|
 Stuart Wood
We've all heard about 'eastern' practices and ideals being used as
complementary therapies. For the first time in the UK principles derived
from Indian and Chinese meditation are being pioneered within the NHS.
People suffering from chronic pain are currently discovering the benefits
of
tai chi techniques. Is this a sign that we are truly entering a new phase
of understanding?
A New Project
In a small rehab unit in the south east, a remarkable project is uncovering
the benefits of using the mind's powers to live with chronic pain for
which
traditional medicine can find no cure. Pain in these circumstances lasts
for many years or months, resulting from rheumatism, chronic fatigue,
sometimes where there is no organic cause for pain.
Mindfulness in principle
As many people know these days, a basic element of Tai Chi is the principle
of Mindfulness. John Kabat-Zinn, an early pioneer of east-west blending
in
healthcare, writes:
"...mindfulness is moment-to-moment awareness. It is cultivated
by
purposefully paying attention to things we ordinarily never give a moment's
thought to."
Techniques such as the 'body scan' and 'loving kindness' are familiar
to many who have attended evening courses, modern health clubs or even
(it's
been known) drama workshops. But how does this basic article of 'eastern'
philosophy apply to disease management?
Already proven effective in the treatment of stress symptoms, mindfulness
is
opening a new paradigm of medical thought. Work in the US has given rise
to
'behavioural medicine' which assumes that psycho-social factors have an
influence on our well-being. Psychologists have discovered that when people
with chronic pain pay conscious attention to themselves and their immediate
situation through meditation, they experience an improvement in areas
such
as balance, blood pressure, muscle strength and general well-being.
 Mindfulness in practice
Clinical Psychologist Dr. Imogen Cotter is part of a team introducing
the
practice of mindfulness meditation to people with chronic pain:
"The concept of mindfulness should in theory be very good for anybody
with a
disability in the sense that it's about 'being in the moment' and it's
about basic awareness of your breath, and your being. Everybody has that
ability
to live in the moment, at a basic level. It's about being a human being,
not a human doing."
A radical change?
Does the idea of introducing mindfulness feel radical?
"It doesn't feel radical in one way because it's common sense. But
it
does feel radical in that I don't think services and institutions have
thought
like this before. It is a bit of a zeitgeist. It's the flavour of the
moment."
So what's zeitgeisty about it?
"It's the idea of society generally turning away from traditional
western
philosophy and science a little. To do with the rise in people interested
in alternative medicine and eastern philosophy, feeling a bit trapped
by
western culture and wanting another way to see things. Eastern philosophy
is very much about connecting with the environment, back with the body
and
nature. It's also novel because it makes it mainstream. I feel that our
group work was a blend of the western model of Cognitive Behavioural
Therapy and mindfulness ideas. This sort of approach makes the
mindfulness ethos more observable and open to scientific enquiry."
Is this a hijack situation?
By using western language and ideas about mindfulness, have you moved
meditation right over to the western camp, or has the western side moved
towards the eastern model too?
"There are probably people who would argue both sides. Some people
may
think that eastern ideas have been hijacked. Others will say that there's
so much not known, that our techniques have limitations and this way of
understanding offers us ways of working which are not open to scientific
enquiry.
The mindfulness group we have just run was a seven week course, with
a
follow up six months later. It was held weekly, and aimed to introduce
the
philosophy of mindfulness, and gradually the techniques of mindfulness.
It
was also about encouraging people to use it in everyday life, to experiment
with it and adapt it to their own needs. It was run in the context of
people with a very specific difficulty. Mindfulness shouldn't be seen
as a
'cure-all' panacea, because at the moment it's being targeted at very
specific groups.
The reason it's worked so well with pain management is that pain is so
complex. The experience of pain involves so many parts of the brain. Pain
is an emotional as well as a physical experience. When we are in pain
we all
have theories and beliefs about that pain. Mindfulness encourages people
not to try and make the pain better, or make it go away, but to live with
it. It also encourages them to focus on the physical experience of pain
in
a more dissociated way psychologically, so it stops being that distress
signal. They can start to think about their experience of pain as an
observable experience."
So when you were bringing this new understanding in to your practice,
did
you actually feel you were standing between ways of working?
"I did, yes. But we had a very skilled CBT therapist running the
course,
and that was very helpful to enable people to deal with possible blocks
to
taking on the techniques. I sometimes felt that I was in a 'Cognitive
Behavioural Therapy Group' then suddenly thought 'I'm in a yoga class
or
an alternative health centre'! And they did feel like different worlds."
Possible problems
Research has shown that this general ethos of mind-body awareness can
be
hard for some people. For example phrases like 'inhabit your body in a
more
alive way' came up in reports as not sitting well within the typical western
framework. What negative thoughts did you have?
"In the beginning I was a bit sceptical. I wondered if people would
be able
to use these techniques and if they would maintain any benefits. However
I
experienced for myself that using everyday mindfulness was a very powerful
technique. I found that people were examining their beliefs for themselves.
People were making cognitive shifts at the end, and I thought that they
could have spent hours of individual cognitive therapy to achieve that.
All
we did was provide a structure. People were discovering things for
themselves.
We will be doing a follow-up six months after the course to examine how
people have maintained any changes, and if they are still using mindfulness
techniques to deal with their pain.
To some degree this is about similar concepts spoken about in different
languages. Not entirely, but there is an overlap. This is a flavour of
how
therapy is changing."
Is part of this about introducing 'spiritual' ideas into psychology?
"Mindfulness proposes that there is an aspect of emotional-cognitive
life
that we can't pigeon hole using western models of the mind. In the past,
spirituality has been talked about as a set of beliefs, whereas mindfulness
says that it is about the connection between body and mind. It isn't about
'being spiritual' , but more about observing the experience of being." |
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