MIND MOVES: Last week I attended a meeting in Oxford University that gathered mindfulness teachers from across Europe to review the explosion of mindfulness-based therapies within mental health services, and to consider ways to respond to the increasing demands from service users and therapists for training and programmes.
Mindfulness is the practice of learning to pay attention to and appreciate our lives as they are unfolding in the present moment. It helps all of us to counter our natural tendency to ruminate, to lose touch with our immediate experience and live in a state of semi-forgetfulness.
The availability of mindfulness-based therapies is growing in Ireland and looks likely to be one of the most promising healthcare innovations in the years ahead. As public demand grows for these approaches, it is wise to consider how to grow this expertise and establish training opportunities that ensure it is provided in an ethical and competent manner.
Mindfulness training is made up of simple practices that help us to live our lives in a more grounded, peaceful and creative way. It teaches us to take time to tune in to our breathing, to connect with our bodies and to accept whatever is real for us in any given moment. It steadies us and allows us to think more clearly and to find creative solutions for the problems that beset us.
The relevance of this practice to mental health services became clear when we began to appreciate that mindfulness could help people deal with the particular vulnerabilities that can trigger relapse into serious mental illness. A major study, repeated twice, showed how mindfulness training reduced the relapse rate by 40 per cent among those with repeated experiences of severe depression. Other recent findings have also suggested that it may be protective for people who experience repeated attacks of anxiety or psychosis.
People who have experienced severe mental distress, such as major depression, anxiety or psychosis, unfortunately may develop particular strategies for coping with stress that very often trigger relapse rather than protect against it. For example, they may try desperately hard to avoid thinking upsetting thoughts or feeling certain emotions, and do whatever they can to escape their painful inner lives.
These coping strategies not only fail but invariably dig them into a deeper hole than the one from which they are trying to escape. Failure to control their bad moods can, in turn, provoke a terrible sense of demoralisation and defeat, and lead to a slide into relapse.
Mindfulness teaches people a different way to react to stress, how to steady themselves, how to allow and accept whatever is happening, rather than try to push it away. By focusing on their breath, for example, they learn to gradually calm and anchor themselves in the present moment and not get carried away by frightening thoughts of what might happen in the future, or in depressing self-blame for what may have occurred in the past.
One man who has experienced a lifetime of hospital admissions for psychosis and depression (a total of 27 admissions over 20 years) has, for the past three years, been practising mindfulness and has not had a relapse; he has been living independently and has had his medication halved.
He recently described an experience that illustrated how the practice of mindfulness was helping him: he had been feeling generally stressed with his life for a few days when he found himself sitting on the DART and overcome with feelings of paranoia. He looked up nervously and felt sure he saw streams of blue light radiating out of the eyes of the man sitting opposite. Recognising that he was having a familiar visual hallucination, he was able to catch himself falling deeper into paranoia.
Whereas previously he would risen from his seat and ran from the train at the next stop - which would have triggered a cascade of paranoid thoughts and feelings - he chose instead to close his eyes and to go back to his breathing and slowly ground himself. He accepted his feelings of stress and identified his hallucination as a sign that he needed to slow down and take care of himself.
After a few moments of this mindfulness practice, he opened his eyes and saw the man opposite looked perfectly normal. There was nothing out there to be afraid of, but simply someone inside himself who needed looking after.
In October, the Limerick Mental Health Association will focus its mental health week on the theme of Mindfulness and Mental Health. Public and professional workshops will help people experience the value of this practice in living more fully and coping with emotional vulnerabilities more effectively.
This week will undoubtedly lead to many inquiries for programmes and for training. Now may be a good time for Irish-based therapists using this approach to come together and consider what may be needed to promote the practice of mindfulness and make it more widely available.
I am beginning the process of convening a meeting of therapists and counsellors interested in developing mindfulness in Ireland. If you're interested, perhaps you might contact me at the e-mail address below.
Dr Tony Bates is principal clinical psychologist in St James's Hospital and can be contacted at tbates@irish-times.ie
