The Buddha Pill is a useful antidote to the current mindfulness/meditation boom in the US/UK and other western societies, and the best book I’ve found that focuses explicitly on whether mindfulness is an effective method of personal change. Other reviews summarize many of the book’s positive qualities, and I’ll mention a few I particularly like. But I also found the book frustratingly orthodox and middlebrow in many spots, as I’ll explain below.
The authors, themselves psychologists and long-time practitioners of and believers in mindfulness, do a good job summarizing the arguments for and against mindfulness in an even-handed manner to show how mindfulness is not nearly the panacea its boosters make it out to be. They use frank, simple language throughout the book, and are able to make plain the basic premises espoused by the mindfulness movement’s proponents while at the same time offering critical conclusions in simple terms that don’t come across as mean-spirited or unfair. In this vain, it’s a safe book to recommend to mindfulness enthusiasts and critics alike.
The authors conclude that meditation is basically a placebo, no better than any other type of rest or exercise at producing lasting personal change. They provide a valuable discussion of a researcher named Jonathan Smith who designed a bogus meditation treatment called PSI (Periodic Somatic Inactivity) in the 1970s, which instructed patients to basically just sit still without talking, moving, etc., arguing in a 71-page manual he concocted that this inactivity was the specific ingredient that made meditation, yoga, and similar techniques work. He then had an independent researcher who was unaware of PSIs fabricated nature compare it in a clinical trial with transcendental meditation (TM). The result? “[T]here were no differences between the TM and PSI groups; they both showed the same level of improvement.”
The authors caught up more recently with Smith and asked his opinion of the quality of current mindfulness-based therapy research, and his comments were unequivocal: “Listen, this new wave of studies on mindfulness is full of disingenuous scientists who are up to their necks in Buddhism.” He admonished the authors to “[l]ook carefully” at the control groups current researchers use. The results aren’t encouraging for meditation proponents, at least according to the author’s review of the latest comprehensive meta-analyses: “When you compared the active controls to the meditation condition, there were no differences; the meditation effect disappeared. . .;” there is “no evidence that mindfulness worked better than activities such as relaxation, exercise, or cognitive therapy.”
So what do the authors recommend instead of mindfulness as the means to personal change? A sort of eclectic mix of orthodox clinical psychology it seems. This is where the book seems weakest, where the authors’ critical approach seemingly evaporates. Mindfulness, according to the authors, “is unlikely to have any impact on shifting the cognitive, behavioural, or interpersonal patterns that are maintaining their difficulties.” True enough—if these patterns are truly what is at the root of, say, a prisoner’s difficulties, mindfulness alone is almost certainly inadequate to shift these patterns, despite positive reviews from service users. But I’m not sure there’s any more science to the idea that standard behavior therapy or a warm relationship with a therapist is sufficient to shift someone either. The authors would seemingly disagree, arguing that they’ve eventually come to realize that—contra their previous naive enthusiasm for mindfulness techniques—“old-fashioned behavioral strategies can do wonders,” tempered of course by age-old wisdom that change takes time. And while mindfulness techniques arguably cannot significantly alleviate the after effects of childhood neglect or trauma, the authors seem to believe that an empathic therapeutic relationship can.
I found this sort of uneven faith in psychological magic to be frustrating, as is any book that looks at prisoners, their “difficulties,” and their prospects for individual change without at least some semblance of a social or political analysis. I know this book is focused on meditation but in America at least, a significant number of prisoners are arguably where they are because of institutional racism, the war on drugs, and growing inequality, rather than individual “cognitive, behavioral, or interpersonal patterns” or a failure to cope or adjust.
At times, I was left with the impression that the authors were merely defending the high church of establishment psychology from it’s more irresponsible low-church enthusiasts. Mindfulness booster’s seem to have packaged mind cure meditation techniques and a hint of the exotic east with the scientific garbs of psychology and neuroscience to form a potent commodity. The authors seem eager to defend psychology's pretense to science, but the “third-wave” shift in psychology toward integrating mindfulness-based therapies probably has more to do with branding than science, a point the author’s don’t really grapple with in their more narrow argument on whether the Buddha Pill works or not.
Many of the authors’ criticisms of the inadequacies of the mindfulness research literature apply equally to that of the more standard, (supposedly) evidence-based psychotherapies—researcher biases, measurements from self-report questionnaires, inadequate control groups. The author’s also cite a dubious argument that standard talk therapy may be superior to mindfulness because the most successful practitioners (“supershrinks” who get the best reviews from their clients) not only deliberately work hard to get better at their craft but, crucially, receive constructive feedback from their clients, something the meditation-based therapies like MBSR apparently lack. Notice here the author's uncritical acceptance of self-report measures in standard psychotherapy literature compared to their more skeptical treatment of the same in the mindfulness literature. And never mind that the research they use to back-up their constructive-feedback-deliberate-practice hypothesis has been questioned by more recent research which suggests that such activity accounts for only 4% in outcome variance among educators, and less than 1% among other professionals (see the New York Times, “How Do You Get To Carnegie Hall? Talent.”) Certainly some healers, for whatever reason, are more helpful than others, but it’s not clear that these qualities can be transmitted through professional training, or that any amount of constructive feedback and deliberate practice can somehow endow a person with little innate talent for the helping professions with super shrink powers.
The experimental psychologist Stuart Sutherland once argued that behavior therapy and cognitive therapy are simply “glorified common sense.” The authors make a similar point about meditation being a rather simple and common sense practice: “the magic of contemplative practices: they’re typically plain and repetitive,” and their book concludes that meditation is probably no more effective than any other common sense coping strategy (relaxation, exercise). Common sense strategies can do wonders, but I imagine when people visit a psychologist they’re expecting something more than common sense for the often substantial fees they pay for professional services, whether through taxes or direct payment.
I had some other frustrations, but I don't want to let the negative in this review get more out of control than it already is. This book really does have a lot to recommend, particularly chapters 3, 5, and 8. The book’s critique of mindfulness is robust, and I learned a lot from their review of the research, so despite my frustrations, I would still recommend this book to anyone with an interest in this topic.