Jon Kabat-Zinn developed Mindfulness-Based Stress Reduction, a trailblazing 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 70s, 80s, and 90s 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.
IYM: How did you and Dr. Dean Ornish meet?
JKZ: I first heard about Dean through my old friend Andy Weil, who I knew from when he was a medical student at Harvard and I was a graduate student at MIT in the late sixties. In the late 1970s, Dean had been an intern at Mass General. Once I had started MBSR, Dean’s name came up in a conversation with Andy, and so I called him up and invited him to give medical grand rounds at UMass. I had to tell the chief of medicine, who said, “We don’t have interns give medical grand rounds.” And I said, “In this case, I think you’d be making a mistake not to have him come.” So, he let me invite him. When Dean came, he reported on his first study [on reversing heart disease using Yoga and lifestyle changes] that he had done in Texas as a medical student. It was mind-blowing.
IYM: How important is the science to getting eastern therapies better understood by western medicine?
JKZ: Very important. That’s why Dean was going to all that effort to do randomized clinical trials and to use the latest technology available to measure cardiac function and cardiac output. We’re all doing that. Now, neuroscience is a big part of things, using technology that didn’t exist 30 years ago. It is showing remarkable changes in the brain when people meditate. It’s very hard to argue with this kind of data, and that’s what changes peoples’ minds in this culture: when you have well-designed scientific studies—and not just one or two, but hundreds—that are demonstrating that mindfulness can have profound effects on one’s health, wellbeing, the brain, the nervous system, immune system, and endocrine system. And that was the aim from the beginning—it’s not just, “Can we learn more about the human body, mind, and emotions by studying meditation scientifically?” That’s interesting, but can we get the regular American public to take up these practices? And it’s not that they would become imitators of Swami Satchidananda, or some Zen master, or the Dalai Lama, or anybody else, but that they would adopt these practices, make them their own, and make it American.
IYM: Do you have concerns about what might get lost when we take the practices out of their historical, cultural, and spiritual context?
JKZ: Of course, but that happened in Asia, long before Columbus discovered America. The dharma has always being lost in translation and then re-excavated, so to speak. Different people hear it differently and even among Buddhist traditions, there are different interpretations of the Buddhist teachings, different compilations of the sutras. These arguments have been going on for thousands of years. I don’t think what’s going on now in our culture is a de-contextualization of the traditional teachings. Rather, it’s a re- contextualization. It is one that’s self-bootstrapping, in the sense that it’s complex and many people aren’t even familiar with the traditional teaching; there’s a certain kind of way in which Americans make things up as they go along.
I think there’s some concern that what I call the dharma elements or the dharma foundation of this entire tradition will, in some sense, get lost. But, even if you look at the thousands of year history of the dharma, it’s gone into decline many times in the past and then come back through this or that renaissance. I think what we’re facing here and now is the potential for an authentic renaissance. I don’t, as a rule, use the word “spiritual” but what we’re talking about when we talk about mindfulness is what it means to be fully human. Spiritual is a very loaded word—it would certainly be subsumed under all the different dimensions of what it means to be fully human.
It’s not important to me to argue about the differences between this tradition or that tradition—or worrying about whether Hatha Yoga, or all of Yoga in some sense, is going to get dumbed down, diluted, or polluted by half-baked notions that really aren’t grounded in the authentic practice. Whenever anything is really out there in a way that’s dynamic, there’ll be a lot of things that will fall by the wayside over time and what will endure is the dharma essence, because that’s what’s powering the whole thing. Without the dharma, you wouldn’t even be getting the scientific results, you’d be getting “garbage in, garbage out.”
IYM: Are you concerned about the commercialization of Yoga?
JKZ: Of course I’m concerned that Yoga has become a multi-billion dollar industry, but, in some sense, that’s the American way. If it takes fancy leotards, lululemon and Gaia to clothe everybody so they feel more like a yogi—well then, in the short run that just may be superficial narcissism, but in the long run people know it’s not about the clothes or whether you can make your body into some remarkable pretzel, at which everybody will hold their breath watching and marvel. People do that in the circus! And it is amazing to behold. But I think people will begin to realize, “I’m not being true to my authentic self. I’m not following my own heart. I’m not attending to my children with enough real openhearted spaciousness and kindness.” That kind of awareness is transformative and healing. And, that’s really where I think this whole thing is going. The evidence—whether it’s Dean’s evidence for heart disease or whether it’s brain science—it’s all pointing in the direction of the power of human intentionality. The mind, thoughts, emotions, and how we relate to the body is actually moving us in the direction of being fully human.
IYM: How important is getting insurance companies to pay for these therapies?
JKZ: Dean has been very, very patient and very, very persistent and he’s been very successful. After sixteen years, he got Medicare to cover his program. This approach, prevention, is the only thing that’s going to save healthcare. All other approaches are too expensive. How long will it take? Will a whole other generation suffer because the Republicans and the Democrats are mostly serving their own self-interests and not really thinking about taking care of their constituents? I hope not.
IYM: Looking back on your journey and then looking ahead, where have we been and where are we going?
JKZ: Before we look ahead, let’s take a look at where we are now. Tim Ryan, a six-term Democratic congressman from Ohio, came out with a book last year called, A Mindful Nation. Chade-Meng Tan, one of the early people who worked for Google and helped develop their search engine for all Asian languages, came out with a book entitled, Search Inside Yourself, which is all about mindfulness. Jeffrey Sachs, who is in the department of economics at Columbia University, came out with a book a few years ago, The Price of Civilization. The whole second half of the book is about mindfulness being the solution to our most pressing human problems. There are so many ways in which mindfulness is explicitly influencing our society. That was certainly not the case 30 years ago.
We’re in a particularly promising place at the moment. There’s a sense that, with the science continuing to do what it’s doing and the clinical medicine doing what it’s doing in terms of training of the mind in meditative awareness and optimizing mind-body connection and—in a number of creative ways, with hundreds of thousands if not millions of people practicing meditation and Yoga and bringing it more and more into their workplaces and into education, another large domain in which mindfulness is becoming important—the bell curve of society is shifting in a way that is very, very desirable.
And, not only is it desirable but, if you think about the forces of ignorance and delusion operating on our planet—in terms of climate change, war, famine, other human-related causes that might create enormous problems for future generations—then the stakes are actually very high for the wellbeing not only our species, but of life on this planet, and the homeostasis of the planetary cycles as a whole. It’s not a matter of a little nadi shodanam, or a little of this or a little of that. The cockroaches and the beetles are going to survive, whatever happens to us human beings; they’re much more resilient than we are. But, if we hope to be here to give something over to our children, grandchildren and great-grandchildren, then we need to start paying attention, which is what the essence of all these meditative practices is all about. It’s not about finding some cave and just happily doing Hatha Yoga or meditating in the cave and feeling at one with the universe, although that is very nice too. It’s about bringing it out into life for the benefit of others.
Thirty years ago, the mainstreaming of mindfulness was virtually inconceivable, yet it has come to pass. Thirty years ago, these types of inner meditative investigations were a kind of countercultural thing to do, and there was a lot of romanticizing of the mysterious, mystical East. We believed there was something wrong with us and, if we only got what was right with the East, then East would meet West and everything would be great (laughs). From the perspective of the present, that seems more than a little romantic, idealized and immature. But, where we are now will seem the same way in 30 years.
About Jon Kabat-Zinn:
Jon Kabat-Zinn, Ph.D. is internationally known for his work as a scientist, writer, and meditation teacher engaged in bringing mindfulness into the mainstream of medicine and society. He is Professor of Medicine emeritus at the University of Massachusetts Medical School, where he was founding executive director of the Center for Mindfulness in Medicine, Health Care, and Society, and founder (in 1979) and former director of its world-renowned Stress Reduction Clinic. He is the author of many books including, Full Catastrophe Living; Wherever You Go, There You Are and Mindfulness for Beginners. He is co-editor of The Mind’s Own Physician: A Scientific Dialogue with the Dalai Lama on the Healing Power of Meditation, and of Mindfulness: Diverse Perspectives on its Meaning, Origins, and Applications.