Mindfulness and Spirituality

buddha lantau


Mindfulness within the Scope of Spirituality

Mindfulness is taught in all world religions, but does not play an equally important role in them. However, there is no other religion where mindfulness is so emphasized, has so much literature and so many monographies and treatises written about it, or has such an educational program for it as with the Buddhists. Mindfulness is a central element of Buddhist teaching.


As in Western psychotherapy, Buddhist psychology values empirical considerations – which means the subjective experiences of the affected individual as the measure of all things – while science strives for objectification in the form of the third-party evaluation by independent researchers.


Buddhism is not a theistic religion. In the deep reverence for Buddha, the believer does not bow to a deity but to a desirable mental attitude embodied in its ideal form in Buddha. The historic Buddha was not a god, but a human being by the name of Siddhartha Gautama. In his early years, he had led an overly sheltered life as the son of a wealthy family and had an identity crisis. Buddha’s lifework was dedicated to the alleviation of psychological suffering. Although he had studied for years with famous yogis and masters while searching for a deeper understanding of the true nature of our existence and had practiced the highest form of meditation, he was disappointed that not much had changed once he re-emerged from the meditation. Worries, hardships, and suffering continued to exist unchanged. These types of disappointments are also preprogrammed today as long as meditation merely focuses on the development of inner peace (concentrative meditation). Long-term effects can only be expected in a context- or object-related form of meditation that is oriented toward gaining insights (analytical meditation).

The Three Mind Poisons

So Siddhartha modified his approach and chose his own mind as the object of his meditations from that time on: his own thoughts, feelings, emotions, sensations, memories, images, impulses, and reactions. This led to the experience – based on insights gained in meditation – that three poisons(compulsions, unwholesome patterns, automatisms) generally threaten our mind:  



1. Misjudging the reality (delusion, ignorance, clinging to preconceived concepts)




2. Attachment (entanglement, inappropriate desire to possess)




3. Rejection





Although these concepts – perhaps especially in the original manner in which they were expressed that speaks of delusion, greed, and hate – may seem somewhat strange to us, this should not be seen as a reason for us to immediately deviate (in the form of an automatism). Even after a brief consideration from the perspective of openness, each of us would admit – even if this may perhaps be reluctantly at first – that a difficult issue has been brought to the point in unsurpassable conciseness.

After Buddha finally achieved perfect insight into the nature of all things through his own type of meditative immersion, he gave in to the pressure of his surrounding world. Just hesitantly at first but eventually over a period of 45 years until his death, he shared his insights and methods on journeys through Northern India with his fellow human beings in thousands of discourses. 


The Four Noble Truths


Buddha’s first discourse is very helpful for understanding the topic of mindfulness and indicates parallels with medical thinking. These statements are called Buddha’s “Four Noble Truths.”

1. Our existence is full of problems. Time and again, we experience it as suffering (symptom of suffering).

2. There is a cause for this symptom, the suffering (diagnosis and cause): Suffering can always be traced back to having allowed space for rejection, attachment, and ignorance in an inappropriate manner.

3. When the causes are extinguished, the suffering also stops. A therapy is capable of freeing us from the suffering (prognosis).

4. In order to end the suffering, we follow an eight-point program called the Eightfold Path (Right View, Right Intention, Right Speech, Right Action, Right Livelihood, Right Effort, Right Mindfulness, and Right Concentration). The eight-point program is the prescription.


The Eight-Point Program for Decreasing Suffering

The Noble Eightfold Path forms an ethical basic concept for life. According to Buddhist teachings, it is suitable for acquiring “good karma” and reducing “bad karma.” This karma decides what kind of future we have ahead of us. Further explanations would not only go beyond the scope of the above explanation but also clearly exceed the competence of the authors in this field. The relevant literature of major Buddhist teachers such as the Dalai Lama or Thich Nhat Hanh is warmly recommended to those who are interested in this topic.


happy, elderly couple

When we move away from transcendence, spirituality, and life after (and before) death and toward our everyday problems – which are sometimes quite powerful and just appear to be so at other times – it makes sense to look at these invaluable Buddhist words of wisdom. Ideally,we should make them our own because directly beneficial and relief-providing changes will occur within and around us – not just perhaps and not just at some point in time, but immediately and profoundly.


We can postulate this without any reservations and very enthusiastically based on our own experience and decades of treating chronically ill, critically ill, and dying patients on a daily basis. Within this scope, it seems important to us to communicate the fundamental message that our well-being is not just determined by external factors (good fortune, coincidence, power, wealth, therapists, or the grace of an almighty). Instead, it portrays the (inevitable) result of the way we create our own life and our attitude toward life. How we experience it and how (to what degree and quality) we suffer, depends on how we deal with unalterable circumstances. But it is absolutely essential to first recognize what is unalterable as such and to differentiate it from what can be changed – to recognize where our own effort is required and where we should restrain ourselves.


In the psychotherapeutic system, this would be expressed in these terms: Opening up to this way of thinking leads to personal responsibility, to internal (as opposed to the frequently external) control attributions and therefore already to a very essential perspective for a healthy understanding of disease.


Buddha based his statements on suffering in general. However, Buddha’s statements and techniques can also be outstandingly used for pain-related suffering. In relation to decreasing the pain-related suffering, the Noble Eightfold Path could be interpreted in the following manner:


1. Right View

In the context of pain, this could mean:

  • Recognizing what is unalterable
  • Awareness of reality and what is feasible

2. Right Thinking

In the context of pain, this could mean:

  • Avoiding attachment (to the postulate of freedom from pain)
  • Avoiding rejection (in the sense of wanting to get rid of the pain)
  • Defining realizable goals in a state of balance

3.  Right Speech

In the context of pain, this could mean:

  • Recognizing the significance of the inner monologue for our own well-being
  • Strengthening health-promoting speech in the inner monologue and outer dialogue
  • “Exposing” health-harming speech in the inner monologue and benevolently letting it pass by without giving in to the impulse of actually verbalizing this speech out loud
  • Communicating about pain in an appropriate way

4. Right Action

In the context of pain, this could mean:

  • Appropriate way of dealing with phenomena such as pain that seem to restrict the quality of life
  • Responsible way of handling ourselves and others by attempting not to use our pain as an instrument for harmful behavior

5. Right Livelihood

In the context of pain, this could mean:

  • No unjustified social advantages at the expense of the others or the society
  • Disability and early retirement remain the last resort

6. Right Effort

In the context of pain, this could mean:

  • Willingness to look inside ourselves, recognizing and changing the portion of the suffering that is “self-made”
  • Being willing to restrict ourselves to what is necessary, effective, and economically reasonable in relation to medical treatment of the pain

7. Right Mindfulness

In the context of pain, this could mean:

  • Self-reflective consciousness
  • Attention directed to present experience
  • Non-intentional realization
  • Self-perception  
  • Surrender of entanglements in dysfunctionalities*

* = Pain-intensifying images, memories, belief systems, thought patterns, and patterns of behavior, etc.


8. Right Concentration

In the context of pain, this could mean:

  • Using meditation as mental medicine
  • Concentrative meditation (such as observing the breath) as preparation for analytical meditation (benevolent contemplation of our own pain-related patterns of thinking, feeling, and behavior)  



Buddha’s Mindfulness Discourse (Satipatthana Sutta)




One of the central discourses of the Buddha is dedicated to the mindfulness practice.


For the complete translation of this discourse and an extensive commentary, please see Thich Nhat Hanh: Transformation & Healing. Sutra on the Four Establishments of Mindfulness. Parallax Press 2006.


For another central discourse in relation to the mindfulness practice, please see Thich Nhat Hanh: Breathe, You Are Alive! Sutra on the Full Awareness of Breathing. Parallax Press 2008.


In his instructions on mindfulness, Buddha calls mindfulness practice (in addition to the Eightfold Path) a further path for ending suffering and pain.


The Four Establishments are related to the objects of meditation:


  • Body
  • Feelings
  • Mind
  • Objects of mind


The person practicing mindfulness is encouraged to view these objects of meditation “from the inside or from the outside or simultaneously from the inside and outside.” This is the technique of the “inner observer” (step two in the mindfulness cascade of MBPT) and serves the disidentification of contents that had previously been seen as belonging to the own self. The goal of the mindfulness practice is insight into the "true nature of things,” which is characterized by:


  • Changeability
  • Intangibility
  • Non-self

These points mean that neither the “self” nor other phenomena  are solidified unities that always and invariably consist of the same parts. Everything is in a state of flow and constantly absorbs elements into itself that are actually “foreign” to its own nature, just like the body is formed from what a person eats and drinks – among other factors – but should obviously not be equated with this food and drink. This manner of contemplating things is also demonstrated in the crucial fourth step of the mindfulness cascade – disidentification in which we as practitioners realize that our “self” may be composed of the various elements, but that we are not identical to neither of these elements (“I am not my thoughts, my feelings, or my pain…”).


In mindfulness-based pain therapy (MBPT), the individual techniques taught by Buddha in both of the central discourses on mindfulness and observation of the breath, as well as in other places, are divided into the mindfulness cascade in seven individual steps (putting mindfulness into action). This division into effective components has many advantages.

As already mentioned in other places on this website, this also makes it accessible to clinical application for therapeutic purposes. Furthermore, this way of translating it into action facilitates the diagnosis when the intention is to filter out the individual components that require special support. It ultimately serves to convey new competencies to the patients, who now can play a constructive role in shaping their own well-being.


Copyright Dr. Peter Tamme and Dr. Iris Tamme

Last update: August 14, 2012