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Ontological addiction theory: Attachment to me, mine, and I

Authors:
  • Awake to Wisdom Centre for Meditation, Mindfulness & Psychological Research

Abstract

Background Ontological addiction theory (OAT) is a novel metaphysical model of psychopathology and posits that human beings are prone to forming implausible beliefs concerning the way they think they exist, and that these beliefs can become addictive leading to functional impairments and mental illness. The theoretical underpinnings of OAT derive from the Buddhist philosophical perspective that all phenomena, including the self, do not manifest inherently or independently. Aims and methods This paper outlines the theoretical foundations of OAT along with indicative supportive empirical evidence from studies evaluating meditation awareness training as well as studies investigating non-attachment, emptiness, compassion, and loving-kindness. Results OAT provides a novel perspective on addiction, the factors that underlie mental illness, and how beliefs concerning selfhood are shaped and reified. Conclusion In addition to continuing to test the underlying assumptions of OAT, future empirical research needs to determine how ontological addiction fits with extant theories of self, reality, and suffering, as well with more established models of addiction.
Ontological addiction theory: Attachment to me, mine, and I
WILLIAM VAN GORDON
1
*, EDO SHONIN
2
, SOFIANE DIOURI
2
, JAVIER GARCIA-CAMPAYO
3
,
YASUHIRO KOTERA
1
and MARK D. GRIFFITHS
4
1
Centre for Psychological Research, University of Derby, Derby, UK
2
Awake to Wisdom Centre for Meditation and Mindfulness Research, Ragusa, Italy
3
Miguel Servet University Hospital, University of Zaragoza, Zaragoza, Spain
4
Department of Psychology, Nottingham Trent University, Nottinghamshire, UK
(Received: November 5, 2017; revised manuscript received: April 13, 2018; accepted: April 14, 2018)
Background: Ontological addiction theory (OAT) is a novel metaphysical model of psychopathology and posits that
human beings are prone to forming implausible beliefs concerning the way they think they exist, and that these beliefs
can become addictive leading to functional impairments and mental illness. The theoretical underpinnings of OAT
derive from the Buddhist philosophical perspective that all phenomena, including the self, do not manifest inherently
or independently. Aims and methods: This paper outlines the theoretical foundations of OAT along with indicative
supportive empirical evidence from studies evaluating meditation awareness training as well as studies investigating
non-attachment, emptiness, compassion, and loving-kindness. Results: OAT provides a novel perspective on
addiction, the factors that underlie mental illness, and how beliefs concerning selfhood are shaped and reied.
Conclusion: In addition to continuing to test the underlying assumptions of OAT, future empirical research needs to
determine how ontological addiction ts with extant theories of self, reality, and suffering, as well with more
established models of addiction.
Keywords: ontological addiction, addiction, mental illness, emptiness, non-attachment, Buddhism, mindfulness
INTRODUCTION
According to the biopsychosocial model of mental illness,
biological, psychological, and social factors, each plays a
signicant role in the onset of mental illness. The biopsy-
chosocial model of mental illness offers a more rounded
alternative to the biomedical model that, in addition to
viewing mental illness as a deviation from normal, has
been criticized as framing psychopathology in a reductionist
manner (e.g., Ghaemi, 2009). However, although the biop-
sychosocial model arguably reects a more encompassing
perspective, it has recently been asserted that the model
overlooks key psychopathology determinants. For example,
it has been argued that a biopsychophysismodel, which
acknowledges the role of natural environmental factors,
reects a more balanced perspective (Van Gordon, Shonin,
& Richardson, 2018).
Another factor posited as being overlooked in the bio-
psychosocial model relates to how an individual constructs
and becomes attached to belief systems concerning their
self-concept (Shonin, Van Gordon, & Grifths, 2016). More
specically, ontological addiction theory (OAT; Shonin,
Van Gordon, & Grifths, 2013;Shonin et al., 2016)[OAT
was conceived and rst presented by Shonin et al. (2013)
and a comprehensive discussion of the theoretical under-
pinnings was provided by Shonin et al. (2016).] is a novel
metaphysical model of mental illness that asserts that human
beings are prone to forming implausible beliefs concerning
the manner in which they think they exist, and that these
beliefs can become addictive leading to functional impair-
ments and mental illness (Van Gordon, Shonin, & Grifths,
2016a). The domain of metaphysics studies concepts and
questions relating to existence, being, and self, with a central
component comprising ontology relating to categories of
being and what entities actually exist (i.e., the nature
of being, becoming, and reality) (Chalmers, Manley, &
Wasserman, 2009).
Ontological addiction is dened as the unwillingness to
relinquish an erroneous and deep-rooted belief in an inher-
ently existing selfor Ias well as the impaired function-
alitythat arises from such a belief(Shonin et al., 2013,
p. 64). In line with the growing integration of Buddhist
principles into Western treatment settings, aspects of the
theoretical underpinnings of OAT derive from the Buddhist
philosophical perspective that all phenomena, including the
self, do not manifest inherently or independently (Shonin,
Van Gordon, Singh, & Grifths, 2015). The Buddhist
teachings assert that human beings and all phenomena
they interact with are marked by the property of
* Corresponding author: William Van Gordon; Centre for Psycho-
logical Research, University of Derby, Kedleston Road, Derby,
Derbyshire DE22 1GB, UK; Phone: +44 1332 597826; E-mail:
w.vangordon@derby.ac.uk
This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License,
which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and
source are credited, a link to the CC License is provided, and changes if any are indicated.
© 2018 The Author(s)
DEBATE Journal of Behavioral Addictions
DOI: 10.1556/2006.7.2018.45
emptinessor non-self(Tsong-Kha-pa, 2004). Emptiness
(Sanskrit: śūnyatā) does not mean that phenomena do not
exist or are not perceptible to the human mind but implies
that they exist in dependence on all other phenomena and
that they manifest only in a relative sense (Thurman, 2005).
Thus, it could also be said that emptinesssomewhat
paradoxically implies fullness,because the attribute of
interdependent existence that infers that a given phenome-
non is empty of an independent self, means that by default, it
signies the existence of all other phenomena (Van Gordon
et al., 2016a). For example, a tree exists in reliance upon
(among other things) (a) water (i.e., that in turn relies upon
rain, oceans, and rivers); (b) air with an appropriate com-
position of gaseous elements (i.e., that in turn relies upon
respiration in other life forms); (c) nutrients and minerals
(i.e., that in turn rely on the decay of organic matter); and (d)
light of an appropriate composition, temperature, and inten-
sity (i.e., that relies upon the sun and the ltering effect of
the earths atmosphere). If any one of these contributing
phenomena were absent, then the tree would not exist.
Similarly, the tree is integral to the existence of all other
phenomena. The tree is emptyof an inherently or inde-
pendently existing self but is fullof the universe.
OAT deviates from the ontological stance adopted in
prominent Western psychological theories of human behav-
ior that, to a greater or lesser extent, imply that the self
exists as a discrete entity (Van Gordon et al., 2016a). For
example, Rogers(1959) humanistic schema of the self
includes the dimensions of self-worth, self-image, and
ideal-self that each plays a role in the formation of an
individuals sense of self-concept. Similarly, social psycho-
logical theories are invariably constructed on the assumption
that there exists a relational self (Smith & Mackie, 2007), and
theories of human motivation, such as self-determination
theory, assume that individuals have evolved a tendency to
grow and master their environment as part of integrating new
experiences into a coherent sense of self (Ryan & Deci,
2017). A further example is Jungs(1981) theory that is
arguably situated closer to the Buddhist model (Van Gordon
et al., 2016a), but nevertheless asserts that there exists a locus
of self that cannot be denitively located.
ADDICTIVE PROCESS IN OAT
OAT asserts that by believing they exist both inherently and
independently, individuals reify their sense of self to a point
that they relate to themselves as the centerpiece in a world in
which all other lifeforms, objects, and concepts are deemed
to be peripheral (Shonin et al., 2016). Each time an indi-
vidual relates to the world and its phenomena as peripheral
to themselves, belief in selfhood is reafrmed and this elicits
rewards in the form of a more secure sense of self. In fact,
according to OAT, reinforcing the self-concept (and the
belief constructs that underlie it) occurs even when unpleas-
ant sensations arise, because such negative experiences
inevitably strengthen the view that there exists a self that
can experience pleasure or pain depending upon the nature
of its interaction with exterior objects, places, and people.
OAT proposes that belief in an intrinsically existing self
has the potential to facilitate an addiction feedback loop due
to the encoding of additional self-belief constructs each time
the individual receives afrmative feedback that its efforts in
the service of selfhood are necessary (Shonin et al., 2016).
Efforts to preserve or further the interests of the self might
include (but are not restricted to) striving to make money,
amassing fame or reputation, staving off illness or hardship,
and/or eliminating perceived threats (Lama & Berzin, 1997).
While it could be argued that such endeavors are a requisite
to living a normal and healthy life, OAT asserts that they
become maladaptive if driven by the belief that the self
exists either independently or intrinsically (Shonin et al.,
2013). In other words, rather than simply eating in order to
eat or working in order to work, and rather than regarding
oneself as an integral yet inseparable part of a larger
macrocosm, the individual suffering from ontological ad-
diction pursues activities and goals with only a supercial
and/or self-orientated regard for the other individuals and
peripheralphenomena they interact with. The terms
supercialand self-orientatedare employed here be-
cause as part of a strategy to preserve selfhood, OAT
acknowledges that while individuals suffering from onto-
logical addiction may at times behave in ways that are
seemingly considerate; such endeavors are ultimately driven
by selsh intentions.
In terms of the association between ontological addiction
and impaired functionality and/or the onset of mental illness,
OAT asserts that by maintaining a false and implausible
belief concerning the manner in which the self and reality
exist, and that by continuously pursuing selsh strategies,
individuals become attached to themselves as well as exter-
nal objects, people, and experiences. OAT denes attach-
ment as the over-allocation of cognitive and emotional
resources towards a particular object, construct, or idea to
the extent that the object is assigned an attractive quality
that is unrealistic and that exceeds its intrinsic worth
(Shonin, Van Gordon, & Grifths, 2014a, p. 126). OAT
further asserts that because the selfis an imputed or made-
up construct, no amount of exposure to desirable conditions
will yield lasting happiness (Shonin et al., 2016). In other
words, having nally acquired the sought-after commodity,
person, or situation, OAT explicates that dissatisfaction will
gradually reemerge and that new commodities or experi-
ences will then become attractive, such that they substitute
the former objects of attachment (Van Gordon et al., 2016a).
According to OAT, attachment is a thirst that can never be
quenched and it leads to psychopathology determinants,
such as fatigue, sleep impairment, ruminative thinking,
resentment, and stress (Shonin et al., 2016). A further
explanation provided by OAT in terms of why a self-
centered strategy is maladaptive is because all phenomena
and situations are impermanent (Van Gordon et al., 2016a).
Impermanence is a core Buddhist principle that refers to the
fact that phenomena do not indenitely endure and that they
are in a constant state of ux (Van Gordon et al., 2016a).
Consequently, efforts to preserve or augment selfhood
can, at best, only yield temporary happiness and will
inevitably result in suffering because as explicated by the
Buddhist teachings: (a) all that is gained must be lost
(e.g., wealth), (b) that which comes together must come
apart (e.g., relationships), (c) that which ascends to a high
position must fall to a low position (e.g., fashions, regimes,
Journal of Behavioral Addictions
Van Gordon et al.
and dynasties), and (d) that which is created must be
destroyed (e.g., the human body; Wallace, 2001). For
example, it is inevitable that sooner or later, an individual
who experiences wealth and fame will, whether through
choice, turn of fortune, or illness or death, be separated from
these circumstances. Furthermore, OAT argues that capacity
for personal and interpersonal growth is impeded due to
being deprived of the meta-cognitive and psychospiritual
resources that arise from comprehending the true insepara-
ble nature of the self and phenomena (Van Gordon, Shonin,
Grifths, & Singh, 2015).
FIT WITH CONVENTIONAL MODELS
OF ADDICTION
According to Shonin et al. (2016), ontological addiction
satises each of the six addiction criteria outlined in
Grifths(2005) components model of addition. Grifths
components model maps onto the fth edition of Diagnostic
and Statistical Manual of Mental Disorders criteria for addic-
tive behavior (as outlined in detail by Grifths, King, &
Demetrovics, 2014) and asserts that addiction features com-
ponents of (a) salience, (b) mood modication, (c) tolerance,
(d) withdrawal, (e) conict, and (f) relapse. Examples adapted
from Shonin et al. (2016) of how ontological addiction
satises Grifthscriteria (and which overlap with the diag-
nostic features for ontological addiction) are as follows:
1. Salience: belief in a discrete Ientity dominates
thoughts, feelings, and behaviors, and becomes im-
portant to the extent that the individual with ontologi-
cal addiction is unable to associate with the belief as
being separate from themselves.
2. Mood modication: belief in an intrinsically existing
selfresults in craving for objects, situations, and
experiences that are understood to advance the inter-
ests of the self. Acquiring such objects, situations, or
experiences elicits temporary feelings of happiness,
satisfaction, and elation.
3. Tolerance: increasing levels of immersion in self-
centered emotions, discursive thinking patterns, and
worldly affairs are required in order to sustain and
further augment the erroneous belief in inherent
existence.
4. Withdrawal symptoms: any suggestion of transcend-
ing selfhood is regarded as a threat and thus repelled.
5. Conict: belief in an intrinsically existing selfresults
in craving for objects, situations, and experiences that
are understood to advance the interests of the self. Not
acquiring such objects, situations, or experiences elicits
intrapersonal and intrapsychic conict.
6. Relapse: ego-driven cognitive-behavioral processes
quickly reestablish themselves following efforts to
undermine addiction to selfhood.
Ontological addiction can occur either in isolation or with
specic DSM-5 mental disorders [e.g., anxiety, depression,
personality disorders, trauma- and stress-related disorders,
dissociative disorders, obsessivecompulsive disorder (OCD),
etc.] that can also be symptomatic of the condition
(Shonin et al., 2016). However, neurodevelopmental dis-
orders and disorders that are principally biological in nature
(e.g., neurocognitive disorders, specic sexual dysfunctions,
etc.) are not deemed to be diagnostically signicant. Ontolog-
ical addiction clearly includes an element of disordered
thinking but given that elements of the cognitive and behav-
ioral patterns that underlie ontological addiction might be
considered functionally adaptive, extant clinical assessment
tools for disordered thinking (e.g., as used when screening for
OCD-spectrum disorders) are unlikely to be of adequate
sensitivity. Furthermore, in the sense that it is contextualized
in OAT, disordered thinking stems from an underlying addic-
tion to selfhood and is more subtle in nature, because it relates
to ignorance concerning the true mode in which reality exists.
In terms of onset, symptoms of ontological addiction are
understood to arise progressively, with the rst occurrence
often manifesting following the development of a sense of
selfhood during childhood (Shonin et al., 2016). For most
individuals, the course is persistent with symptoms typically
intensifying during adulthood unless treatment is initiated.
According to OAT, direct functional consequences of on-
tological addiction involve the mind turning-inon itself
such that addiction to selfhood restricts clarity of thought,
perspective, and reasoning capacity. Furthermore, a dispro-
portionate focus on me,”“mine,and Iultimately hin-
ders the individualsability to perceive and remain aware of
the present moment (Van Gordon et al., 2016a).
EMPIRICAL SUPPORT FOR ONTOLOGICAL
ADDICTION
OAT posits that in addition to specically targeting the
aforementioned addiction components, treatment strategies
should seek to undermine attachment or addiction to self-
hood and thus help to remove the loci upon which emotional
and conceptual baggage(i.e., determinants of psychopa-
thology) can accumulate (Van Gordon et al., 2016a). This is
in line with research demonstrating that reduced attachment
to self is associated with (a) lower subjective perception of
distress as well as superior physical and psychological
health more generally (Pande & Naiku, 1992); (b) enhanced
acceptance, non-reactivity, mindfulness, self-compassion,
subjective well-being, and eudemonic well-being (Sahdra,
Shaver, & Brown, 2010); (c) increases in prosocial behavior
(Sahdra, Ciarrochi, Parker, Marshall, & Heaven, 2015); and
(d) reduced psychological distress and chronic pain (Van
Gordon, Shonin, Dunn, Garcia-Campayo, & Grifths,
2017). The treatment model advocated in OAT is also
consistent with ndings from a mixed-method study of
advanced meditation techniques in Buddhist meditators,
which found that in addition to increasing levels of non-
attachment, specic advanced meditation practices led to
experiences of emptiness and non-self that helped partici-
pants harness the potential of their mind(Van Gordon,
Shonin, Dunn, et al., 2018, p. 8).
Furthermore, a second-generation mindfulness-based
intervention known as meditation awareness training
(MAT) which explicitly teaches emptiness meditation
and accepts the key assumptions of ontological addiction
has been shown to be efcacious in the treatment of
individuals suffering from work addiction (Shonin, Van
Gordon, & Grifths, 2014b;Van Gordon, Shonin, Dunn,
Journal of Behavioral Addictions
Ontological addiction theory
Garcia-Campayo, Demarzo, et al., 2017), sex addiction (Van
Gordon, Shonin, & Grifths, 2016b), gambling addiction
(Shonin, Van Gordon, & Grifths, 2014c), bromyalgia (Van
Gordon, Shonin, Dunn, Garcia-Campayo, & Grifths, 2017),
and stress, anxiety, and depression (Van Gordon, Shonin,
Sumich, Sundin, & Grifths, 2014). MAT has also been
shown to improve work-related well-being and job perfor-
mance in middle managers (Shonin, Van Gordon, Dunn,
Singh, & Grifths, 2014) as well as increase civic engage-
ment in clinical samples (Van Gordon, Shonin, Dunn, Garcia-
Campayo, & Grifths, 2017). Qualitative studies evaluating
MAT have demonstrated that participants associate engaging
in emptiness techniques with improvements in psychological
and spiritual well-being, as well as with the undermining of
maladaptive egoistic constructs (Shonin & Van Gordon,
2015;Shonin, Van Gordon, & Grifths, 2014d;Van Gordon,
Shonin, & Grifths, 2016c). Furthermore, in the aforemen-
tioned bromyalgia study (a randomized controlled trial
evaluating the treatment effectiveness of MAT), non-
attachment to self was shown to fully mediate the relationship
between meditation and reductions in both somatic and
psychological bromyalgia symptoms (Van Gordon, Shonin,
Dunn, Garcia-Campayo, & Grifths, 2017).
Further support for OAT is derived from the growing
body of research into compassion and loving-kindness
meditation that have been shown to improve (among other
things) (a) schizophrenia symptomatology; (b) positive and
negative affect; (c) depression, anxiety, and stress; (d) anger
regulation; (e) personal coping resources; and (f) affective
processing (for a comprehensive review, see Shonin, Van
Gordon, Compare, Zangeneh, & Grifths, 2015). From the
Buddhist perspective, compassion and loving-kindness are
deemed to foster psychospiritual well-being by cultivating
other-centeredness (i.e., rather than self-centeredness),
which facilities the undermining of self-focused beliefs and
strategies (Shonin, Van Gordon, Compare, et al., 2015).
In terms of likely mechanisms of action, OAT asserts that
cultivating an experiential understanding of emptiness, as
well as competency in some of the aforementioned meditation
techniques, helps to formulate a view of reality that is more
accurate and thus more adaptive. A less-pronounced sense of
self fosters clarity of perceptive and cognitive processes and
allows the individual to construct a sense of self that is
dynamic, inseparable from its environment, and that is full
and complete due to experiencing that all things are empty
(VanGordonetal.,2016a). In other words, when the sense of
selfhood which is the locus upon which emotional and
conceptual baggagecan accumulate becomes less pro-
nounced, both psychological exibility and psychological
well-being begin to increase. This is consistent with the
transtheoretical model of behavior change (Prochaska,
Norcross, & DiClemente, 1995) in the sense that the meta-
cognitive effects of emptiness and related forms of training
appear to enable ease of movement in behavioral change.
CONCLUSIONS AND FUTURE DIRECTIONS
According to the Buddhist three trainings principle
(Sanskrit: trishiksha), contemplative techniques can be
grouped into those primarily concerned with (a) ethical
awareness including compassion and loving-kindness,
(b) meditation including mindfulness and other concentrative
techniques, and (c) wisdom (in Buddhism, wisdom refers to
insight into the true nature of self and reality) (Shonin et al.,
2014a). Concepts such as non-self,”“non-attachment,and
emptinesscan be classied as wisdom principles and there
currently appears to be a trend toward investigating them
empirically as well as exploring their application in applied
settings. Emerging ndings show promise (Shonin et al.,
2016), but there is clearly a need to develop this research area
and continue to test the underlying theoretical assumptions
and applied utility of OAT.
OAT provides a novel perspective not only in terms of
the factors that underlie mental illness and human behavior
more generally, but also in terms of how beliefs concerning
selfhood are shaped and reied. Furthermore, OAT offers an
alternative scientic viewpoint concerning the manner in
which the self exists and challenges the plausibility of
established scholarly opinions concerning the underlying
nature of reality. It is hoped that this paper will be successful
in fostering scientic discussion and stimulating research to
identify areas of convergence and divergence between OAT
and extant theories of self, reality, and suffering. A key
future direction will be to determine where ontological
addiction ts in relation to current models and classications
of more traditional and established models of addiction.
Funding sources: No nancial support was received for
this study.
Authorscontribution: All authors were involved in the
conception and writing of the paper. Furthermore, we
conrm that all authors are responsible for all contents of
the article and had authority over manuscript preparation
and the decision to submit the manuscript for publication.
Conict of interest: The authors declare no conict of
interest.
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Campayo, J., & Grifths, M. D. (2018). Meditation-induced
near-death experiences: A three-year prospective study. Mind-
fulness. Advance online publication. doi:10.1007/s12671-018-
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Van Gordon, W., Shonin, E., & Grifths, M. D. (2016a). Buddhist
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Van Gordon, W., Shonin, E., & Grifths, M. D. (2016b). Meditation
awareness training for the treatment of sex addiction:
A case study. Journal of Behavioral Addictions, 5(2), 363372.
doi:10.1556/2006.5.2016.034
Van Gordon, W., Shonin, E., & Grifths, M. D. (2016c). Meditation
awareness training for individuals with bromyalgia syndrome:
An interpretative phenomenological analysis of participants
experiences. Mindfulness, 7(2), 409419. doi:10.1007/s12671-
015-0458-8
Van Gordon, W., Shonin, E., Grifths, M. D., & Singh, N. N.
(2015). There is only one mindfulness: Why science and
Buddhism need to work together. Mindfulness, 6(1), 4956.
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Van Gordon, W., Shonin, E., & Richardson, M. (2018). Mindful-
ness and nature. Mindfulness. Advance online publication.
doi:10.1007/s12671-018-0883-6
Van Gordon, W., Shonin, E., Sumich, A., Sundin, E., & Grifths,
M. D. (2014). Meditation awareness training (MAT) for psy-
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students: A controlled pilot study. Mindfulness, 5, 381391.
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Journal of Behavioral Addictions
Ontological addiction theory
... According to ontological orientation, the system of beliefs is formed, and the identity and how the individual relates to society and the environment are shaped (Watts et al., 2020). Ontology forms the belief system that makes people understand how they think, who they are, and what image they have of themselves and the world (Van Gordon et al., 2018). According to ontological addiction theory (OAT) maladaptive ontological beliefs result in faulty selfconstructs that leads to mental health and behavioral problems. ...
... According to ontological addiction theory (OAT) maladaptive ontological beliefs result in faulty selfconstructs that leads to mental health and behavioral problems. Eliminating these beliefs by changing ontological core schemas can lead to psychological and spiritual health (Van Gordon et al., 2018). In the present study, ontological core schemas about existential concerns include freedom, choices, isolation, death, and meaning were addressed. ...
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The integration of cognitive and existential therapy can be seen when existential therapy attempts to change ontological core schemas. This study aimed to investigate the effectiveness of existential therapy based on ontological core schemas on rumination and mindfulness of depressed women. A randomized clinical trial design with waiting list control group was conducted. 70 depressed women were selected by purposeful sampling method and randomly assigned into experimental and control groups. The participants of experimental group received 10 sessions of existential therapy based on ontological core schemas and control group was put on the waiting list. All participants answered to the Freiburg mindfulness inventory and Ruminative response scale as dependent variables at 3 time points (pre, post and 2-month follow-up test). The findings showed that, compared to control group, the rumination and mindfulness in experimental group after the intervention significantly decreased and increased, respectively (p < .01); also, These changes were maintained after two-month follow-up (p < .01). Although, due to the lack of comparative intervention groups, it cannot be conclude to what extent existential therapy based on ontological core schemas can be more effective than existential therapy or cognitive therapy, but the findings of this study show that when existential therapy is combined with cognitive therapy to address ontological core schemas, it can reduce rumination and increase the mindfulness of depressed women.
... Third wave CBT explores self-concept. As mentioned in the National Alliance on Mental Illness (NAMI) [5], when we think about ourselves, our sense of Self is based on a feeling or concept of inherent separation (called self-grasping ignorance [6,7]) which leads to an experience of distressing existential void and a sense of separation from experiences of satisfaction, security, and value. Based on incorrect self-identification, sexual orientation or gender characteristics can be perceived as an obstruction or a necessity to satisfaction, security and value. ...
... prejudice events) and proximal (i.e. self-stigma) factor; • a third wave CBT's perspective focusing on mistaken selfidentification [6,7]. ...
Article
Purpose Self-concept, at the core of minority stress, is associated with negative mental health outcomes. Methods We aimed to assess the effectiveness of a one-shot third-wave CBT intervention targeting correct self-identification to address suffering related to minority stress. The study population included 172 participants (n = 98 heterosexuals, n = 13 transgenders). The intervention consisted of a 90 minutes conference including overview of LGBT's suffering related to distal and proximal factors, a wisdom understanding of the root of suffering (mistaken self-identification) followed by a Questions & Answers session. Participants completed online self-questionnaires assessing sociodemographic data, acceptance by others (external) and oneself (internal) for sexual orientation and gender variables before the conference, immediately after the conference, and three months later. Results The conference helped to improve external acceptance of transgender for the whole sample, especially among the majority group. Those belonging to the minority (LGBT) had a positive benefit from the conference by reducing their fear of judgment. Adding a Q&A session to the conference failed to show any additional benefits. Conclusion A specific wisdom-based self-identification conference appears to be an effective and low-cost intervention to target minority stigma, and therefore mental health and social integration of LGBT people.
... Psychological research demonstrates the consequences of viewing the self as a discrete entity. Mental fixations with the self and attempts to enhance or preserve self-conceptualizations are associated with anxiety, reactivity, mental illness, and addiction (Brown et al., 2008;Shonin et al., 2014;Shonin et al., 2016;Van Gordon et al., 2018;Hasenkamp, 2019). These negative outcomes provide support for the not-self as a means to mitigate distress (Sahdra et al., 2010(Sahdra et al., , 2016. ...
... Buddhist-informed psychological models that serve to define the relationship between the self and environment have also been established. For example, according to ontological addiction theory, maintaining beliefs about an inherent self leads to impaired functioning (Van Gordon et al., 2018). The metacognitive processes model articulates the importance of decentering (i.e., shifting experiential perspective from within one's subjective experience onto the experience itself) and its relationship with mechanisms of mental health. ...
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Objectives People conceptualize their identities, in part, by their social roles. We defined the construct of “selfing” as excessive identification with a social role. This over-identification may influence feelings of psychological stress; research to understand this theorized association requires reliable and valid measurement of the selfing construct. Method The Selfing Scale was developed and validated using both classical and Rasch methodology with a large sample (N = 1882) including undergraduate students and MTurk workers. Two randomized samples (n = 400 each) were extracted and subjected to Rasch analysis to ensure replicability of the results. Additional independent samples were used to establish test–retest reliability and validity by examining relationships with other measures relevant to the self. Results An exploratory factor analysis on the initial 27 items yielded a 25-item solution with acceptable psychometric properties that supported a single overarching selfing factor. To achieve the best Rasch model fit, we uniformly rescored disordered thresholds, removed 7 misfitting items, and used testlet models to address local dependency resulting in a more robust 18-item scale. Conversion algorithms were also developed to transform ordinal scores into the interval-level metric to enhance accuracy of the scale. Selfing was negatively related to trait and interpersonal mindfulness and frequency of meditation among mindfulness practitioners, and positively related to psychological stress among non-practitioners. Conclusions This study developed a reliable and valid Selfing Scale to measure over-identification with the self that is useful to investigate the impact of selfing on an individual’s health and well-being.
... Hence, the safe and just operating space for selfidentity delineates an ideal parameter space for the degree of individual versus collective identity, and evidence suggests that exceeding these bounds at either end can lead to environmental degradation and low levels of health and wellbeing. 13,24,38,39,[95][96][97] Furthermore, feedback interactions between individual mindsets and environmental quality mean that transgressing the boundaries of this safe and just operating space can lead to society becoming locked into a vicious feedback cycle ( figure 1). ...
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A safe and just operating space for socioecological systems is a powerful bridging concept in sustainability science. It integrates biophysical earth-system tipping points (ie, thresholds at which small changes can lead to amplifying effects) with social science considerations of distributional equity and justice. Often neglected, however, are the multiple feedback loops between self-identity and planetary boundaries. Environmental degradation can reduce self-identification with nature, leading to decreased pro-environmental behaviours and decreased cooperation with out-groups, further increasing the likelihood of transgressing planetary boundaries. This vicious cycle competes with a virtuous one, where improving environmental quality enhances the integration of nature into self-identity and improves health, thereby facilitating prosocial and pro-environmental behaviour. These behavioural changes can also cascade up to influence social and economic institutions. Given a possible minimum degree of individual self-care to maintain health and prosperity, there would seem to exist an analogous safe and just operating space for self-identity, for which system stewardship for planetary health is crucial.
... Therefore, when we experience pleasure, we react with a disproportionate attachment or even addiction to the things that are sources of that pleasure. Gordon et al. (174) argue that because of our ever-changing environment, our incessant search for pleasure in external things leads to a greater vulnerability to painful sensations. Therefore, the absence of pleasurable sensation is seen as a situation from which to escape. ...
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The risk of suicide in psychiatric hospitals is 50 times higher than in the general population, despite patient safety being a priority for any hospital. However, to date, due to the complexity of assessing suicide risk, there has been no consensus on the suicide prevention measures that should be in place in hospitals. The aim of this work is: To provide an overview of the progress that has been made in the field of inpatient suicide prevention in recent years; discuss the problems that remain; and suggest potential future developments. As new clinical dimensions (notably anhedonia, psychological pain and hopelessness) develop, they should become new therapeutic targets. Team training (like the Gatekeeper Training Program) and the latest advances in suicide risk assessment (such as the Collaborative Assessment and Management of Suicidality) should be implemented in psychiatric wards. Suicide prevention plans (e.g., ASSIP, SAFE-T, etc.) represent easy-to-administer, low-cost interventions. The Mental Health Environment of Care Checklist has been proven effective to reduce suicide risk at hospitals. Furthermore, the types of psychotherapy recommended to reduce suicide risk are cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT). There are several pharmacological treatments for suicide risk, such as lithium and clozapine, which have been shown to be effective in the long term, as well as ketamine and esketamine, which are more effective in the short term. Following some encouraging recent results, buprenorphine may also be proposed to patients with a suicide risk. Triple chronotherapy rapidly improves depressive symptoms over 9 weeks. Regarding brain stimulation techniques, rTMS has proven to be effective in alleviating multiple dimensions of suicidality.
... [6] In addition, yoga practice influenced well-being [7] and the perceptions about well-being, [8] which can influence the recovery from addiction. [9] The present study compared two groups of university students, of whom one group practiced yoga regularly whereas the other group did not practice yoga and continued their routine activities. The yoga practices included asana (posture), yoga breathing (pranayama), meditation (dhyana), and guided relaxation. ...
Article
Background: Addictive behavior can be effectively managed with yoga. This study compared smartphone use, self-rated sleep, and beliefs about well-being in university students who practiced yoga regularly with those who did not. Materials and methods: One hundred and forty-two university students (average age ± standard deviation: 20.2 ± 2.2; male: female = 1:1) who practiced yoga (90 min a day, 6 days a week, and 29.7 months) were compared for smartphone excessive use, self-rated sleep, and beliefs about well-being, with an equal number of comparable age- and gender-distributed university students who did not practice yoga. Results: The yoga group had lower scores on the short version of the Smartphone Addiction Scale with fewer nocturnal episodes of checking their smartphone. The nonyoga group reported longer nocturnal sleep time compared to the yoga group, whereas there was no significant difference in the beliefs about well-being scores between the two groups. Conclusions: University students who practice yoga may be less likely to use a smartphone excessively as well as have uninterrupted sleep than students who do not practice yoga.
Chapter
Buddhist practices when transferred into organizational contexts tend to bear little resemblance to their original forms of practice, leading to misinterpretations of their characteristics of ‘universal’ adaptability. For example, the popular ‘mindfulness revolution’ in the business world has been criticized for reducing mindfulness practices to psychological traits and non-judgmental awareness. Such secular approaches do not represent the Buddhist ethics-based notion of ‘right mindfulness,’ which originates from the Noble Eightfold Path. This chapter takes a critical view of Buddhist-enacted practices in the workplace (e.g., right mindfulness, the Middle Way, skillful means, non-self) to highlight the need for these practices to be interpreted and managed more context-sensitively in organizational contexts. The chapter suggests ways to move forward and present implications for coping mechanisms in contemporary organizations in response to impermanence and crises.
Chapter
This chapter introduces how nonconceptual mindfulness can be adopted in organizations to navigate crisis preparedness in the pre-crisis stage of crisis management. Drawing from the context of the COVID-19 crisis, which has caused significant disruptions to businesses and societies, the chapter extends the crisis management literature by integrating the two outlooks of system perspectives and the cultural approach to crisis management via nonconceptual mindfulness. The chapter introduces a conceptual framework of mindful crisis preparedness for organizational crisis management with (i) mindful awareness of impermanence to navigate defensive mechanisms, (ii) non-judgmental awareness and cognitive awareness to navigate organizational assumptions, and (iii) mindful bias professing to navigate organizational structure for crisis preparedness.KeywordsMindfulnessNonconceptualCrisis preparednessCrisis management
Article
Borderline personality disorder (BPD) is a severe and relatively prevalent psychiatric disorder, responsible for high rates of suicidal behaviors. Disturbed identity appears as at the very core of this disorder, being inter-related with all other BPD features. Notably, from a dimensional perspective on mental disorders, one should realize that it is from our usual self-representation that we live all our daily experiences. Then, if the understanding of self-concept (or identity) is impaired, all the interventions implemented to decrease the self's suffering will subsequently be impaired. The purpose of the present case study was to illustrate the nine identity diffusion categories described by Jørgensen & Bøye (2022) and how the level of identity function can be improved in a third-wave cognitive and behavioral therapy targeting progressive correct self-identification.
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Ontological Addiction Theory is a metaphysical theory of mental illness which conceptualises psychological suffering in terms of excessive ego-centeredness. This study aimed to develop and validate the Ontological Addiction Scale (OAS) and compare OAS scores with mental health measures. A 31-item prototype scale was developed based on traditional Buddhist theory and contemporary models of addiction. An ego-centeredness form of the Five-Factor Narcissism Inventory (FFNI) was the main criterion measure. For mental health measures, the Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder Scale (GAD-7) and Rosenberg Self-Esteem Scale (RSES) were used. The prototype OAS and two shorter versions showed excellent internal consistency and test–retest reliability. Construct validity was evidenced by medium to large correlations with criterion measures. OAS scores showed strong correlations with PHQ-9, GAD-7 and RSES, suggesting a clear relationship between OAS and mental health. The OAS appears to be a valid and reliable instrument suitable for assessing OA.
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Van Gordon, W., Shonin, E., & Richardson, M. (2018). Mindfulness and nature. Mindfulness, Advance Online Publication, DOI:10.1007/s12671-018-0883-6.
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Background and aims Workaholism is a form of behavioral addiction that can lead to reduced life and job satisfaction, anxiety, depression, burnout, work–family conflict, and impaired productivity. Given the number of people affected, there is a need for more targeted workaholism treatments. Findings from previous case studies successfully utilizing second-generation mindfulness-based interventions (SG-MBIs) for treating behavioral addiction suggest that SG-MBIs may be suitable for treating workaholism. This study conducted a controlled trial to investigate the effects of an SG-MBI known as meditation awareness training (MAT) on workaholism. Methods Male and female adults suffering from workaholism (n = 73) were allocated to MAT or a waiting-list control group. Assessments were performed at pre-, post-, and 3-month follow-up phases. Results MAT participants demonstrated significant and sustained improvements over control-group participants in workaholism symptomatology, job satisfaction, work engagement, work duration, and psychological distress. Furthermore, compared to the control group, MAT participants demonstrated a significant reduction in hours spent working but without a decline in job performance. Discussion and conclusions MAT may be a suitable intervention for treating workaholism. Further controlled intervention studies investigating the effects of SG-MBIs on workaholism are warranted.
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Objectives: The purpose of this study was to conduct the first randomized controlled trial (RCT) to evaluate the effectiveness of a second-generation mindfulness-based intervention (SG-MBI) for treating fibromyalgia syndrome (FMS). Compared to first-generation mindfulness-based interventions, SG-MBIs are more acknowledging of the spiritual aspect of mindfulness. Design: A RCT employing intent-to-treat analysis. Methods: Adults with FMS received an 8-week SG-MBI known as meditation awareness training (MAT; n = 74) or an active control intervention known as cognitive behaviour theory for groups (n = 74). Assessments were performed at pre-, post-, and 6-month follow-up phases. Results: Meditation awareness training participants demonstrated significant and sustained improvements over control group participants in FMS symptomatology, pain perception, sleep quality, psychological distress, non-attachment (to self, symptoms, and environment), and civic engagement. A mediation analysis found that (1) civic engagement partially mediated treatment effects for all outcome variables, (2) non-attachment partially mediated treatment effects for psychological distress and sleep quality, and (3) non-attachment almost fully mediated treatment effects for FMS symptomatology and pain perception. Average daily time spent in meditation was found to be a significant predictor of changes in all outcome variables. Conclusions: Meditation awareness training may be a suitable treatment for adults with FMS and appears to ameliorate FMS symptomatology and pain perception by reducing attachment to self. Statement of contribution What is already known on this subject? Designing interventions to treat fibromyalgia syndrome (FMS) continues to be a challenge. There is growing interest into the applications of mindfulness-based interventions for treating FMS. Second-generation mindfulness-based interventions (SG-MBIs) are a key new direction in mindfulness research. What does this study add? Meditation awareness training - an SG-MBI - resulted in significant reductions in FMS symptomatology. SG-MBIs recognize the spiritual aspect of mindfulness and may have a role in the treatment of FMS.
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Background Sex addiction is a disorder that can have serious adverse functional consequences. Treatment effectiveness research for sex addiction is currently underdeveloped, and interventions are generally based on the guidelines for treating other behavioral (as well as chemical) addictions. Consequently, there is a need to clinically evaluate tailored treatments that target the specific symptoms of sex addiction. It has been proposed that second-generation mindfulness-based interventions (SG-MBIs) may be an appropriate treatment for sex addiction because in addition to helping individuals increase perceptual distance from craving for desired objects and experiences, some SG-MBIs specifically contain meditations intended to undermine attachment to sex and/or the human body. The current study conducts the first clinical investigation into the utility of mindfulness for treating sex addiction. Case presentation An in-depth clinical case study was conducted involving an adult male suffering from sex addiction that underwent treatment utilizing an SG-MBI known as Meditation Awareness Training (MAT). Following completion of MAT, the participant demonstrated clinically significant improvements in addictive sexual behavior, as well as reductions in depression and psychological distress. The MAT intervention also led to improvements in sleep quality, job satisfaction, and non-attachment to self and experiences. Salutary outcomes were maintained at 6-month follow-up. Discussion and conclusion The current study extends the literature exploring the applications of mindfulness for treating behavioral addiction, and findings indicate that further clinical investigation into the role of mindfulness for treating sex addiction is warranted.
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Despite the fact that there is increasing integration of Buddhist principles and practices into Western mental health and applied psychological disciplines, there appears to be limited understanding in Western psychology of the assumptions that underlie a Buddhist model of mental illness. The concept of ontological addiction was introduced and formulated in order to narrow some of the disconnect between Buddhist and Western models of mental illness and to foster effective assimilation of Buddhist practices and principles into mental health research and practice. Ontological addiction refers to the maladaptive condition whereby an individual is addicted to the belief that they inherently exist. The purposes of the present paper are to (i) classify ontological addiction in terms of its definition, symptoms, prevalence, and functional consequences, (ii) examine the etiology of the condition, and (iii) appraise both the traditional Buddhist and contemporary empirical literature in order to outline effective treatment strategies. An assessment of the extent to which ontological addiction meets the clinical criteria for addiction suggests that ontological addiction is a chronic and valid—albeit functionally distinct (i.e., when compared to chemical and behavioral addictions)—form of addiction. However, despite the protracted and pervasive nature of the condition, recent empirical findings add support to ancient Buddhist teachings and suggest that addiction to selfhood can be overcome by a treatment process involving phases of (i) becoming aware of the imputed self, (ii) deconstructing the imputed self, and (iii) reconstructing a dynamic and non-dual self.
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In recent decades, there has been growing assimilation of ancient Buddhist practices and principles into Western research and applied psychological settings. One Buddhist principle currently receiving an increasing amount of scientific interest is emptiness. Emptiness asserts that all phenomena-including the "self"-are empty of intrinsic existence. We examine how logical inquiry and evidence from diverse psychological and scientific disciplines appear to be gradually adding credence to the notion of emptiness. We explicate how, if emptiness theory continues to be validated and accepted by Western psychologists, it will become necessary to reexamine some established beliefs in relation to the workings of both the psychological and physical world. Examples of how emptiness might develop and/or complement psychological and wider scientific understanding in this respect include coming to the acceptance that: (a) what is currently understood to be waking reality is effectively a shared dream, (b) the "self" does not inherently exist, © the underlying cause of mental illness is an individual's belief that they inherently exist, and (d) maladaptive psychosocial functioning and the absence of mental illness are not necessarily mutually exclusive occurrences. We conclude that there is a clear need for greater research into the validity and applications of emptiness. However, if supportive empirical findings relating to emptiness continue to emerge, it is possible that some of the next important scientific "discoveries" about mind and matter will emerge at the intersection of ancient Eastern contemplative practice, empirically grounded Western psychological insights, and quantum mechanics. (PsycINFO Database Record
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Fibromyalgia is a disabling syndrome. Results obtained with different therapies are very limited to date.The goal of this study was to verify whether the application of a mindfulness-based training program was effective in modifying anger, anxiety, and depression levels in a group of women diagnosed with fibromyalgia. This study is an experimental trial that employed a waiting list control group. Measures were taken at three different times: pretest, posttest, and follow-up. The statistical analyses revealed a significant reduction of anger (trait) levels, internal expression of anger, state anxiety, and depression in the experimental group as compared to the control group, as well as a significant increase in internal control of anger. It can be concluded that the mindfulness-based treatment was effective after 7 weeks. These results were maintained 3 months after the end of the intervention.
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Fibromyalgia syndrome (FMS) is a complex and poorly understood psychosomatic pain disorder. The illness has been the subject of controversy, both in terms of the alleged lack of interest and capability of the medical community to understand and support patients with FMS, and the burden that such individuals place upon economic and healthcare resources. Due to the lack of convincing data for the effectiveness of extant pharmacological and non-pharmacological FMS treatments, a recent direction in FMS research has been the empirical investigation of mindfulness and other meditation-based approaches. The present qualitative study explored whether following participation in a mindfulness-based intervention, patients with FMS report experiencing changes in (i) how they experience and relate to their illness and (ii) their attitudes towards societal participation, work and unemployment. Ten individuals with FMS were randomly selected from the intervention arm of a randomised controlled trial (RCT) evaluating the effectiveness of a mindfulness-based intervention known as Meditation Awareness Training (MAT) for the treatment of FMS. Transcripts of semi-structured interviews were analysed using Interpretative Phenomenological Analysis, a robust and rigorous qualitative methodology for analysing subjective experiences. Five super-ordinate themes emerged from the dataset: (i) reservations about participating, (ii) improvements in psychosomatic well-being, (iii) spiritual growth, (iv) awareness of impermanence and (v) increased sense of citizenship. MAT was experienced as both an acceptable and accessible intervention by individuals with FMS, and participants reported experiencing improvements in psychosocial functioning as well as an increased sense of societal responsibility. MAT appears to have utility for treating FMS and for changing the attitudes of some individuals with FMS towards community engagement and societal contribution.
Chapter
Emptiness is a fundamental Buddhist principle that refers to the fact that phenomena are devoid of intrinsic existence. This absence of intrinsic existence refers as much to the true and absolute nature of the individual that practices mindfulness, as it does to the present moment they are supposed to be observing. Therefore, if an individual is to become accomplished at the practice of mindfulness, they must familiarize themselves with the absolute mode in which the present moment abides. Following an explication of the emptiness principle, this chapter elucidates the practice of mindfulness of emptiness and includes a discussion of (i) its theoretical and scriptural provenance, (ii) how to practice mindfulness of emptiness, and (iii) its role in the wider context of the Buddhist path to spiritual awakening. The final part of the chapter addresses the fact that mindfulness itself is also empty of intrinsic existence and discusses the risks associated with developing attachments to Buddhist concepts and practices.