Mindfulness - what is it good for?

Last year, a wonderful man, Michael Stone, died following an overdose of the opioid drugs he had bought on the black market. Despite being an accomplished teacher of yoga and meditation, he had struggled with a serious mental health issue, bi-polar disorder, for many years and ultimately, he lost the battle. There is no doubt in my mind that he must have felt inhibited in seeking proper mental health care because of the stigma involved. I also think it's entirely possible that he held on to the idea that he should be able to deal with his distress using the resources his years of practice had given him. He was wrong, and the results were tragic, for his family, for all of us.

Mindfulness doesn't always get a good press. There is a lot of critical, and sometimes hostile, comment out there, in the papers, on blogs and social media. Much of the criticism follows the line, "mindfulness doesn't work". What they mean by this is that mindfulness (or meditation - the two things are frequently confused) fails to live up to the hype that has grown around it over the last few years. In particular, it's often pointed out that mindfulness training doesn't deliver the clinical outcomes that are claimed for it. And they are absolutely right, it doesn't - or at least the evidence to support it is flimsy and the research is rarely of good quality. Does this mean practicing mindfulness is pointless?

In a recent blog post, my former colleague Linda Gask, someone for whom I have enormous respect, said "There's nothing so depressing as focussing on how awful you feel 'in the moment'". Putting aside the notion that mindfulness has anything to do with focusing on how "awful" you feel, it's still a valid point. Mindfulness is, far too often, recommended to people as an answer to genuine issues of psychological distress - and my issue with that is that the people doing the recommending don't always know what it is they are endorsing to begin with. If you're depressed, grieving, traumatised or paralysed with panic, you need to do something about it. Grief and trauma need to be processed; there is a process of healing that you need to go through and it takes time. Depression, as opposed to common human misery, often requires that you seek help from a therapist or, even if you dislike the idea, take the tablets. So too with crippling anxiety or addictions or any of the other things that afflict us poor human beings. But don't use mindfulness to make you better, because it won't. Not by itself anyway, and it may even make things worse if you're not careful. Pain and disappointment are hard-wired into our organism. We can try, but we'll never escape that fundamental truth. Mindfulness meditation isn't going to make us immune from that. It's not magic.

All the same, mindfulness is one of the great gifts we possess as human beings and nothing that I know of is better able to enhance the lives of ordinary people or help them deal with the everyday messiness and unsatisfactoriness of their lives. People have discovered the ability to live with pain that they once considered unbearable. Others have discovered untapped wells of creativity. Most just find they can get by a little better than they did before. And some, a few, can touch experiences of real joy. The ultimate test of mindfulness practice is how well you learn to live your life  - and try finding an outcome measure for that. The mindfulness I practice and teach doesn't fit well in the world of randomised controlled trials, clinical effectiveness, therapeutic interventions and so on. If anything, I would argue that it's the therapists and professionals who need mindfulness, much more than the people they care for. A mindful doctor is much more likely to treat you with compassion and respect and a mindful therapist will truly be present for you in your distress. People should come to mindfulness when they are ready to do so and not simply because someone else thinks it's a good idea.

I ought to mention the most common 8-week programme taught in the UK, Mindfulness Based Cognitive Therapy. It's as effective as drugs in managing recurrent depression but it's significant that teachers of MBCT must have a strong personal practice before they can begin to teach. Despite the term "therapy" it does not claim to cure depression, or anything else for that matter. Rather it gives people the tools to recognise and manage relapse. Any MBCT teacher will tell you that you need to get help for your depression first before you start the course. I would confirm that. Incorporating an element of mindfulness into what could broadly be called "therapy" is almost certainly a good thing, but it needs to be combined with action. So, please, come and do a course – it’s a great experience – but don’t do it to fix a problem that should be fixed elsewhere.

Stay well.


Donald MurrayComment