A lot of concerns have been voiced lately about the possible harmful effects of meditation practice. The pendulum is swinging back against the story that mindfulness is universally beneficial, and researchers are increasingly cautioning us to look honestly at the cases where people have suffered significant psychological stress and even trauma when engaging in rigorous meditation practice. I would like to push back a little against this pushback, arguing that an important distinction is to be made between means and ends.

It is to be expected that serious psychological transformation involves some level of discomfort and difficulty. Indeed, learning how to tolerate exposure to discomfort and gaining the ability to confront and overcome difficulty has a lot to do with what makes a person grow in new ways. The knack is to know how much of this is healthy, even if painful, and at what point it may become unhealthy. The Buddha offers the analogy of a physician healing a wound—much pain is involved with its cleaning, probing, and bandaging, but all this is necessary to the healing process. No Buddhist would want to see people suffer, however, and in situations of real psychological harm intensive meditation is clearly contraindicated.

It is useful to distinguish between mindfulness as a mental state on one hand and the unskillful pursuit of this state on the other. Consider the case of a person plunging into the jungle, in search of a beautiful and healing flower, he gets torn up by thorns and battered by branches in the process. The problem is not that the flower itself is harmful; what is harmful is only the means of pursuing it. A similar confusion exists when researchers (or media reports of research) say “Mindfulness can be harmful” when what they really mean is something like “Going into prolonged situations of silence and isolation, with unrealistic or uninformed expectations, under the inadequate guidance of an unsuitable teacher, when one has a history of psychological fragility, can be harmful.”

Mindfulness is a sankhara, a mental/emotional/behavioral state that arises and passes away in a moment in conjunction with consciousness and other functions such as feeling and perception. Co-arising with such factors as trust, equanimity, nonattachment, and lovingkindness, it is an inherently healthy state. Mindfulness itself is always healing and never harmful; mindfulness meditation is the practice of cultivating this benevolent quality of mind, moment after moment.

There are many other sankharas arising in the mind that are not healthy, not helpful, and not skillful. These “flavor” consciousness with states such as anger, fear, hatred, cruelty, restlessness, delusion, greed, and other afflictive emotions. When this happens we are suffering, and it is this very suffering that the entire Buddhist path is intended to heal.

Meditation alone, understood as the training of attention to focus upon a chosen object and holding it there over multiple mind-moments, whether on a fixed target as in concentration practices or a moving target with insight practices, can create the conditions for healthy or unhealthy mind states to occur.

The critical question becomes one of skillful means. What are the best ways to use attention training to abandon unhealthy states and cultivate healthy states? For some people, going into a retreat environment of sustained silence provides a wonderfully supportive setting for this. For others, these are exactly the wrong conditions, and such an environment has the opposite effect. There are even those of us for whom it starts out one way, winds up the other, or fluctuates, often between being the best and worst of worlds. But when things go wrong, it is not because of mindfulness; rather, it is due to the lack of mindfulness.

Here is a simple four-part model that can help clarify the course of meditation training, derived from the Abhidhamma:

Wandering Mind

The mind in its natural state is uncontrolled and free to wander. Its wanderings are never random; they follow a path blazed by bodily sensations, sensory cues, and internal habits that are largely outside our conscious awareness. Also known as the default mode, this describes our mind as we walk down the street, notice things that move or make a sound, reflexively step around obstacles, and generally daydream about the past and future.

Focused Mind

Here we decide to meditate and so sit down on a cushion with our backs straight, deliberately place our attention on a particular object, and try to hold it there with steadiness. We may repeat a word internally, focus on bodily sensations as we breathe, or in some other way harness the mind and direct it consciously and intentionally. Of course it will still wander off the chosen point, but when this happens we notice it, let go of wherever we were headed, and gently return attention to the primary object, repeating as necessary.

Afflicted Mind

Quite often, even when the mind is successfully focused on a single object, various unpleasant and disturbing emotional states will manifest. Perhaps it is some form of restlessness, agitation, or turmoil; or a subtle or intense yearning for gratification; or annoyance at a sound, a recurring thought, or an uncomfortable bodily pain. These afflictions can be minor incidents to be explored with interest and then abandoned, or they can flare up, grab hold of the mind, and rage out of control to inflict real suffering and even cause mental harm.

Mindful Mind

At other times when the mind is focused, an emotional attitude of mindful equanimity arises. In these cases the awareness feels soft, tranquil, trusting, and gentle, and at the same time light, agile, alert, capable, and clear. Evenly “poised in the middle” (a translation of the wonderful word tatramajjhattata) between attraction and aversion, it is able to regard anything under its view with profound equanimity, neither favoring nor opposing what is happening in the moment. With mindfulness thus established, the mind is capable of gaining insight and can begin to see things as they actually are.

Recognizing that a wandering mind can easily get entangled with suffering and cause harm to ourselves and others, we undertake the training of a focused mind. What we see as we look inward with growing stability and clarity is an afflicted mind, besieged by all sorts of unhelpful mental states. The appropriate strategy here is to notice them, understand that they are harmful, and abandon (not suppress!) them. We access a mindful mind only occasionally and fleetingly at first, but eventually the afflictions diminish in frequency and intensity and mindfulness becomes established.

When in this process we get lost in the wilderness of afflictive emotions, by all means let’s find skillful remedies to extricate ourselves from the difficulty and get back on track. But let’s also understand that the flower of mindfulness is never the cause of these difficulties but remains their best solution.