Mind the Gaps: Are Conclusions About Mindfulness Entirely Conclusive?

Mindfulness is generally regarded as a "quality of consciousness" (Brown, Ryan, & Creswell, 2007, p. 211); beyond this consensus, however, disagreement abounds. Currently, an abundance of evidence supports the benefits of mindfulness (e.g., Brown & Ryan, 2003; Eberth & Sedlmeier, 2012), with some researchers suggesting that the therapeutic benefits of mindfulness may be transdiagnostic (i.e., beneficial for a range of emotional and physical concerns as well as effective across a diversity of populations; e.g., Baer, 2007). Indeed, in such a climate of positive expectation, Ng (1999) suggested that "there may be social pressures upon the individual to experience and report benefits" (p. 203). Such fervor may have arrested a more balanced and temperate investigation of mindfulness (Brazier, 2013), and the existing evidence may be of questionable validity given a lack of conceptual and operational agreement as well as research designs of varying rigor (Chiesa & Malinowski, 2011; Goyal et al., 2014). Although the mindfulness literature undeniably suffers from the standard criticisms of modern scientific inquiry--methodological concerns, inadequate sample diversity, insufficient multicultural sensitivity, and so forth (e.g., Hickey, 2010)--this article primarily presents gaps more unique to the mindfulness literature In this pursuit, we address current conflicts and gaps within the mindfulness literature, not as an exhaustive critique, but as an aggregation of concerns in hopes of stimulating dialogue and empirical attention to those areas in need of greater clarification. First, we introduce the roots of mindfulness, as informed by the Buddhist canon. Second, we address the difficulties Western researchers continue to navigate in conceptually and operationally defining mindfulness. Third, we examine differences between two commonly conflated mindfulness practices: mindfulness meditation (MM) and mindfulness-based interventions (MBIs). Fourth, we discuss attrition factors, potential adverse effects of mindfulness, and populations contraindicated for mindfulness-based techniques. Finally, we review screening tools for individuals interested in participating in mindfulness-based practices and techniques, along with implications for practice. * What Is Mindfulness? History and Conceptual Definitions Mindfulness is a central element of Buddhist scriptures, specifically addressed in the Abhidhamma, a collection of Buddhist psychological and philosophical treatises. Foundationally, the Buddhist tradition holds that suffering is fundamental to the human condition (Hanh, 1998). However, the Buddhist tradition also contends that suffering can be overcome by means of the Four Noble Truths (suffering exists, the origin of suffering can be known, suffering can end, and the end of suffering is the Eightfold Path) and the Eightfold Path (right understanding, right thought, right speech, right action, right livelihood, right effort, right mindfulness, and right concentration; Hanh, 1998). Situated as the seventh element of the Eightfold Path, mindfulness has been traditionally understood as "an understanding of what is occurring before or beyond conceptual and emotional classification about what is or has taken place" (Chiesa, 2013, p. 256). Within the Buddhist context, the development of mindfulness is not taken as a goal itself, but as a means of reducing suffering and promoting psychological well-being (Chiesa, 2013). Therefore, right mindfulness is an important qualifier given that mindfulness has been traditionally grounded in an ethical (i.e., Buddhist) framework, which situates mindful practice as a means to a greater end. Difficulty understanding mindfulness begins with the translation of the Sanskrit word smriti or the Pali word sati. (Both Sanskrit and Pali are classical languages of India.) Smriti and sati are often translated into English as mindfulness and denote a quality of consciousness applied to internal and external phenomena such that experiences are clearly perceived, unmuddled by preconceptions and biases. …