Monday, 28 January 2008

New Ideas

I've been spending a lot of time with therapists of late.

No no no, I've not been going under quite yet, it's simply that we've had to generate business cases for more therapists, then job plans for them, then job descriptions and adverts, then interview questions and model answers, then the interviews.

Through this process it's been evident that Cognitive Behavioural Therapists (CBT) and Cognitive Analytical Therapists (CAT) have, for a good while, been preoccupied with (mindful of?) the concept of Mindfulness.

Since about 2000 it's been described in terms such as, "Mindfulness is a technique in which a person becomes intentionally aware of their thoughts and actions in the present moment, non-judgmentally."

It's a sort of acceptance (and mindfulness is at the foundation of Acceptance and Commitment Therapy).

It's been enthusiastically embraced by many clinicians and patient groups because intuitively it makes sense and because its roots are old (thousands of years old, linked to Buddhism and Sufism) so it's neither someone's new fangled get-rich-quick fad, nor a Government edict to change and try this for the sake of being seen to do things differently. Plenty of evidence supports its theory, application and outcomes.

Still, you've got to wonder, although it's been in vogue for 7 or 8 years now, it's not a new idea at all. Is it seen in EastEnders or Corrie this year? No, not yet, but it was foisted 'pon the masses over 400 years ago :

". . . for there is nothing either good or bad, but thinking makes it so."
- Hamlet, Act II, scene 2


Aphra Behn said...

I've been thinking a bit about mindfulness myself recently in, as you'd expect, the context of Art.

Seems to me that a lot of what artists do is merely framing things: Deschampes did it first, with the urinal as fountain and so did Ms Emiin with her empty bed.

That's really no more than mindfulnesm and we should be doing it for ourselves. I say "really no more" as if mindfulness were easy as well as simple. Hah!

It is something I should start practising again though. The Mindfulness of Washing Up, both spiritual AND useful!

Fiona Marcella said...

Do your new therapist friends have any tips on how to handle those who truly believe that thinking about things only makes them worse and that "therapy is like picking scabs. Everyone knows you should leave well alone"? Presumably they don't have to treat people who are totally resistant to the idea of therapy, but someone has to try to relate to them, be it the psychiatrist, GP or carer.

Socrates said...

NOT FOR PUBLICATION: An autisic writes: i would be very interested in hearing about your experiences with autistic spectrum conditions, and your colleagues attitudes and opinions of them...

The Shrink said...

Aphra, if you suss out how to employ such focus and serenity through your day, tell me!
Better still, bottle it and make squillions :-)

Marcella, I've had an annual appraisal of late when all my activity over 12 months is scrutinised. Every single patient is detailed. From this I know that I haven't referred anyone to a psychologist in the last 12 months and I've only referred a handful to a CBT practitioner. Partly that's through our psychology service being rubbish (and undergoing change), partly it's that there's therapy in Primary Care, mostly it's that psychological intervention, through intervening, has side effects. I'm cautious in using drugs, ECT, admission or talking therapies, every meaningful intervention has consequences.

Zarathustra, huh?
*is muddled*
It's a while since I worked in CAHMS, surely you're better placed to let folk know how the MDT conceptualise and manage the spectrum of disorders? Or are you inviting me to wax lyrical?

toolate said...

Mindfulness training is about 4500 years old. It should not be understood as a means to obliterate thinking. That would be brain washing. Indeed, it enhances conscious and purposive thinking.
The resolve to resist all thought is only for the duration of a given mindfulness task. Over time,
one begins to have the thoughts instead of thoughts unconsciously having, or more easily, misleading you.
Likewise, mindfulness of feeling also enables a degree of detachment that makes it possible to have a feeling without being led by or consumed by it.
The overall benefits from learning to do this regularly are well documented. However, a brief example would be similar to having a cup of coffee after abstaining for one day. 'Ummm, lovely', (or not). One really notices it.
Artistic and creative rumination can also be mindfully purposive as well as conscious reflecting and remembering.
For those that are fearful of or caught in unwanted thoughts, mindfulness teaches you to enter the dark with a lamp and map, instead of blind and at the mercy of anxious wonderings.
Mindfulness is a very useful technique to enhance consciousness in all things, including and especially thoughts and all manner of thinking.

toolate said...

apologies, mindfulness practice is aprox 2500 years old

Spirit of 1976 said...

I actually think of driving along an open stretch of country road to be a very natural form of mindfulness. You're relaxed, yet aware of your surroundings.

Hmmm, there appear to be two people called Zarathustra commenting on this blog now. This could get confusing.

Disillusioned said...

I've found mindfulness to be an extremely useful part of my toolkit in coping with my own mental health issues. It does need practice (and committment) and time - which seems to be one of my major stumbling blocks! However, I know when I do practice and devote the time it is very helpful. "The Mindful Way Through Depression" is an excellent read - practical and inspiring - I recommend it.