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A Mixed Methods Approach to Understanding Conceptions of Mindfulness Meditation

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  • Massachusetts General Hospital/Harvard Medical School

Abstract and Figures

Background: Mindfulness meditation (MM) is an increasing area of interest for health professionals and the general public alike. Beneficial outcomes are associated with this practice; however, definitions of mindfulness and meditation are varied, and anecdotal accounts suggest that people hold conceptions about the constructs. Furthermore, mindfulness has been incorporated into therapeutic modalities without much consideration for context, including the client's previous experiences with and understanding of MM. To date, only one research article [1] has been published on the layman conceptions of MM. Research has yet to establish if conceptions exist; and, if they do, how prevalent these conceptions are in varied samples. To examine the discrepancies between popular views of MM and research, 479 college students were surveyed. Methods: Attitudes and beliefs toward MM were assessed via a series of open-ended questions and vignettes, with self-report questionnaires assessing religion and spirituality, trait mindfulness, barriers to practicing meditation, avoidance and acceptance, values, and demographic variables. A mixed-methods (deductive qualitative analytic and quantitative) approach based on several common conceptions from practitioners and personal experiences with conceptions (e.g., emphases on religious and cultural factors; using meditation as a means of control) was used to study the social phenomenon of participants' conceptions of MM. Results: Several key themes emerged from the data. As examples, approximately 96% of the sample said MM was about relaxation and over half described it as a strictly religious practice. Conclusions: Several conceptions about mindfulness exist and this may have implications for mindfulness-based treatments. Study limitations and future directions are discussed.
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Open Access
OBM Integrative and
Complementary Medicine
Research Article
A Mixed Methods Approach to Understanding Conceptions of
Mindfulness Meditation
Ethan G. Lester, Amy R. Murrell *, Dickson E. Dickson
University of North Texas, 1155 Union Circle #311280, Denton, TX, USA; E-Mails:
ethanlester@my.unt.edu, amy.murrell@unt.edu, dicksondickson@my.unt.edu
* Correspondence: Amy R. Murrell; amy.murrell@unt.edu
Academic Editors: Sok Cheon Pak and Soo Liang Ooi
Special Issue: Health Benefits of Meditation
OBM Integrative and Complementary Medicine
2018, volume 3, issue 4
doi:10.21926/obm.icm.1804026
Received: June 19, 2018
Accepted: October 8, 2018
Published: October 15, 2018
Abstract
Background: Mindfulness meditation (MM) is an increasing area of interest for health
professionals and the general public alike. Beneficial outcomes are associated with this
practice; however, definitions of mindfulness and meditation are varied, and anecdotal
accounts suggest that people hold conceptions about the constructs. Furthermore,
mindfulness has been incorporated into therapeutic modalities without much consideration
for context, including the client’s previous experiences with and understanding of MM. To
date, only one research article [1] has been published on the layman conceptions of MM.
Research has yet to establish if conceptions exist; and, if they do, how prevalent these
conceptions are in varied samples. To examine the discrepancies between popular views of
MM and research, 479 college students were surveyed.
Methods: Attitudes and beliefs toward MM were assessed via a series of open-ended
questions and vignettes, with self-report questionnaires assessing religion and spirituality,
trait mindfulness, barriers to practicing meditation, avoidance and acceptance, values, and
demographic variables. A mixed-methods (deductive qualitative analytic and quantitative)
approach based on several common conceptions from practitioners and personal
experiences with conceptions (e.g., emphases on religious and cultural factors; using
OBM Integrative and Complementary Medicine 2018; 3(4), doi:10.21926/obm.icm.1804026
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meditation as a means of control) was used to study the social phenomenon of participants’
conceptions of MM.
Results: Several key themes emerged from the data. As examples, approximately 96% of the
sample said MM was about relaxation and over half described it as a strictly religious
practice.
Conclusions: Several conceptions about mindfulness exist and this may have implications for
mindfulness-based treatments. Study limitations and future directions are discussed.
Keywords
Meditation; mindfulness; conceptions; mixed methods
1. Introduction
1.1 Mindfulness and Mindfulness Meditation
The word “mindfulness” with regard to Buddhism comes from the Pali word “to remember”
(sati). This word is related to consciousness, attention, being fully present, and maintaining a
presence of mind [2, 3], and it has countless overlaps with Western conceptualizations of this
word (e.g., attention, focus). Mindfulness can be conceptualized as self-management [4], a coping
skill where awareness of conditions allows for better responding. Further, mindfulness practice
can function to increase acceptance. Acceptance is an integral component of meditation
particularly emphasis on non-striving, nonjudgment, openness to experience, and curiosity to new
thoughts and feelings. Although there are many different conceptualizations of mindfulness and
related concepts, it is thought to be a distinct, innate human experience that all are capable of
practicing [5].
Two popular, and seemingly ubiquitous, Western understandings of the term mindfulness are
the definitions offered by Bishop et al. [6] and Kabat- Zinn [7]. Bishop et al. [6] define mindfulness
as the self-regulation of attention to immediate experiences while adopting an attitude of
curiosity, openness, and acceptance. These authors [6] set an objective of operationally defining
mindfulness, so that it may be studied and tested. Kabat-Zinn [7] has defined mindfulness as “the
awareness that emerges through paying attention on purpose, in the present moment, and non-
judgmentally to the unfolding of experience, moment to moment.”
Shapiro, Carlson, Astin, and Freedman [8] elaborate on the definition of mindfulness offered by
Kabat- Zinn [7] they outline an axiom labeled intention. Intention is the purpose of practice, and
it can lead to a substantial change in perspective. Shapiro et al. [8] argue that, with the
Westernization of mindfulness, some of the fundamental components of intention have been lost.
They state this feature of mindfulness is often overlooked in some newer understandings of
mindfulness [8].
Mindfulness is an experiential quality, which can be utilized in many ways and in multiple
settings. For example, meditation can be used to gain skills in mindfulness. These practices are
commonly used in a secular fashion, often with some integrated Buddhist philosophy. Mindfulness
can also be more active. It can be brought to all daily activities that are relevant to a person (e.g.,
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breathing, eating, walking). It can also be practiced in more formal settings such as tai chi, yoga,
and Pilates, and it is being incorporated more and more in psychotherapy settings.
Psychological treatments that incorporate mindfulness include Mindfulness Based Cognitive
Therapy (MBCT; [9]), Dialectical Behavior Therapy (DBT; [10]), Acceptance and Commitment
Therapy (ACT; [11]), and Mindfulness Based Stress Reduction (MBSR; [12]). Mindfulness in a
therapeutic context can be understood in several ways. Kabat-Zinn suggests that Mindfulness-
Based Stress Reduction (MBSR; [12]) can serve as an exposure technique. Exposure to ongoing
experiences, with the absence of judgment and “catastrophic consequences,” allows for
desensitization of physical and psychological pain by reducing the emotional response to that pain
(decreasing emotional reactivity). Clinically, mindfulness can also be viewed as a type of “mental
training,” which includes increasing awareness and responding skillfully to reduce cognitive
vulnerability [6]. Many forms of mindfulness (including meditation) involve gaining an
understanding of one’s thoughts, as well as viewing and experiencing thoughts and feelings with a
transient nature and subjectivity [6, 13].
1.2 Relaxation and Mindfulness
In the West, MM is commonly conceptualized as a relaxation technique. This relationship
between mindfulness and relaxation proves to be complex [4]. Mindfulness is a non-goal-oriented
processes; therefore, relaxation may or may not be a side effect of practicing mindfulness,
including meditation. In fact, some “side effects” of mindfulness seem paradoxical to relaxation
(e.g., racing thoughts and autonomic arousal). Baer [4] suggests even though mindfulness
practices may lead to relaxation, this result is not the main reason for practicing these skills,
particularly in the context of therapy.
Although mindfulness and meditation can induce feelings of relaxation, these outcomes - if
achieved - tend to be secondary, and for the sake of clinical work are not necessarily desired.
Relaxation can actually interfere with exposure [14]. Clinicians may use mindfulness techniques to
help clients be in the present moment rather than following rules that are dictated by some
imagined consequence. This process allows for two other important processes. First, exposure to
thoughts, emotions, and sensations allows for habituation of autonomic arousal and elicitation.
Second, opportunities for a broader range of behavioral responses are evoked as a result [15].
Without an initial heightening of arousal and elicitation to become desensitized, this process
cannot effectively occur [4].
Although not true of empirical therapeutic models that incorporate mindfulness, some current
mindfulness practices emphasize the hypoarousing and relaxing effects of meditation with little
focus on the stimulation and alertness [16]. In contrast original Buddhist practices of meditation
describe “a state of relaxed alertness”, being a middle ground between extreme hypoarousal and
hyperarousal. Britton et al. [16] describe a nonlinear trajectory of meditation practices, where
earlier devoted practice brings about a propensity for sleep and fatigue, and later stages produce
more wakefulness. These changes over time are dependent on dose (the amount of time spent
meditating), meditative expertise, and one’s contemplative trajectory [16].
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1.3 Trajectories and Musings
With a variety of different interpretations of mindfulness processes, conceptions and
misunderstandings can occur. In other words, when people first start meditating, it may just make
them relaxed; whereas, later, meditation may heighten their arousal. Similarly, inexperienced
meditators often note distress whereas more experienced meditators report less discomfort
during meditation exercises [16].
An individual may interpret one MM experience as "the way meditation is" across time and
situation. Mindfulness can be practiced in several ways, and can take on the functions of the
related activity. Although this is a typically efficient way to learn, when an individual relates
mindfulness to a single activity, such as meditation or psychotherapy, or when they think it will
always lead to relaxation (or distress), rigid ideas may develop. It can be problematic when
individuals categorize their practice by themes (e.g., mindfulness for relaxation, spirituality, or
avoidance). As scientific inquiries develop, and as growing interest in creating new mindfulness
and meditation-based interventions increases, researchers and clinicians need to consider the
effects these multiple interpretations can have [17, 18].
Understanding these interpretations are fundamental to influencing the acquisition of
mindfulness. An individual's acquisition of mindfulness and MM outside of a formal setting might
be quite different than in a formal one. Learning about MM from a diverse set of sources (e.g.,
media and popular culture, word of mouth) may lead to different, and possibly inconsistent,
interpretations of mindfulness and meditation. As stated previously, there are substantial
misunderstandings of meditative disciplines within Western psychology [19], and in a therapeutic
context, these conceptions might limit effectiveness.
Although much research exists on the psychological and physiological effects of mindfulness,
limited research has been done on the popular conceptions of mindfulness, or how these factors
affect the teaching and acquisition of MM. In fact, only two studies to the authors’ knowledge
have explicitly explored both conceptions and potential barriers to utilizing meditative practices
([1, 20], respectively).
Hitchcock et al. [1] explored common conceptions of mindfulness in a college sample (N = 361).
They determined through a series of open-ended responses that students paralleled the concept
of mindfulness to awareness awareness of internal sensations, external objects, and present
moment awareness. Of these three, approximately twice as many individuals linked mindfulness
with external, rather than internal stimuli. Also, using a factor analytic approach, they identified
three latent factors of mindfulness conceptions: relax, stop thought, avoid; notice, be present; and
control difficult emotions. Participants also considered mindfulness as unrelated to psychological
acceptance. The factor for controlling difficult emotions and the unrelatedness of psychological
acceptance are especially striking, given that many mindfulness-based psychotherapy approaches
attempt to undermine control agendas that patients have and increase their psychological
acceptance. The authors suggest that clinicians who take a mindfulness-based approach may want
to consider the “diverse views” that individuals (in this case, students) have [1].
Relatedly, Williams et al. [20] developed and validated a measure in attempts to explore
reasons for attrition in meditation-based studies. Specifically, they explored barriers to
participating in meditative practices. This resulted in The Determinants of Meditation Practice
Inventory (DMPI). Through expert interviews and a comprehensive literature review, the authors
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identified three domains for their measure: Perceptions and Conceptions, Pragmatic Concerns, and
Sociocultural Beliefs. The measure displays strong psychometric properties, and adequately
assesses an individual’s attitudes and beliefs towards meditation and engagement in related
behavior [20]. Although little research has used the DMPI, the measure has potential for being an
indicator of an individual’s beliefs, perceived barriers and conceptions, and their willingness to
engage in future meditation.
1.4 Present Study
The popularity of mindfulness in contemporary psychological research is unmistakable.
Alternate conceptions and differences in information sources may result in challenges to
mindfulness practices and research exploring its effects. Building on the works of Hitchcock et al.
[1] and Williams et al. [20], this study was designed to examine the extent to which conceptions
are prevalent using a diverse college sample. The purpose was not to challenge current methods
of teaching and utilizing mindfulness, but rather to study how MM is conceptualized by individuals
to increase practicality and usability. Conceptions for this study refer to content reported by the
participants that seemed “unworkable” for the person in the context of clinical work or clinical
research. It should be noted that participants may have answered questions considering a
different context, as well as dependent on their experience with MM (e.g., meditation retreats,
classes, seminars, counseling). It was hypothesized that undergraduate students would present
with conceptions; however, no a priori hypothesis specific conceptions, or their relationships to
demographic variables.
2. Method
This study was approved by the University's Institutional Research Board, which is in
compliance with The Belmont Report and the Declaration of Helsinki.
2.1 Participants
Adult undergraduates (N = 479; M age = 21) at a public university in the South-Central United
States were recruited online to complete measures and were compensated with extra credit in a
psychology course for completing the survey. Participants in this study were predominantly White
(47.6%), Christian (59.3%), single (88.8%), female (69.3%) undergraduate students. After consent,
all participants were given the online survey, including the qualitative, quantitative, and
demographic measures.
2.2 Measurement
Kentucky Inventory of Mindfulness Skills (KIMS). The KIMS [21] is a 39-item self-report
questionnaire assessing facets of trait mindfulness. Items are rated on a 5-point Likert-type scale
ranging from 1 (never true) to 5 (almost always or always true) with higher scores indicating more
trait mindfulness. The KIMS demonstrates adequate to good test-retest reliability (r = .65 to .86) in
a student sample, after a 14 and 17-day time interval. Subscales also show adequate convergent
validity with the Mindful Attention and Awareness Scale (r= .24 to .57; [22]). Lastly, in the
validation study, divergent validity was shown with measures of neuroticism (r = -.42 to -.31),
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experiential avoidance (-.35 to -.26) and dissociation (-.28; [21]). The Cronbach’s alpha for this
sample was .81.
The Avoidance and Fusion Questionnaire for Youth (AFQ-Y). The AFQ-Y [23] contains 17 self-
report items examining experiential avoidance, psychological inflexibility, and cognitive fusion.
Items are rated on a scale of 0 (not at all true) to 4 (very true). Higher scores are indicative of
higher levels of avoidance and fusion. The AFQ-Y, which was intended for and normed with a child
and adolescent population, has also demonstrated good internal consistency in undergraduate
samples (α = .84 -.92; [24, 25]). The AFQ-Y correlates positively with depression (r = .59), stress (r
= .55), and anxiety (r = .53; [25]). The Cronbach’s alpha for this sample was .91.
The Religious Commitment Inventory 10 (RCI-10). The RCI-10 [26] measures religious
commitment in both intrapersonal and interpersonal domains. Items are rated on a scale from 1
(Not at all true of me) to 5 (Totally true of me). Worthington and colleagues [26] found the RCI-10
to have an excellent internal consistency reliability alpha of .93 for the full scale. The RCI-10 was
also seen to correlate significantly with measures of religiosity and significantly differ from
measures of morality [26]. The Cronbach’s alpha for this sample was .96.
The Daily Spiritual Experience Scale (DSES). The DSES [27] measured participants’ experience of
divinity in their lives on a daily basis. The DSES consists of 15 items which are rated on a scale from
1 (Many times a day) to 6 (Never or almost Never). The total score is summed and reversed. In a
number of samples, Underwood and Teresi (2002) found excellent internal consistency reliability
alphas. The DSES is preliminarily thought to be related to decreased alcohol consumption,
improved quality of life, and positive psychosocial attributes [27]. Observed Chronbach’s alpha of
the DSES in this study was .97.
Measure of Religious and Spiritual Flexibility (MRSF). The MRSF [28] is a 6-item self-report
measure of an individual’s psychological flexibility regarding religion and spirituality. This measure
uses a 7-point Likert-type scale ranging from 1 (Strongly disagree) to 7 (Strongly agree). All items
are reverse scored, and higher scores indicate higher religious and spiritual flexibility. Initial
internal consistency measurements with the MRSF range from a Cronbach’s alpha of .73 to .82, in
both theistic and non-theistic samples [28]. The internal consistency in the current sample was .80.
Qualitative Meditation Survey. The Qualitative Meditation Survey (QMS) was designed
specifically for this study. It was based on the results of a pilot study conducted by the authors,
which explored common conceptions of MM. The QMS was presented as part of the demographic
questionnaire and consisted of 14 open-ended questions and six vignettes about meditation
related activities. Of these 20 items, six open-ended questions and one vignette were used for
analyses. The vignette was chosen because it was written to be ambiguous and interpretable in
multiple ways thus prompting variable responding. The six questions were chosen pragmatically,
as they were the ones that were coded first by the research team. The six qualitative questions
and the meditation vignette included: Q 1: What is meditation?; Q 2: In general, what kind of
people meditate?; Q 3: How do you know when you are good at meditating?; Q 4: Should your
mind wander during meditation? Q 5: Do people who meditate look a certain way?; Q 6: What are
some reasons why people meditate?; Vignette 1: You are walking to class when you overhear a
conversation between two people. One mentions to the other that they just finished meditating for
an hour and had another "supernatural experience" during the practice. In your opinion, what kind
of "supernatural experience" did this individual have?
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Demographics and Mindfulness Meditation Survey (DMMS). The DMMS assessed age, ethnicity,
primary language, religion, educational status, gender, marital status, employment,
socioeconomic status and income, previous mindfulness and meditation experience, and attitudes
towards these practices.
2.3 Procedure
Participants first completed the consent form online and then completed all measures in the
order listed, so that qualitative responses about mindfulness knowledge and attitudes would not
interfere with quantitative responses. Further, the quantitative measures were believed not to
spoil the qualitative responses in this order. Qualtrics Force Response feature was used in this
study so that no missing data would occur in the dataset. Force Response requires participants to
answer all questions on a given survey page before moving forward. Although the benefit of this
feature is a complete dataset, the cost is that incomplete participant data is not collected and
therefore cannot be analyzed.
Participants' responses were then de-identified and coding took place before analyses. Using an
informal process (i.e., internet search) and a deductive analytic approach, a basic structure for
initial organization of qualitative content from the survey was formed. Themes were added as
qualitative data was rendered and coded; if less than five codes were added to a new theme, the
codes were redistributed to a related theme. Conceptions were grouped into the following labels:
large time commitment, controlling thoughts/emptiness of mind, specific populations/religious
and spiritual practice, relaxation technique/stress reduction, complex practice, achievement/goal
oriented, physically and mentally dangerous, self-serving/avoidance, insight/genius, and
physical/mental/emotional/environmental control.
After this, a more formal coding strategy was used. Data were coded semantically in Nvivo 10
software by the first author and a research assistant. Frequency and correlation analyses were
used. Approximately 50 coding hours were accrued. Consistency and variation were examined
before nodes were added as new themes in the data emerged. Overall, over 20,000 references
were coded at more than 40 nodes for this project. These conceptions are explored below in the
results section.
3. Results
3.1 Qualitative Analysis
Using a qualitative deductive analytical approach, several key conceptions emerged from
coding survey responses. Participant responses were downloaded from Qualtrics and key parts of
sentences were highlighted and “moved” into nodes (similar to how a file is moved into a folder
on a computer). In NVivo 10, nodes are points at which references (i.e., survey content) are coded.
For example, content related to relaxation/relaxing were referenced from the survey data in the
Relaxation node 459 times for the 479 participants across the 6 qualitative questions and one
meditation vignette. Specific frequencies for coded nodes and word frequency can be seen in
Table 1.
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3.2 Quantitative Analysis
References coded at each node were exported from the Nvivo software to SPSS in a
quantitative coding frequency dataset and combined with participants’ demographic data.
Bivariate correlations were run to examine the relationship between demographic variables and
node frequencies. From this analysis, several correlations were significant (p < .05), and these
relationships were examined further.
3.3 Outcomes
For these analyses, independent samples t-tests were used to compare groups on key
conceptions. A Levene’s test was used to assess for homogeneity of variance in each analysis.
These tests proved significant (p < .05) for all run analyses, and therefore all t-values were
adjusted for equal variances not assumed.
Previous MM practice reported. An independent samples t-test was used to compare
individuals who reported previously practicing MM (n = 165) to those who reported not previously
practicing MM (n = 314). Individuals who reported previously practicing MM had more
conceptions related to: Focus (t(280.97) = 2.47, p = .01), Insight (t(254.58) = 3.37, p = .001), Mental
Control (t(290.56) = 2.99, p = .003) , Emptying the Mind (t(280.97) = 2.13, p = .03) , and People
with Ailments Using Meditation (t(243.30) = 2.40, p < .01).
Willingness to practice. An independent samples t-test was used to compare individuals who
reported being willing to practice meditation (n = 418) to those who reported not being willing to
practice meditation (n = 61). Individuals who reported being willing to practice meditation
reported more conceptions related to: Ascension, t(98.35) = 2.08, p = .05, Happiness, t(108.50) =
2.65, p = .01, and Difficulty of practice, t(417.00) = 2.01, p = .05.
Gender differences. An independent samples t-test was used to compare male participants (n =
143) to female participants (n = 332) for coded conceptions. Female participants reported more
conceptions related to: Difficulty of practice, t(331.00) = 2.01, p = .05, and Stress Relief, t(323.93) =
3.14, p = .01.
Religious practice reported. An independent samples t-test was used to compare individuals
who reported having a religious practice (n = 161) to those who reported not having a religious
practice (n = 318). Specifically, individuals who reported having a religious practice reported more
conceptions related to meditation being strictly a Religious Practice, t(280.94) = -2.54, p = .01.
However, there was no significant difference between these individuals for meditation being a
strictly spiritual practice, t(322.79) = -.57, p = .90.
Self-reported variables and conceptions. After examining significant bivariate correlations (i.e.,
p < .05), several analyses were run using self-report measures and coded conceptions.
Correlations between self-report measures (e.g., KIMS and AFQ-Y) can be seen in Table 2. With
regards to the relationship between self-report variables and conceptions, several significant
correlations were found.
First, trait mindfulness as measured by the KIMS was significantly positively correlated with
conceptions of Ascension (r = .12, p < .001), Insight (r = .10, p < .001), and Comfort (r = .12, p
< .001). Religious commitment as measured by the RCI was significantly positively correlated with
conceptions of Achievement (r = .10, p < .001), and meditation being a religious practice (r = .15, p
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< .001). Daily spiritual experience as measured by the DSES was significantly negatively correlated
with the conception of Large Time Commitment (r = -.10, p < .05), and meditation being a religious
practice (r = -.16, p < .001). Religious and spiritual flexibility as measured by the MRSF was
significantly negatively correlated with the conception of Interpersonal Connectedness (r = -.09, p
< .05), and significantly positively correlated with the conception of Physical Control (r = .13, p
< .001), and the conception of Empty Mind (r = .10, p < .001). Last, experiential avoidance was not
significantly correlated with any conceptions.
Table 1 Frequency of Coded Nodes for Mindfulness Meditation Conceptions.
Node
Number of Coding References
Percentage of Content
Relaxation
459
96
Achieve Focus
359
75
Achieve Peace
316
66
Achieve Insight
310
65
Religious Practice
283
59
Stress Relief
272
57
Achieve Calm
252
53
Empty Mind
219
46
Spiritual Practice
148
31
Other Population
136
28
Mental Control
132
28
Achieve Supernatural
111
23
Physical Control
110
23
Achieve Goal
97
20
Achieve Happiness
97
20
Environmental Control
80
17
Achieve Ascension
73
15
People with Ailments
73
15
Other Practice
53
11
Achieve Centered
53
11
Achieve Openness
47
10
Avoidance
38
8
Emotional Control
36
8
People without Ailments
32
7
Personality Related
22
4
Achieve Health
21
4
Effortless
20
4
Regional Practice
12
3
Achieve Interpersonal
12
3
Drug Users
8
2
Race related
7
1
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Table 2 Correlations (Pearson’s r) between self-report variables (N = 479).
KIMS
AFQY
RCI
DSES
MVM
MRSF
KIMS
-
.42**
.03
-.13**
-.05
.35**
AFQY
-
.04
.13**
.32**
-.45**
RCI
-
-.70**
-.15**
-.09**
DSES
-
-.04
-.08
MVM
-
-12**
MRSF
-
** p < 0.01 level; * p < 0.05 level
4. Discussion
Within Western culture, there have been substantial misinterpretations of meditative
disciplines [19]. Within a therapeutic context, these conceptions may limit potential benefits. The
current research is consistent with the notion that MM conceptions exist. In fact, the prevalence
rate of conceptions as they would be relevant to a therapeutic context was high in this college
sample. Most of the conceptions found were congruent with research on western cultural
expectations of what mindfulness entails (e.g., relaxation, controlling thoughts; [29]). However,
some novel conceptions emerged (e.g., People with Ailments Using Meditation).
Some conceptions are more prevalent than others and might require more attention and
considerably more work to overcome. Further, individuals' approaches to MM, along with their
conceptions of it, may look quite different based on their level of experience. Quantitative data
suggests undergraduates who reported practicing meditation were more likely to reported
stronger conceptions related to Focus, Insight, Mental Control, Emptying the Mind, and MM being
Practiced by People with Ailments.
There are several possible explanations for this finding. First, it might be that an introduction or
familiarity with MM might propagate some of these conceptions. Accordingly, these findings also
demonstrate that those who report more willingness to practice were more likely to report
conceptions related to Ascension, Happiness, and Difficulty of Practice. In a study examining inner
city cardiovascular disease patients’ attitudes toward meditation, almost half of these patients
expressed interest in participating in a meditation practice to reduce stress. Given this was a
college sample and not a medical one, it may still be that individuals who are willing to engage in
these practices, particularly those with high levels of stress (such as cardiovascular patients), might
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be even more inclined to experience their practice as being difficult, and might possibly become
more troubled by a lack of attaining Happiness or Ascension directly from their practice.
Women were more likely than men to report conceptions related to Difficulty of Practice and
using meditation for Stress Relief. Although there is not a clear rationale for why this particular
gender difference might be present, it is clinically relevant to understand these associated
features when teaching meditation and incorporating meditation into individuals’ lives. Some
research demonstrates that men are less likely to seek treatment for mental health problems than
are women (e.g., [30]), which may in part help contextualize gender differences for meditation
being used as a means of alleviating stress if meditation is thought to aid in this way. It is also
possible that men have social scripts in which they are less likely to admit difficulties (e.g., [31]),
which may also explain a portion of these novel findings given that limited research on this area
currently exists.
Religion and spirituality seemed to play a large factor in an individual’s conceptions of
meditative practices. Individuals who reported having an existing religious practice were more
likely than those without to hold the conception of meditation being a religious practice, but no
difference existed for these individuals with the conception of Spiritual Practice. It is the second
authors clinical experience that individuals of Christian faith in this region of the country hold
more beliefs of meditation being a religious practice different than their own (with the exception
of universal groups, such as The World Community for Christian Meditators). Given that most of
this sample was Christian, our findings of this conception as it relates to religious persons mapped
onto our clinical practice. Students with this frame of reference would typically make a distinction
between religion and spirituality, providing support for this finding as well.
Students who reported more religious commitment were more likely to have conceptions of
Meditation Being a Religious Practice and Achievement. Like all learning, people integrate new
acquired knowledge with their existing knowledge. It might be that individuals who are religious
and have never practiced MM would be more likely to view these practices as being more religious
and devotional in nature purely based on their frame of reference. Anecdotally, individuals’
responses to questions like “What is meditation?” with a religious focus tended to state answers
such as “prayer” and “connecting with G-d.”
In contrast, the conception of Achievement as it relates to religious commitment proves to be
much more nuanced in this study. One possible reason for this correlation is the internalization of
specific religious teachings. A religion which may have a return of the afterlife based on one’s
worldly deeds could have an influence on how the religiously committed view Achievement as it
relates to meditation. That is, to meditate is to gain various qualities which could bring one “closer
to G-d” and achieve/receive a life after death. It could also be that this correlation is related to the
interwoven nature of intelligence and achievement. The relationship between acquired knowledge
(intelligence) and achievement has been studied extensively in psychology. Speculatively, theology
and religion may be one such knowledge base for those who have high religious commitment, and
therefore acquiring and utilizing this knowledge holds some value of Achievement for these
individuals. Another possibility may be the context of the university in that university students
may be more achievement focused and therefore reported more conceptions related to
mindfulness meditation. Still, given the limited nature of these findings and empirical data, pause
is warranted.
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Relatedly, the Family Environment Scale (FES; [32]), a measure used to assess a family’s
interpersonal dynamics, has 10 different subscales two of which are Achievement Orientation
and Moral-Religious Orientation. In a study by King [33] using the FES, the Moral-Religious
Orientation was associated with higher academic performance in high school, as well as higher
rates of college attendance in college classrooms. Additional studies suggest a correlation
between religious commitment and academic achievement (e.g., [34, 35, 36]).
Students who reported more daily spiritual experiences were less likely to hold conceptions of
Large Time Commitment, and meditation being a religious practice. Along with a more religious
worldview, it may be that individuals who have daily experiences of spirituality and divinity have
invested more of their energy in seeking divine explanations and therefore influence their
perception of how MM functions. Last, students who were more religiously and spiritually flexible
were less likely to have the conception of Interpersonal Connectedness, and significantly positively
correlated with the conception of Physical Control, and the conception of Empty Mind. The
negative correlation may demonstrate less rigid parallels between meditation and resulting
interpersonal connectedness; however, the positive correlation to Physical Control and Empty
Mind prove to be inconsistent with theory and practice of psychological flexibility, and merits
further investigation by researchers. It may be that religious and spiritual flexibility holds different
features than psychological flexibility more broadly.
Students with more trait mindfulness were more likely to have conceptions of Ascension,
Insight, and Comfort. Although in the right context these features can be seen as positive and
possibly even accurate conceptions of one’s meditative practice, a certain level of flexibility and
sensitivity is needed if these individuals are new to the practice of meditation and are attempting
to incorporate the tenets of mindfulness into their practice.
Last, experiential avoidance was not significantly correlated with any conceptions. It is possible
that experiential avoidance does not correlate with any specific conception due to the nature of
conceptions more broadly. The content of these conceptions was likely not used as avoidance of
the correct conception of MM, but rather represents differing knowledge levels related to the
theoretical and context dependent understanding of MM.
4.1 Limitations and Future Directions
As a limitation to this research, it is unclear how much previous experience participants had
with MM, or the kind of experience that they had. Further, the QMS questions that were included
in analyses revealed no information about attitudes toward mindfulness. For time efficiency, only
key questions from the measure were coded. The six coded open-ended questions were chosen
because they provided information about participants’ knowledge of participation. Another
limitation is that no measure of distress was included, and this is especially useful in assessing how
mindfulness relates to functioning as individuals are first becoming exposed to the concept.
Without a distress measure, it is difficult to extrapolate how these findings apply to those who are
symptomatic of mental and physical health issues. Last, although this sample was representative
of the diverse university at which the data was collected, a majority of the participants were young,
white, single, Christian, female identifiers pursuing higher education in the South-Central region of
the USA. Findings may therefore be more tenuous for other populations (e.g., general, medical)
and this restriction of sample diversity should be considered.
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Future research of MM should attempt to incorporate multiple measures of mindfulness (both
quantitative and qualitative) to gauge participant understanding, as well as use measures
targeting mechanisms of change that are essential to the practice of MM. Researchers may also
benefit from exploring how these conceptions function in a broader sample and whether they
have different variations in other nonclinical samples based on participants information sources
(e.g., media, psychotherapy, readings) for MM. Furthermore, understanding how these prevalent
Conceptions affect client outcomes in therapy would be clinically beneficial for practitioners and
clients of MM interventions.
5. Conclusions
The pursuit of conceptions about MM was in an effort to understand and provide a practical or
“workable” addition to a person’s practice, particularly as might be relevant to clinical work.
Several conceptions were found, through both qualitative and quantitative analyses.
Understanding and confronting these conceptions about MM might mitigate some of the
perpetuation of future MM conceptions and encourage greater awareness, acceptance, and
understanding toward this practice. In the end, it is equally important to remain flexible with how
these conceptions are addressed in clinical and research contexts, and strive to understand their
function they serve for clients rather than just the form.
Acknowledgments
There was no funding for this project. We would like to thank Bini Sebastian for her help with
coding.
Author Contributions
The first author primarily conceptualized this project with help from the second author who
supervised the project. The second author helped the first author design the project. The first
author analysed the majority of the data. The first and second authors did the majority of the
writing, while the third author contributed to writing as well as conducted some analyses and
worked on editing, formatting and related issues.
Funding
N/A
Competing Interests
The authors have declared that no competing interests exist.
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