To What Extent is Mindfulness as Presented in Commonly Used Mindfulness Questionnaires Different from How it is Conceptualized by Senior Ordained Buddhists?

Abstract

The current study responded to the need for more empirical investigations into differences in the conceptualization of mindfulness between Buddhism and Western psychology. Five senior clergy from three branches of Buddhism were interviewed for their opinion on the Mindfulness Attention and Awareness Scale (MAAS), Kentucky Inventory of Mindfulness Skills (KIMS), Five Factor Mindfulness Questionnaire (FFMQ), and Freiburg Mindfulness Inventory-30 (FMI-30). The interviewees also rated the questionnaire items for an ideal Buddhist in their tradition, in order to provide a stimulus for discussion and to collect quantitative data along with the qualitative data. Eight themes in relation to the elements and features of Buddhist mindfulness emerged from thematic analysis. The themes indicated that there are considerable differences between Buddhist mindfulness and mindfulness as presented by items in the questionnaires. While mindfulness in psychology is frequently conceptualized as non-judgmental, present-centered awareness, Buddhist mindfulness contains elements of attentional flexibility, skillfulness, purposefulness, wisdom, and ethics. Buddhist mindfulness not only involves awareness of the present but also the past and future. It not only focuses on self but also on others. The quantitative results revealed that the MAAS and the FMI-30 appeared less incongruent with Buddhist mindfulness than the KIMS and the FFMQ. Any conceptual differences highlighted in the present study provide avenues for future research as aspects unique to Buddhist mindfulness practice may be linked to psychological benefits also in secular contexts, thus assisting efforts to investigate to what extent secularization of mindfulness practice may have resulted in loss of some potentially beneficial characteristics.

Introduction

The systematic use of mindfulness techniques as psychological interventions started with the development of mindfulness-based stress reduction (MBSR) by Jon Kabat-Zinn in the late 1970s. Based on Buddhist meditation and mindfulness practices, this structured program was originally intended to help patients who did not respond well to traditional medical and psychological treatments (Kabat-Zinn 2003). Commonly focused on fostering the development of non-judgmental present-moment awareness, Western psychological mindfulness techniques have become a core element of mindfulness-based interventions (MBIs), including MBSR, mindfulness-based cognitive therapy (MBCT) (Segal et al. 2002), and to some extent dialectical behavior therapy (DBT) (Linehan 2015). For such clinical contexts, mindfulness can be defined as “the non-judgmental observation of the ongoing stream of internal and external stimuli as they arise” (Baer 2003, p. 125). Another, commonly cited, definition of mindfulness in the psychological literature is “the awareness that emerges through paying attention on purpose, in the present moment, and nonjudgmentally to the unfolding of experience moment by moment” (Kabat-Zinn 2003, p. 145).

The spread of mindfulness techniques in psychological interventions inevitably has led to increased theoretical interest in the concept, although with little consensus so that conceptualizations vary widely. For example, Baer et al. (2004) conceptualized mindfulness as a set of skills. Bishop et al. (2004) proposed that mindfulness has a state-like quality, and defined mindfulness as an attention-regulation process with an attitude of curiosity, openness, and acceptance. In contrast, Brown and Ryan (2003, 2004) viewed mindfulness as a trait without incorporating acceptance into their definition as they argued that acceptance follows directly from giving full attention to the present moment and was therefore redundant. They developed the unidimensional Mindfulness Attention and Awareness Scale (MAAS) that assesses mindfulness as one factor that they named present-centered awareness and attention. The Kentucky Inventory of Mindfulness Skills (KIMS; Baer et al. 2004), on the other hand, provides a four-dimensional profile of mindfulness, reflecting the mindfulness skills of DBT, and Baer et al. (2006) later developed the Five Factor Mindfulness Questionnaire (FFMQ) by combining items from several scales to produce five sub-scales of mindfulness. While the MAAS, KIMS, and FFMQ are the three most highly cited scales to date, there are certainly others, and correlations between mindfulness measures vary widely from very low such as 0.10 to high (0.74) (Medvedev et al. 2016a).

The considerable variation in the conceptualization and measurement of mindfulness in psychology hinders systematic investigations of the mechanism by which MBIs are assumed to exert their health benefits (Baer 2011). Studies employ different mindfulness questionnaires to investigate the benefits of MBIs (e.g., Birnie et al. 2010; Keng et al. 2012). Although these scales measure somewhat different constructs, the efficacy of MBIs is generally attributed to the same term of mindfulness. In addition, secularized mindfulness in psychology has been criticized by Buddhist scholars who claimed that Buddhist mindfulness is not ethically neutral as implied by the definitions of mindfulness in psychology (Bodhi 2011; Dreyfus 2011). Instead, Buddhist mindfulness distinguishes between wholesome and unwholesome aspects, considers certain objects to be more proper to keep in mind than others, and actively regulates attention so that the right path toward the goal of ultimate liberation and compassion with all living beings is maintained.

Mindfulness is the English translation for the Pali word sati, which is literally remembering (Gethin 2001). In Buddhism, right mindfulness is one of the eight factors of the Noble Eight-Fold Path that represents three-fold training in ethics, concentration, and wisdom to achieve enlightenment (Gethin 1998). Right mindfulness refers to the combination of wholesome mental qualities with a state of mind that is free from desire and discontent and directed toward the body, feelings, and mental objects (Anālayo 2003). Right mindfulness together with right effort and right concentration constitute the concentration group of the Noble Eight-fold Path. These three path factors work together to support the development of ethics and wisdom in the sense that none of the factors of the eight-fold path are isolated elements (Gethin 2001). Irrespective of any differences in Buddhist traditions and practices, ethics, concentration, and wisdom are always conjointly required to be developed for the ultimate goal of enlightenment (Gethin 1998).

The Noble Eight-fold Path is realized with the aid of Buddhist meditation. An influential approach is the traditional Satipaṭṭhāna practice, which is normally translated as the four establishings of mindfulness (Gethin 2001) or the four foundations of mindfulness (Gunaratana 2012). Satipaṭṭhāna practice includes contemplations of the body, sensations, mind, and elements of Buddhist teachings in order to develop wisdom through clear awareness of mental and physical phenomena. Present-day MBIs have also been influenced by the Satipaṭṭhāna approach, particularly through drawing on the teaching of the modern Burmese vipassanā meditation school (Samuel 2015). Vipassanā is a Pali term for insight, which refers to clear seeing of the nature of reality (Harvey 2015). The cultivation of insight is said to be guided by the metacognitive functions of sati (Kuan 2012). In the context of Burmese insight meditation, the German-born Theravāda monk Nyanaponika typically referred to bare attention in his teachings of mindfulness, although he never intended for this to be a translation of the term sati (Bodhi 2011). Bare attention was said to be “kept to a bare registering of the facts observed, without reacting to them by deed, speech or by mental comment which may be one of self-reference (like, dislike, etc), judgment or reflection” (Nyanaponika 2005, p.32). To what extent mindfulness can be described or even reduced to a process similar to bare attention is contentious among Buddhist scholars. Nyanaponika (2005) viewed bare attention as one aspect of sati. Bodhi (2011) argued that discourse about bare attention may be useful as a procedural directive or technique for cultivating mindfulness but cannot be a conceptualization of mindfulness itself. After all, Buddhist mindfulness practice involves evaluation of wholesome and unwholesome mental states for ethical practice and thus cannot not simply be bare attention to stimuli as they present themselves.

While proponents of MBIs have also acknowledged that being aware of one’s conduct in relation to its potential to harm others is important in the cultivation of mindfulness (Kabat-Zinn 2011), such secular programs cannot prescribe a single set of ethical guidelines to avoid conflict with belief systems of participants from diverse religious backgrounds (Cullen 2011). To what extent the kind of mindfulness taught in MBIs now differs from the type of mindfulness that it was originally derived from has increasingly become a topic of debate in theoretical scholarship (Bodhi 2011; Dreyfus 2011; Shonin et al. 2015). However, hardly any empirical work has been conducted to compare Buddhist mindfulness and mindfulness in psychology. One exception is a recent study by Christopher et al. (2014) who evaluated the cultural validity of the FFMQ (Baer et al. 2006) and Toronto Mindfulness Scale (TMS) (Lau et al. 2006) with six ordained and eight lay Zen Buddhists. Cognitive interviewing was conducted with the participants to identify areas of concern and strength of these two mindfulness questionnaires. For instance, aspects of intention to return awareness to the present moment as well as awareness of aversion and suffering were found missing from the FFMQ and TMS. The former was said to be the aspect of remembering of Buddhist mindfulness, and the latter was insightful understanding. Extending beyond one’s self was also identified as an aspect of Buddhist mindfulness that was missing from the FFMQ and TMS.

Although Christopher et al. (2014) provided valuable empirical information on some of the differences in mindfulness between Buddhism and psychology, their study was limited to a comparison with the Zen Buddhist tradition. This current study aimed to extend these findings and collect further empirical data by interviewing senior Buddhist practitioners from all three branches of Buddhism, namely, Mahāyāna, Theravāda, and Vajrayāna (Gethin 1998). Additionally, we presented participants with the three most commonly used mindfulness questionnaires (MAAS, KIMS, and FFMQ), as well as the Freiburg Mindfulness Inventory-30 (FMI-30) as this scale was developed explicitly based on Buddhist insight meditation (Buchheld et al. 2001). Thematic analysis was employed to analyze the interview transcripts to extract the specific and unique aspects or characteristics of Buddhist mindfulness. In addition, participants in the current study rated each individual item of the four mindfulness scales to provide detailed information about where the Buddhist understanding of mindfulness might differ from what is assessed in mindfulness questionnaires. A more detailed understanding of the differences between Buddhist and secular conceptualizations of mindfulness may help pinpoint areas for future research, particularly potentially beneficial aspects that we have not been carried over into secular practice. To date, most of such comparisons have been limited to theoretical discussion. Our study adds much needed empirical data to this debate.

Method

Participants

Data were collected from five senior Buddhist clergy: two female ministers from Mahāyāna traditions (Zen and Won Buddhism), one male monk from the Thai forest tradition of Theravāda, one female ordained teacher of a Theravāda-based tradition named Triratna, and one nun from the Vajrayāna tradition. Four of the participants were Westerners and one Asian. All of them were advanced Buddhist practitioners who engage in Buddhist practice daily. Among them, one had 31 years of experience, two had 30 years of experience, one 19 years, and one 12 years of experience. The youngest participant was 34 years old, and the oldest participant was 73 years old. Two participants were in their early 50s (51 and 52), and another participant was 55 years old. Participants were visited at their temples or meditation centers in the wider area of Auckland, New Zealand, except for the Asian participant, who joined from South Korea via videoconferencing. Participants were recruited through convenience and snowball sampling by contacting individuals through the researchers’ networks and by referral after having contacted the New Zealand Buddhist Council. Inclusion criteria required that participants were senior ordained clergy who speak sufficient English to understand and express nuances around mindfulness. To maintain anonymity of the participants, they will be referred to as participants 1 to 5 and referred to as they even in singular to avoid revealing their gender.

Procedure

Individual interviews were conducted by using existing commonly used mindfulness questionnaires as a stimulus to engage participants to share their views on Buddhist mindfulness. These were the MAAS (Brown and Ryan 2003), FMI-30 (Buchheld et al. 2001), KIMS (Baer et al. 2004), and FFMQ (Baer et al. 2006). After explaining the purpose of the interviews, each participant was given the combined mindfulness questionnaire with the instruction not to rate themselves but to imagine rating an ideal Buddhist in their tradition. This could be an idealized person or a teacher. Participants were not required to reveal who they were imagining. These instructions were explicitly discussed with the participants, and it was explained that the purpose was for the participants not to discuss and rate these items in terms of their own judged levels of mindfulness but from the perspective of their aspirations.

Participants were given sufficient time to complete the 91-item questionnaire, which typically took 20 to 25 min. As participants were asked to rate an ideal Buddhist such as a highly regarded master or teacher in their tradition, one would expect that a high rating if an item captures content relevant to Buddhist mindfulness. In the case of positively worded items, this means a rating of at least 5 (very frequently), and for negatively worded items a rating of 2 (very infrequently) or below. Following the participants’ questionnaire ratings, participants were asked to comment on the items, particularly when answers indicated that the item did not assess content relevant to Buddhist mindfulness practice. The interview was flexible. Participants who preferred to talk through the items while completing the questionnaire were welcome to do so. The participant joining via videoconferencing had completed the questionnaire prior to the interview. They reported their score verbally to the interviewers, while also talking about their answers item by item. Toward the end of the interview, participants were invited to discuss the following general questions: Could you please comment on the questionnaire? To what extent are these questions about mindfulness as you understand it in your Buddhist tradition? Are there items missing?

Measures

The questionnaire used for the interview included the MAAS, FMI-30, KIMS, and FFMQ. To make the format of the four mindfulness scales consistent, the six-point Likert scale ranging from 1 (almost never) to 6 (almost always) of the MAAS was adopted throughout the whole questionnaire. Originally, items of the FMI-30 are rated on a 4-point Likert scale ranging from almost never to almost always, and both KIMS and the FFMQ items are typically rated from 1 (never or very rarely true) to 5 (very often or always true).

The MAAS (Brown and Ryan 2003) is a 15-item uni-dimensional scale that assesses the frequency of the state of attentiveness and awareness of the present moment in everyday life. All items can be thought of as assessing mindlessness, and ratings are reverse scored so that higher scores represent a higher level of mindfulness. An example item is “I could be experiencing some emotion and not be conscious of it until some time later.”

The 30-item FMI was developed explicitly on the basis of Buddhist insight meditation (Buchheld et al. 2001). A four-factor solution ((1) dis-identifying attentional process of mindfulness, (2) accepting, open attitude toward experience, (3) process-oriented understanding, and (4) paying attention to the present moment without distraction) found with data from respondents prior to participating in a meditation retreat was not replicated post-retreat. Example items include “I accept myself as I am” (accepting, open attitude toward experience) and “I know I am not identical to my thoughts” (dis-identifying attentional process of mindfulness). Familiarity with Buddhist meditation is required to meaningfully understand items of the FMI-30.

The KIMS (Baer et al. 2004) comprises 39 items measuring four factors of mindfulness, namely, observing, describing, acting with awareness, and accepting without judgment. The design of the KIMS is essentially based on the mindfulness skills reflected in dialectical behavior therapy (Linehan 2015). Items include “I pay attention to whether my muscles are tense or relaxed” (observing), “I’m good at thinking of words to express my perceptions, such as how things taste, smell, or sound” (describing), “When I’m doing something, I’m only focused on what I’m doing, nothing else” (acting with awareness), and “I tend to evaluate whether my perceptions are right or wrong” (accepting without judgment). The scale measures the general tendency to be mindful in daily life with language aimed to be understandable by populations without Buddhist meditation experience.

The FFMQ (Baer et al. 2006) is a 39-item instrument based on the MAAS, the FMI, the KIMS, the Cognitive and Affective Mindfulness Scale (CAMS; Feldman et al. 2007; Hayes and Feldman 2004), and the Mindfulness Questionnaire (MQ; Chadwick et al. 2005). Five factors including observing, describing, acting with awareness, non-judging of experience, and non-reactivity to inner experience were extracted from the pooled data of those scales. Thirty-two items of the FFMQ overlap with the MAAS, FMI, and KIMS. Therefore, employing the FFMQ in this study meant adding another seven items from the CAMS and the MQ to the combined questionnaire.

Data Analyses

Inter-Rater Reliability Analysis

Inter-rater reliability analysis was first conducted through the methods of percentage agreement. Answers to negatively worded questions were reverse coded so that for all items higher scores indicated a higher level of mindfulness. Items that had been rated 5 or 6 on the 6-point Likert scale were indicative of capturing content relevant to a Buddhist perspective of mindfulness, and ratings of 1 to 4 indicated that content was irrelevant or ambiguous. Analyses distinguished between items rated consistently by all participants as relevant or irrelevant to Buddhist mindfulness and items where there was no agreement among participants. The criterion for an item being classified as a high agreement item was that the difference between the score of the participant with the highest rating and the score of the participant with the lowest rating was no more than 1. When the range of ratings was larger than 1, or if at least one participant did not provide a rating, the item was identified as a low agreement item. The percentage of low agreement items of each scale was calculated, and the scale that had the lowest percentage of low agreement items was considered to have the highest inter-rater reliability.

Inter-rater reliability was further examined by calculating Gwet’s AC1, which is a chance-corrected agreement measure that can be applied to multiple raters and categories (Gwet 2014). It was designed to be less affected by skewed distributions of categories compared to other inter-rater reliability measures such as Cohen’s Kappa. Since the participants in the present study were required to rate an ideal Buddhist, and the data presented ceiling effects, Gwet’s AC1 was believed to be the most appropriate measure for the dataset of the present study.

To calculate Gwet’s AC1, all the ratings were recoded and classified into three nominal categories. Ratings 1 and 2 on the 6-point Likert scale were recoded as 1 and were classified into the category of “Irrelevant to a Buddhist perspective of mindfulness.” Ratings 3 and 4 were recoded as 2 and classified into the category of “Neither irrelevant nor relevant to a Buddhist perspective of mindfulness.” When a participant did not rate an item or commented that it depended on the situation, the item was recoded as 2. Ratings 5 and 6 were recoded as 3 and classified into the category of “Relevant to a Buddhist perspective of mindfulness.” The Gwet’s AC1 values were generated by running a free Gwet’s AC1 syntax for SPSS that was available at http://www.ccitonline.org/jking/homepage/Gwet.sps. Gwet’s AC1 was calculated for all the items of the four mindfulness scales, and separately for each scale. According to Altman’s (1991) criteria, values of inter-rater reliability ranging from 0.41 to 0.60 indicate moderate inter-rater reliability, good inter-rater reliability requires the value to be at least 0.61, and the value from 0.81 and above suggests very good inter-rater reliability. In addition, values < 0.20 and 0.21–0.40 represent poor and fair agreement, respectively.

The primary purpose of questionnaire rating was to provide a stimulus for discussion, such as triggered by the content of the questions themselves or by the actual ratings. Despite the small sample size, the quantitative results were analyzed and reported, but interpreted in conjunction with the qualitative information provided by the participants.

Qualitative Data Analysis

Each interview was recorded on audiotape, transcribed, and analyzed by two researchers together. Thematic analysis (Braun and Clarke 2006) was used to examine the interview transcripts about what Buddhist mindfulness is. The themes that represent Buddhist mindfulness were extracted. These included statements mentioned in several contexts though expressed in different ways. Themes were sent to participants later for verification of accuracy.

Thematic analysis is interpretive. It is a foundational method for qualitative analysis to help identifying, analyzing, and reporting patterns (themes) within dialog (Braun and Clarke 2006). The key advantage of thematic analysis compared with other analytical methods for searching themes and patterns is that thematic analysis is not bound within a theoretical framework. For the current project, thematic analysis was conducted in a deductive way at a semantic level. A deductive approach is driven by the researcher’s theoretical interest in the research area, which in this case, is the difference in mindfulness between psychology and Buddhism. Analysis of data at the semantic level means that the analysis did not go beyond what participants had stated in order to explore any underlying ideas and assumptions.

Thematic analysis was based on the guidelines provided by Braun and Clarke (2006). Firstly, the interview data were transcribed into a written form. Two researchers read the transcripts repeatedly to familiarize themselves with the data. Initial ideas about the patterns were noted down. Secondly, initial codes were generated manually by the two researchers who worked independently. Since this stage was to code for as many potential themes as possible, when two researchers coded the same data extract differently, both codes were retained for further analysis on themes. In addition, an extract can be coded more than once for many potential themes. For example, one participant commented that “[i]t depends on the situation because there’re some situations where it’s appropriate to be giving all your attention to just one thing and you don’t need to pay attention to other things, but there are other times, you know, when we are not meditating, for example, then you need to have a wide mindfulness.” The codes of “situation dependent mindfulness,” “flexible mindfulness,” and “wide mindfulness” were generated for the comment. Thirdly, after all data were initially coded, the relationships between codes were investigated, and relevant codes were combined for potential themes. The two researchers worked together from this stage. Fourthly, the potential themes were reviewed and refined. A theme should be distinct and should not overlap too much with other themes. In addition, the data extracts of each theme were inspected to see if the themes contained coherent data. As a result, a candidate theme could be discarded, and a new theme also could be created. Lastly, each theme was defined and named. Each theme as well as data extracts were written on separate pieces of paper and were shuffled around to see if a data extract could be organized into a previously identified theme that it belonged to. The final themes should reflect data extracts accurately and also can be defined clearly. All the themes together delineated a picture of Buddhist mindfulness. In addition, we made reasonable attempts to contact participants to provide feedback on the themes extracted in the data. Names and descriptions of themes were emailed to participants to make sure that the themes were satisfactory to them.

The final number of participants was determined after emergence of data saturation. Data saturation is more likely when interviewing experts in the area of inquiry and may be reached after interviewing as few as four individuals (Guest et al. 2006). Fusch and Ness (2015) pointed out that data saturation was about the quality and quantity of data, not the sample size. The indicator of data saturation was that no new codes and themes could be identified. In the current study, the transcripts of the first three interviews were analyzed. Subsequently, the fourth and fifth interviews were analyzed to see if there were data extracts that were relevant to the research question but could not be assigned to the already emerged themes. The fourth interview yielded only little additional information, and for the fifth interview, all the relevant data extracts were covered by the finalized themes. As a result, the two researchers concluded that data saturation had been achieved.

Results

Quantitative Data Results

Table 1 shows the number of high agreement items and low agreement items, and the percentage of low agreement items by scales. Of all four scales, the MAAS had the smallest percentage (6.67%) of low agreement items, i.e., 1 out of its 15 items. The largest percentage of low agreement items was found for the 39-item KIMS, where 29 items (74.36%) had low agreement. Separate analyses for the KIMS sub-scales revealed that the percentage of low agreement items for the observing factor was the highest (91.67%), followed by 87.50% for the describing factor. Acting with awareness and the accepting without judging factors of the KIMS had 50 and 66.67% of low agreement items, respectively. The FMI-30 had six low agreement items, which represented 20% of the total items. The high percentage of low agreement items of the FFMQ (61.54%) was mainly attributed to the high percentage of low agreement items of the KIMS as the FFMQ has 24 items overlapping with the KIMS. Among the five factors of the FFMQ, all items of the observing factor were low agreement items whereas none of the items in the factor acting with awareness were low agreement items. Overall, the results indicated that the MAAS and the FMI-30 were the scales with the smallest percentage of low agreement items.

Table 1 Shown separately for mindfulness questionnaire (and separately by sub-scale), the number of high agreement items (with range of scores rated by participants ≤ 1), and low agreement items (with range of scores rated by participants ≥ 2, or at least one unrated item), as well as percentage of low agreement items

Without exception, when items were rated with high agreement by participants (with range of scores ≤ 1), these ratings were all 5 or above. In other words, when participants gave very similar scores, these were all for items that an ideal Buddhist would be thought to score high on. The scores for low agreement items, in contrast, were more variable (Table 2). The only low agreement item of the MAAS was item 5 (“I tend not to notice feelings of physical tension or discomfort until they really grab my attention”). Although the first four participants’ reversed scores were “6”s, the last participant commented that the phrase “grab my attention” was not applicable to ideal Buddhists as their attention was always under control and cannot be grabbed. This participant also noted that an ideal Buddhist would notice physical tension and discomfort, but only when it was appropriate to pay attention to his/her body.

Table 2 Responses to items of the MAAS, KIMS, FMI-30, and FFMQ, shown separately for each participant. Only results of low agreement items are shown here

Of the six low agreement items of the FMI-30, item 19 (“I accept myself as I am”) had contradictory ratings. While three participants rated it as “6,” the rating of “1” given by participant 1 suggested that an ideal Buddhist in their tradition almost never accepted themselves as they are. This participant stated explicitly that while it was understandable that accepting self was important to patients in psychological therapies, accepting self was not an indicator of Buddhist mindfulness. Participant 3 was concerned with the term “myself” and did not rate the item. They asserted that the item needed fuller explanation because an enlightened person would only accept self as a process, body, and mind instead of an individual being. Participant 3 also pointed out that acceptance without ethics as a foundation could be unwise acceptance.

Low agreement items of the KIMS mainly lay in the observing and describing factors, where only one item each was rated with high agreement. Five of the low agreement items in the KIMS had contradictory ratings: two items of the observing factor and one item each from the other three factors. Two items of the observing factor were item 13 (“When I take a shower or a bath, I stay alert to the sensations of water on my body”) and item 30 (“I intentionally stay aware of my feelings”). For item 13, three participants’ ratings were “5” and above, whereas participant 4 gave a rating of “2” (very infrequently), and participant 5 did not rate it. Participant 4 explained that the sensations of water on body were not a proper object of attention when taking a shower or a bath in their tradition. This participant also commented, based on their situation, that living together with other roommates meant that they would not focus attention on sensations, but the goal was typically to finish a shower as soon as possible due to time pressure. Participant 5 noted that sensations of body were not necessarily the object of attention, and other objects could be chosen. Item 30 was rated at least “5” by three participants. Participant 5, however, rated it as “1” and commented that an ideal Buddhist in their tradition would never intentionally stay aware of his/her own feelings because he/she had gone beyond the stage of being interested in a self. Participant 3 would only rate it as “6” if the term “intentionally” was removed, as a fully enlightened person was believed to be aware of feelings without making a deliberate intention.

The item with contradictory ratings of the describing factor of the KIMS was item 34 (“My natural tendency is to put my experiences into words”). Only Participant 4 rated the item as “6,” three other participants rated it below five (“1,” “2,” and “4”), and participant 3 did not rate the item and explained that it depended on personality.

Within the KIMS factor acting with awareness, item 19 (“When I do things, I get totally wrapped up in them and don’t think about anything else”) also had contradictory ratings ranging from “1” (almost never) to “5” (very frequently). Participant 3 did not rate the item and commented that it needed fuller explanation because the state of absorption without thinking anything else was an indicator of mindfulness in some situations, but the wording of the item sounded negative, which seemed to suggest that being absorbed was not mindfulness. The item of the KIMS with contradictory ratings was item 8 (“I tend to evaluate whether my perceptions are right or wrong”) of the factor accepting without judgment. While two ratings of “6” indicated that an ideal Buddhist almost never tended to evaluate rightness or wrongness of perceptions, other three ratings (“1,” “2,” and “3”) suggested that an ideal Buddhist evaluated perceptions to some extent.

Same as with the KIMS, both observing and describing factors of the FFMQ had largest number of low agreement items. Four items (item 2, 7, 27, and 37) of the describing factor were viewed by either one or two participants as not applicable to an ideal Buddhist. For example, participants 3 and 5 did not rate item 27 (“Even when I’m feeling terribly upset, I can find a way to put it into words”) as they believed that ideal Buddhists would not feel terribly upset. As with the accepting without judgment factor of the KIMS, most items of the non-judging of experience factor of the FFMQ were low agreement items. The non-reactivity to inner experience factor contains four low agreement items that refer to distressing thoughts and images. According to participant 3, an ideal Buddhist would not have distressing thoughts or images and thus those three items were not applicable.

The results using percentage agreement were confirmed by Gwet’s AC1 as a measure of inter-rater reliability. Gwet’s AC1 for all the items overall was 0.69, which indicated an overall good inter-rater reliability for items presented to the raters. Gwet’s AC1 of 0.97 for the MAAS was the highest, whereas Gwet’s AC1 of 0.49 for the KIMS was the lowest. The FFMQ and the FMI had Gwet’s AC1 values of 0.60 and 0.89, respectively. This indicated that both the FFMQ and the KIMS had moderate inter-rater reliability, and both the MAAS and the FMI had very good inter-rater reliability. The inter-rater reliability of the MAAS was the highest among the four scales.

Qualitative Data Results

Thematic analysis extracted the following eight themes: scope of attention and awareness, skillful mindfulness, purposeful mindfulness, profound mindfulness, wise judging, ethical and compassionate mindfulness, subtlety and effort in mindfulness, and irrelevance to Buddhist mindfulness. These eight themes describe from different perspectives the differences between mindfulness as conceptualized by Buddhism and that by Western psychology.

Scope of Attention and Awareness

According to the participants, mindfulness can be at times narrow-focused attention on an object, and at other times a broad and general awareness that is open to the emergence of internal and external stimuli. In other words, one’s scope of attention varies depending on the situation one is currently in, and thus neither narrow attention nor broad awareness is a definitive indicator of mindfulness. In response to KIMS item 38 (“I get completely absorbed in what I’m doing, so that all my attention is focused on it”), Participant 3 commented:

It depends on the situation because there’re some situations where it’s appropriate to be giving all your attention to just one thing and you don’t need to pay attention to other things, but there are other times, you know, when we are not meditating, for example, then you need to have a wide mindfulness, you know, [one that] takes in the whole environment.

Participant 5 stated that “mindfulness can be a spread out one or it can be a narrower one”. Participant 2 also commented that “I guess the truly awakened state is being able to shift back and forth between being aware and being mindful, and non-minded, just complete kind of uniting with one’s experience.” Further supporting the theme, participant 1 elaborated from the perspective of the categories of Buddhist meditation:

Samatha practice is about developing concentration,…focused awareness,…and with Vipassana practice or insight practice, I’m training myself to notice, say, sensations coming and going, and reflect on impermanence and so on. So, that’s a more broad awareness,…those two different types of practices are training two different mindfulness capacities…then we use these two capacities in everyday life as we move between situations.

In the questionnaire, the multi-tasking item 31 of the KIMS (“I tend to do several things at once rather than focusing on one thing at a time”) was designed to assess the opposite of undivided attention and needs to be reverse scored to express a high level of mindfulness. However, the participants disagreed. Participant 3 stated that “[a] mindful person can do several things at once with high degree of mindfulness.” Participant 4 commented that “you should be mindful of both, if that’s what you have to do.” Similarly, participant 2 added that “…..you know modern life; often we’re doing more than one thing at a time, and um, when we’re doing two things, then we’re doing two things.”

Skillful Mindfulness

Whether mindfulness is focused attention or broad awareness, it should be suitable to the situation. The theme skillful mindfulness denotes responding appropriately to the present situation through skillful application of either narrow-focused attention or broad awareness.

Participant 3 commented that:

…when we’re just sitting meditating, our responsibility for being mindful is essentially just within this body and mind, right? We don’t have to pay attention to sounds…But, if we are in a different situation,…our responsibilities change…The teacher would say ‘you’re not being mindful’, you are not responding appropriately to the situation, so this is the key aspect of mindfulness…when we’re talking about mindfulness, we’re not just talking about being aware, because it’s, or let’s say, there are guests arriving, then the young monks will have the duty to go receive,… and if they’re just sitting watching their breath, they might be mindful of their breath, but they’re not mindful of the whole situation.”

Relatedly, participant 1 talked about the cognitive flexibility of switching between focused attention and broad awareness through an example that shows how an ideal Buddhist would respond to an interruption while working:

They’ll be really focused on the work at hand and able to move really easily in terms of open receptive broader awareness and then to move back, and back without the jarring feeling that most of us have.

Purposeful Mindfulness

The participants saw mindfulness as purposeful in the way that one bears in mind one’s long-term life goals and also short-term goals such as when developing wholesome habits or dealing with unwholesome mental states. Participant 1 pointed out that mindfulness of purpose was missing from the mindfulness questionnaire, and stressed that remembering one’s life purpose and trajectory was important because it guided one’s thoughts and actions in the present moment. Relatedly, three other participants commented that mindfulness served the purpose such as developing wholesome habits and eliminating unwholesome habits. Here, the object of mindfulness varies depending on the specific purpose. For instance, the KIMS item 17 and FFMQ item 11 “I notice how foods and drinks affect my thoughts, bodily sensations and emotions” is designed to measure the observing aspect of mindfulness, and participant 2 reacted to it by commenting:

…when…you’re working on a kōan (succinct paradoxical statements or stories to be reflected on in Zen practice to challenge conventional logic or thinking),…if you really are…deeply absorbed in a kōan, you may not be tasting the food you’re eating, in the sense of thinking to yourself “I am tasting sourness or something bitter.”

Therefore, when eating and drinking, not paying attention to the object associated with food and drink is not necessarily absence of mindfulness if one’s mind is working toward another specific goal such as working on a kōan. Instead, mindfulness is expressed appropriately in the way that objects irrelevant to the purpose are ignored. The same participant summarized that “mindfulness is being a practice, um, bring one’s attention, directing one’s attention to something, the chosen something.”

The same view was expressed through other participants’ reactions to other items from the observing sub-scale. For example, in response to the KIMS item 13 and FFMQ item 6 “When I take a shower or a bath, I stay alert to the sensations of water on my body,” they commented that sensation of water may not necessarily always be the chosen object of attention. Participant 3 said ideal Buddhists “can be fully mindful, but paying attention to something besides the water, because there are many things happening.” Likewise, for the MAAS item 5 “I tend not to notice feelings of physical tension or discomfort until they really grab my attention,” the same participant commented that if the ideal Buddhist was focusing on someone else, such as giving the person right instruction, the ideal Buddhist’s attention would not be on themselves and they would thus not notice feelings of tension or discomfort.

Profound Mindfulness

The theme profound mindfulness refers to looking at things from different angles to challenge egoistic perceptions and to understand cause and effect. Profound mindfulness is introspective awareness that goes beyond simply being aware in the present moment in order to investigate the truth of reality, and it nurtures insight which is a critical quality developed through Buddhist practice. Participant 3 commented that:

Our perceptions are conditioned by our mood, by our cultural upbringing, by our attachments, by our identifications, all of these things, so yeah, when someone is practicing, they are constantly challenging their perceptions, they are not just believing the face value.

With regards to feelings, participant 5 stated that mindfulness brought awareness of suffering of the mind, the impermanent nature of feelings, and human beings’ potential ability to overcome such negative feelings. Participant 3 stated that being mindful of causes and conditions and drawbacks of negative feelings helps tackle negative feelings: “Fear arises according to causes and conditions, and if we understand that and we’re mindful of that, then it doesn’t grow out of proportion.” Participant 4 also shared that being aware of causes and conditions was a huge part of their mindfulness practice. Similarly, participant 1 said mindfulness practice involved noticing sensations coming and going, and reflecting on the insight of impermanence, suffering and no-self. Participant 2 supported that perception and thoughts are limited and distorted in some way. The ideal mind state in this participant’s tradition is a nondual awareness that goes beyond the notion of subject and object, and just experiencing and being one with experience.

Mindfulness, as suggested by participants, is always practiced within the context of the Noble Eight-fold Path and cannot be separated from the other seven path factors. Participant 3 commented that “…within the way of the Buddha teaches mindfulness, it goes together with the other seven steps of the noble eight-fold path, so you can’t have, you can’t just take one step out and get the same results.” The participant later added that “… it’s really helpful if you’re practicing it together with wisdom, right effort, morality in a larger context.”

Wise Judging

All participants agreed that mindfulness involves a form of wise judging, which recognizes unwholesome and wholesome qualities and their consequences. Wise judging is different from the judging based on defilements, such as personal likes or dislikes that are rooted in greed, hatred, and delusion, which enhance one’s ego. In the KIMS and FFMQ questionnaires, one of the sub-scales assesses mindfulness as non-judgmental awareness, measured by items such as “I tend to make judgments about how worthwhile or worthless my experiences are” (KIMS item 24). Participant 3’s reaction to the item was as follows:

I think from an enlightened point of view, there is some of the judging going on, um, but it’s coming from wisdom, not from delusion…I think this question is assuming that people who are mindful don’t judge things, which I think is a mistake.

Similarly, for the item “I see my mistakes and difficulties without judging them” (FMI-30 item 17), the same participant said:

It really depends whether wisdom is present or not. If we follow our defilements, say, if we make mistakes based on greed, based on our desires, or selfishness, and then we recognize that, then we may, a wise person gets, can judge, not with like the heavy guilt-ridden type of judging that we might associate within the west, but just judge as recognizing it’s not wholesome, it has bad results.

The theme of wise judging was also strongly supported by other participants. Participant 4 emphasized the importance of wise judging: “it’s not just present awareness or judgmental but there is an aspect of keeping in mind what’s wholesome and unwholesome.” Participant 2 explained that there is no judgment in the state of absorption, but there are other situations where evaluation is required, and anger which is unwholesome should be overcome through Buddhist practice.

Ethical and Compassionate Mindfulness

Another theme, ethical and compassionate mindfulness, denotes being mindful of making ethical choices. Participant 1 stated that people should be “mindful of the ethical implications of one’s actions from moment to moment,” and mindfulness is “awareness of actions and consequences.” Two other participants elaborated an unethically mindful behavior by independently referring to the same example of a bank robber. Participant 3 said:

So, for example, if you’re a bank robber, you have to be very mindful to be a good bank robber, but obviously the śīla, or the morality aspect is not developed, so the results aren’t going to be very good…So that’s the example of, well, if you take something out of its context, you know, even something good, then it can be twisted, and then can cause harm.

The same participant later added that ethical awareness is recognizing the negative consequences of unwholesome attention, which is then to be abandoned. Participant 5 also pointed out that a bank robber was mindful but “it’s not got any kind of teachings behind it, you know, conscientiousness,” whereas Buddhist mindfulness helps “you see that you’ve been unskillful.” Although the bank robber applies a high degree of attention to the present moment, this is not Buddhist mindfulness due to the lack of the presence of ethics and wisdom.

Subtlety and Effort in Mindfulness

The theme subtlety and effort in mindfulness relates to different levels of mindfulness practice. Beginners start from gross objects and also need to make effort to be mindful of the object. With continued practice, mindfulness becomes more effortless, and increasingly more subtle objects can be noticed. Responding to the item “I intentionally stay aware of my feelings” (KIMS item 30), participant 3 said:

…for one who is fully enlightened, they don’t have to make that intention anymore. It happens automatically…for one who is training and practicing, they have to bring up that attention, it’s like keep reminding themselves.

Participant 2 expressed the same view when commenting on the KIMS item 9 and FFMQ item 1 “When I’m walking, I deliberately notice the sensations of my body moving”:

…being in the beginning of the course one has to do these things deliberately, but…[one] eventually moves into just noticing without being deliberate…So the ideal is to move to something that’s completely natural, which actually is a true way of functioning, but we have to get the naturalness by, um, thorough training.

The same participant also described mindfulness as “an ability to put your attention to where you want to go, to direct your attention, and do so and more and more at a more subtle level.” Another participant stated that mindfulness measured in psychology was gross mindfulness whereas in Buddhism, gross mindfulness evolves into subtle mindfulness with practice. They shared the role of natural mindfulness in the extreme subtle mind state called rigpa in their tradition:

…they recognize their own very very subtle mind states. When this happens, there is no other practice to do but abide continuously in this rigpa, subtle wisdom mind state and rigpa alone, this is accomplished through mindfulness, however, there are two kinds of mindfulness, contrived and natural, this practice cannot be achieved through contrived mindfulness.

Irrelevance to Buddhist Mindfulness

The remaining theme that emerged is irrelevance to Buddhist mindfulness. Particularly the describing factor of the FFMQ and KIMS as well as items on accepting oneself were not seen as indicators of mindfulness as relevant to Buddhist practice. All five participants expressed their concern for the describing items. Participant 1 commented that “mindfulness is about being aware of one’s feelings and thoughts, not necessarily about being able to describe them.” Sharing similar reactions, participant 2 said that “my emphasis in Zen is, um, to go beyond words, immediate experience rather than the descriptions of experience.” Participant 3 believed that it depended on the individual and “even some fully enlightened teachers, they’re just not that eloquent, they don’t speak that much.” Participant 5 gave an interesting comment by stating that “I’m sure they are very good at describing their feelings, but they would never describe them.”

Further supporting this theme, participant 1 pointed out that not only describing but also accepting self were irrelevant to Buddhist perspective of mindfulness:

I was really struck by two things, emphasis on putting things into words, and emphasis on whether you accept yourself, or whether you label your emotions as good or bad. Those two things don’t fall into Buddhist definition of mindfulness.

Sharing the same concern for accepting oneself, for FMI item 19 (“I accept myself as I am”), participant 3 commented:

Someone can just accept themselves as they are but be very foolish. I mean they may be doing terrible things, and they just accept themselves as they totally are…that would be an unwise way of accepting oneself.

Discussion

Eight themes of aspects of Buddhist mindfulness in comparison to Western psychological ones emerged. The scope of attention and awareness theme suggests that mindfulness can be either narrow-focused attention or a broad awareness and that neither is an exclusive characteristic of mindfulness. The theme skillful mindfulness explains how the appropriateness of narrow-focused versus broad awareness depends on skillfully responding to the present situation that the practitioner finds themselves in. The theme of purposeful mindfulness emphasizes the goal-oriented nature of mindfulness practice, including broader life goals and trajectories. The themes profound mindfulness and ethical mindfulness relate to the role of mindfulness in developing insight and ethics, respectively. According to the theme of wise judging, judging is not necessarily an indicator of lack of mindfulness as long as this judging is a form of wise judging and thus informed by wisdom and evaluation of wholesome versus unwholesome thoughts. How the specific characteristics of mindfulness depend on the practitioner’s progress or level of mindfulness is reflected by the theme of subtlety and effort in mindfulness. And lastly, the theme of irrelevance to Buddhist mindfulness identified content in mindfulness questionnaires such as describing that are irrelevant to Buddhist mindfulness. While each theme refers to a distinct aspect of mindfulness, the present discussion describes how the themes are interlinked and what implications they present for theory and measurement of mindfulness.

Skillfully and Purposefully Shifting Between Narrow-Focused and Broad Awareness

Narrow-focused attention concerns one or a very limited number of objects, while open awareness takes in a wide range of internal and external stimuli. According to the comments of the participants in the present study, Buddhist mindfulness is flexible in that it operates either in narrow-focused attention or broad awareness depending on the situation. Hence, to view mindfulness as either open awareness or narrow-focused attention reflects only a partial understanding of Buddhist mindfulness.

Mindfulness in psychology has been greatly influenced by vipassanā/insight meditation (Samuel 2015), so that mindfulness is sometimes conflated with insight or insight meditation (Gethin 2014). Since insight meditation features open broad awareness rather than narrow-focused attention on a fixed object, which is claimed to be the characteristic of concentration meditation (Brown and Ryan 2004), mindfulness in psychology is often conceptualized as open broad awareness. For example, Bishop et al. (2004) referred to an orientation of curiosity, experiential openness, and acceptance toward experiences and Brown and Ryan (2004) operationally defined mindfulness as “open or receptive attention to and awareness of ongoing events and experience” (p. 245).

When mindfulness in psychology is conceptualized on the basis of mindfulness skills developed in DBT, narrow-focused attention is instead implied in the conceptualization of mindfulness. For instance, one of the skills that can be taught in DBT is participating, which refers to “entering completely into the activities of the current moment, without separating him- or herself from ongoing events and interactions” (Linehan 2015, p.154). Another skill is one-mindfully, which is “focusing attention on only one activity or thing at a time, bringing the whole person to bear on this thing or activity” (Linehan 2015, p.209) and “the essence of the idea is acting with undivided attention” (Linehan 2015, p.210). The KIMS has some items based on the above two mindfulness skills. For example, scores on item 38 (“I get completely absorbed in what I’m doing, so that all my attention is focused on it”) contribute positively to the respondent’s overall mindfulness score. This type of mindfulness tends to be narrow-focused attention that excludes irrelevant stimuli rather than open and receptive awareness that constantly takes in various stimuli entering into consciousness.

The understanding of mindfulness as being focused present-moment awareness on current activities also seems to have led to the view that engagement in more than one task at a time is an indicator of lack of mindfulness. The multi-tasking item of the KIMS (item 31: “I tend to do several things at once rather than focusing on one thing at a time”) was designed to measure divided attention (Baer et al. 2004). This item needs to be reverse scored such that lower scores in the item contribute to a higher score on the act with awareness sub-scale. However, some participants in the present study disagreed that multi-tasking per se indicates the absence of mindfulness. A divided attention task involves attentional engagement with two or more simultaneous messages (Matlin 2009) as opposed to full engagement in one’s current activity with undivided attention focusing on one thing at a time (Baer et al. 2004). Some of the examples that Brown and Ryan (2003) used to illustrate mindfulness include eating while being aware of the feeling in one’s stomach, and having a conversation with a friend while being aware of the emotional tone. However, Brown and Ryan (2003) presented these examples to illustrate how mindfulness can enhance attention to current experience and they did not consider these as instances of divided attention or multi-tasking. Brown and Ryan (2003) seemed more concerned with distraction from focusing on the present moment. Thus, multi-tasking is not an indicator of absentmindedness if the individual engages mindfully in the multiple tasks that they have committed themselves to. It is therefore important to distinguish between deliberate engagement in multiple tasks from distractive multi-tasking (Calderwood et al. 2014).

Just as multi-tasking per se is not an indicator of absentmindedness, the participants also discussed how fully focused attention is not necessarily an indicator of mindfulness—at least as they understood it. Instead, the discussion centered on the importance of appropriate shifting between narrow-focused and broad awareness. Here, the participants clarified that mindfulness in Buddhism is characterized by skillful and purposeful shifting of attention in order to be able to respond appropriately to one’s current situation. While the psychological literature on mindfulness makes frequent reference to attention-regulation and monitoring of one’s stream of consciousness, these are typically either in the context of meditation or primarily about maintaining focus on the present moment (Bishop et al. 2004). With that understanding, items from the observing sub-scales of the KIMS and FFMQ are considered indicators of mindfulness (e.g., KIMS item 25 and FFMQ item 20 “I pay attention to sounds, such as clocks ticking, birds chirping, or cars passing”). The Buddhist participants of the current study, however, generally raised concerns about all the observing items of the FFMQ and 11 of the 12 observing items of the KIMS. According to the participants, the object of observing should be consistent with the purpose of observing. Since the purpose is not indicated in the observing items, the object designed for the items cannot be identified as proper objects to be observed.

As participants in the present study stressed, Buddhist practices are to develop wholesome qualities and overcome unwholesome qualities. These objectives make mindfulness practice purposeful, both in relation to short-term goals, such as dealing with a certain unwholesome quality, but also in respect of long-term goals (Thanissaro Bhikkhu 2012). One participant explicitly pointed out that mindfulness bears life goals in mind. In the Sikkha Sutta (Thanissaro Bhikkhu 2012), purposeful mindfulness in terms of long-term goals is described as a governing principle in the way that one clearly knows what should be accomplished in the future. As another participant commented, mindfulness involves recollecting the past, considering the present, and contemplating the future. Buddhist mindfulness thus involves an element of prospective memory (Wallace 2008), namely remembering to perform a planned action or intention at some future point in time (McDaniel and Einstein 2007).

The psychological literature on mindfulness on the other hand tends to emphasize present-centered awareness, and being in the present moment is a common phrase used to describe mindfulness practice (Bishop et al. 2004; Kabat-Zinn 2013). The present is said to be of utmost importance because “it is the only time that any of us ever has” (Kabat-Zinn 2013, p.16), and the goal of mindfulness practice is “simply to experience what is present from moment to moment” (Kabat-Zinn 1996, p.163). This focus on the present moment, however, is starting to attract increasing criticism. Purser (2015), for example, pointed out that psychology’s emphasis on being in the present moment primarily serves the purpose of symptom reduction of therapeutic mindfulness. While it is a useful therapeutic tool to deal with excessive worry and rumination to alleviate suffering of patients, equating it to mindfulness neglects the broader spiritual and meaning-making aspects of Buddhist mindfulness practice. Purser also argued that time is dynamic, and that the present moment is only meaningful due to its causal link to past and future. In addition, Christopher et al. (2014) identified that intention to return awareness to present moment is missing from the FFMQ and TMS. Intention was said to be an essential factor in Buddhist mindfulness practice that is linked to the construct of remembering in Buddhism.

Cultivation of Wisdom and Ethics

In Buddhism, right mindfulness works in conjunction with the other seven factors of the Noble Eight-fold Path (Gethin 1998). This includes the development of Buddhist insight and wisdom. As raised by the participants of the present study, mindfulness practice in Buddhism involves deep inquiry, discernment, and reasoning, as well as challenging perceptions and judgments for a deeper understanding of phenomena. While the theme of profound mindfulness indicates that the wisdom dimension of mindfulness is not adequately captured in measures of mindfulness, this seems to apply less, however, when making comparisons with the theoretical conceptualization of mindfulness in the psychological literature. As Bishop et al. (2004) acknowledged, part of mindfulness involves gaining insight into the processes of one’s mind. Kabat-Zinn (1994) stated that mindfulness involves a thorough examination of ourselves including questioning who we are and what our place in the world may be. He also explicitly argued that MBSR includes a wisdom dimension of mindfulness that discerns and understands the differences and relationships between various objects of observation (Kabat-Zinn 1996). In DBT, there are three sets of mindfulness skills, and wise mind is a critical one described as finding the inherent wisdom that everybody has within themselves (Linehan 2015).

Even though the KIMS was based on mindfulness skills in DBT (Baer et al. 2004), the concept of wise mind was not included. Among the questionnaires used in the current study, only the FMI-30 has a factor related to wisdom, namely process-oriented insightful understanding. Examples are item 15 “I consider things from different perspectives” and item 14 “I am aware how brief and fleeting my experiences are” (Buchheld et al. 2001). All items of the process-oriented insightful understanding factor were consistently rated as relevant by all participants of the present study. This is consistent with the notion that insightful understanding is a characteristic of Buddhist mindfulness. Most recently, Christopher et al. (2014) identified that the awareness of suffering and aversion facet of Buddhist mindfulness was missing from the FFMQ and the TMS. Participants in that study commented that the insight of suffering was important in Buddhism and could be measured through items of awareness of aversion to unpleasant experiences.

In Buddhism, wisdom also plays a role in evaluating and judging events and behavior, which Dreyfus (2011) described as wise mindfulness. This was also reported by the participants of the present study in the theme wise judging according to which judgments are rooted in wisdom and are thus different from egocentric subjective judgments. The Pali word pañña is often translated as wisdom although it also captures elements of discernment of events and actions as well as how these are causally connected (Thanissaro Bhikkhu 2013). Buddhist practitioners thus direct discernment toward intentional action by determining whether these may be skilful or unskillful, whereby such discernment itself will eventually become an intentional action. Psychology, in contrast, frequently discusses mindfulness as non-judgmental awareness, which is also a core element of MBIs (Kabat-Zinn 1994; Segal et al. 2002). Kabat-Zinn (2013), for example, linked stress to a restless mind that makes judgments constantly based on personal likes and dislikes. In MBSR, course participants are encouraged to suspend judgments, not to react to judgments and opinions, but to observe and acknowledge them instead. Similar advice is typically given in DBT (Linehan 2015). Since some of the mindfulness questionnaires were developed specifically to evaluate the effects of such psychological interventions, it is not surprising that items referring to non-judgmental awareness were included. However, as Brown et al. (2007) cautioned, non-judging reflects an attitude toward perceptions and experience that is to be fostered in the context of clinical settings and should not be regarded as a theoretical understanding of mindfulness more broadly. They described mindfulness as non-conceptual, non-discriminative, and non-discursive and without involving comparisons, categorizations, and evaluation. Brown et al. (2007) equated mindfulness with bare attention, and the mindful mode of processing is said to prolong the initial fleeting moment when the mind contacts the world before concepts are being formed.

The focus on non-judgmental awareness in psychological interventions and the concomitant psychological literature is to some degree reflective of the origins of MBIs. Modern forms of Buddhism, particularly the vipassanā movement (Samuel 2015), played a substantial role in the development of MBIs. The most influential vipassanā or insight meditation school is linked to the teachings of the Burmese monk Mahāsi Sayadaw and the Satipaṭṭhāna Sutta (Mahāsi Sayādaw 1990). In particular, the beginner’s exercises of this approach focus on present-moment awareness (Mahāsi Sayādaw 1990; Gilpin 2008). According to this insight approach, the goal is to learn to perceive things as they really are, unaffected by preconceived ideas based on experience and expectations (Nyanaponika 1989). Much of these teachings on bare attention entered the West through the German-born Theravada monk Nyanaponika Thera (Bodhi 2011) who spent a period of time training under Mahāsi Sayādaw. Other scholars and teachers continued the dissemination of Buddhist teachings to the West by introducing mindfulness in the context of bare attention and nonjudgmental awareness (Gethin 2011).

As Bodhi (2011) argued, bare attention is only one of numerous ways to teach and practice mindfulness, and such teaching instructions should therefore not be taken as a theoretical definition of the concept. In some of the major Buddhist traditions, bare attention is not even practiced (Dorjee 2010). Instead, what unifies Buddhist mindfulness practice is the cultivation of wholesome qualities (Dorjee 2010), which does include elements of evaluation. Buddhism frequently distinguishes explicitly between mindfulness practice during dedicated meditation time and practice while engaging in everyday life affairs. So, while a non-discriminating mind is the aim in meditation practice, Buddhist practice outside these times involves being attentive to actions and mind states in order to cultivate wholesome actions and avoid unwholesome actions (Chwasan 2012). The latter situation may be suitably described by the term heedfulness (Sanskrit: apramāda, Pali: appamāda), which Lomas and Jnanavaca (2015) defined as “being aware of one’s actions in the light of…ethical guidelines, i.e. reflecting on the extent to which one’s actions are in accordance or otherwise with these recommendation” (p. 302).

The theme of ethical and compassionate mindfulness that emerged in the present study echoes comments that have been increasingly raised in recent academic debates (Monteiro et al. 2015). Participants explicitly state that Buddhist mindfulness contains awareness of the ethical implications and consequences of one’s actions, whether from moment to moment or in general and as applied to both narrow- and broad-focused awareness. Mindfulness as presence of mind cultivated through meditation enables one to be aware of one’s intentions and motives. This helps practitioners to develop awareness of the impact of their own actions on themselves and others, and in turn to make ethical choices (Thanissaro Bhikkhu 2010). Buddhist mindfulness also helps to develop healthy judgment by remembering lessons learnt from past mistakes (Thanissaro Bhikkhu 2010). Buddhist mindfulness therefore is not ethically neutral and it is conducted in conjunction with precepts. The presence of an attentive factor only is not necessarily Buddhist mindfulness, as indicated by the bank robber example. Rather, Buddhist mindfulness is sammā-sati, right mindfulness, which contains the elements of ethics and wisdom (Bodhi 2011). MBIs, in contrast, are generally secular and do not refer to any specific behavioral guidelines or precepts (Cullen 2011). However, without following some moral guidelines to prevent the mind from entertaining regrets and remorse due to moral transgressions, meditation and mindfulness practitioners will find it difficult to calm their minds (Bodhi 2006). It also seems likely that mindfulness is more beneficial when it is aligned with personal values and beliefs, and this alignment may happen naturally even in the absence of explicit references to ethics (Krägeloh 2016). However, more research is necessary to investigate the role of ethics and morality in the context of mindfulness practice. In any case, references to ethical dimensions of mindfulness are currently missing from questionnaires, as clearly identified by the participants of the present study.

In relation to mindfulness and ethics, the participants also commented on the general lack of mindfulness questionnaire items concerning awareness of others. This concern was also raised by participants in the study by Christopher et al. (2014). They noticed that both the FFMQ and the TMS focused on self whereas Buddhist mindfulness practice involves compassion to others and goes beyond self. Of the four scales employed in the current study, only the FMI-30 has a factor of nonjudgmental, nonevaluative attitude toward self and others, which is described by the authors to involve being patient, tolerant, and open to one’s own and other people’s experiences. However, within this factor, there is only one item that explicitly mentions other people (item 29: “I am impatient with myself and with others”), and even then not exclusively as it is also referring to self. Such focus on self again may be a reflection of the use of such scales to evaluate the effects of MBIs. Program participants particularly those who suffer from anxiety and depression may benefit from self-compassion as it allows them to counter self-criticism and judgment with kindness to oneself (Birnie et al. 2010). Baer et al. (2012) noted that the difference between self-compassion and mindfulness is that all experiences are objects of mindfulness whereas self-compassion concerns suffering and pain. Since MBIs often deal with psychological symptoms of patients, self-compassion ought to overlap more with mindfulness in the context of interventions than in other contexts. However, as Neff (2003) explained the concept of self-compassion in the context of mindfulness practice is ultimately based on Buddhist philosophy and should not be taken as having connotations of self-centeredness. Within the practice of self-compassion is the understanding of interconnectedness and common humanity that allows a practitioner to see their experiences as part of the larger human experience and that all beings are worthy of compassion. Thus, while the rationale for including questionnaire items on self-compassion is not per se incongruent with Buddhist philosophy and understanding of mindfulness, such focus on self could be misunderstood by respondents who are not familiar with the context of MBI teachings.

Relevance of Items and Factors in Mindfulness Scales

The theme of subtlety and effort in mindfulness indicates that the appropriateness of item wording depends on the respondent’s stage of practice. Some items of the current mindfulness questionnaires such as “I intentionally stay aware of my feelings” (KIMS item 30 of the observing sub-scale) were considered not applicable to advanced Buddhist practitioners whose mindfulness is seen as more effortless and spontaneous. Classic Buddhist literature on meditation also acknowledges that more effort is needed at the beginning stages to sustain attention on the chosen object of meditation (Wallace 2006). Additionally, the objects of meditation increasingly change from gross level of body such as sensations at the beginning stages to more subtle mental experiences and even awareness itself at advanced stages. The items of the current questionnaires that describe mindfulness practice with gross objects (e.g., KIMS item 9/FFMQ item 1: “When I’m walking, I deliberately notice the sensations of my body moving”) thus appear more suitable for beginning practitioners.

A similar concern was raised in Christopher et al. (2014). Their participants suggested that the TMS was associated with basic mindfulness practices and thus less suitable for advanced practitioners. However, Christopher et al. (2014) identified that many of the items in the observing factor of the FFMQ are appropriate for measuring mindfulness. The mixed results about the observing items could be due to the fact that participants in Christopher et al. (2014) assessed the FFMQ against their own levels of practice, whereas participants in the current study evaluated the items for an ideal Buddhist. For such hypotheses about differential item functioning by sample sub-groups, Rasch analysis is a particularly suitable method. A recent Rasch analysis (Medvedev et al. 2016b) of the KIMS, however, did not find any issues with items of the observing sub-scale in a sample of university students, although results may have been different in a sample of Buddhist practitioners. The different finding could also be due to the fact that Christopher et al. (2014) had a sample of Zen practitioners only—a limitation they acknowledged. As mentioned earlier, the FFMQ items were derived from several mindfulness questionnaires including the KIMS (Baer et al. 2006). All the observing items of the FFMQ are from the KIMS (Baer et al. 2006). Since the KIMS was developed based on mindfulness skills in DBT, which drew some inspiration from Zen (Linehan 2015), the Zen participants in Christopher et al. (2014) could have been more likely to endorse the observing items than participants from other traditions.

Other studies have found evidence that the observing factor seems to be an indicator of mindfulness only for individuals with meditation experience. Baer et al. (2004) suggested that observing items may function normally in meditators. This hypothesis was tested and confirmed in their study of validating the FFMQ in meditating and non-meditating samples (Baer et al. 2008). In contrast to the small non-significant positive correlations between the observing factor and psychological well-being in two non-meditating samples, the observing factor was positively correlated with psychological well-being in a meditator sample. Van Dam et al. (2009) investigated differential item functioning of the FFMQ and the results again supported that items of the observing factor of the FFMQ functioned differently in meditators and non-meditators. Thus, noticing and observing are intended to be a characteristic of mindfulness and found to be related to health and well-being in meditators. Such behaviors could also be indicators of absentmindedness as indicated by the correlation with absentmindedness (Baer et al. 2006) or unhealthy rumination (Hansen et al. 2009). The issue may be related to the particular purpose of observing, which is not made clear in any of the items. While almost none of the observing items of the KIMS and FFMQ were clearly endorsed by participants as reflecting mindfulness, the participants did not comment that observing itself was irrelevant to Buddhist mindfulness. As the theme of purposeful mindfulness suggested, participants were more concerned about the context and purpose of the observing items instead of observing itself. Their comments suggest that the object of observation should be suitable for the situation and matches the goal of observation.

Some studies have also reported unexpected results for the act with awareness subscale of the FFMQ and the mind/body awareness subscale of the FMI-30. For instance, Baer et al. (2008) reported that the act with awareness subscale of the FFMQ had no significant correlation with meditation experience. Leigh et al. (2005) tested the validity of the FMI-30, and three factors including mind/body awareness were extracted from factor analysis. They then tested the relationship between mindfulness and substance use, and the results showed that frequent binge-drinkers and smokers had higher scores on the mind/body awareness factor than non-drinkers and non-smokers, respectively. As mentioned previously, the FMI-30 was designed explicitly based on Buddhist insight meditation and is suitable for people with meditation experience only (Buchheld et al. 2001). The results indicated that heightened awareness could have resulted from mindful observing, or enhanced by harmful habits. Therefore, heightened awareness may not necessarily be beneficial, unless it is developed through wholesome means with wholesome purposes.

The results of Christopher et al. (2014) suggested that the describing factor of the FFMQ was problematic. This finding is supported by the current study. Based on the participants’ comments and ratings, the describing factor of the KIMS and FFMQ can be considered irrelevant to Buddhist understandings of mindfulness. Items referring to describing were designed for the KIMS based on DBT mindfulness skills (Baer et al. 2004). Item 6, for example, states: “I can easily put my beliefs, opinions, and expectations into words.” The participants of the current study explicitly pointed out that mindfulness concerned nothing about the ability of describing, and some enlightened teachers may not be very eloquent. One of the very few links of describing to a Buddhist perspective was provided from Joseph Goldstein, a prominent Buddhist meditation teacher in the United States who has connections with the Mahāsi Sayādaw lineage of Burmese insight meditation (Wilson 2014). Both Goldstein (2002) and Mahāsi Sayādaw (1990) made references to the technique of labeling what happens in the present moment, such as rising and falling of one’s abdomen as a result of breathing. However, Mahāsi Sayādaw’s instructions were not to be taken as literal verbal repetition of words but only a device for becoming aware of these processes (Gethin 2014). Goldstein (2002) stated that the labeling technique is useful at the beginning of the practice to stabilize attention and maintain awareness, but when practice deepens, mental labeling is said to give away to bare awareness of the experience. The participants in the present study were fairly consistent in their perception about the irrelevance of the describing factor to Buddhist practice, indicating that the indirect references to any meditation or mindfulness techniques did not seem obvious to them.

The final cluster of items that were considered by the participants as ambiguous or incongruent with Buddhist mindfulness was those items pertaining to acceptance. Acceptance is related to the non-judging characteristics of mindfulness. It is frequently incorporated into the definitions of mindfulness (Bishop et al. 2004; Siegel et al. 2009) or even often used interchangeably with mindfulness (Block-Lerner et al. 2005; Siegel et al. 2009). Siegel et al. (2009) acknowledged that, while acceptance is only implied in Buddhist teachings, it is explicitly incorporated into MBIs in order to help patients face difficult experiences. Chiesa and Malinowski (2011) reviewed MBIs and Buddhist mindfulness meditations and concluded that acceptance as emphasized in MBIs is not part of Buddhist mindfulness meditation. As participants in the present study explicitly pointed out, acceptance especially accepting self (e.g., item 19 of FMI-30) was not Buddhist mindfulness. If one’s thoughts and actions were foolish and self-indulgent, acceptance would not be beneficial to one’s moral development. Additionally, the most important thing in establishing Buddhist mindfulness is not accepting unpleasant experiences but to understand them (Thanissaro Bhikkhu 2010).

Of the four mindfulness scales rated by the participants in the present study, the MAAS had the lowest percentage of items rated as incongruent with Buddhist understandings of mindfulness, closely followed by the FMI-30. Both the MAAS and the FMI-30 also had better inter-rater reliability indicated by Gwet’s AC1 values compared to the KIMS and the FFMQ. However, it is important to stress that this only means that the MAAS and the FMI-30 contain fewer irrelevant items to Buddhist mindfulness practice and not that they provide a complete assessment of mindfulness in Buddhist contexts. As the preceding discussion revealed, ethics and wisdom are missing from the MAAS and FMI-30 as much as from the KIMS and FFMQ. While one could conclude that it is timely to develop a Buddhist mindfulness scale that includes these elements, such a scale would only have applicability in limited contexts, and an opportunity would be missed to try to understand the role of these concepts in non-religious mindfulness practice. While secularization of mindfulness practice has the advantage that it is inclusive of individuals, irrespective of their personal, spiritual, and religious beliefs, there is the risk that lack of explicit coverage of ethics and morality leaves the MBI participant to work out their own unguided way in which to integrate mindfulness practice with their personal philosophies and worldviews (Krägeloh 2016).

As a result of its long history, Buddhism amassed a large vocabulary to express subtleties and nuances of Buddhist practice (Shonin et al. 2015). Since the steep rise in popularity of MBIs since the late 1970s, psychology is arguably still in the process of developing its systematic scientific vocabulary (Schmidt 2011). The same term mindfulness is thus still used when referring to state, trait, skill, and technique, which somewhat hinders progress in achieving conceptual clarity. Additionally, there is no consensus on a suitable scope of definition of mindfulness. Brown et al. (2007) criticized the clinical approach of Baer et al. (2004) for conceptualizing mindfulness through mindfulness skills and argued that the observing factor in the KIMS and the FFMQ is a skill to cultivate mindfulness rather than an aspect of mindfulness itself. Similarly, Brown and Ryan (2004) argued that wisdom, compassion, and acceptance are qualities developed as a result of mindfulness rather than being elements that need to be included in mindfulness measures. Future work is necessary to investigate whether such characteristics are indeed separate (albeit related) constructs and thus redundant to include in the assessment and theoretical conceptualization of mindfulness.

Limitations

The following limitations need to be acknowledged. Firstly, the present study asked participants to provide questionnaire ratings of an ideal Buddhist in their tradition. The intention of this procedure was to provide a novel approach in mindfulness research that investigates mindfulness practitioners’ aspirations as opposed to achievements (Grossman and Van Dam 2011). Even though this purpose was explained to the participants, the specific idealized Buddhist that the participants chose would have represented to varying degrees a mixture of an actual person or abstracted teachings. While we cannot claim complete representation of all Buddhist schools in our small sample, the focus of the present analyses on commonalities in perceptions across participants is likely to have mitigated such bias and thus revealed themes that appear common to Buddhism in general. Our small sample size did not enable us to explore whether some of the items in the mindfulness questionnaires may be interpreted differently by Buddhist practitioners from various schools or with different levels of familiarity with concepts from insight meditation that some of the items may tap into. Future research could explore this possibility.

Changes in respondents’ interpretations of items with increased experience are known in the literature as response shift, which is likely to affect mindfulness questionnaires as much as other kinds of subjective rating scales (Sauer et al. 2013). Significant new experiences such as completion of a mindfulness course and having been introduced to relevant jargon is likely going to affect how mindfulness questionnaire items are understood. However, while there is evidence that individuals not familiar with meditation and mindfulness may interpret some questions of the FMI very differently to those with meditation experience, it seems that differences among meditators are less noticeable (Belzer et al. 2013). The presence of response shift raises the fundamental question whether mindfulness questionnaires are even suitable to use for those unfamiliar with the practice (Belzer et al. 2013), but future research may also attempt to explore response shift in mindfulness questionnaires using retrospective techniques specifically designed for that purpose, such as the then-test procedure (Finkelstein et al. 2014).

It is needless to say that response shift will equally be present in Buddhist as in secular mindfulness practitioners. As the theme purposeful mindfulness of the present study indicated, mindfulness according to Buddhist practitioners involves remembering the purpose and trajectory of one’s life. Purposeful mindfulness and continually cultivating a purpose are therefore dynamically related, and changes in personal standards may even be a sign of progress. Thus, while response shift poses challenges for measurement, awareness of the phenomenon opens new approaches of using psychometric instruments such as tools to generate discussion about progress and goals as opposed to comparison of pre- and post-intervention scores only (Krägeloh et al. 2015).

The sample size also limits any interpretations of the quantitative questionnaire ratings by the participants. As outlined in the method section, the ratings served primarily as a stimulus for the qualitative interviews, and the quantitative data were only interpreted in conjunction with relevant qualitative data. A very conservative criterion was applied to determine degree of consensus among the participants about the relevance of each questionnaire item to their practice. This may have led to underestimation of number of items that were judged as relevant to Buddhist practice. A future quantitative study may wish to provide similar data with a larger sample, which may include investigations of differences across Buddhist traditions or even with secular mindfulness experts. Additionally, instead of asking participants to rate an ideal Buddhist, alternative methods could be explored to assess participants’ aspirations. This could include the use of importance ratings as is common in the development of health-related quality of life questionnaires (Krägeloh et al. 2016) or investigation of how much practitioners value specific behaviors (Grossman 2011).

The rationale of this study was informed by conceptual literature that highlighted differences between Buddhist and secular understandings of mindfulness. However, to minimize the possibility that the researchers’ previous knowledge of the differences highlighted in the scholarly literature may have biased the results, we ensured that the interviews did not prompt the participants in any particular way. Instead, we used to questionnaire items as stimuli to elicit responses from the participants. Any remaining potential for biases in interpretation of the data were minimized by discussion of the results among the research team who had varying degrees of familiarity with Buddhist literature. Nevertheless, an implicit assumption of this procedure is that the items in the mindfulness questionnaires are an accurate reflection of how mindfulness is defined in psychology. Even if there was consensus among mindfulness experts and Buddhist scholars on definitions of mindfulness, the challenges in translating concepts of mindfulness into actual questionnaire items remain (Grossman 2008, 2011).