New Currents: Participatory Medicine

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An Interview with Jon Kabat-Zinn, Ph.D.

Jon Kabat-Zinn has learned, through both science and personal practice, about mindfulness as a way of life. He developed Mindfulness-Based Stress Reduction, a groundbreaking behavioral medicine program. Thanks in large part to this pioneering program, mindfulness has now become a recognized element of integrative medicine and general health promotion. In this interview, Dr. Kabat-Zinn discusses key issues in integrative medicine and its direction.

Integral Yoga Magazine (IYM): Hatha Yoga is a part of your Mindfulness-Based Stress Reduction program (MBSR).

Jon Kabat-Zinn (JKZ): I love Hatha Yoga. I was going to say that I’m an aficionado but it’s far deeper than that. I just absolutely love Hatha Yoga; it’s one of the great gifts to the planet. Of course, there’s a lot to be said about how it’s practiced—what kind of attitude you bring to it and whether it turns into a narcissistic body preoccupation, but I think most people understand—even if at first that’s the door they enter through—that Yoga is a deep, meditative practice that, the younger you are when you begin, the more it actually re-arranges your entire being, including the molecules that constitute your body and life.

The thing about Swami Satchidananda that most impressed me was his book on Integral Yoga Hatha, which I always felt was one of the best and most sensible. There are a million books on Yoga, but  there was something coming off every  page of that book that for me transcended the words. It had to do with the photographs, how present he was on every page, demonstrating the various postures. I never  met him. I was never in his presence. But I felt, “Here’s somebody who really practices what he preaches.” I always felt the he was one of the authentic ones.

IYM: Some people practice Hatha for the physical portion and then seek out Buddhist meditation.

JKZ: As if they’re different! (Laughs)

IYM: What are your thoughts on that?

JKZ: That’s one of the reasons that Hatha Yoga is a large part of MBSR and other mindfulness-based interventions. It is based on my own experience with Yoga and meditation as living practices. I felt from the beginning that if Hatha Yoga is done mindfully—whether you are using the framework of Raja Yoga or of Buddhist meditation—what matters is whether you are inhabiting the space of awareness intrinsic to the entirety of your being, not just regarding your body. Hatha Yoga can, in some sense, catalyze that awareness, that inhabiting, that opening because it works so powerfully on the body—at any and every level of physical fitness and wellbeing.

There was a wonderful book that came out in the 1970s called Easy Does It Yoga. It was all about people in their 70’s, 80’s, and 90’s who were doing Yoga and it was filled with photographs of them practicing. I used it in the early days in my MBSR classes. When MBSR got started in 1979, there was still the sense that bringing Yoga and meditation into the mainstream of medicine was tantamount  to the Visigoths being at the gates about to tear down the citadel of Western civilization. Now, of course, Yoga and meditation are so mainstream—not only in the wider culture, but also within  preventive medicine and clinical care. They have really become a part of what truly good medicine across the lifespan is all about.

IYM: Where do you see integrative medicine going?

JKZ: I talk about it as participatory medicine, which is what the medicine of the present needs to be; I don’t even want to say, “In the medicine of the future,” because it’s really happening now. People need to take responsibility to whatever degree they can, for their own health and wellbeing—whatever their age, their circumstances, their diagnoses, and so forth—and do that interior work that nobody on the planet can do for them as a complement to what the doctors and health care team can do for them. Without that participation, no amount of money and high-tech medical procedures being thrown at the patient is actually going to result in optimal outcomes and in health.

That’s one of the reasons that the promise of real medical reform, of real health care reform, would be very, very different from what we’re seeing now, which is basically—at its best—health care payment reform, reimbursement reform, not real health care reform. If you got people to participate from early on—even learning about the body in childhood—and had them doing Hatha Yoga and various other kinds of contemplative practices to deal with their own stress and with their own development, you could actually reduce the disease burden in the society for lifestyle-related and chronic illnesses that come 20, 30, 40, 50 years down the road, by an enormous amount. The cost-savings would be huge. That’s a no-brainer for anybody who has actually been in the Yoga world for a long time. That doesn’t mean that you won’t ever get sick or die, but it does mean that you’re shifting things in the direction of greater and more optimal resilient health so that you’re not as likely to suffer from stress-related diseases and from chronic pain conditions due to disuse, atrophy, etc. . .

Read the rest of this article in the Fall 2013 issue of Integral Yoga Magazine.

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