Research Method
TEACHING CALM ABIDING
MEDITATION TO MENTAL HEALTH
WORKERS: A DESCRIPTIVE ACCOUNT
OF VALUING SUBJECTIVITY
Sharn Rocco, Shaun Dempsey and David Hartman
Teaching an eight-week calm abiding meditation course to staff in a Child and Youth
Mental Health Service located in a regional Australian city presented a curious meeting
of Buddhism with Western culture. This meeting highlighted both the potential benefits
and challenges of teaching meditation in the workplace and the value of qualitative
methods for contributing to the development of meditation research. The thematic
analysis of weekly participant responses to emailed reflective questions and follow-up
interviews indicated that workplace meditation training can precipitate sustainable
changes in attitudes and behaviour beyond the workplace. Participants reported being
less reactive and better able to manage emotions, having heightened self-awareness,
self-acceptance and acceptance of others and of circumstances; and, in the longer term,
were better able to make healthier lifestyle choices. The analysis is contextualized by a
rich description of the course and salient concerns and conditions evident in
contemporary Buddhist teachings and studies of mindfulness meditation.
Introduction
The Child and Youth Mental Health Service (CYMHS) in which this study was
conducted is a multi-disciplinary assessment and treatment service that takes
urgent and routine referrals from primary health care services and from schools.
Workers need to engage empathically with children and teenagers who have
experienced varying degrees of distress, abuse and neglect. Specialist teams work
with abused children within Child Protection services, and with young offenders in
the local Youth Detention centre. An administration team represents the front-line
of service delivery for children, adolescents and families experiencing a high level
of distress. Families are often in a state of crisis and workers have to intervene in
situations characterized by high levels of family conflict, where different family
members may have widely differing and conflicting expectations of service
delivery. This work can be enjoyable and rewarding while also demanding a high
Contemporary Buddhism, Vol. 13, No. 2, November 2012 ISSN 1463-9947 print/1476-7953 online/12/020193-211
q 2012 Taylor & Francis http://dx.doi.org/10.1080/14639947.2012.716707
level of self-control that according to Schmidt and Neubach (2007) accrues
physical and psychological costs.
There is a rapidly growing body of literature that supports the teaching of
meditation in secular settings as a strategy for reducing stress, improving emotion
regulation and enhancing health and wellbeing. Typically, this literature refers to
meditation as mindfulness, mindfulness training, mindfulness meditation or
mindfulness practice and describes both meditation and mindfulness as forms of
attentional training or focused awareness that can be cultivated with practice and
which are associated with heightened psychological, psychosocial and physical
wellbeing (Brown and Ryan 2003; Chambers, Gullone, and Allen 2009; Hayes and
Wilson 2003; Kostanski and Hassed 2008; Shapiro et al. 2005). The most commonly
implemented and studied meditation course offered in healthcare settings appears
to be Mindfulness Based Stress Reduction (MBSR). Healthcare professionals
attending workplace MBSR training have reported that they more often
experienced feelings of confidence, competence and enjoyment at work and
became more present with their patients (Cohen-Katz et al. 2004). In a randomized
trial in which qualitative and quantitative data were collected to examine the
effects of MBSR on job burnout and psychological distress among health
professionals doing clinical work, Shapiro et al. (2005) found significant decrease in
perceived stress and greater self-compassion among participants who also
reported significant positive impact on their lives beyond the workplace. Baer
(2011, 242) points out that interventions such as MBSR and mindfulness-based
cognitive behaviour therapy (MBCT) ‘produce clinically significant improvements
for people suffering from many important problems, including depression, anxiety,
pain and stress’. Within this emerging body of literature is a call for further research
(Brown and Ryan 2003; Kostanski and Hassed 2008; Langer and Moldeoveanu
2000). This paper, in small part, answers that call and addresses Bruce and Davies’
concern that ‘empirical investigation into mindfulness meditation is dominated
almost exclusively by quantitative research designs using Western theoretical
frameworks’ (2005, 1332).
The small-scale qualitative study described below was initiated by David
Hartman, Clinical Director of the CYMHS who had been feeling that staff, including
himself, were increasingly stressed by the demands of the job. A serendipitous
encounter with a colleague engaged in a project investigating the effects of
teaching meditation in Catholic schools (Campion and Rocco 2009) prompted him
to reflect on his experience of practising Buddhist meditation as a young doctor in
the UK. He was also interested in the increasing number of research articles reporting
the therapeutic effects of meditation and the congruent therapies adopting explicit
mindfulness techniques. After several meetings, David invited Sharn, to teach and
evaluate the calm abiding meditation course at the CYMHS. The first entry in the
journal David kept from inception to completion of the course commented,
I was looking forward to the course . . . I hoped it would help a couple of
colleagues who were showing marked levels of stress and unhappiness. . . .
194 S. ROCCO ET AL.
More generally I was hoping that the course would . . . contribute to the sense
of this being a good team to work in, where staff are looked after and valued,
and where innovative practices are embraced.
The decision to implement training in a traditional Buddhist meditation
practice was informed by three factors. First and most importantly, although Sharn
had attended meditation teachings and retreats with teachers from various
traditions and cultures—Thai and Sri Lankan Theravada, Vietnamese and Pacific
Zen, Goenka Vipassana, Nyingma and Drukpa lineages of Tibet—her training and
experience as a meditation teacher is in the technique of calm abiding meditation.
She received this training within the Sakya lineage of Tibetan Buddhism where,
even though it retains evidently Buddhist imagery and psychology, this particular
meditation technique was described as a secular practice (Choedak 2002a, 2002b;
Dalai Lama 2002). Second, Shapiro, Schwartz and Bonner (1998) reported that
spirituality can enhance psychological and physical wellbeing and emotional
resilience. Third, a literature search conducted by the authors revealed an absence
of literature describing this particular technique in previous studies of the
perceived subjective effects of meditation practice. This presented an opportunity
to contribute new data to the field which to date is dominated by early studies
designed to measure the effects of Transcendental Meditation (TM) and more
recent studies focussed on MBSR (Kabat-Zinn 2011).
As much of the recent literature on application of meditation in work
and clinical environments is related to MBSR, it is worth commenting on the
relationship between mindfulness meditation and calm abiding meditation, and
the relationship between mindfulness and concentration. Calm abiding meditation
is śamatha (shamatha) or concentration meditation focussed on incremental
development of sustained mindfulness of body, feeling and thoughts. Mindfulness
is described by Thich Nhat Hahn (2008, 6) as ‘our ability to be aware of what’s going
on both inside us and around us . . . the continuous awareness of our bodies,
emotions and thoughts.’ Mindfulness meditation is usually understood as separate
from concentration meditation but without concentration, mindfulness is not
possible. Trungpa (1995) addresses this interrelatedness of concentration and
mindfulness cautioning that ‘ . . . concentration is a dangerous word to use in
connection with the practice of meditation. Instead we refer to this practice as
mindfulness.’ (1995, 71–72). Calm abiding meditation incorporates a suite of
techniques for concentrating the mind during formal sitting meditation practice
that accrue benefits in the form of heightened mindfulness in meditation and in
daily life. The suite of techniques incorporated in the calm abiding meditation
practice, learned and taught in this instance as an intensive eight-week course,
leaves little room for even the busiest mind to stray without notice. It incorporates
and integrates recitation, visualization, and awareness of posture, breath and
thoughts into the practice of sitting meditation. There is much for the student to
attend to. Participants were encouraged to take this mindful awareness into their
daily life, to notice how they use time, what distracts and distresses them, and to
TEACHING CALM ABIDING MEDITATION TO MENTAL HEALTH WORKERS 195
contemplate how busyness can be a form of laziness—keeping us from things that
would be more beneficial to ourselves and others, including meditating. After the
fourth class, David reflected:
I have realised that the eight-week course is really a whole lifetime’s worth of
meditation technique compressed into two months. There is enough in even
one lesson to build on and refine for many years to come.
The calm abiding meditation course taught at the CYMHS followed the curriculum
articulated by Lama Choedak based on the teachings received by him as a student
of Sakya Lineage holder, Chogye Trichen Rinpoche. It differs from the eight week
MBSR curriculum in two distinct ways: recognition and inclusion of traditional
Buddhist practices, and the structure, content and pedagogy of weekly classes.
Although originating from, and inspired by, Buddhist meditation practices, the
MBSR curriculum has avoided explicit reference to Buddhism and does not include
Buddhist iconography, ritual or scripture (Kabat-Zinn 1990, 2011). On the other
hand, the calm abiding meditation course, although devised by Lama Choedak as a
secular meditation curriculum and practice, makes explicit reference to its Buddhist
origins; in particular, the traditional ritual of setting motivation and dedicating
merit, and reference to the Buddhist meditation deity, Mañjuśrı̄ (Manjushri), and
recitation of the associated mantra. Weekly MBSR classes are sequenced to
introduce and progress through a range of postures and movement—lying down,
walking, standing and sitting presented and integrated with a range of interactive,
inquiry-based practices and discussion that include didactics as a dialectic in varied
group constellations, focussed on understanding mind-body connection from
intra-personal, interpersonal and neuro-physiological perspectives (Kabat-Zinn
1990, McCown, Reibel, and Micozzi 2010) but, on the other hand, participants in the
calm abiding meditation classes are informed of the four classic meditation
postures—standing, walking, reclining and sitting—but only sitting is practiced.
Classes are presented in a routine pattern dominated by didactics and guided
practice based on information imparted with some space for teacher led, whole-
class discussion and questions. Despite these differences, both curricula appear to
have the same learning outcomes in mind: ability to attend to present moment
experience, increased intra-personal awareness and understanding of the
relationship between thoughts, feelings, actions and consequences.
Participants and participation—how Calm Abiding Meditation (CAM) was taught at CYMHS
It was important that staff did not experience the opportunity to attend the
course as yet another demand on their time so, with the agreement of the CYMHS
management, the eight week CAM course was taught as weekly 90 min classes that
began 45 min before ‘knock-off’ each Wednesday afternoon. This represented a joint
time commitment from the organization and from the participants as individuals.
An invitation went out to all staff and David noted in his journal that:
196 S. ROCCO ET AL.
Interest in the course escalated over the week prior to it starting and some who
were interested felt the time commitment made it impossible . . . the common
reason being the late afternoon slot is difficult if you have small children to get
from daycare.
The course began with 16 CYMHS staff attending, nine of whom contributed
reflective accounts and interview responses to the study—including the co-authors
David and Shaun. This group of nine contributors were six women and three men
including two psychiatrists, two clinical psychologists, two administrative workers,
one occupational therapist, a clinical nurse and an indigenous mental health
worker. This group of nine are the ‘participants’ referred to throughout the
remainder of the paper.
The first class vibrated with an air of excited anticipation. David’s journal
entry describes:
Going to the room with Sharn I was pleased to see that three people had arrived
early and had started rearranging the furniture. By the start time there was a
steady trickle of people arriving . . . I had a moment of panic that we wouldn’t
have enough room or mats . . . Interestingly everyone chose to sit on the floor
rather than on the chairs provided, including some older more creaky looking
colleagues . . . there seemed to be something quite good and wholesome about
sitting on the floor with your colleagues and employees.
Once everyone was settled and welcomed, Sharn explained the Buddhist
origins of the curriculum, how she received the teachings and that although her
teachers considered it to be a secular practice, there are elements that, for non-
Buddhists, would seem to be religious in nature; that she had considered leaving
these out but had decided it was more respectful to her teachers and to the
participants to maintain the integrity and authenticity of the curriculum in its
entirety. She encouraged everyone to be open to the practice and to be open to
not doing what did not feel right for them.
In the first class participants were introduced to the ‘Reflections on Calm
Abiding Meditation’, a series of verses that encapsulate the sequenced teachings and
instructions of the course in its entirety which are recited at the beginning of each
class (see below). This was followed by an explanation of the seven points of the
posture—legs, hands, back, shoulders, neck, mouth eyes, including how each point
correlates with the harmonising of a particular element and the cultivation of
associated positive qualities. There were two meditation practice sessions—one of
10min and the second of 15 min during which participants were guided through
paying attention to the points of the posture and their meanings. Between each of
these practice sessions there was discussion and clarification of the technique. In the
second practice session participants were also asked to pay attention to the
sensations of the breath, to identify three phases of the breath—inhalation, abiding
and exhalation. At the end of the class everyone was set homework and introduced to
the concept and practice of dedicating merit—both of which would be a routine
TEACHING CALM ABIDING MEDITATION TO MENTAL HEALTH WORKERS 197
conclusion to each of the classes. The homework for week one was to establish a time
and place for daily practice. To dedicate merit participants were invited to bring to
mind theirmotivationfor attending the class thentoimagine giving away the benefits
to those that they love, to people they hardly know and to people with whom they
have difficulty, wishing that they too benefit from our practice of meditation.
Each of the classes followed a similar structure within which additional
elements of the technique were introduced, explained, practiced and discussed.
There were two meditation sessions between which an explanation of the
underlying philosophy and psychology of particular elements of the technique
was presented were bookended by the recitation of verses to set motivation, and
the dedication of merit and setting of homework to conclude each class. The first
meditation in each class was guided practice of what has been learnt thus far. The
second meditation was guided practice with the additional element of instruction.
Week by week participants were incrementally introduced to concepts and
techniques for developing mindfulness of the body, mindfulness of feeling and
mindfulness of thought. Week two connected mindfulness of the body with
mindfulness of feeling. The focus was on becoming aware of the physical aspect of
feeling in its gross form—pain. Participants were asked to contemplate how pain is
all pervasive and transitory and that whatever pain they may experience there are
always others suffering more. They were asked to observe this during the meditation
practice by seeing that any pain in their body is only a very small part of the whole
body and to notice that the pain is always subtly changing. This observation and
awareness is supported, or possibly challenged by the notion that suffering can be
transformed and the instruction to simultaneously ‘qualify’ the three phases of the
breath. Qualifying the breath is a process of visualizing the inhalation as white light
filled with positive qualities, the ‘abiding’ phase as a nourishing and healing red light,
and the exhalation as a dark blue or grey light that carries with it the pain and
negativities the meditator wants to abandon. Week three introduced the meditation
deity ‘Manjushri’ as the Lord of Speech; speech being the outward manifestation of
emotion and mental feeling. Participants received a copy of the ‘Meditation on
Blessing One’s Speech’ that through recitation and visualization supported the
practitioner to develop speech that is ‘gentle, soft and truthful’ and ‘to remain calm,
focussed and patient’ when faced with anguished others who ‘are unable to use
their speech skilfully’. From week four onwards recitation of the ‘Meditation on
Blessing One’s Speech’ and the associated mantra that students were encouraged to
recite each day upon waking, were included in the routine beginning of each class.
Each week the two meditation sessions got a little longer—ideally 30min each but in
reality the second ‘sitting practice’ is usually shorter, somewhere between
10–25min. By week five students were receiving instructions to ‘super qualify’ the
breath. This required refining attention on the sensations of the breath—while
maintaining the established visualization of the breath one is able to observe that each
phase of the breath has three phases. This refined attention to the breath led into
counting the super qualified rounds of breath and supported mindfulness of thought.
Week seven presented an explanation of the iconographic ‘Taming the Elephant Mind’
198 S. ROCCO ET AL.
as a synthesis of the stages of meditation and the experiences of the student. Week
eight was a summary and reflection on what was taught and learned. This summary is
encapsulated in the ‘Reflections on Calm Abiding’ read at the beginning of each class.
Reflections on Calm Abiding Meditation
My mind has long been lost in search of happiness
Not knowing how transient all things are.
Seeing the unsatisfactory nature of real life experiences
I will not let my mind wander outside.
Turning back the forces of harmful habitual inclinations
And holding firmly to the peace and tranquillity within,
I rejoice in the store of joy I have discovered
In the happiness of observing the intrinsic calmness.
Let this clear and luminous nature of the mind
Not be overshadowed by my habitual tendencies;
Abiding in the natural calmness of the mind
Let me see all perceptions as nothing but mere reflections.
Neither grasping nor rejecting any sensory perceptions,
I shall see them as adventitious ripples and waves
Of the sea of my mind in deep meditation
And absorb them into the ocean of clear mind.
As I focus my mind to sit in the correct meditation posture
Let the physical self express the deep yearning
To experience the calm, still and spacious nature of the mind
And transcend the problems I have with this body.
The incoming breath brings in all the positive things outside me
And permeates the whole nervous system of my body;
Like the rays of the morning sun dispelling the darkness
It soothes the pain and temporary discomfort.
As I retain the breath, let me sustain
The vital energies of wakefulness and alertness
Enabling me to let go and forgive the past
And to enjoy the fresh manifestation of this bare moment.
My outgoing breath releases all feelings
Of tension, anger, stress, anxiety and worry;
TEACHING CALM ABIDING MEDITATION TO MENTAL HEALTH WORKERS 199
Like the masses of dark clouds suddenly disappearing
Let the adventitious circumstances elapse to dawn a new beginning.
Breathing and observing the bare moment of awareness
Without assuming what it will become
May I live every moment with pristine awareness,
Without waiting for unforseen future to cultivate it.
Following the wise sages by respecting their words of wisdom
May I remember skilful ways to apply them in everything
I do, say and think, so that my conduct brings no harm to others
And I do not become a victim of what I do, say and think.
While watching the constant flow of thoughts
Without discriminating between those that are good or bad
Let me neither be overjoyed with my meditation
Nor depressed by my lack of concentration.
Sinking in a withdrawal of the senses
Is relaxation of the conscious self, but not meditation.
Let me not be excited by the slight virtues of concentration
I have just begun to experience.
Holding the rope of mindfulness and the hook of alertness,
May I resolve to tame this mind which is like a wild elephant.
Steadily focussing the mind with a moderate application of antidotes,
May I discover what causes its restlessness.
When I find no sensory objects that are not my own reflection,
All visions and experiences are circumferences of myself.
Like trees, mountains, rivers and the earth
My existence is to give and share what I have with others.
How can I cling to and grasp what I have obtained from others?
As soon as I let something go, I create space and experience joy;
As soon as I give things away, I find a joy not found in keeping them.
Learning to cherish others will bring me a happiness that will last.
Participating and responding: What constituted ‘the data’
The research dimension of the course was qualitative, subjective and
ethnographic in approach. Interested in individuals’ attitudes and perceptions of the
200 S. ROCCO ET AL.
effects of participating in a meditation course offered in their workplace, we took a
micro approach that focussed on the detail of individual cases and environments in
an effort to gain some understanding of the culture—the experience and its effects,
as a whole (Sacks 1992). While the validity of this approach might draw criticisms
from the quantitative research fraternity for reasons including small sample size,
researcher bias and a general lack of objectivity, we sought to honour the subjectivity
of participants. The authors, being both participants and researchers, David and
Shaun as students and Sharn as teacher, were positioned as participant observers
and as such brought an ethnographic dimension to the data and analysis. The nine
participants who contributed data to our research responded to reflective questions
emailed weekly throughout the course, almost half participated in a semi-structured
group interview at course completion and all but one engaged in individual
interviews 15 months later.
The record of attendance shows that in week one there was full attendance
and all participants submitted feedback. One participant attended all the classes and
three others missed only one class. Over the eight week course the pattern of
attendance and feedback across the cohort was irregular. All participants attended
four or more of the classes and more than half missed two or less. In all but one
instance, work demands were cited as the reason for missing classes. The eight
participants tallied 46 attendances (attending a mean of 5.75 of the eight sessions)
and submitted 30 feedback forms. Four of the eight contributed feedback for more
than 75% of the classes attended, as well as participating in the group and individual
interviews which had five and seven participants, respectively. The ninth participant
attended every class and contributed to group and individual interviews.
Midweek between meditation classes, Sharn emailed each of the eight
participants who had consented to contribute regular reflective accounts of their
participation. (The ninth research participant asked to be included in the research
group subsequent to completion of the course.) Each week these participants were
sent a list of questions designed to guide reflecting on the focus of the previous
class, the progress of their meditation and its effects on their daily life with specific
regard to the ‘cognitive keys’ that arose in the classes. Questions were grouped to
prime reflection and support learning of the cognitive keys. Each key represented a
‘chunk’ of information—‘collections of bits of information (both cognitive and
behavioral) that, when taken together, are more significant and have a greater
impact than individual bits of information in isolation’ (Bodie, Powers, and Fitch-
Hausser 2006, 122). The eight keys were: (1) setting up daily practice: meditation is
a practical skill—if we do not practice we do not learn; (2) mindful breathing;
(3) mindful speech; (4) mindfulness of feeling—awareness of feelings turning into
deeds and speech; (5) transforming thoughts and reactions; (6) awareness of
obstacles; (7) application of the technique; and (8) appreciating benefits of
maintaining practice. Weekly reflective questions included: How would you
describe your current use of the elements of this key? To what extent would
increasing your effective use of this key help you to achieve your short- and long-
term goals? What obstacles or resistance have you encountered to effectively using
TEACHING CALM ABIDING MEDITATION TO MENTAL HEALTH WORKERS 201
this key? What are you actually going to do to improve your effective use of this
key? How has your use of this key affected other parts of your life—actions,
feelings, thoughts? Participants were encouraged to report other comments/
feedback/anecdotes. Review of the collated weekly responses informed the
structure and focus of the follow-up interviews. With the exception of the
researcher participant journal maintained by David, responses were collected and
collated by question and by participant. All responses were transcribed and de-
identified.
The group interview facilitated by Sharn collected responses from four of
the nine consenting participants. Two consenting participants expressed their
regret at being unable to attend due to illness. The interview took place in the
same location and for the same duration as the meditation classes. During the
interview all participants, including Sharn, took notes that were later transcribed,
collated and aggregated.
Fifteen months after completion of the course and initial thematic coding of
the weekly reflections and group interview responses, the consenting participants
were invited to contribute to an individual, audiotaped follow-up interview. All
responded enthusiastically. To avoid any inhibition or skewing of responses due to
pre-existing and hierarchical relationships with the authors and to enable Shaun
and David to participate, these interviews were arranged and conducted by a
research assistant. Prevailing circumstances were such that seven of the now nine
participants were interviewed. Interviews were 10–20 min duration and semi-
structured around the questions: What do you remember about the course? How
regularly did you attend? Has it had any lasting effects? Do you still practice? Why
did you decide to do the meditation course? Did you complete the course? What
encouraged you to keep going? What got in the way of attendance? Did it meet
your expectations? Would you do it again? Would you recommend it to others?
What would you say to someone who was thinking about doing the course?
This methodofdatacollectioniscongruentwitharesearcherethicthatrespects
the humanity of research participants by acknowledging reflecting and commu-
nicating as valid ways of knowing. Doing research in this way offers possibilities for
eroding ‘the boundaries between researcher and researched, objectivity and
subjectivity, public and private’ (Rocco 1999, 61). Positioning participants to reflect on
their experience would likely enhance the potential benefits of participation in the
meditation course.
Analytic approach
A thematic analysis was employed to illuminate consistent and specific
issues and effects that appeared within and across the differing forms, variable
patterns and rich content of the data. According to Braun and Clarke (2006) a
thematic analysis ‘is a method for identifying, analysing and reporting patterns
(themes) within data. It minimally organizes and describes your data set in (rich)
detail . . . captures something important about the data’ (2006, 79–82). Our
202 S. ROCCO ET AL.
approach was to consistently focus on semantic themes progressing nonlinearly
through inductive, deductive and theoretical analysis. Our initial round of analysis
identified themes embedded in the data and the second round, enriched by
subsequent data collection sought to articulate a more detailed analysis of the
initial themes. During the meditation course, the feedback data were collated each
week by question and respondent; and points of interest were highlighted,
connected or juxtaposed with points from David’s journal. At completion of the
course, these points of interest and reflections seemed to aggregate around
concepts of time, relationships, speech/silence, the body and meta-cognition.
These concepts formed the foundation for questions and discussion during the
group interview. The analysis began with a close reading of the data collated from
weekly feedback, group interview notes and David’s journal, followed by a second
reading in which recurring themes were identified. Extracts that best exemplified
the themes were excerpted and analysed. Once the major themes had been
identified, clarified and exemplified, the data were read again in their entirety in
order to identify any counter-instances and to ensure that the analysis provided a
verifiable representation of the data.
What was reportedly experienced, perceived and understood
There were early indications of perceived benefits of meditation that
persisted and diversified throughout the course and some that were still evident
15 months later. In week two, a participant who attended all classes, provided
feedback almost every week, contributed to the group and individual interviews
and established a daily meditation routine early in the course, reported:
My blood pressure has been lower since starting meditation. I am able to stick
with my exercise routine more as my routine and plans have a purpose i.e.
meditation to be done each morning. I feel more in tune with myself than I ever
have before. My thoughts are not so clouded any more and I think clearer. I have
purpose in life. I have set goals and I am positive that I am going to achieve them
this time. I am happier. I am not so scared of letting go and I am able to talk
about my feelings more. Being part of this and putting myself out there is
something that I would never have done before. I always kept all my feelings
and problems within me to try and solve myself but now I am aware that it is not
healthy to do that and you need to let go at times to get what you want out of
life and those around you. I try to radiate happiness to help myself and others
around me including people in the queue or serving in a shop. This certainly
makes life better.
The sentiments conveyed in this feedback touch on each of the overarching
themes that are woven throughout the data: (a) recognizing and managing stress
responses; (b) improving outlook, lifestyle choices and wellbeing; (c) appreciating
and respecting self and others as interconnected; and, (d) navigating obstacles—
the value and challenge of self-discipline. Within each of the themes there are
TEACHING CALM ABIDING MEDITATION TO MENTAL HEALTH WORKERS 203
echoes of the others. They are not mutually exclusive but interrelated as are
developing mindfulness of body, of feeling and of thought. Overall, the data
convey a strong sense of recognition that meditation practice is not about getting
better at meditation but about becoming more aware of ‘whether or not it is
beneficial to maintain this or that particular state of mind’, that practising
meditation promotes metacognition and reflective awareness of the relationship
between habits of mind and behaviour.
Recognizing and managing stress responses
Participants reported consciously invoking an aspect of the meditation
technique to manage a stressful situation, recognizing in hindsight that they were
less reactive than they had habitually been in a given situation or were able to
recover more quickly from situations in which they experienced stress. Particular
elements of the CAM technique applied to ameliorate stress reactions included
mantra recitation: ‘I calm myself down with the Manjushri mantra’, visualization:
‘I’ve just concentrated on the white, red and blue light, thought of options to
resolve issue and skipped panic phase’, posture: ‘I sit with my hands in my lap, fold
them with my thumbs just touching and tell myself to relax’, and, most commonly
and consistently, focussing on the breath for cultivating calmness and reducing
reactivity: ‘I have used the breathing when I felt stressed’. The stressful situations
included: ‘when I have to do something at work that is new to me’, ‘agitated
clients either on the phone or face to face’, ‘playing squash’, ‘poor service in a
shop’, ‘when someone does something stupid on the road’, ‘flight turbulence’,
‘family demands’, ‘being responsible for sixteen staff’, ‘the dentist’ and ‘waiting’.
Fifteen months later when the participants were asked individually if they felt
there were any lasting effects from the course, their responses invariably denoted
improved ability to recognize and manage stress responses: ‘I certainly feel less
reactive’, ‘I get over stuff quicker’, ‘I’m not getting so stressed out about so much’,
‘I’m better at managing feelings and emotions’, ‘Don’t swear as much or as
enthusiastically’, ‘don’t panic as much when I’m in a rush’.
Improving outlook, lifestyle choices and wellbeing
Becoming more self-aware is central to the process of mindfulness and of
self-control. The CAM qualified breathing encouraged participants to identify
positive qualities that they wanted to cultivate and express, to know what they are
breathing in and, likewise, to identify tensions, worries, pains, or any negative
habits of body, speech or mind that they wish to transform and breathe out—
acknowledging stuff and letting it go. Exercizing self-control by suppressing
responses such as irritability, impatience and inconsiderate verbal utterances may
cause physical and mental fatigue (Muraven and Baumeister 2000; Schmidt and
Neubach 2007). In contrast, the reflections of participants suggest that
acknowledging ‘stuff’ and letting it go can lead to a more positive outlook and
204 S. ROCCO ET AL.
better lifestyle choices: ‘I am happier’, ‘I am more in tune with myself than ever
before’, ‘Giving up on some unhealthy habits without really trying’, ‘I am not
reaching for the wrong foods as much as I used to’, ‘I am looking for healthy food
rather than biscuits and chocolate as I would normally have done before’, ‘Feeling
great, starting to look better’, ‘I am making more thoughtful and purposeful
decisions in my life’. Two of the participants reported improved success in
establishing and maintaining an exercise routine. One of these said during the
follow-up interview that although he was not formally meditating he felt that
‘swimming laps, up and down, up and down, is meditative in its own right’.
The weekly feedback data reported relief from chronic ailments: ‘My
headaches are better . . . not absent, but more transient’, ‘My neck and back have
been in particularly good nick too since beginning the course’, ‘My blood pressure
has been lower since starting meditation’. At follow-up interview another
participant who was no longer meditating but who had established and
maintained regular practice throughout and for several months after the course,
reported no longer experiencing road rage and attributed no longer requiring anti-
anxiety medication to meditation helping her to think differently about situations.
Improved wellbeing was also indicated in reports of improved sleep. In
week eight a participant stated, ‘My quality of sleep is better’. Other participants
commented: ‘I seem to be more awake during the day like not needing a nanna
nap in the afternoons’; ‘I am happier to wake up; I used to want to go back to
sleep, now I think, “Oh, I’m awake early, I can do stuff”’. At the follow-up interview
another participant reported, ‘I use it (meditation) to go to sleep at night. . . .
I used to lay awake thinking about work. Now I know when I’m doing it and I just
get myself into that frame of mind . . . ’
Appreciating and respecting self and others as interconnected
Bureaucracies and the organization of work groups within them are
characteristically hierarchical. During the group interview that took place two
weeks after completion of the course, discussion about perceived impact on
relationships at work and in general prompted David to say that ‘Sitting on the
floor together is a very levelling perspective.’ A participant positioned at the
opposite end of the staff hierarchy responded saying she, ‘didn’t think these
people would sit on the floor and do this. Because they are all learned people.’
Trungpa (1976) advises:
We must be willing to be completely ordinary people which means accepting
ourselves as we are without trying to become greater, purer, more spiritual,
more insightful. If we can accept our imperfections as they are, quite ordinarily,
then we can use them as part of the path. But if we try to get rid of our
imperfections, then they will be enemies, obstacles on the road to our ‘self
improvement’. (Trungpa 1976, 44)
TEACHING CALM ABIDING MEDITATION TO MENTAL HEALTH WORKERS 205
The experience of sitting meditating together, making an effort towards
self-improvement generated a sense of respect for self and for others, a sense that
‘we’re all human after all. It doesn’t matter where we come from’; ‘It shook
preconceptions of people’; ‘I feel more accepting of others now, less judgemental.’
A senior member of staff summed it up in this way:
I find I can summon more respect for people I might dislike or be annoyed by.
I think the basis for this tolerance of their failures and weaknesses, comes from
tolerance of one’s own failures and weaknesses. To forgive others you need to
first learn to forgive yourself. This comes in part from the recognition that (for
me anyway) a ‘perfect’ meditation session is impossible to achieve, but a ‘good
enough’ session is, well . . . good enough . . .
The data are punctuated with implicit and explicit instances of recognition
of interconnectedness of being aware that our actions and attitudes impact
others. Almost everyone mentioned at some point that they were more mindful of
their speech. One participant reported: ‘ . . . if I usually have something negative to
say I won’t say it’ and another noticed that in meetings she spent time thinking
about what she wanted to say rather than listening to what was being said.
Similarly, another reported being more aware of agitation in meetings and ‘urges
to speak and contribute when this is not strictly necessary, more able to resist
these urges’. Reduced road rage appeared early in the feedback data and two
participants said in the follow-up interviews that their road rage was completely
gone. One of several participants who reported their heightened awareness made
them feel happier, said she tries ‘to radiate happiness to help myself and others
around me including people in the queue or serving in a shop. This certainly
makes life better.’ Another in the final round of feedback said:
[I am] taking more responsibility for my own emotional reaction to situations.
At the same time, being more aware of and tolerant of others’ emotional
reactions. For me, how I play squash is a barometer of my state of mind. I find
that I still play an erratic game with unforced errors, easily get angry with myself,
show too much emotion on the court (which isn’t necessarily pleasant for my
opponent). However last night I had a flash of insight into myself—thinking:
“what’s the point of getting upset when you lose points? It doesn’t enhance
your enjoyment of the game or the enjoyment of your opponent. What’s more
important to you—to win the game or to have fun with your opponent? Maybe
it’s good if they win points because then they’ve enjoyed the game and feel
good about themselves. Maybe more important than winning is to play with
dignity, i.e. to play mindfully even when losing.
Navigating obstacles —the value and challenge of self discipline
Like a great river runs down toward the ocean, the narrowness of discipline leads
into the openness of panoramic awareness. Meditation is not purely sitting alone
206 S. ROCCO ET AL.
in a particular posture attending to simple processes, but is also an openness to
the environment in which these processes take place. (Trungpa 1976, 4)
Encountering and navigating obstacles is a salient aspect of traditional meditation
teachings. Onsurveying the data our researcher curiosity waspiquedby the apparent
contradiction between expressed enthusiasm for participation, belief in and initial
experiences of the benefits of meditation and what seemed at first glance to be
haphazard attendanceand struggles to establish and maintain a practiceroutine. The
feedback data showed that in the first weeks physical discomfort ‘mostly my knee
hurting’, ‘my back hurts’, was a common obstacle but these soon gave way to
seemingly external barriers such as pressures of time and interruptions arising from
family and work demands, ‘finding time’, ‘finding the right time and place’, ‘change of
routine’, ‘my family—a herd of baby elephants’. By week eight it was more common
thatresponsestothequestionaboutobstaclestopracticereferredtoobstacleswithin
the meditation and recognition of personal responsibility for external conditions, for
example ‘Laziness—it’s very easy to make excuses for e.g. a shortened sitting session’.
Overall, it seemed that the concept of ‘time’ was perceived as both a barrier and an
enabler to meditation in the sense that competing demands on available time was an
obstacle to engaging in formal practice but devoting time to practice would enhance
both the practice and the perceived benefits. ‘Time’ became a point for discussion
during the group interview. Participants agreed that making time to practice was a
constantchallengeyetatthesametimetheyfeltthatpractisingmeditationhadmade
them more aware of how they used their time and to manage time more effectively:
‘focus onnarrowerslicesoftimeseemstoexpandtime’, ‘I likethedisciplineofit . . . the
regularity of it . . . the predictability of it . . . it makes me sit still for approx 20min each
day, and that’s a good thing’, ‘Sometimes the discipline is not to be hard on yourself’.
The notion of the need for, and challenge of, self-discipline began to emerge and we
decided to explore this further in the follow-up interviews.
Even though 15 months after the course was completed only two of the
participants were meditating regularly, everyone, except one of the regular
meditators, said that they would do the course again and would recommend it to
others. They also said whenever they were absent from the course it was not
because they did not want to be there but because something else got in the way.
One respondent who said meditation was on his ‘should do list’ expressed the
conundrum: ‘It’s a case of you’re not going to see benefits until doing regularly but
because not doing it regularly not enough benefit to make one sit’. One of those
still meditating daily said, ‘Personally I think the obstacles are yourself, how
committed you are and what it’s doing for you . . . to me it’s beneficial’. When
asked what had encouraged her to keep going she cited becoming aware that she
was better able to remain calm during a crisis, to think things through on her own
without advice and to quiet the busy chatter in her mind after work. She said, ‘It
gives a good start to the day’ and ‘If something goes haywire during the day you
can look forward to the next time you sit’. Many of the respondents told of how
interruptions to their routine would often suspend, and then finally lead to
TEACHING CALM ABIDING MEDITATION TO MENTAL HEALTH WORKERS 207
abandonment of their practice. At the same time, within the follow-up interview
data there are various indicators of external conditions conducive to developing
the self-discipline needed to establish a practice routine. These included having
time available during work hours, having the support of colleagues and family,
living alone, finding a suitable time and place, and reciting inspirational verses.
(In)conclusion
Analysis of the data reporting what participants experienced, perceived and
understood as a result of participation in the calm abiding meditation course
offered at their workplace indicates that teaching calm abiding meditation in the
workplace can offset the inherent institutional and emotional demands of working
in a mental health service. Participation appears to have had lasting effects in terms
of improving staff wellbeing in a range of domains including stress management,
emotion regulation, lifestyle choices, and relationships. Few of the participants
continued to meditate regularly after completion of the course but 15 months later,
almost all used particular elements of the meditation technique such as the posture
of the hands, the speech blessing and paying attention to the breath, to improve
levels of mindfulness in daily life. Their descriptions and reflections support what
Baer suggests is the reasonable assumption ‘that teaching participants to practice
mindfulness meditation or mindfulness skills should cultivate their ability to
respond mindfully to the experience of daily life, including sensations cognitions
and emotions, as well as sights, sounds, and other environmental stimuli’ (Baer
2011, 243). Similarly, patients in MBSR programs reported that they became
‘motivated to live a life of greater awareness that extends far beyond the eight
weeks they are in the programme’ (Kabat-Zinn 2011, 293).
The research method, by way of requiring participants to reflect on their
experience, may have contributed to these effects. This method positioned
participants to regularly reflect on the direct experience of the meditation training
and observing its effects. The role of reflection in enhancing the benefits that
might accrue from meditation practice is worthy of further study. As Fennel and
Segal (2011, 138) point out:
. . . experience is of little value unless what has been experienced is clearly seen.
Equally, lessons derived from specific experiences and observations are unlikely
to become part of a new way of being unless reflection follows—placing new
observations in context, relating them to pre-existing knowledge, creating
meaning. Within mindfulness-based interventions, observation and reflection
are facilitated by the inquiry process that follows meditation practices.
Collecting reflective responses throughout the course, on completion of the
course and 15 months later enriched the analysis of participant experiences and
indicated the ways in which benefits were sustainable and the enablers and
barriers to participation and ongoing practice. The quality and detail of responses
to the structured weekly feedback and the semi-structured group and individual
208 S. ROCCO ET AL.
interviews suggests the value of these methods for augmenting the concern
reported by Baer (2011, 252) that when responding to questionnaires, participants
‘are unable to report accurately on their own tendency to be mindful because they
are unaccustomed to noticing these aspects of their own functioning.’ Collecting
reflective data throughout and subsequent to the intervention is a way of giving
participants practice in ‘noticing’ and ‘reporting’.
The evidence of the relative benefits of participating in mindfulness training,
in this case presented in a particular form of Buddhist meditation practice, is open
to interpretation, without conclusion. The veracity attributed to each
interpretation will be always and inevitably subjective. From a Buddhist
perspective ‘all phenomena are filtered through our subjectivity’ (Norbu 1992,
35). This makes the benefits and sufferings no less real to those who experience
them. In the context of the study of the mind, ‘reality’, truth, can only be stated
subjectively. This ‘truth’ does not sit well with dominant discourse of scientism
within which objectivity is assumed to be a condition of truth (Wallace 2000).
Within Buddhist philosophy ‘reality’, and by extension, ‘truth’, is always and at
once relative and ultimate. Ultimate reality is only apparent or available to the
mind that is not bound by the habit of binary logic usually referred to as dualistic
thinking or the dualistic mind. Dualistic thinking is competitive, hierarchical,
exclusionary. It is what constitutes and characterizes samsara and relative reality.
Ultimate reality is non-judgmental, egalitarian, inclusive. Mindfulness meditation
research, researchers and researched will become richer when there is a loosening
of the tensions and boundaries arising within the historically and discursively
produced false dichotomies of subjectivity/objectivity, qualitative/quantitative
and associated dualistic notions of what does or does not constitute the fabric of
valid research, ‘truth’. By qualitatively attending to what captured the attention of
participants in an eight-week calm abiding meditation course taught in their
workplace, this paper, joining the call for further research, illustrates the potential
benefits and possibilities of Buddhist practices in secular settings: and, suggests
the value of qualitative inquiry for investigating the effects and potential benefits
of mindfulness meditation.
ACKNOWLEDGEMENTS
We thank research assistant, Michelle Dyer, and the research participants for their
invaluable contribution to, and Health Queensland for supporting, this study.
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Sharn Rocco, PhD, Lecturer in Teaching for Learning at James Cook University
School of Education, Townsville, Queensland, Australia. Sharn’s research
interests include reflective practice, meditation and mindfulness practices
in schools and workplaces, and the implications for education of Buddhist
philosophy, feminism and poststructuralism.
Address: School of Education, James Cook University, Townsville, Qld, 4811,
Australia. Email: Sharn.Rocco@jcu.edu.au
Shaun Dempsey, PhD, M App Psych, Clinical Psychologist with Queensland
Health. Shaun’s research interests include meditation and mindfulness, the
public image of psychologists and supervision in postgraduate clinical
psychology training.
Address: Queensland Health, Townsville, Queensland, Australia.
David Hartman, FRANZCP, Clinical Director, Child and Youth Mental Health
Service, Townsville, Queensland, Australia.
Address: Queensland Health, Townsville, Queensland, Australia.
TEACHING CALM ABIDING MEDITATION TO MENTAL HEALTH WORKERS 211
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