Understanding 'mindfulness' and its importance in mental health
Christos Papalekas, a rational emotive and cognitive behavioural psychotherapist at Priory Hospital Hayes Grove, explains the history and importance of mindfulness as an approach to dealing with a range of mental health conditions.
Interventions based on training in mindfulness skills are becoming increasingly popular. Mindfulness involves bringing one’s attention to the internal and external experiences occurring in the present moment and is often taught through a variety of meditation exercises (R. Baer, 2003, American Psychological Association). The ability to direct one’s attention in this way can be developed through the practice of meditation, which is defined as the intentional self-regulation of attention from moment to moment (D. Goleman & G.Schwartz, 1976, Kabat-Zinn, 1982, Journal Of Consulting and Clinical Psychology, Vol 44). It has been described as paying attention in a particular way; on purpose, in the present moment and non-judgementally (Kabat–Zinn, 1994, Wherever you Go, there you are: Mindfulness Meditation in everyday life).
Origins of mindfulness
Until recently, mindfulness has been a relatively unfamiliar concept in much of our culture, perhaps because of its origins in Buddhism. Mindfulness has its origins in ancient meditation practices. The founder of modern day mindfulness is Jon Kabat-Zinn who founded the Stress Reduction Clinic at the University of Massachusetts Medical School in the late 1970s. Since then, over 18,000 people have completed the Mindfulness Based Stress Reduction (MBSR) programme to help with conditions as diverse as chronic pain, heart disease, anxiety, psoriasis, sleep problems and depression.
In the 1990s,, Mark Williams, John Teasdale and Zindel Seagal further developed MBSR to help people suffering from depression. Mindfulness based cognitive therapy (MBCT) combined cognitive behavioural therapy (CBT) with mindfulness. MBCT is clinically approved in the UK by the National Institute for Health and Care Excellence (NICE) as a "treatment of choice" for recurrent depression. Mindfulness training is also a central component of dialectical behaviour therapy (DBT), an increasingly popular approach to the treatment of borderline personality disorder.
How mindfulness therapy can help
If we start to think about our thoughts, or get annoyed with ourselves for not being able to retain focus, it stops us paying attention and takes us away from the present moment. If we just acknowledge our thoughts and let them go without judgement, we retain our focus on being in the present moment. Mindfulness is not an abstract or remote body of knowledge, like physics or history. It’s more of a practical skill, like being able to ride a bike or play the piano. A commonly used way to get into a 'mindful' state is to simply sit on a chair, close your eyes and begin to focus on your breathing. As you sit still, relaxed, but alert, you direct your attention to the sensation of each inhalation and exhalation: perhaps the gentle rise and fall of your chest or the feeling of air as it enters and leaves your nostrils. Mindfulness is not a way to shut off the pressures of the world or your own mind: “You can’t stop the waves, but you can learn to surf” (Kabat-Zinn). It’s not a form of relaxation; relaxation is not the goal but it may sometimes be a by-product. It takes effort and commitment to practise. A key skill in mindfulness is to recognise which mind mode you are operating and to consciously disengage from ‘doing’ into ‘being’ mode. “Mindfulness is a concept of awareness, not thinking. It involves a particular attitude; one of openness and curiosity which allows us to ‘wake up’, connect with ourselves and appreciate the fullness of each moment of life’’ (R. Harris, 2009. Book: ACT Made Simple).
Mindfulness in practice
As with all new skills, the more we practise it, the easier it becomes. Canadian psychologist, Donald Hebb, coined the phrase "neurones that fire together, wire together". In other words, the more we practise mindfulness, the more we develop neuro-pathways in the brain associated with being mindful, which make it easier to be fully in the present moment.
Historically, mindfulness has mainly been used in the clinical context of treating mental health problems such as stress and depression. However, its preventative applications have been recognised by western psychology and it has been used in psychiatric hospitals, schools, universities and businesses. Although some regard it with scepticism, studies appear to show a clinical benefit for treating a range of mental health problems. Priory Hospital Hayes Grove has launched mindfulness groups which are available to all patients in order to help them to learn the art and practice of mindfulness and subsequently, the ability to disengage from difficult thoughts, feelings and urges.
The growth in mindfulness therapy
Thousands of mindfulness sessions are prescribed to NHS patients every year to help treat anxiety and depression. Now, ministers have disclosed that they believe that mindfulness techniques “certainly merit consideration” with reports that Education Minister, Liz Russ, has been actively looking into the practice (Daily Mail, March 12th, 2014). Hollywood stars Meg Ryan and Goldie Hawn are advocates of mindfulness as is Kok-Song Ng, who finds time to meditate for 25 minutes twice a day, while working as chairman of global investments at GIG, Singapore’s sovereign wealth fund. A so-called ‘quiet revolution’ is gripping the City of London – with soaring numbers of fast–paced financiers finding solace in mindfulness’ (Daily Mail, May 6th, 2014).
Mindfulness allows us to bypass problems associated with disputation and avoidance. It helps us to make space for thoughts and feelings to exist; we stay exposed to them for their natural duration without feeding, repressing or fighting them. We observe what happens in the moment and we contain whatever is there to be experienced by not getting into a ‘problem-solving’ mode. Mindfulness is an emotionally non-reactive state which can enrich our lives. It’s a different concept to the views of the Western culture of ‘feel-good’ or ‘no-fear’. It challenges the ideas that we are defective when we are not happy and that we should always control our thoughts and feelings. Mindfulness helps to be awakening to the patterns of the mind rather than emptying the mind. It helps you to be in touch with your way of ‘being’ rather than ‘doing’. It is a concept that could be life-changing and worth experiencing.