Classical mindfulness: an introduction to its theory and practice for clinical application.

Among the modern versions of mindfulness, mindfulness based stress reduction (MBSR) has played the key role in introducing mindfulness practice to the field of psychology and medicine. In fact, the efforts to integrate mindfulness into psychology have resulted in further adaptation of MBSR into more secular and psychological forms as well as the creation of a number of mindfulness measures such as the Mindful Attention Awareness Scale, the Freiburg Mindfulness Inventory, the Kentucky Inventory of Mindfulness Skills, and the Cognitive and Affective Mindfulness Scale. At the same time there is increasing scrutiny of mindfulness that goes beyond the initial positive efficacy studies resulting in several important questions being raised. These range from the absence of an operational definition of mindfulness as well as little evidence for the mechanisms of mindfulness that account for outcome changes for various psychopathology and medical conditions. Questions about the defining characteristics of mindfulness are also being raised such as the lack of differentiation between the features called attention and awareness and the interchangeable use of the two terms in modern descriptions of mindfulness. Such questions resonate with traditional practitioners of Buddhist contemplative psychology for whom attention signifies an every-changing factor of consciousness, while awareness refers to a stable and specific state of consciousness.