Dialectics of mindfulness: implications for western medicine

In the last two to three decades, the concept of mindfulness has received increasing attention, particularly in the health sciences. Mindfulness is about being aware of actual experiences from one moment to the next with gentle acceptance [1-3]. This concept has been proposed to contribute to the coping and recovery process in many health conditions.Both clinical as well as basic science researchers have devoted a significant amount of study to this topic [4]. Moreover, with rapidly mounting evidence regarding the therapeutic capacities of mindfulness practice, medical professionals are increasingly incorporating such techniques into their clinical repertoire. Probably the best known and evaluated mindfulness-based treatment is the Mindfulness-Based Stress Reduction (MBSR) that is used in many clinical settings in the US and Canada and evermore, in Europe [4].Yet, integrating mindfulness into existing therapeutic concepts may challenge medical professionals' usual practices for number of reasons. First and foremost, mindfulness approaches do not aim at symptom reduction. Fundamentally, mindfulness is not intended to explicitly eradicate pain, distress, or unwanted emotions. However, philosophically and practically, medical professionals endeavor to reduce suffering. If mindfulness does not aim at reducing symptoms, then how can it be helpful? In this essay, we argue that while mindfulness is not meant to actively reduce symptoms, it may passively modify their impact by changing an individual's perceptions and mindset. Mindfulness is a set of practices, if not a "way of being" that may incur salutogenic (i.e., health-promoting) effects. This may lead to a misconception of what mindfulness is, and how it works. We believe that some of the apparently contradictory aspects of mindfulness can be best understood by taking a dialectical approach. It is not a new idea to explain psychological health-related processes through the use of paradoxical or dialectical approaches