Abstract: This paper introduces an innovative “therapy-neural-culture continuum” framework that reconceptualizes mindfulness as a holistic psychological intervention, elucidating the unique psychotherapeutic mechanisms and neural foundations of Eastern mindfulness. Rooted in Chinese Mahāyāna (Han) Buddhism and integrated with Confucian and Daoist philosophies, Eastern mindfulness addresses the limitations of Western mindfulness models, which have often undergone decontextualization and ethical omission, leading to conceptual reductionism and potential adverse effects. By restoring the integral Three Trainings—śīla (morality), samādhi (concentration), and prajñā (wisdom)—as a unified system of mental cultivation, this approach transcends individualistic and instrumental adaptations, providing a culturally grounded pathway for deep psychological transformation and enhanced intervention safety.
A central innovation lies in the psychological reinterpretation of Eastern mindfulness’s theoretical core, distilled into four interrelated pillars: emptiness (śūnyatā), Buddha-nature (tathāgatagarbha), bodhisattva practice, and non-duality. Emptiness is reframed as cognitive de-reification, enabling practitioners to perceive thoughts and self-concepts as transient processes rather than fixed entities. This aligns with the defusion process in acceptance and commitment therapy (ACT), yet surpasses cognitive behavioral therapy’s (CBT) reappraisal techniques by fundamentally challenging the reality of mental constructs. Buddha-nature reframes healing as the realization of inherent potential rather than the correction of deficits, paralleling posttraumatic growth (PTG) theory in which trauma catalyzes resilience and wisdom beyond mere recovery. Bodhisattva practice transforms motivation from self-centered relief to altruistic fulfillment, promoting prosocial behavior through compassion training—supported by evidence of enhanced empathy, gratitude, and reduced bias. Non-duality fosters psychological flexibility, integrating opposing experiences such as pleasure and pain, enabling value-driven living amid distress, as demonstrated in studies of emotional adaptability. Collectively, these pillars define Eastern mindfulness as a wisdom-oriented psychotherapeutic model that unites ethical, cognitive, and relational dimensions.
The practice architecture is reconstructed through the Three Trainings as an interdependent psychological model. Morality (śīla) functions as ethical self-regulation, reducing inner conflict and strengthening psychological immunity through disciplined conduct, establishing a secure foundation for deeper contemplative work. Concentration (samādhi) enhances attentional stability and emotional regulation via focused-attention and loving-kindness meditation, bridging external behavioral harmony with internal cognitive clarity. Wisdom (prajñā) culminates in metacognitive insight, paralleling open monitoring meditation, deconstructing the illusion of self for profound transformation. Unlike Theravāda’s emphasis on individual liberation, Mahāyāna’s prajñā integrates altruistic insight, emphasizing compassionate awakening. This spiral progression ensures comprehensiveness, as each training reciprocally reinforces the others, forming a dynamic system of behavioral ethics, cognitive clarity, and transcendental understanding. The study further outlines these mappings through conceptual modeling, highlighting how Eastern mindfulness fuses Buddhist ethics, Confucian moral harmony, and Daoist natural balance into a relational, holistic approach that surpasses Western models focused solely on attention and awareness.
Clinically, although direct randomized controlled trials (RCTs) on the integrated Eastern framework are limited, aggregated evidence from related interventions supports its efficacy. Compassion and loving-kindness meditation reduce anxiety, enhance positive affect, and improve social cognition. Body-mind practices such as Qigong and Baduanjin alleviate depression, stress, and inflammation by upregulating serotonin and brain-derived neurotrophic factor (BDNF), and by modulating autonomic nervous system activity. Ethical and compassion-based practices reduce compassion fatigue and strengthen prosocial connectedness, while wisdom-oriented practices foster non-dual awareness and self-transcendence, mitigating self-centered cognition.
At the neural-physiological level, the model innovatively delineates multi-pathway integrations. Morality engages compassion-prosocial circuits, activating the dorsomedial prefrontal cortex (dmPFC) and temporoparietal junction (TPJ) for empathy while downregulating the amygdala to achieve emotional equilibrium, with gamma synchrony marking stable trait changes. Concentration modulates default mode-executive control network (DMN-ECN) dynamics, reducing rumination via posterior cingulate cortex (PCC) deactivation and enhancing executive regulation through anterior cingulate (ACC) and prefrontal (PFC) engagement. Wisdom activates insight-deconstruction pathways, diminishing self-referential processing in the DMN and amplifying gamma/theta oscillations linked to cognitive flexibility. Systemic effects manifest through the neuroendocrine-immune axis, where HPA-axis downregulation lowers cortisol, enhanced vagal tone increases HRV and parasympathetic dominance, and anti-inflammatory shifts (e.g., interleukin-6 reduction) foster resilience. Cultural neuroscience further clarifies that repetitive engagement in these practices shapes “culturally patterned neural activity”, accounting for Eastern mindfulness’s superior safety, ethical depth, and integrative efficacy.
Future work should focus on empirical verification, protocol standardization, and cross-cultural adaptation. The paper calls for high-quality RCTs, neuroimaging validation, and indigenous psychometric development to establish Eastern mindfulness as a scientifically robust Chinese psychotherapy paradigm. Ultimately, this therapy-neural-culture continuum not only restores mindfulness’s Buddhist essence but also positions it as a bridge linking therapy, neuroscience, and culture, offering globally relevant insights for ethical, transformative, and culturally attuned mental health interventions, and expanding the scientific boundaries of mindfulness research.

Key words: mindfulness, Chinese Mahāyāna Buddhism;, localized Chinese psychotherapy, neural mechanisms, cultural neuroscience