Jon Kabat-Zinn, Ph.D., and director of the Stress Reduction Clinic at the University of Massachusetts Medical Center, is internationally known for his work using meditation to help medical patients find relief from chronic pain and stress-related disorders. More important, perhaps, he brings to the arena of mind/body science a touch of the poet as well as the pragmatist, giving us the hows and whys of meditation in a language we don't often associate with the subject.
In this interview with Bill Moyers, Kabat-Zinn describes meditation as a way of being, a reservoir of stability and insight.
How do your patients react when you begin to talk with them about meditation?
One of the questions we had to answer right from the beginning was: Would this be so weird that nobody would be interested in doing it? People might say, "What are you talking about? Meditation? Yoga? Give me a break!" Meditation had never been tried before in a medical center, so we had no idea whether mainstream Americans would accept a clinic whose foundation was intensive training in meditative discipline.
Doctors refer patients to us for all sorts of very real problems. These people are not at all interested in meditation, or yoga, or swamis, or Zen masters, or enlightenment. They're suffering, and they come because they want some relief from their suffering, and they want to reduce their stress. One reason that people take to our program is that it's completely demystified. It's not anything exotic. Meditation just has to do with paying attention in a particular way. That's something we're all capable of doing.
I wonder if it would have been as successful if you'd called it "Courses in Meditation" instead of "Stress Reduction Clinic"
Oh, I can guarantee you that it wouldn't have. Who would have wanted to go to a meditation class? But when people walk down the halls in this hospital, and they see signs saying "Stress Reduction and Relaxation," they respond, "Ah, I Could use that." Then meditation seems to make sense, because we're trying to penetrate to the core of what it means to work with the agitated mind by going into deep states of relaxation.
That makes me wonder whether you may have tapped into the power of the placebo here. People think it will work for them, so they feel better even though they're not sure what is happening.
Why not? I'll take transformational change any way it comes. One way to look at meditation is as a kind of intrapsychic technology that's been developed over thousands of years by traditions that know a lot about the mind/body connection. To call what happens "the placebo effect" is just to give a name to something we don't understand. If people have very strong expectations that something might happen, that expectation itself might be useful.
We ask people to do a lot of hard work, so we hope they'll start out with a positive attitude—even if that might be thought of as a placebo. But actually, people very often start with more of a negative attitude. We ask them just to try to suspend judgment and not to become so hard to convince that they can't listen to their own breathing or observe their own minds.
What do your hard-nosed colleagues—the cardiologists and brain surgeons, for example—think of you and this little crowd?
We get patients from all of them, and many come themselves. They feel that the proof is in the pudding and that what we really need to do is study this stuff a lot more. The notion that the mind and body are actually different sides of the same coin goes all the way back to the origins of medicine. For most of its history the practice was not separated from other aspects of human activity.
Is that why you begin with something as common and simple as eating a raisin?
Yes. The point of that exercise is to respond to all the baggage people carry about what meditation is. We want to dispel those notions right away. So we say, "Look, the first exercise we'll do isn't breathing; it isn't sitting in the full lotus posture and pretending you're in a fine arts museum, or standing on your head. We're just going to eat a raisin—but eat it mindfully, with awareness."
You look at the raisin—feel it, smell it, and with awareness bring it to the mouth gradually, and see that saliva starts to get secreted just as you bring it up. Then you take the raisin into the mouth, and you begin to taste this thing that we usually eat automatically. From there it's a very short jump to realize that you may not actually be in touch with many of the moments of your life, because you're so busy rushing someplace else.
And do you bring people back to their breathing for the same reason—to give the mind one thing to concentrate on?
Yes, exactly. Once we do the raisin exercise, people begin to realize that there's nothing magical about mindfulness. Most of us do a lot of different things when we're eating—read, talk, watch television. Slowing it down and really tasting your food helps bring you into the present moment. Then we transfer mindfulness from eating to breathing and say, "Now, taste your breath in the same way."
Some people ask, "Why should I pay attention to my breathing? It's so uninteresting." I say, "Well, if it's so uninteresting to you, try this experiment: Clamp your thumb and forefinger over your nose like this, and keep your lips closed. Then see how long it takes for breathing to become really interesting." Turns out it's not very long. We don't appreciate some of the things that are most valuable in our lives.
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