ExcerptedLiteratureReview.docx

The following is a portion of a literature review excerpted from a doctoral research project submitted by a UoR student. The purpose of this excerpt is to demonstrate characteristics of a literature review, not to present a full discussion of the topic.

Definition of Mindfulness

The term mindfulness has been used in the literature for decades, including early mentions in works by Hanh (1987), Langer (1989), Bain (1995), and Kabat-Zinn (1991), but the term has been in the common vernacular for over 300 years (Dhiman, 2009). Most commonly, the research surrounding mindfulness has been clinical in nature (Brefczynski-Lewis et al., 2007; Chambers et al., 2008; Chan, 2008; Chang, 2004; Christopher & Gilbert, 2010; Davidson et al., 2003; Fernandez, 2010; Galantino, 2005; Jha, 2010; Sasser, 2008; Shapiro, 2009; Way, 2010) with only a few organizational studies emerging in recent years (Lewis, 2014; Love, 2008; Roche, 2014; Salamon, 2010; Walach, 2007). In Buddhism, mindfulness is a state of being, not simply a trait, and an overarching way to live life. Sati, or awareness, is part of Right Mindfulness, one of the Eightfold Paths of Buddhism (Dhiman, 2009). Mindful breathing, or Anapanasati, is the foundation for this awareness (Hahn, 1987). The definition of mindfulness, as it is understood in Western communities and for this research study, is simply a present-centered, non-judgmental awareness (Kabat-Zinn, 2002). This definition is based directly on simpler Buddhist teaching of a consciousness awareness to the present (Hahn, 1987).

More deeply, mindfulness is intentional cognitive behavior directed at implicit processes, “also called indirect, automatic, intuitive, and unconscious, those [cognitive processes and behaviors] that become active without conscious choice, effort, or intention” (Brown & Ryan, 2003, p. 833). Mindfulness meditation is not an active cognitive exercise, however, but a “witnessing or observant stance toward ongoing emotional and other psychological experiences” (Brown & Ryan, 2003, p. 840). From a biological perspective:

The brain is the central organ of stress response and recovery, and essential to these processes is an individual’s awareness of his or her internal physiological state, also known as interoception…a process through which the brain monitors and updates the body about its overall physical state, including its ability to recognize bodily sensations, be aware of emotional states, and maintain physiologic homeostasis. (Johnson et al., 2014, p. 844)

Theoretical underpinnings of mindfulness include the theory of self-control (Baumeister, Schmeichel, & Vohs, 2007) and the theory of mindfulness (Shapiro & Carlson, 2009). The concept of self-control differs from mindfulness in that the state of the ego in mindfulness is best described as self-as-process versus self-as-object. To elaborate, self-control theory has three core processes of goal setting, goal monitoring, and goal operating (Carver & Scheier, 1998). At the core of these processes is a feedback loop that occurs from goal operating back to goal setting, operating like a thermostat in a home that signals the mechanical system to add or subtract heat from a home based on the sensed temperature (Burnette, O'Boyle, VanEpps, Pollack, & Finkel, 2013). When feedback is divergent from perceived reality, the ego may perceive a threat know as ego threat (Burnette et al., 2013). When this occurs, there are implicit processes within an individual that determine whether the goal is then abandoned or a new approach taken (Burnette et al., 2013). Bandura (1989) supported this feedback process theory in his social cognitive theory, where goal setting is influenced by capabilities and perceived self-efficacy; when there is no perceived control, then stress and anxiety can occur. In this way, self-control is an active cognitive process aimed at determining behavior likely to achieve a goal, in which case the ego moderates the self-as-object, or individual attitudes and ideas about him or herself (Rentz & White, 1967).

Conversely, a mindful ego views the self-as-process, or the “group of psychological process that function as determinants of behavior” (Rentz & White, 1967, p. 277). In this way, mindfulness meditation, or living Right Mindfulness, is a way of being that negates the need for active cognition per se, but instead replaces it with an ever-present awareness that is either immune or buffers against ego threat. “Mindfulness—in its capacity to more clearly and fully inform on what is taking place—may act as an integrative agent by enhancing capacities to act congruently with one’s perceptions, reflectively considered goals, and self-endorsed value” (Brown, Ryan, & Creswell, 2007, p. 274).

Understanding the differences between what mindfulness offers the self, outside of self-control, enhances the prospect of expanding leadership capability within individuals by addressing self-regulation autonomously—the practice of non-judgmental presence becomes second nature, or a so-called state mindfulness (versus trait mindfulness), and does not require active cognition to remain focused and present (Brown & Ryan, 2003). The self-as-object is an active cognition and coping with emotions and subsequent ego threats that can degrade and cause anxiety and other mental problems (Kobasa, 1979) while the self-as-process, through mindfulness, alters that relationship so that emotions are simply observed and not directly processed as an ego threat (Davidson, 2010).

The theory of mindfulness proposes that mindfulness practice shifts a person’s perspective through the non-judgmental “reperceiving” (p. 94) of thoughts and feelings within consciousness (Shapiro & Carlson, 2009). The reperceiving enhances the ability to be objective about internal and external stimuli, thus separating a person from his or her own embedded conscious. This separation allows a person to de-identify with thought, sensations or emotions that arise and just be present with those thoughts and emotions instead of feeling defined by them. One example is a pain patient who lives daily with pain and begins to feel as if he or she causes his or her own pain, deserves it, and ultimately suffers because of some past wrong. This patient exemplar has placed meaning to his or her pain, whether real or imagined. Mindfulness would provide the separation of meaning from the pain, allowing the experience of pain to be detached from emotion and allowing the patient to be able to be process the pain objectively, often with a noted decrease in the experience and suffering from pain (Selfridge, 2011).

The kind of awareness involved in mindfulness differs profoundly from the kind of awareness at work in our usual mode of consciousness…With the practice of mindfulness, awareness is applied at a special pitch…The mind is trained to remain in the present, open, quiet and alert, contemplating the present moment. All judgments and interpretations have to be suspended, or if they occur, just registered and dropped. (Bodhi, 1984, p. 75)

Generally, mindfulness is accepted within the psychological community as stemming from Zen Buddhist traditions (Kabat-Zinn, 2002). Practitioners can spend decades training their minds and bodies into being fully integrated as presently aware and attentive entities. In Western psychology, the attempt to operationalize mindfulness through various measurements and assessments steers somewhat from the original Buddhist scholarly tradition by polling individuals to self-report their awareness from a position of incomplete understanding of what mindfulness truly entails. The results are often differing scores on mindfulness self-assessments between experienced mindful meditators and those without much experience (Tran, Gluck, & Nadar, 2013).

In Buddhist understanding, the practice of mindfulness is integrated into life so that reflection becomes a state of being, inseparable from one’s experience. Disturbing emotions occur not as overwhelming stimuli affecting decisions, but as thoughts which cognitively pass by, are noticed, and then are discarded so as to prevent interference in the process of living (Shapiro & Carlson, 2009). In Western tradition of only a few decades, mindfulness is a trait that is cultivated through the practice of meditation (Stanley, 2014; Stanley et al., 2011). Outside of medical circles, being mindful is often used to indicate clarity and calmness or to deal with active cognition and thoughts (Bennett, 2011; Joyner, 2008; Khisty, 2010; Langer, 1997).

The hope that simply mediating will lead to specific improvement in cognitive areas separates the trait of mindfulness from the state of being intended by the spiritual aspects of mindfulness. The trait cultivation is utilized as a clinical intervention for depression, PTSD, poor resilience, chronic pain, anxiety, and attention disorders (Jha et al., 2010; Thompson et al., 2011; Tomac, 2011; Walach et al., 2007; Way, 2010). State mindfulness occurs following an undetermined amount of time practicing mindfulness and incorporating the tenets into daily life. Much of both of these types of mindfulness remains subjective and only recently have some biological data suggested possible brain processes that contribute to either state or trait mindfulness (Chan, 2008; Heydenfeldt, Herkenhoff, & Coe, 2011; Hölzel, 2010; Way, 2010).

Mindful Debate over Definition

One of the striking features found in reviewing the literature on mindfulness, as noted in the introduction, is finding two distinct descriptions and understandings of mindfulness. The first is primarily used in the clinical setting and stems directly from Kabat-Zinn’s work, pioneered in 1979 at the University of Massachusetts, and the original philosophical routes of mindfulness in Zen Buddhism (Chang et al., 2004; Kabat-Zinn, 2002). In the Eastern tradition of mindfulness, the act of being mindful is present-centered and non-judgmental. The goal is not reframing cognitive patterns or thinking about thinking; instead, the only focus is on the present and redirecting the mind to present things, such as breathing, body awareness, or other predetermined objects. Mindfulness, in this sense, is a moment-by-moment awareness or “a state of psychological freedom that occurs when attention remains quiet and limber, without attachment to any particular point of view” (Davis & Hayes, 2011, p. 198). The most important aspect of mindfulness in this definition is the absence of action toward fixing, altering, or processing what the mind is focused on or aware of. Instead, the purpose is to simply notice, acknowledge, and redirect the mind when it wanders.

Kabat-Zinn’s (2002) desire was educating Westerners on this Eastern philosophical path without alienating them based on the religious foundations of mindfulness. His belief was the core concepts of mindfulness were universal, “it has everything to do with being human and being awake” (Kabat-Zinn, 2002, p. 68). Kabat-Zinn and the University of Massachusetts created a rigorously studied course known as Mindfulness-Based Stress Reduction or MBSR. It is typically an 8-week course consisting of two to three hours each week in guided didactic and experiential mindfulness practice, culminating in a day-long mindfulness retreat. Over a decade of data exists to provide an evidence base for the current MBSR course length and content, highlighting effectiveness through standardized curriculum and facilitator certification (Chang et al., 2004; Galantino, Baime, Maguire, Szapary, & Farrar, 2005; Hofmann et al., 2010; Oman, Sasser, 2008; Shapiro, Thoresen, Plante, & Flinders, 2008). Although other MBSR-types of training exist and have shown efficacy, such as Mindfulness-Based Cognitive Therapy, the original course is the most commonly known within the clinical psychology and medical communities for treatment of a variety of mental health concerns (Geschwind, Peeters, Drukker, van Os, & Wichers, 2011; Khoury et al., 2013). “The most common and well-validated training program is mindfulness-based stress reduction (MBSR); more than 250 U.S. hospitals offer MBSR programs, and more than 50 research articles document its utility in many domains” (Stanley & Jha, 2009, p. 147).

The second description of mindfulness in common use contemporaneously was founded in 1989 by Langer, who has also been given credit for pioneering mindfulness in psychology (Levinthal & Rerup, 2006). This definition involves a specific cognitive process to examine and alter thoughts and emotions in order to gain greater meta-cognition about those thoughts and emotions. Langer’s concept of mindfulness is a state of active awareness described as the “continual creation and refinement of categories, an openness to new information, and a willingness to view contexts from multiple perspectives” (as cited in Levinthal & Rerup, 2006, p. 502). In Langer’s definition, mindfulness is seeing novel patterns within routines with the goal to alter them (Langer, 1989). Langer’s mindfulness is not based on Eastern philosophy and her conceptual model introduced mindlessness, the opposite of mindfulness, as the default state of cognition for most people, essentially “being mindless, colloquially speaking, is like being on automatic pilot” (Langer, 1997, p. 4). Automatic routines as cognitive processes are recognized in psychological literature (Langer, 1997; Weick & Sutcliff, 2006) and combating that complacency is the basis for many organizational awareness practices (Weick & Sutcliffe, 2006; Weick, Sutcliffe, & Obstfeld, 2000).

Despite the differences in definition, the reviewed literature will discuss both Buddhist mindfulness and Langer’s interpretation of mindfulness. Medical and sports psychology literature trends toward the Buddhist definition while organizations and businesses focus on Langer’s definition and the mindful model for High Reliability Organizations hypothesized by Weick and Sutcliffe, which also utilizes Langer’s definition (Weick et al., 2000). This schism is interesting and provides mindfulness researchers with two sets of literature, courses, and instruments with which to study mindfulness. However, the difference between the two definitions is so great that results cannot be substituted. It is speculation that MBSR courses may increase mindfulness on Langer’s mindfulness measurement due to the attentional training although no evidence of this was discovered in this review. Yet, the underlying cognitive processes that are developed from these two methods are different simply because the understanding and philosophy of what encompasses mindfulness are different.

The gap between these two understandings and applications of mindfulness is the key to understanding the gap in leadership research utilizing the Zen Buddhist understanding of mindfulness, which demonstrates positive clinical and behavioral effects in individuals. Instead, Langer’s approach is most frequently used in organizational applications, and is decidedly absent in literature reviews of medical and psychological literature discussing mindfulness. Langer’s focus of finding newness in routine and applying cognitive processes in new ways could appeal to industry as the emphasis is on specific actions that organizations can take instead of personal enlightenment at the individual level. Langer’s prominence at Harvard and within Harvard business circles may also explain the skew. Additionally, business researchers may ignore the medical application due to misunderstanding of mindfulness or from stigma of the clinical approach. Leaders may want to avoid comparisons to the mentally ill, so the alternative perspectives of mindfulness posed by Langer are likely more welcome in organizational and business settings.

Unfortunately, Langer’s use of the term “mindfulness” is inaccurate and misleading. Her research surrounding mindfulness has mostly been presented outside of peer-reviewed professional journals, although her research on control, possibility and other empirical studies are ground-breaking and published in leading journals (Feinberg, 2010). Her version of mindfulness may include being mindful, or thoughtful and focused, to changes and patterns but it is not present-centered and non-judgmental awareness rooted in Buddhism. Langer’s mindfulness assessment (Mindfulness/Mindlessness Scale), as described in Park et al. (2013), includes questions such as “I like to investigate things” (p. 2649) and “I try to think of new ways of doing things” (p. 2649), which are congruent with cognitive processing, but are incongruent with a state of mindful attention to the present without judgement.