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It's not easy. Lying on a blue plastic mat, dressed in an uncomfortable work suit and open necked shirt, with an air conditioning unit grumbling close by, my mind isn't that keen on being escorted anywhere. Instead, it's wondering if anyone else is struggling to focus. It's wondering how I will be able to recall this experience in enough detail to jot it down afterwards. It's thinking about the Viking occupation of
For the growing army of people who have taken part in mindfulness training, these reflective rituals of the 40-minute "body scan" will be all too familiar. The scan plays a key part in helping people to become more mindful - to live more in the moment and to spend less time anticipating stresses, or reliving disasters from the past.
Mindfulness is everywhere at the moment. If you don't know someone who has done a course, downloaded an app or read a book, you will soon. Based on centuries-old Buddhist meditation practices and breathing exercises, it is prescribed to thousands of patients on the NHS each year to help prevent anxiety, depression and stress. Even more pay for private classes believing that they improve the quality of their lives and relationships. And more than 1 million people looking for mindfulness on-the-go have downloaded apps such as Headspace. The mindfulness industry is vast, and growing weekly.
So can an approach so deeply rooted in eastern spiritualism, and which at times comes close to sounding like new age waffle, really work?
"It's a preventative treatment - that's what makes it different," says Williams. "People usually seek treatment when they're depressed or anxious, and cognitive therapy is one of the major success stories in treatment. But cognitive therapy is used when people are ill. What we wanted to do was extend this to teach people skills to stay well that they could use before depression threatens."
The idea behind mindfulness is straightforward. Kabat-Zinn calls it "paying attention on purpose, moment by moment, without judging". Practitioners argue that the brain's habit of reliving past stresses and worrying about potential future problems can become an obstacle to mental health.
Mindfulness encourages people to get those critical thoughts about the past and future into perspective so they no longer dominate. Instead, people are given tools to help them become anchored more in the present, and to focus more on the sensations of the world from moment to moment. That is achieved through meditation techniques such as the body scan - a practice where participants are "invited" to focus on the sensations of their own body. Thoughts that pop up during the exercise are acknowledged and "observed kindly" before the mind is refocused back to the sensations of the body.
Other practices focus on breathing and on linking stresses and mental distractions to physical sensations in the body such as tense shoulders, clenched hands or shallow breath. It sounds simple, but it's not. It takes hard work and lots of practice.
"A good example of how it can work is when you're kept awake at night thinking," says Williams. "You toss and turn and you get angry because you can't sleep. The anger doesn't help, but you can't seem to stop it. Mindfulness isn't about suppressing those thoughts, but about enabling you to stand back and observe them as if they were clouds going past in the sky. You see them and you cultivate a sense of kindness towards them."
The best documented benefits are preventing relapses of depression, where it helps people entering the downwards spiral to notice when self-critical thoughts are beginning to arise and to help prevent those negative thoughts from escalating. And it draws attention to small pleasures around people, helping to lift mood.
For those suspicious of therapy and mysticism it can sound vague and woolly. But Williams insists this is a practical, clinically proven approach. And while its origins are in Buddhism, it is completely secular.
The clinical evidence for mindfulness as a way to prevent depression, stress and anxiety appears to be sound. A review of the eight-week course was published in 2011 in Clinical Psychology Review by
After looking at six clinical trials involving 593 people, they concluded that mindfulness-based cognitive therapy reduced the risk of relapse for patients with at least three previous incidents of depression by 43% compared with people who received treatment as usual. However, there was no significant benefit for people with fewer than three major incidents.
A review of the research in Clinical Psychology Review last month by researchers at the
These are the best of the recent studies - but the published evidence goes back further. In 2004, Nice - the NHS's rationing body - was convinced enough of the benefits that it ruled mindfulness-based cognitive therapy was cost effective. Its most recent advice, updated in 2007, is that it can be prescribed for people with three or more episodes of depression. There is also growing evidence that it's effective for chronic long-term health conditions such as ME.
"Taking a mindfulness course was something I thought long and hard about. I was concerned about the Buddhist origins of mindfulness. I'm an atheist, so the idea of engaging with anything mystical worried me. I'm also a very pragmatic person and anything with the word 'therapy' attached to it makes me uneasy. Moreover, there's been a lot of controversy around the way ME has been regarded as a psychiatric disorder, and I felt concerned that following a mindfulness course would seem to endorse this view about the nature of the illness."
After an eight-week course at the
"There's a popular notion that it's a panacea - it's not," she says. "Practising it in a formal or informal way is a constant challenge. The brain doesn't like being still and being focused on something as mundane as your breath. The challenge is to observe your mind wandering, not criticise, and just lead it back."
The changes brought about by mindfulness are difficult for Jackson to quantify.
"It has given me lots more options in my life, but only when I wake up to them. There's a sense that we drift through our lives. Mindfulness gives you an awareness and therefore a choice as often as you choose to bring it to mind - that ability to step out of the situation and evaluate things and make a conscious choice: do I want to pick up my smartphone and distract myself, or choose to see the sunset and notice how it makes me feel?
"But it has worked. Exhaustion can have a cyclical pattern in ME. A lot of people overdo things and become exhausted. Then when they've rested and are feeling less tired, they overdo things again. That's a pattern I fell into. There's been a huge benefit in being more aware of that pattern and the way I feel, and making a conscious choice of how to react and look after myself."
"People often say they notice how much of life passes them by," she says. "Suddenly they are noticing things in nature, in their friendships and neighbours - perhaps they have different relationships with their children and families. They are more present in what they do and they get a sense of appreciating more fully the life they are living."
But there is a danger that the benefits of mindfulness are being overstated, without the clinical data to support them. There are books on applying it to business leadership, to parenting and to weight loss. There are mindfulness exercises for children and guides on living with pain. There is no shortage of courses, books or even smartphone apps being offered to an enthusiastic public - and sometimes little way for people to tell whether they are authentic, quality-controlled and reliable - or on the fringes of new age crankism. Even the experts in mental health can occasionally overstep the mark.
That is true, but only to a point. The MHF website glosses over an important caveat in the BMJ Open paper. The authors, who include Prof Williams, point out in the paper that the study had no control group, meaning there was nothing to compare the course with. More research is needed.
Williams is acutely aware of the dangers of overclaiming.
"A lot of people think it will cure everything. But we know there is nothing that cures everything. There is some interesting work in psychosis, bipolar disorder and schizophrenia but it's in its early days. There's a lot of hype around mindfulness and we need to be cautious because it doesn't serve our science or patients well if we're overenthusiastic. We have to make sure the science catches up with the enthusiasm."
EXERCISE: Three-minute breathing space
This three-minute mini-meditation is designed to be done during the day - while sitting at a desk, standing quietly in the garden, resting in a chair, or in a parked car. It breaks up the day and lets you pause when your thoughts threaten to spiral out of control. It is best done between longer meditations taught as a part of a mindfulness-based cognitive therapy course. It is made up of three steps, each lasting roughly one minute.
Adopt an erect standing or sitting posture and shut your eyes if possible. Start to acknowledge what is going on with your body and what your experience is right now. First, gently investigate what thoughts are passing through your mind. Acknowledge these thoughts as "mental events" floating past like clouds in the sky. Second, investigate what feelings you have. Notice any uncomfortable or unpleasant feelings without trying to suppress or change then. Finally, gently explore with your mind what body sensations you have. Scan the body for any sensations of tightness or tension. Again, acknowledge them but do not try to change them.
Redirect your attention to the physical sensations of breathing, and in particular the sensations in your lower abdomen as it gently expands and contracts with each breath. Use each breath to anchor yourself into the present. If the mind wanders into the past, into daydreams, or starts anticipating future events, acknowledge the fact uncritically and non-judgmentally and then gently escort your attention back to the breath.
Expand your field of awareness around the breathing so it includes a sense of the whole body - including your facial expression and posture - as if the whole body was breathing. If you become aware of discomfort or tension, imagine your breath could move into and around the part of the body where the discomfort is. Explore the sensations and "befriend them" rather than trying to change them.
Devised by Prof
App developers have been quick to respond to the popularity of mindfulness.
AND RELAX Mindfulness differs from meditation in that instead of asking subjects to clear their minds, it invites them to investigate and acknowledge their thoughts. Alamy
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