Positive Therapy: Mindfulness (pg 92-93)

Transcription

1 Positive Therapy: Mindfulness (pg 92-93) Ever meditated? How do you do it? What is the purpose? The positive approach to psychology is different to the others we have looked at in that it is not interested in the causes of mental illness, nor is it focused exclusively on the treatment of the mentally ill. The other therapies we have investigated have all been for the treatment of some sort of mental problem that is causing suffering for the individual. Psychosurgery is used for severe mental illnesses such as OCD, systematic desensitisation treats phobias, dream analysis uncovers traumatic repressed thoughts in the unconscious, and CBT alters maladaptive thinking. Mindfulness is a therapy in as much as it can be used for the alleviation of the suffering caused by mental illness. However, it is much more than that. Mindfulness techniques can be used by anyone, at any time. It can help anyone to improve their mental wellbeing, even if there is nothing particularly wrong with them. This ties in with other aspects of the positive approach that focus on improving wellbeing and helping people achieve their full potential. How does this therapy link with the assumptions of the positive approach? Mindfulness links strongly with the overall aim of positive psychology which is to improve wellbeing and aid in the flourishing of human potential. Therefore, it could be argued that mindfulness is linked with the assumption of the good life. Another link is that of the authenticity of goodness and excellence. As discussed above, the other approaches in psychology have produced therapies that focus on the treatment of illness. Mindfulness is focused on nurturing positive emotions, strengths and virtues, and emphasises their importance and authenticity. Mindfulness is based on the assumption that humans have free will. One of the key ideas of mindfulness is to train an individual to gain control over their thoughts and emotions, in contrast to a determinist stance that would argue that our thoughts and emotions are beyond our control Aims Look at the images of mindfulness on the board. What do you think mindfulness is about? 1

2 Mindfulness is a mental state achieved by focusing one s awareness on the present moment, while calmly acknowledging and accepting feelings, thoughts, and bodily sensations. By being fully present in this way not forcing things or hiding from them, but actually being with them, we create space to respond in new ways to situations and make wise choices. We may not always have full control over our lives, but with mindfulness we can work with our minds and bodies, learning how to live with more appreciation and less anxiety. Making mindfulness a frequent aspect of daily life requires training and a lot of practice. If you re motivated, a fresh perspective can begin to emerge and extend to the whole of your life when we start practising mindfulness, we re embarking on a journey that helps us live life more fully, to really be alive. Mindfulness practices aren t new they have Buddhist origins and have been around for thousands of years. But recently in western healthcare, they have been formalised into the therapies of MBCT and MBSR. This means you don t need to be religious or spiritual to learn to practise mindfulness and enjoy the benefits. For decades now, scientific research has been showing how useful these therapies are for reducing stress, anxiety and depression, helping people manage a wide range of physical conditions, and for our general wellbeing. So mindfulness isn t only useful if you re feeling stressed or have a mental health problem it can help any of us enjoy a more wakeful, healthier, happier life. Anyone can learn and practise mindfulness; children, young people and adults can all benefit. It s simple, you can practise it anywhere and the results can be life-changing. There are different ways to develop an understanding of, and how to practise mindfulness in daily life. It can be learnt in person, either through a group course or one-to-one with a trained teacher. There are books, audios and videos and online courses too, where you can learn through selfdirected practice at home. (Taken from Read the text above and summarise the aims of mindfulness. Main components (principles) of mindfulness The main aim of mindfulness is to enable a person to be present in the moment rather than focusing on the past or future. It aims to help people control their thoughts and emotions. This can be done by a number of techniques. Gaining control of thoughts: We are often too focused on the past or future to be fully present in the here and now. Mindfulness teaches a person to focus on the present. This can be achieved in a number of ways. There is more than one way to practice mindfulness, but the goal of any mindfulness technique is to achieve a state of alert, focused relaxation by deliberately paying attention to thoughts and sensations without judgment. This allows the mind to refocus on the present moment. All mindfulness techniques are a form of meditation. Basic mindfulness meditation Sit quietly and focus on your natural breathing or on a word or mantra that you repeat silently. Allow thoughts to come and go without judgment and return to your focus on breath or mantra. Body sensations Notice subtle body sensations such as an itch or tingling without judgment and let them pass. Notice each part of your body in succession from head to toe. Sensory Notice sights, sounds, smells, tastes, and touches. Name them sight, sound, smell, taste, or touch without judgment and let them go. Emotions Allow emotions to be present without judgment. Practice a steady and relaxed naming of emotions: joy, anger, frustration. Accept the presence of the emotions without judgment and let them go. Urge surfing Cope with cravings (for addictive substances or behaviours) and allow them to pass. Notice how your body feels as the craving enters. Replace the wish for the craving to go away with the certain knowledge that it will subside. ( 2

3 Meditation and mindful breathing: Two key methods to enable a person to focus on the present is to use meditation and breathing. Meditation itself is a central concept, and the best way in which to focus on the here and now. It can take a while for a person to get to grips with meditation, and it takes practice and formal training to be able to meditate properly. Meditation is more than simple relaxation. Through body posture and breathing exercises, the individual is learning to tune out distractions and focus instead on the sensations from their body. Thoughts and emotions come and go from the mind, are acknowledged, but not dwelt upon. The person will come to realise that these thoughts and feelings are impermanent and transitory, and will soon pass. This is argued to be a healthier way to deal with negative thinking. The book contains information on mindful breathing. This exercise teaches basic mindfulness meditation. Sit on a straight-backed chair or cross-legged on the floor. Focus on an aspect of your breathing, such as the sensations of air flowing into your nostrils and out of your mouth, or your belly rising and falling as you inhale and exhale. Once you ve narrowed your concentration in this way, begin to widen your focus. Become aware of sounds, sensations, and your ideas. Embrace and consider each thought or sensation without judging it good or bad. If your mind starts to race, return your focus to your breathing. Then expand your awareness again. Above all, mindfulness practice involves accepting whatever arises in your awareness at each moment. It involves being kind and forgiving toward yourself. Some tips to keep in mind: Gently redirect. If your mind wanders into planning, daydream, or criticism, notice where it has gone and gently redirect it to sensations in the present. Try and try again. If you miss your intended meditation session, you simply start again. By practicing accepting your experience during meditation, it becomes easier to accept whatever comes your way during the rest of your day. ( 3

4 Informal practices of mindfulness: Mindfulness techniques are not just restricted to a few minutes a day. Really successful mindfulness practice can be done constantly, by focusing on the present, and being fully engaged in whatever task you are doing. In addition to formal meditation, you can also cultivate mindfulness informally by focusing your attention on your moment-to-moment sensations during everyday activities. This is done by single-tasking doing one thing at a time and giving it your full attention. As you floss your teeth, pet the dog, or eat an apple, slow down the process and be fully present as it unfolds and involves all of your senses. You can choose any task or moment to practice informal mindfulness, whether you are eating, showering, walking, touching a partner, or playing with a child or grandchild. Attending to these points will help: Start by bringing your attention to the sensations in your body Breathe in through your nose, allowing the air downward into your lower belly. Let your abdomen expand fully. Now breathe out through your mouth Notice the sensations of each inhalation and exhalation Proceed with the task at hand slowly and with full deliberation Engage your senses fully. Notice each sight, touch, and sound so that you savour every sensation. When you notice that your mind has wandered from the task at hand, gently bring your attention back to the sensations of the moment. ( Over the next few week, try to live a mindful life. Take a few minutes each day to practice some mindful meditation. Be present in the here and now, engaging completely with whatever task you are doing. Accept your thoughts without judgement or dwelling on them Each day, write your experiences down in the box below. What was your experience like? Did you enjoy it? Was it difficult? Do you think you will carry on doing it? Can you see the benefit? 4

5 Evaluation What are your first thoughts on mindfulness? Do you like it? What strengths and weaknesses can you see? Evaluation: Effectiveness There is a growing body of evidence suggesting that mindfulness techniques can have positive effects on our mental wellbeing. Mindfulness can be used either in isolation, or incorporated with another therapy, such as Mindfulness-Based Cognitive Therapy (MBCT) or Mindfulness Based Stress Reduction (MBSR). Crane et al (2014) found that for people who have experienced three or more previous episodes of depression, MBCT reduces the recurrence rate over 12 months by 40 50% compared with usual care. Similarly, Williams et al (2013) found that MBCT is as effective at reducing recurrence as antidepressants. Because of the research supporting the effectiveness of mindfulness, the UK, the Government s National Institute for Health and Clinical Excellence (NICE) has recommended MBCT in their Guidelines for Management of Depression (2004, 2009) for service users who have had three or more episodes of depression. What did Teasdale et al (2000) do and find? (pg 93) What did Reibal et al (2001) do and find? (pg 93) Mindfulness techniques have also been adapted for a variety of settings such as the workplace, prisons, and even to help pregnant women. Research suggests that mindfulness is adaptable enough to be applied in all aspects of life. One such scheme that has shown some success is mindfulness for schools. A successful Mindfulness in Schools project was set up in 2007 and is now being taught in 12 different countries. This nine-week course is especially designed for school students, whether they are dealing with exam stress, bullying, or seeking to enhance study skills. It s being used to improve students wellbeing as well as helping them to learn and concentrate better. Schemes such as this have been demonstrated to have positive outcomes with regards to reducing anxiety and distress as well as improving behaviour, among other areas (Weare, 2013). Evidence also suggests that children who used mindfulness practices more frequently reported higher wellbeing and lower stress scores (Kuyken, 2013). 5

6 However, the research into mindfulness is not without its critics: C1. Approach 5: The Positive Approach 2: Therapy Mindfulness The evidence seems strong that mindfulness helps with depression, although some dissident psychiatrists suggest the methodology behind the positive studies hasn t been as rigorous as it might be. Many of the studies are small, are pilot studies and are carried on those who are not very ill, says Professor Patricia Casey of University College Dublin. So they would be at the mild end of the spectrum. Studies have not sufficiently frequently investigated how mindfulness compares with other therapies including pharmacological interventions. Neither have researchers paid much attention to what the active ingredient is is it being looked after, or looking after oneself? Melanie McDonagh, The Spectator, 1 November 2014 Evaluation: Effectiveness Generally, mindfulness has been seen to be highly ethical. As a therapy, it has few side effects (particularly if compared to biological therapies such as psychosurgery and drugs), and takes a highly positive attitude towards individual wellbeing. It promotes free will, empowering people to make changes in their own lives. Read a positive approach to therapy on pg 93 What advantage does mindfulness have over psychodynamic therapy? What advantage does mindfulness have over CBT? Another ethical strength is that mindfulness is reasonably accessible to all. There are thousands of mindfulness courses run all over the country, costing around 25 for an hour. Here anyone can be taught the basics of mindfulness and meditation, usually in a group with others. There are many websites that run online mindfulness courses. This is a strength for people who may be reluctant to visit a traditional psychologist, or who would prefer to undergo therapy without having to disclose their problems and issues to a stranger. In this way, mental health relief can be accessed by people who would otherwise receive no support. However, mindfulness is not without its issues. There is a big issue with mindfulness being delivered by untrained practitioners. This is of particular concern for people who use mindfulness as a way of reducing the symptoms of mental illness. Many practitioners of mindfulness will only have a week of training before running their own sessions. Dr Florian Ruth, a consultant psychiatrist at the Maudsley hospital in south London stated in the Guardian (25/08/14): "There is a lot of enthusiasm for mindfulness-based therapies and they are very powerful interventions, but they can also have side-effects. Mindfulness is delivered to potentially vulnerable people with mental illness, including depression and anxiety, so it needs to be taught by people who know the basics about those illnesses, and when to refer people for specialist help." 6

7 One issue raised by the use of meditation, particularly that based on Buddhist practices such as mindfulness, is a phenomenon known as the dark night, first investigated by Willoughby Britton. The dark night phenomenon is a rare but serious potential side effect of prolonged deep meditation. Some Buddhist meditators have been plagued by traumatic memoires, cognitive and perceptual abnormalities, a loss of a sense of self, and an impairment of social relationships. It has been described as an "irreversible insight into emptiness". While rare, and unlikely to be triggered by the mild meditation used in mindfulness, this is nevertheless an issue that needs further investigation, and something that mindfulness practitioners (particularly those who have not undergone extensive training) may not be aware of. Even without something as serious as the dark night, meditation can cause issues, particularly for the vulnerable. Marie Johansson from Oxford University stated in the Guardian (25/08/14): "Taking the course is quite challenging. You need to be reasonably stable and well. Noticing what is going on in your mind and body may be completely new and you may discover that there are patterns of thinking and acting and behaving that no longer serve you well. There might be patterns that interfere with living a healthy life and seeing those patterns can bring up lots of reactions and it can be too much to deal with. Unless it is handled well, the person could close down, go away with an increase in self-criticism and feeling they have failed." One of the biggest problems with mindfulness is that it was not developed to specifically cure or alleviate the symptoms of mental illness. Mindfulness grew out of traditional Buddhist meditation, and its main aim is to help people control their thoughts and fully experience the here and now. As such, it may have limited usefulness when used as a therapy for mental disorders. It might be more useful as a way of promoting wellbeing in mentally healthy people rather than as a therapy One common criticism is that it does not get to the root cause of a psychological disorder. If mental illness is being caused by traumatic childhood memories, faulty thinking or current life stressors for example, mindfulness is of limited use in addressing these issues. During mindfulness, an individual is taught to accept their thoughts without judgement and without dwelling on them. However, this does nothing to address the issues that caused the thoughts in the first place. This means these thoughts could keep reoccurring if left unexamined. Therefore, mindfulness may not be appropriate for disorders such as Post Traumatic Stress Disorder (PTSD), anxiety and Schizophrenia, which are characterised by intrusive (uncontrollable) thoughts. On the other hand, while mindfulness may not get to the root cause of these thoughts, it helps an individual cope with them and not dwell on them, therefore alleviating their suffering. For many people, this may be all they desire from a therapy. 7