Sunday, January 10, 2010

Mindfulness Works in Depression Treatment

The London Times Online  today had an interesting article entitled Mindfulness therapy pushes the bad thoughts to one side. I read the article, liked it, and sent off a brief comment, which now appears after the article using the above link.

The article describes the experience of Kathy Andrews, a 48 year old woman with a long depression history:

"After years struggling with the ongoing trauma of depression and rising doses of antidepressants, Kathy Andrews, 48, found out about mindfulness therapy and spoke to her GP for a referral. Since taking the course more than two years ago, she has yet to suffer a relapse and has been able to cut down her medication. "

Mindfulness has indeed shown itself as an effective way of preventing relapse for people who suffer with depression issues. As well, the professional literature documents how many therapists use mindfulness in their work with patients, whose diagnoses include depression, post traumatic stress disorder, and anxiety, to name but a few.

The practice of mindfulness began thousands of years ago in the Buddhist tradition, and has become known in North American health care circles largely due to the work of Jon Kabat-Zinn who is founding executive director of the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School.

During the 1990s, three clinical psychologists, Zindel V. Segal, J. Mark G. Williams, and John D. Teasdale were seeking new ways to deal with a major problem faced by patients with depression, namely the high relapse rate.

They were familiar with Marsha Linehan's dialectical behavior therapy which includes a variation of mindfulness training for treating individuals with borderline personality disorder. She mentioned Kabat-Zinn's work to the three psychologists, and that lead them to the UMass Stress Reduction Program and Kabat-Zinn.

As a result of meeting Kabat-Zinn a most productive relationship developed, leading to a book the three psychologists authored and which, in the forward he authored, Kabat-Zinn calls "courageous" and "a seminal book."

Indeed it was. Very quickly after publication by Guilford Press in 2002, Mindfulness Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse, found favor among psychotherapists. To this day, it is still the leading book for using mindfulness to work with depression. As well, it presents as good an introduction to mindfulness as one may find anywhere.

An interesting observation made by the authors is that mindfulness is not just a technique. For it to be taught, those teaching it need to be meditators themselves, because in dealing with issues that arise in teaching mindfulness, the instructors themselves must be able to embody mindfulness. They can only do that if they are experienced in mindfulness.

I had the pleasure of doing a seven day intensive training in mindfulness for health care professionals with Kabat-Zinn in 2008. Though I'd be lying if I said I practice mindfulness regularly, I can say from personal experience that the more I meditate, the more I use it with clients, and in both their lives and mine I can see the benefits.

On my other blog, Unsticking Joe's Life, I'm describing a self-experiment to overcome my own life-long issues with depression, ADHD, and executive functioning. The major part of that experiment is a 101 Day Count Down, and mindfulness is a significant part of it. Yet, even though I am confident there will be great benefits from the part mindfulness plays, I am trying to have no expectations of mindfulness per se. As I wrote in my comment to the London Times Online:

"The ironic challenge of mindfulness is that while it is a very simple technique to learn, it is very nuanced and rich in the results it may yield. The yield, however, is inversely proportional to one's expectations. In other words, if one begins mindfulness with expectations and is attached to the notion of results, disappointment often follows."

The books and tapes pictured here reflect Kabat-Zinn's genius in making the ancient practice of mindfulness accessible to our times. A major part of his work has been documenting in contemporary terms the myriad benefits of mindfulness meditation. Those who use any of Kabat-Zinn's books or tapes will find them a gentle introduction to mindfulness practice.

I'd be most interested in learning how readers of Lerner's Notebook have experienced mindfulness or other meditation practices. Your comments are welcome.

1 comment:

  1. Hi, Joe,
    I wholeheartedly agree with your comment to the Times, and all that you've written here -- including the very common struggle to practice regularly.
    My seven-year old can tell the difference in me almost immediately if I haven't meditated that day...
    I strive to be as compassionate as he is when I detect the same differences in my patients, and gently invite them back to their mindfulness practices. (And I sometimes remind them of the quantifiable, measurable differences they're making in their brains when they practice -- that seems to appeal greatly to the Type "A" folks, myself included.)
    Looking forward to more of your posts!