How it happened
Jon Kabat-Zinn, who had practised Zen and vipassanā, began a programme at the University of Massachusetts Medical Center in 1979 for patients with chronic pain that medicine could not resolve. He built it from meditation practice, taught in eight weeks, deliberately stripped of Buddhist vocabulary so that it could be offered in a hospital.
Mindfulness Based Stress Reduction spread into healthcare worldwide. Mindfulness Based Cognitive Therapy, developed later for recurrent depression, is recommended by clinical guidelines in several countries, including the United Kingdom.
What the evidence shows
The strongest evidence is for the specific clinical uses: relapse prevention in recurrent depression, and some benefit for anxiety, chronic pain and stress. Beyond those, results are mixed, and reviews have repeatedly criticised the field for small studies, weak control conditions and selective reporting.
Claims made for mindfulness in schools and workplaces usually run well ahead of the evidence for them.
The argument about it
Critics, Ronald Purser's McMindfulness among them, argue that a practice meant to loosen craving has been sold as a way to cope with the conditions that cause it, and that teaching employees to manage their stress is cheaper than addressing why they are stressed.
Defenders answer that relief is relief, that the programmes were built for people in genuine difficulty, and that many people meet the tradition properly only after meeting it stripped down. Both can be true. What is clearly true is that secular mindfulness and Buddhism are related but not the same thing, and treating them as interchangeable misleads in both directions.
Why it matters
For many people, mindfulness is now their first contact with Buddhist ideas, often without the wider tradition around it.
History and tradition
What historians can say
The clinical history is documented in the trials themselves and in Kabat-Zinn's published accounts. Jeff Wilson's study traces how the practice was reshaped by American culture as it spread, and how it reshaped American Buddhism in return.