Mindfulness as defined by Jon Kabat Zinn is paying attention in a particular way, on purpose, in the present moment, non-judgementally. But it is also, as Kabat Zinn himself admits in the foreword to this large and comprehensive multi-authored book, used by his group “as an umbrella term that subsumes all the other elements of the Eightfold Noble Path, and indeed of the dharma itself. . .” (p. xxviii). This tension between mindfulness as a technique or natural phenomenon of attentional regulation, and mindfulness as a component of a philosophical system that offers a radical way of being in the world, runs through this book and indeed the whole mindfulness movement. Can mindfulness be extracted from the Buddhist context in which it originated as a concept? If so, what is it and what is the new context in which we locate it in Western clinical practice? But another dilemma also runs through the whole of this book: how it is possible to use words to describe a way of attending that is ultimately non-conceptual and experiential.

The book is divided into four parts. In Part 1 “Theory, conceptualization and phenomenology” the basic concepts of mindfulness are discussed. There is a very accessible chapter by Siegel and colleagues on what mindfulness is and where it came from and a concise summary by Treadway and Lazar of the neurobiology of mindfulness. Part 2, “Clinical applications: general issues, rationale and phenomenology”, is a rather mixed section, where I suspect the editor placed a number of chapters that were not easily classified. It contains an interesting chapter by the editor on how mindfulness can be used with feelings of emptiness – a symptom reported in a number of personality disorders, and difficult to work with using traditional cognitive methods. There is a chapter by Baer and colleagues that helpfully reviews the instruments for assessing mindfulness. This part also includes a timely reminder by Kocovski and colleagues that mindfulness-based cognitive therapy (MBCT) is not a general purpose therapeutic technology, but may work best when applied within a specific problem formulation for a given disorder. Part 3, “Mindfulness-based interventions for specific disorders”, covers several disorders: anxiety disorders, OCD, depression, borderline personality disorder, eating disorders, addictions, PTSD, ADHD, psychosis, chronic pain, and oncology. This may be the section that is of most interest to the cognitive behaviour therapist who wishes to understand how to apply MBCT and MBSR in clinical practice. The therapist will find some useful tips on how the standard programme is adapted for different problems. Most, though not all, of these chapters contain case examples that bring to life the application to real individuals. The final section, “Mindfulness-based interventions for specific settings and populations”, describes mindfulness in individual psychotherapy, with children, older adults, inpatients, and with health care professionals. The appendix, “Mindfulness practice”, gives brief guidance to the forms of meditative practice within this tradition.

Inevitably a book with so many authors is variable in style, but I found all the chapters very readable, and all open a window onto one or more aspects of the practice. This volume will probably be of most interest to a clinician who already has some understanding of mindfulness and who is interested in a clinically based overview of how it is blossoming in ever increasing areas. I was struck, however, by how few randomized controlled trials there still are for an approach that has attracted so much attention. And, for a way of being that cannot be put into words, there are a lot of words in 523 pages.