The MBSR Police

Mindfulness-based Stress Reduction (MBSR) was first presented 36 years ago by Jon Kabat Zinn in the Pain Clinic of the University of Massachusetts’ Medical Center.  Since then, tens of thousands of patients have benefited from mindfulness training by taking classes that adhere to, and classes that are similar to, the MBSR program.  Today, variants of the program have sprung up at leading medical centers worldwide.  This has led many to wonder how should mindfulness be best taught as a medical intervention, and by whom?

Zinn has been adamant that only a program that exactly follows the one outlined in his book Full Catastrophe Living can truly be called MBSR.  At a teacher training with Zinn and Saki Santorelli, Director of the Center for Mindfulness, it was expressed that a move is being made to certify MBSR teachers, and that only teachers that train at the Oasis Institute of the Center for Mindfulness will be able to earn this certification.  Several teachers at the retreat spoke of adjustments they have made to the eight-week program that Zinn developed, and others spoke of very different methods of teaching mindfulness-based therapies.  Zinn’s reply was “that’s fine, just don’t call it MBSR.”

On the one hand, it seems as if the Center for Mindfulness is tightening its grip on its franchise and erecting barriers to entry for new entrants with new ideas concerning mindfulness instruction.  This is classic economic stasis.  As any enterprise grows and becomes successful it can seek to bar or hassle new competitors by lobbying for certification, regulation, and control.  The Center for Mindfulness, as it seeks to firmly establish what is and is not MBSR, can tweak its 36 year old program.  But no one else can and expect the respect of the Center.

On the other hand, the MBSR program, and its results, have been heavily researched and peer-reviewed.  It would be clinically invalid for any program that deviates significantly from the MBSR program to claim the same, or even the same potential, results attributed to MBSR without being subject to the same rigors of research.  And yet this is happening.  A lot.

Also, there exists the potential that insurance companies may begin to cover mindfulness-based therapies such as MBSR.  They are effective and inexpensive when compared to other therapies for stress-related illness.  However, if an insurance company is going to write a teacher a check, it is going to want to know that that person is qualified.  Licensing and certification are common devices used to establish expertise and qualifications.

Many types of meditation, from TM to Metta, have their own body of research.  Some produce results similar to those found through MBSR, others do not.  So it makes sense that the proponents of MBSR want to develop and monitor the program that bears the title.  But having a small group in charge that is resistant to ideas and training beyond its direct control can stifle development of the pedagogy and practice of MBSR.  A successful move toward certification seems certain.  One can only hope that a more open, dynamic certification board and a more creative and less tradition bound education system than the one currently proposed prevails.