What Is Mindfulness? A Plain-English Definition Without the Mysticism

Paying attention to what is happening right now, on purpose and without judging it: that is mindfulness, in the working definition published in 2003 by Jon Kabat-Zinn, who created the Mindfulness-Based Stress Reduction program at the University of Massachusetts Medical Center.¹ It covers what you notice inside you, such as thoughts, feelings and body sensations, and what you notice around you.² Kabat-Zinn calls it an inherent human capacity that can be developed through meditation.¹

So the short answer to what is mindfulness is a way of paying attention, not a belief system. What it does is more modest than its reputation. In a 2014 Johns Hopkins review of 47 randomized trials of meditation programs with 3,515 adults who had a health condition or high stress, mindfulness programs brought small improvements in anxiety, depression and pain, but there was no evidence that meditation programs beat drugs, exercise or other therapies.³

What is mindfulness, in the words of the researchers who defined it

Two definitions are the usual starting points in research. Jon Kabat-Zinn’s 2003 version describes the awareness that comes from paying attention “on purpose,” in the present moment and without judgment.¹ A 2004 consensus paper by Scott Bishop and ten colleagues split it into two parts: steering attention to the present, and meeting whatever you find with curiosity and acceptance.⁴ A 2018 critical review calls Kabat-Zinn’s version one of the most frequently invoked definitions and lists Bishop’s among several attempts at a consensus.⁵

Bishop’s group wrote that mindfulness had not yet been defined in a way researchers could test, and met to agree one; their work was funded by a Canadian Institutes of Health Research grant. The first component, self-regulation of attention, keeps attention on immediate experience so that you recognize thoughts, feelings and sensations as they arise. The second is an orientation of curiosity, openness and acceptance toward those experiences, pleasant or not. The authors add that mindfulness is not a practice in suppressing thoughts: every thought is something to observe, not a distraction.⁴

The UK’s National Health Service (NHS) puts it more simply: mindfulness means paying attention to what is going on inside and outside ourselves, moment by moment, including the sights, sounds, smells and tastes of the present.²

1. Anchor: attention rests on something happening now, such as the breath
2. Wander: the mind drifts to a thought or feeling, which is noticed rather than pushed away
3. Return: attention is steered back, again and again: the first component, self-regulation of attention
4. Attitude: whatever turns up, pleasant or not, is met with curiosity, openness and acceptance: the second component

Neither definition is universal. That 2018 review, by Nicholas Van Dam and colleagues in Perspectives on Psychological Science, found no single accepted technical definition of mindfulness and called it an umbrella term for many practices, processes and traits. The authors warn that studies may treat a five-minute meditation from a phone app and a three-month retreat as the same thing, because both are labeled meditation.⁵

What does practicing mindfulness involve?

In practice, mindfulness usually starts with a sitting meditation in which you rest attention on your breath, notice when your mind wanders, and bring it back, again and again, without scolding yourself, as Bishop’s paper describes the standard exercise. You are asked to use the same noticing in daily life, with the breath as an anchor.⁴

Myth

Mindfulness means emptying your mind of thoughts.

Fact

The mind wanders, and noticing that it has wandered, then returning, is the exercise. Bishop and colleagues describe mindfulness as observing thoughts, not suppressing them.

Mindfulness and meditation overlap but are not the same thing. The US National Center for Complementary and Integrative Health (NCCIH) uses meditation for a family of practices, some focused on a single object such as a sound or a repeated word (a mantra); mindfulness is one form, defined by attention to the present moment without judgment.⁶ The NHS also describes informal practice: noticing the food you eat or the air on your skin as you walk, and changing small routines so you see them afresh.²

Secular by design, with Buddhist origins

Mindfulness comes from Buddhism, but its best-known modern form was deliberately built without the religion. Kabat-Zinn writes that mindfulness has been called the heart of Buddhist meditation, yet argues there is nothing particularly Buddhist about attention itself.¹ The word itself translates the Pali term sati.⁷

In 1979 Kabat-Zinn created Mindfulness-Based Stress Reduction (MBSR) at an outpatient clinic of the University of Massachusetts Medical Center, to train medical patients in mindfulness meditation. He wrote that the program had to be free of the cultural, religious and ideological trappings of its Buddhist origins, because the aim was not to teach Buddhism.¹

The standard MBSR course involves 20 to 26 hours of formal training across eight weekly group classes and one all-day class, plus about 45 minutes of home practice six days a week. Mindfulness-Based Cognitive Therapy (MBCT) adapts it by adding elements of cognitive behavioral therapy.⁵

Small but real effects in randomized trials

Mindfulness programs eased anxiety, depression and pain by small amounts, with no evidence that they beat other active treatments, in one strict test: a 2014 systematic review by Madhav Goyal and colleagues at Johns Hopkins, funded by the US Agency for Healthcare Research and Quality. It counted only randomized trials in which the comparison group got an activity matched for time and attention, to control for the effects of attention and expectation.³

The study

Moderate evidence

Meditation programs against time-matched activities: the Johns Hopkins review (Goyal et al., 2014)

Mindfulness programs improved anxiety, depression and pain by small amounts compared with the matched activities, with effect sizes of about 0.2 to 0.4 standard deviations, and the reviewers graded that evidence as moderate. Evidence for less stress and better mental-health quality of life was low. For positive mood, attention, substance use, eating, sleep and weight, the evidence showed no effect or was insufficient. There was no evidence that the programs beat active treatments such as drugs, exercise or other behavioral therapies.³

The trials enrolled people with conditions ranging from anxiety to heart disease, not healthy office workers. The reviewers also note that most trials were short and unregistered, and that none of their conclusions reached a high grade of evidence.³

Newer reviews point the same way. A 2022 umbrella review by Simon Goldberg and colleagues reviewed 44 meta-analyses covering 336 randomized trials and 30,483 participants. Mindfulness programs beat doing nothing on most outcomes, did less well against active comparisons, and performed about as well as established treatments such as cognitive behavioral therapy or antidepressants. Where study quality made a difference, better-designed trials showed smaller effects.⁷

For adults in nonclinical settings, a 2021 review in PLOS Medicine by Julieta Galante and colleagues pooled 136 trials with 11,605 adults in 29 countries. Compared with no intervention, mindfulness programs reduced anxiety, depression and distress and improved well-being in most but not all analyses, but showed no clear advantage over other active practices such as physical exercise. Confidence in the results was moderate to very low, and only the effect on distress held when trials at higher risk of bias were removed. In secondary analyses for depression, trials run in the US showed smaller effects, and programs aimed at people at higher risk, such as carers, showed larger effects than programs offered to everyone.⁸ A universal program for younger people showed no benefit: in the 2022 MYRIAD trial of 8,376 UK pupils aged 11 to 14, school mindfulness lessons did no better than usual social-emotional teaching after a year.⁹

Further reading

• 

  Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness

  by Jon Kabat-Zinn

  The founder of MBSR describes the eight-week program and its practices, the course this article's trials build on.

• 

  Altered Traits: Science Reveals How Meditation Changes Your Mind, Brain, and Body

  by Daniel Goleman and Richard J. Davidson

  Richard Davidson, co-author of the 2022 umbrella review, sorts strong meditation findings from weak ones.

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Workplace programs: some stress relief, performance unproven

Workplace mindfulness training eases stress but has not been shown to improve work performance, according to a 2019 meta-analysis of 23 randomized trials by Larissa Bartlett and colleagues. It found moderate reductions in stress, anxiety and distress, a smaller gain in well-being and a small improvement in sleep. It could draw no conclusions about burnout, depression or work performance, and most trials compared mindfulness with a waiting list or usual routine rather than another activity. The authors concluded that claims about better work performance are ahead of the evidence.¹⁰ A 2025 meta-analysis of 99 trials, mostly of employees or students, by Maris Vainre and colleagues, found a small gain in task performance against no-treatment groups but none against active comparisons (only four trials), and rated its confidence very low.¹¹

Workplace mindfulness also has official backing in England. A 2022 guideline from England’s National Institute for Health and Care Excellence (NICE) on mental wellbeing at work tells employers to offer all employees, or help them access, mindfulness, yoga or meditation on an ongoing basis.¹²

If stress is what draws you to mindfulness, read up first on how the stress response works and what sets it off.

Unpleasant effects are not rare, and a few last

Mindfulness practice can bring unpleasant experiences, and most trials have not looked for them: in the 2014 Johns Hopkins review, only 9 of the 47 trials reported on harms at all, and none found any.³ Van Dam’s group estimated that fewer than a quarter of meditation trials actively ask about adverse effects, and that relying on spontaneous reports has fed the mistaken conclusion that meditation has no adverse effects.⁵ The NCCIH says few studies have examined potential harms, so definite statements about safety are not possible.⁶

A 2020 systematic review by Farias and colleagues, which included trials, observational studies and case reports, found adverse events in 55 of 83 studies. The pooled rate was 8.3 percent: 3.7 percent in experimental studies and 33.2 percent in observational ones. Anxiety and depression were the most common, and the authors note that such events can occur in people with no previous history of mental health problems.¹³

How you ask changes the answer. In a 2021 US study led by Willoughby Britton of Brown University, an independent interviewer questioned 96 adults with mild to severe depression symptoms three months after they finished one of three versions of an eight-week MBCT course. Fifty-eight percent reported at least one meditation-related experience they found unpleasant, and 37 percent of the 81 who rated its impact reported one that harmed their functioning. For just over half, the longest-lasting meditation-related effect was over within an hour, but disruptive effects lasted more than a day for 14 percent and more than a month for 6 percent, rates the authors call similar to those of other psychological treatments.¹⁴ The NHS agrees that mindfulness is not right for everyone and can make some people feel worse.²

Check with a clinician first if you have a psychiatric history

Standard mindfulness courses screen some people out: the exclusion criteria that the University of Massachusetts Center for Mindfulness and the Oxford Mindfulness Centre publish for MBSR and MBCT exclude current suicidal thoughts or any current psychiatric disorder, according to Van Dam’s review. MBCT guidance also warns of possible flashbacks for people with trauma histories, and many centers stress that mindfulness is not meant to replace standard psychiatric care.⁵ That does not shut out everyone with depression: Britton’s MBCT trial, following those guidelines, enrolled adults with mild to severe depression symptoms but excluded active suicidal thoughts, extremely severe depression, a lifetime history of psychosis or bipolar disorder, and current post-traumatic stress disorder.¹⁴

For depression, mindfulness-based therapy is a clinical treatment, reached through a clinician rather than by signing up for a general course. NICE’s 2022 depression guideline (England) lists group mindfulness and meditation, such as MBCT, among treatment options for less severe depression: a program designed for people with depression, usually eight sessions, preferably run by two practitioners, at least one with therapy training. NICE asks clinicians to match the options to each person’s needs and preferences, and notes this one may be difficult for people with intense or highly distressing thoughts, or who find focusing on the body difficult.¹⁵ For people whose depression lifted on antidepressants alone but who are at higher risk of relapse, the same guideline says to consider group CBT or MBCT, either instead of the medication for those who do not wish to continue it, or alongside it; such a course usually runs 8 sessions over 2 to 3 months. NICE also advises anyone who wants to stop an antidepressant to talk to the prescriber first, because the dose usually has to be reduced in stages.¹⁵ The NCCIH advises against using mindfulness to replace conventional care or to put off seeing a health care provider.⁶

When to get help, and how fast

Thoughts of suicide or self-harm, or a feeling that you cannot keep yourself safe, need help straight away, whether meditation or anything else brought them on. Distress that lingers after practice is a reason to see a doctor soon, and any mental health history is worth raising before you sign up for a course. We sorted advice from the NIMH, the NHS and the NCCIH into three tiers; the grouping is ours.

• Straight away: if you are thinking about suicide or are in emotional distress in the US, call or text the 988 Suicide & Crisis Lifeline; in a life-threatening situation, call 911 or go to the nearest emergency room, the National Institute of Mental Health says.¹⁶ In the UK, the NHS says to call 999 or go to A&E if someone’s life is at risk or you do not feel you can keep yourself or someone else safe, and it lists Samaritans (116 123) as a free, confidential listening service.¹⁷ Elsewhere, call your local emergency number.
• Promptly: in Britton’s study, insomnia, emotional numbness, trouble thinking clearly and a disturbed sense of self were linked to effects that lasted.¹⁴ If experiences like these, or panic or traumatic memories, persist after practice, talk to a doctor rather than pushing through; the NCCIH advises against using mindfulness as a reason to put off seeing a health care provider.⁶ In England, the NHS says to call NHS 111 and choose the mental health option, or ask for an urgent GP appointment, if you need urgent help for your mental health.¹⁷
• Before you start a course: if you have a current mental health condition, or a history of trauma, psychosis, bipolar disorder or depression, raise mindfulness with a clinician before you enroll. The NCCIH suggests telling your health care providers about any complementary approach you use and asking about an instructor’s training and experience.⁶

The bottom line

Strip away the mysticism and mindfulness is a habit of attention you can train: noticing what is happening now, on purpose and without judging it, with no belief system required. Structured programs bring small, real improvements in anxiety, depression and pain in adults with health conditions or high stress, about as much as other good treatments and no more. Practice can also bring unpleasant effects, so if you have a psychiatric history, talk to a clinician before you sign up; with depression, a clinician is also the route to MBCT, which England’s NICE lists as a treatment option.