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attempts by researchers to develop with some degree of valid-
    ity and precision various scales to “measure” mindfulness [see Chapters by
    Brown and Cordon; and Baer, Walsh and Lykins]. Along with these attempts
    come many attendant problems that are also well-recognized in these pages
    and elsewhere [6].
    The choice to have the word mindfulness does double-duty as a com-
    prehensive but tacit umbrella term that included other essential aspects of
    dharma, was made as a potential skillful means to facilitate introducing what
    Foreword
    xxix
    Nyanaponika Thera referred to as the heart of Buddhist meditation into the
    mainstream of medicine and more broadly, health care and the wider society
    in a wholly universal rather than Buddhist formulation and vocabulary. I felt
    that Nyanaponika Thera’s inclusive and non-dual formulation offered both
    validation and permission to trust and act on my own direct experience of
    the meditation practice and the dharma teachings I had received over the
    course of my life, even if technically speaking, it was glossing over impor-
    tant elements of Buddhist psychology (as outlined in the Abbidharma, and
    in Zen and Vajrayana teachings) that I felt could be differentiated and clari-
    fied later, once it was recognized that mindfulness , based on our operational
    definition, however, it was construed or contextualized in detail, might con-
    tribute profoundly to clinical care and to our understanding of the nature
    of the mind itself in a Western mainstream medical and scientific setting. In
    Nyanaponka’s words, mindfulness is
    the unfailing master key for knowing the mind and is thus the starting point;
    the perfect tool for shaping the mind, and is the focal point; and the lofty
    manifestation of the achieved freedom of the mind, and is thus the culminating
    point.[7]
    That means that mindfulness is the aim, the methods or practices, and the
    outcome or consequences all wrapped up together, wholly fitting for a non-
    dual orientation that emphasizes nowhere to go, nothing to do, and nothing
    to attain [8]. Together with the words of the Buddha in his most explicit
    teaching on mindfulness, found in the Mahasattipathana Sutra, or great sutra
    on mindfulness
    this is the direct path for the purification of beings,
    for the surmounting of sorrow and lamentation,
    for the disappearance of pain and grief,
    for the attainment of the true way,
    for the realization of liberation –
    namely, the four foundations of mindfulness
    it seemed like an appropriate choice to feature mindfulness as the uni-
    fying factor and name under whose umbrella the work of the stress reduc-
    tion clinic, later known as mindfulness-based stress reduction , or MBSR,
    could unfold. Now we have our first clinical handbook of mindfulness, which
    includes a broad range of perspectives on this veritable koan, the nature of
    mindfulness, its myriad applications, and potential impacts.
    To make matters even more interesting, since in all Asian languages the
    word for mind and the word for heart are the same word, it feels important
    to remind ourselves that unless we hear “heartfulness” when we are using
    or hearing “mindfulness,” we may be missing the mark in a fundamental way
    that could have unfortunate consequences both for how mindfulness-based
    interventions are constructed and delivered, and for how we approach rele-
    vant research issues. Many of the authors here are very strong on this point
    in the discussion of their work. For me, the dimension of heartfulness re-
    inforces the core Hippocratic injunction: primum non nocere – first, do no
    harm, to which we all need to accord continual present-moment attention in
    relationship to those who come to us with untold vulnerabilities.
    xxx
    Foreword
    One last word on the subject of mindfulness and its definitions: a small
    group of meditation teachers and Buddhist scholars recently developed a col-
    lective articulation/definition of mindfulness that may