, correlate with psychotic symptoms and schizophrenia. And that those troubles, undetected and unchecked, could perpetuate a hopeless vicious circle that may be the main fuel of the nightmare of psychosis. The most obvious diagnosis of troubles with Germinal Mindfulness would be an incapacity to even begin to focus on a single thing clearly and for a significant amount of time. Of course … the inability to even conceive the concept of Bare Attention comes to mind too!

The Unconscious, Sigmund Freud, and Jacques Lacan

While mentioning primordial mental processes, we may think of perceptions, neurophysiology, and also of the unconscious of traditional psychology. Since Sigmund Freud (Austrian neurologist and father of psychoanalysis, 1856-1939), the unconscious has been customarily tied to mental health and even to the endogenous and spontaneous energy of the mind. Modern neuroscience has established without much doubt the importance of an unconscious primordial beginning of much mental activity. Very briefly, a psychological unconscious is known to be linked to and affecting the neurological substrate of the mind that accompanies us 24 hours a day—of course, even while sleeping and dreaming. A deficient neurological substrate of some type should naturally impair a person’s indispensable Germinal Mindfulness: as indispensable as every healthy transition to consciousness. The potential preciousness of a solid Germinal Mindfulness would obviously increase along with the depth and power that could be attributed to the unconscious.

Arguably, the success of Buddhist practices in global mental health stems from their keen interest in the unconscious—an interest ancestrally perfected toward its limits. I propose the hypothesis of the existence within psychosis of a vicious circle, driven by an unhealthy unconscious actualizing itself through a malfunctioning Germinal Mindfulness. Does Bare Attention have the power to break that link?

It is interesting to ramble that both the unconscious and Germinal Mindfulness would in some way be hovering around the opposite sides of the subliminal-supraliminal conscious mind barrier. Rambling on, this barrier could be grossly located, neurologically, somewhere around the deeper, “primitive” parts of the brain. The deeper parts of the brain are traditionally associated with controversial degrees of unconsciousness; they are rather evidently differentiated from the very human, doubtlessly lucid, and intelligent cerebral cortex. Those parts include the basal ganglia, the cerebellum, the thalamus, the hypothalamus, the pituitary gland, the hippocampus, the amygdala, and the—deepest—brain stem. Students are often surprised to discover that those primitive parts are also most vital and homeostatic: a well-known fascination (and often “raison d’etre”) for psychologists and other scientists interested in the unconscious. We know that abnormalities in the deepest parts of the brain have the capacity to extend to the entire brain…and usually not vice versa. We also know that most perceptions are first filtered by the thalamus. And there is some evidence suggesting that the normal holistic micro-electrical integration of the entire brain may begin in its deeper parts.⁶ Brain integration may just be the closest concept that could be considered a psychiatric panacea by many neurologists. Would a malfunctioning Germinal Mindfulness correlate with pathologies in the integrating mechanisms of the primitive brain? Could strengthening Germinal Mindfulness correlate with integration? (The exact location of the unconscious remains a contentious issue for most scientists, and even as a complete mystery for some. A few have dared to invert the traditional scheme, claiming that cortical functions are aroused consciously from the primitive brain: a delicate subject for psychotherapists and pharmacologists interested in the seat and control of emotions.)

The hierarchical scheme of brain function resulted in the terms “top-down” and “bottom-up” in neuroscientific literature. Generally speaking, “bottom” should refer to the bodily raw sensory data and “top” to the conceptual mind. The terms are meant to describe interactive mental processing, and could also be interpreted as unconscious-conscious interactions. There are many hypotheses describing how the impairment of those interactions may cause schizophrenia. The hypotheses include abnormalities outlined in both directions: what everybody agrees on is that integration is the seal of health. The “down” or “bottom” part of the hierarchy can include the heart and the rest of the body. When a similar hierarchy is outlined into three systems, cortical functions appear at the top, a limbic “emotional brain” is commonly inserted in the middle, and a rather non-controversial unconscious appears at the bottom, including the brain stem. The brain stem regulates main vital instincts such as the heart rate, breathing, and sleeping.

Within the hierarchical schemes, the sexual instincts appear firmly rooted in the limbic system and the unconscious primitive brain. Consequently, it would make sense to consider a healthy transition to consciousness as linked to a healthy sexuality; for example, and in my opinion, the one identified subjectively with affectionate feelings of pleasure and joy that extend to sensual pleasures in general.

In traditional Freudian psychological terms, the unconscious is inharmonious and abnormal if it is filled with repressed urges, feelings, memories, and thoughts, therefore causing common neuroses. Neuroses include relatively mild mental disorders that do not include delusions and hallucinations. French psychiatrist and psychoanalyst Jacques Lacan (1901-1981), famous for daring to plan intensive talk therapy with psychotics, coined the term “foreclosure of the unconscious.”⁷ This term refers to a radical repression—an exclusion—of a mechanism of the unconscious that is postulated as fundamental. Considering traditional psychological terms (with no neurological meaning), one of the more direct ways to interfere with the normal functioning of Germinal Mindfulness could be inferred from Lacan’s foreclosure of the unconscious. The foreclosure is still linked by Lacan’s followers with serious psychotic symptoms and schizophrenia. In a nutshell, Lacan proposed that the whole rational mind, beginning with language, would be impaired by the repudiation, in the early development of children, of the paternal figure. The uprooting of a precious part of our psychology on which everything else depends could be a metaphor for such a “foreclosure of the unconscious.” I recommend that schizophrenics attempt to understand, within a critical and hopeful stance, Lacan’s celebrated theory of psychosis. Regardless of what we may think of such an extreme paradigm as Lacan’s (to which feminists have shown ambivalence), people diagnosed with schizophrenia should make the effort to delve into what may have really caused the impairment of primordial processes of the mind. Even though a genetic predisposition is usually considered, I bet that those repressed traumas the recollection of which would shock the very depths of a human being, as well as related long wrong paths, would appear foremost in many lists (the author is a critic of genetic determinism and especially of the treatments that consider it).⁸ How much self-harm can be caused by fruitless identities along irrational dead-ends, with deep frustrations and powerless ruminations of noxious emotions like envy, anger, and hatred? Who knows how many grays exist between something like Lacan’s radical foreclosure and mild neurotic repressions? Would Lacan’s foreclosure get a prize on the number of neurons affected? (Of course, many other theories around unconscious mental pathologies besides Freud’s and Lacan’s exist.)

Neuroplasticity

Schizophrenia being accepted as a brain disorder, some words on neuroplasticity are warranted. Neuroplasticity is a discovery cemented empirically only in the past few decades that spells a revolution for psychology and other sciences of the mind. While the neuroscience of religion (or neurotheology) studies neuroplasticity in all spiritual traditions, the term has, in our times, become commonly associated with meditation. Many scientists claim that neuroplasticity is the latest paradigm of neuroscience and a few even of medicine.

Neuroplasticity is an extremely lengthy subject, but one motto referring to an important neuroplastic mechanism is worth mentioning: “Neurons that fire together, wire together.” Specialists may also add, generally negatively and pessimistically, “neurons that fire apart, wire apart.” The subtle and, for now, extremely specialized neologism metaplasticity—signifying “plasticity of plasticity,” currently defined and documented from cellular levels—points toward the existence of uncharted, higher-order (perhaps holistic?) mechanisms that influence neuroplasticity.

Neuroplasticity is modern proof of the existence of psychosomatic processes within the brain. And it warns us unequivocally about the preciousness of psychological habits, since the human brain appears to be particularly susceptible to change for the worse under adverse circumstances. It is a concept where the new biology of the mind and traditional psychology meet fruitfully. Neuroplasticity is indeed the key to the somatic manifestations of dangerous psychological vicious circles. It also undermines genetic determinism and pessimism, while it would refute nihilism as it appears to vindicate the role of ethics in mind-body causality. From a negative perspective, repressed traumas and long wrong paths could then calcify abnormal neurology. But in its therapeutic aspect, positive neuroplasticity could potentially break the formations of the vicious circles of traumas and wrong paths, giving many the hope to recover the normal lucidity of their minds. Hand in hand with the integrative emphasis of the diverse therapies available, it is my hypothesis that the cultivation of Germinal Mindfulness should be an important practice to obtain benefits from positive neuroplasticity applied to psychoses like schizophrenia. I add that besides mindfulness, meditations on self-compassion and non-referential loving-kindness have been proven by researchers to promote positive neuroplasticity; also exercise—especially aerobic—the Hindu practice of Yoga, an active mind-brain, a healthy social life including therapeutic connections, and generally, a healthy lifestyle.

Name Changes for Schizophrenia

Schizophrenia is beginning to be accepted as a disorder in the integration of neural networks within the brain, and that is one of the reasons behind its recent name changes in Japan (2002) and South Korea (2012): a lasting shock to world psychiatry. The Greek etymology of schizophrenia corresponds to “split mind.” The new Japanese term means “integration disorder,” and the Korean term means “attunement disorder.” The Korean word attunement is related to the Buddhist metaphor of the mind functioning as a well-tuned musical string instrument. The principal motivation for those name changes has been to combat the stigma caused by the etymological meaning of the word schizophrenia, while encouraging more humane and optimistic treatments. Along the same lines, another name for the disease was also chosen officially in Taiwan in 2012, and more informally but successfully in Hong Kong around 2004: “disorder with dysfunction of thought and perception.” In Singapore, psychiatrists tend to describe schizophrenia as a “disorder of thinking,” but there is no formal proposal to rename it. In mainland China, no proposals exist, in part because the process is very complex. In Europe, many proposals exist but have advanced considerably less fast than in the mentioned countries of the Far East. Importantly, the new names coincide with the recent neurological findings relating schizophrenia to a disorder of neural networks.⁹

The name changes in Far East Asian countries amount to a major social experiment on top of being a commotion to global psychiatry. Generally, the name changes mark a shift from a poor prognosis, untreatable or even hereditary description of schizophrenia to one including reversibility and potential for treatment. How far-reaching for global mental health are the implications and coincidences of these name changes in these countries with a deep Buddhist heritage, in our era of mindfulness and neuroplasticity? How valid is the question today, considering that Buddhists are a clear minority population in these countries?

Calming the Mind Toward Integration

Thera famously—and controversially, for other philosophies—defined “mind” in his book as “nothing beyond its cognizing function” (Ibid., p.27). Besides representing the general spirit of the empirical sciences, this definition fits perfectly with the popular therapeutic metaphor found in Buddhist self-help books of the mind being naturally bright and lucid, and the mental afflictions being obstructing passing clouds. Experienced meditators know that this definition embodies a formidable tool that calls mental afflictions by their true names. It also fits well with a description of delusions and hallucinations as being irrational involuntary reactions to perceptions and memories that can only cause further obscurations and the beginning of vicious circles.

Delusions and hallucinations consist of an exaggerated, surely tormenting torrent of words and images that can obviously wreak havoc on any interpretation of Germinal Mindfulness and a healthy primordial present-centeredness. They should also be included within complex mental functions, fueled mostly by abstract thought, and grossly located neurologically in the conceptual brain, the intelligent human cortex.

There is some evidence to conclude that meditation conduces to brain integration. It is known that silent meditation reduces the activity of the conceptual brain, fostering in the long term its rest, integration, and efficiency (with some scientists claiming an increase in its size in the long term). Many neuroscientists believe that during meditation, urgent homeostatic mechanisms occur that try to find a healthy balance between the different parts of the brain and also the rest of the body, including the vital and affectionate heart. Therefore, an integration of unconscious-conscious bodily processes should occur. During meditation, one tries to quiet the “monkey mind” (a popular metaphor in Eastern cultures) that is exacerbated during psychosis. One common way to do that is to sit quietly and silently, scanning the body and feeling the breath. Why do homeostatic mechanisms occur during meditation? Human beings are introverted creatures, and Buddhists are the historical champions of introspection. And we know that the wild and often noxious imagination associated with psychotic symptoms can generate a toxic, disintegrating biochemistry. The fact that those positive homeostatic mechanisms are activated within physical and mental states of stillness and calm has been interpreted by innumerable students of meditation as worthy proof of the peaceful essence of the human mind.¹⁰ Advanced meditators have the capacity to direct and maintain their attention, activating and strengthening the primitive, “silent” parts of the nervous system, which are devoid of images and chatter. Some can even mix mindfulness with interoception to calmly feel the primordial breathing movements of the diaphragm, and the heartbeat. Many meditators have communicated feelings of great relief and even joy after their tormenting higher cortical functions are overwhelmed by the healthy functioning of the so much more important rest of their vitality. Specifically for schizophrenics, the therapeutic hypothesis of this essay appears here in a nutshell: after calming the positive symptoms, the negative symptoms may just be conquered with an optimistic mind.

Optimistically, in a therapeutic meditative scheme, the cultivation and strengthening of Germinal Mindfulness would be correlated with the strengthening of the most vital and integrating parts of the nervous system and body. The parts usually associated with the unconscious, with the cardiorespiratory system foremost in the list. Would healthy Germinal Mindfulness correlate with good sleep? With healthy sexuality? Proper tasting of food? General bodily efficiency and satisfaction? As one becomes aware of the pervasive mental health potentially bestowed by the strengthening of Germinal Mindfulness, I invite people diagnosed with schizophrenia and other psychotics to digest a crucial therapeutic, hopeful realization: psychotic symptoms are not primordial to our mental activity nor for that very reason around-the-clock. From this perspective, I cannot think of a better medicine for psychosis than a serious plan to strengthen and integrate every part of the body that does not generate the true poison of the disease: unfortunate abstract thought.

In philosophy, very generally, abstract thought is defined as the very opposite of concrete, as being withdrawn or separated from material objects or practical matters. Concrete thought refers to the ones with a physical or factual referent. Abstract thought is also the fountain of human genius and creativity, and it is full of symbols, analogies, and metaphors. In very few words, Thera chooses to encompass abstract thought as a generalization of experience.

More Lucid Paragraphs by Nyanaponika Thera

I add more lucid paragraphs from the beginning of Thera’s book that may also justify the lure that mindfulness holds on those interested in mental health:

“Bare Attention consists in a bare and exact registering of the object. This is not as easy a task as it may appear, since it is not what we normally do, except when engaged in disinterested investigation. Normally man is not concerned with a disinterested knowledge of ‘things as they truly are’, but with ‘handling’ and judging them from the point of view of his self-interest, which may be wide or narrow, noble or low” (Ibid., pp.19-20).

“For instance, the normal visual perception if it is to any interest to the observer will rarely present the visual object pure and simple, but the object will appear in the light of added subjective judgments as: beautiful or ugly, pleasant or unpleasant, useful, useless or harmful” (Ibid., p.20).

“In that condition, i.e., closely intertwined with subjective additions, the perception will sink into the storehouse of memory. When recalled, by associative thinking, it will exert its distorting influence also on future perceptions of similar objects, as well as on the judgments, decisions, moods, etc., connected with them” (Ibid., p.20).

“Bare Attention slows down, or even stops, the transition from thought to action, allowing more time for coming to a mature decision” (Ibid., p.29).

“By learning, through Bare Attention, to pause, to slow down and to stop, the plasticity and receptivity of the mind will grow considerably, because reactions of an undesirable nature will no longer occur automatically, with the same frequency as before” (Ibid., p.29).

“Bare Attention will also allow us time for the reflection whether, in a given situation, activity by deed, word or mental application is necessary or advisable at all” (Ibid., p.29).

“Bare Attention brings order into the untidy corners of the mind. It shows up the numerous vague and fragmentary perceptions, unfinished lines of thought, confused ideas, stifled emotions, etc., which are daily passing through the mind. Taken singly, these vain consumers of mental activity are weak and powerless, but by their accumulation they will gradually impair the efficiency of mental functions. Since these thought-fragments are mostly allowed to sink into the subconsciousness without being properly attended to, they will naturally affect the basic structure of character, dispositions and tendencies. They will gradually reduce the range and lucidity of consciousness in general, as well as its plasticity, i.e., its capacity of being shaped, transformed and developed” (Ibid., p.31).

The similarities of Bare Attention with the point of view of the Western scientist are deep: one difference is that the Buddhist perfects and prioritizes introspection and, of course, allows the abundant mystical elaborations typical of ancient spiritual traditions. It can also be concluded from two of these paragraphs that those contaminated perceptions and thoughts that sink into the subconsciousness may result from deficiencies in Germinal Mindfulness … causing the beginning of vicious circles.

Some Other Thoughts

In an essay describing sense-centeredness and psychosis, a paragraph is needed to mention that in Buddhist psychology, the mind is postulated as the sixth sense. This definition interferes with a unitary, idealistic theory of the mind. It also results in as controversial as mystical elaborations regarding the organic nature of the higher mental faculties, and mind-body dualism. Traditionally, the sixth sense extends the limits of perception toward the mysteries of intuition. Despite the controversies surrounding the possible perceptual origins of some psychotic symptoms, the sixth sense definition may open for some psychotics a welcome door to pacifying the mind hinged on avoiding shame and frustration respecting many thoughts and perceptions … but instead taking the decisive steps needed to calm them down (and of course summoning the courage to soberly accept one’s own ill-fated mental fabrications). In a world full of turmoil, the essential admonition of Bare Attention to suspend mental comment on perceptions appears here as particularly appropriate, and peculiarly urgent. Arguably, it would also be imperative that the development of the postulated sixth sense occurs along with healthy doses of compassion and goodwill.

Buddhist philosophy emphasizes the fact that numberless causes and conditions evidently affect just about everything we perceive. And from that specific perspective, it recommends that anchoring the mind in the present is clearly one of the most important things we should learn to do. Restraining the mind with mindfulness has been associated in Buddhist literature with the metaphor of putting on the best sandals instead of ambitioning to carpet the whole path. It is also relatively common knowledge that when the human mind is centered in the present, we are more prone to confront difficult situations: this is simply because only then can we best subdue the tendencies that drive the “autopilot,” and so the number of rational options increases.

Conclusions

In a final synthesis, Bare Attention is concerned with tidying up and lengthening the seed and bedrock of experience, external and internal: the primordial present. This essay could be interpreted as a hopeful plea to unblock the primordial and arguably ubiquitous and around-the-clock, flow of the mind. Bare Attention slows down the transition from the receptive to the active phase of consciousness, a transition that is surely vulnerable to subliminal, and often overwhelming, unconscious influences. Germinal Mindfulness should be pivotal in that transition, and it is hypothesized that its neurological location should correspond to the liminality of consciousness, somewhere in the deep non-conceptual brain. Bare Attention may attempt to break this crucial link of psychosis, and delusions and hallucinations may cease to disintegrate the brain, poison vitality, and wreak havoc on present, sense-centeredness. The lengthening and strengthening of that hypothetical “present,” so famous and widespread in the recent explosion of Buddhist self-help literature, would obviously come along with the strengthening of Germinal Mindfulness through Bare Attention. Furthermore, It is inferable that in a purely receptive state of mind, psychotic symptoms could potentially be almost absent. Mindfulness of the present would then leave the external world speaking clearly and for itself (paraphrasing Thera). Importantly, a sense-centered mind should also awaken the optimal functioning of the unconscious autonomic nervous system, general bodily satisfaction and effectiveness, and hopefully even the joy present in the normal flowing mind. The potential blessings for mental health of a non-pharmacological and very accessible method like meditation should be considered with optimism.

While concluding, it is important to emphasize again that learning to consider distressing thoughts and feelings as transient and even insubstantial is the very essence, for many, of the therapeutic success of mindfulness. Innumerable patients and meditators have found relief again and again on that emphasis. Furthermore, the application of mindfulness to bodily processes is obviously more important in illnesses not grouped essentially as psychological or psychiatric.

In Thera’s Theravada Buddhist sect and most others, mindfulness is a preliminary practice leading to meditations grouped as insight practices (also called Vipassana, “clear seeing” in Pali). In these practices, Bare Attention is the key instrument used to view one’s own mental and bodily processes as concretely and directly as possible, culminating in the insight into the Three Characteristics (or “signata”) of life and phenomena according to Buddhism: impermanence, suffering, and impersonality.

I also quote the last paragraph of Thera’s own introduction to The Heart of Buddhist Meditation: The Buddha’s Way of Mindfulness:

“It is heartening to find that there is a growing interest in meditation in the East as well as in the West, and that it comes at least partly, from a genuine inner need. It is hoped that the present book will be helpful to many, in many lands, who wish to develop the human mind’s potential for greater calm and strength, for a more penetrative awareness of reality, and finally, for its unshakable deliverance from Greed, Hatred, and Delusion” (Ibid., Introduction, p.xxiii).

Bibliography

Thera, Nyanaponika (2014). The Heart of Buddhist Meditation: The Buddha’s Way of Mindfulness. San Francisco: Weiser Books. (The first part of the book, along with a shorter version of the Discourse on the Four Foundations of Mindfulness, was first published in Colombo, Sri Lanka—then Ceylon—in two editions, 1954 & 1956, by “The Word of the Buddha Publishing Committee.” The complete version was first published in 1962 in London by Rider & Co.: the book was translated into more than seven languages and reprinted in many editions.)

Notes

1. Traditionally, “mindfulness” has two related senses. Mindfulness with a capital “M” refers to the contemplative practice that serves as basic meditation training in Buddhist traditions, as well as to the secular psychotherapy. Mindfulness with a small “m” refers not to a kind of meditation but to the mental muscle essential in the practice; different Buddhist traditions add other mental muscles than mindfulness to complement the contemplative practice, like alertness. Confusions and fine lines between Mindfulness and mindfulness are common: Also, I acknowledge, in this essay, that I used mindfulness throughout, except in complex specific terms.

2. Jon Kabat-Zinn defining mindfulness, see:

http://www.mindful.org/jon-kabat-zinn-defining-mindfulness/

3. I mention psychosis and neurosis in the singular, referring to traditional clinical entities including specific symptoms. Psychoses and neuroses, in the plural, refer to clinical categories and the diverse forms they take. The symptoms of psychoses are considered worse than those of neuroses, and psychoses are usually given a bad prognosis. Borderline personality disorder (BPD) was originally called so to categorize people on the “borderline” between psychosis and neurosis. Anxiety and depression are typical neuroses. Chronic psychotic symptoms are typical of schizophrenia. Psychosis may also be a symptom of bipolar disorder, other personality disorders, and serious depression. Psychosis can also be a symptom of dementia, Parkinson’s disease, Huntington’s disease, epilepsy, and cerebral lesions. Non-chronic psychotic symptoms are common: they may appear in substance abuse, excessive stress, and sleep deprivation.

4. Bare Attention means that, when attending to the sixfold sense-impression during meditation, attention is kept to a bare registering of the facts observed without reacting to them by deed, speech, or mental comment. The full scope of the applications of Bare Attention, the latter understood as the fundamental instrument of mindfulness—within meditation and extending to daily life—is described elegantly and in detail by Thera online:

http://www.buddhanet.net/pdf_file/powermindfulness.pdf

For very ambitious and optimistic readers of my essay, I paraphrase Thera from the link: There is actually nothing that can withstand the Satipatthana Method (mindfulness).

5. The Method refers to the entire Buddhist method described in detail in the Discourse of the Four Foundations of Mindfulness, called in Pali the Satipatthana (“sati” meaning mindfulness, and “patthana” meaning “placing near one’s mind”) Sutra, or discourse. The Commentary refers to text added to the Discourse by ancient sages. We are often surprised, in Buddhist literature, at finding the term beings: this is usually related to the mystical concept that Buddhists should preach to all beings.

6. Neuroscientist Rodolfo Llinás (Colombia/USA), by studying brain-wave patterns of humans during waking and dreaming, discovered a bioelectrical rhythm that integrates consciousness from the thalamus and the basal ganglia, deep within the core brain; this rhythm sweeps holistically throughout the entire cortex forty times a second. The rhythm is a part of the crucial and well-studied thalamocortical interaction, the abnormality of which (dysrhythmia) is associated with many psychiatric disorders, including schizophrenia. Llinás’ theories are described in many articles and in his book I of the Vortex: From Neurons to Self (Cambridge, MIT Press, 2002).

7. I invite the reader to a critical understanding of the succinct explanation in Spanish of Lacan’s foreclosure “¿Qué es la forclusión?” by the psychologist M. A. Castro Arbeláez, and to consider it as one of the many possible mechanisms underlying severe, chronic psychosis—the term is often considered and studied in great depth in Latin psychological circles:

https://lamenteesmaravillosa.com/que-es-la-forclusion/

8. Some psychologists have linked the pervasive pathological “voices” of schizophrenia with serious, even shameful trauma. In these cases, the “voices” could be interpreted as internal reactions and reflections around incommunicable events. Admitting that this is a controversial standpoint, it is interesting to ponder whether the resulting “voices” are exacerbated and extend chronically because an affected individual became incapable of establishing concrete, intimate, long-lasting, humane communications. Along these lines, the author chooses to criticize the genetic paradigm of schizophrenia causation as stigmatizing and hopeless: this paradigm may even be invoked to influence the selection and discarding of human embryos.

9. The facts on the name changes described: Sartorius, N., Chiu, H., Heok, K.E., Lee, M.S., Ouyang, W.C., Sato, M., … Yu, X. (2014). Name change for schizophrenia. Schizophrenia Bulletin, 40(2), 255-258. 

https://doi.org/10.1093/schbul/sbt231

10. The 2004 article of the Proceedings of the National Academy of Sciences (USA), “Long-term meditators self-induce high-amplitude gamma synchrony during mental practice,” a famous study on Tibetan meditators performed at the University of Wisconsin at Madison (USA) has been occasionally and informally ranked as the fifth most consulted article in the history of science. The article offered many readers refreshing proof that the highest peaks of human intelligence and concentration (linked with exceptional brain integration) appear with and coexist with the highest levels of compassion. The article also suggested that these cognitive feats are trainable according to the laws of positive neuroplasticity.