Mindfulness - what's it all about?

Mindfulness has attracted increasing attention recently as an approach to stress reduction and serenity. I’m currently participating in the 8 week Mindfulness-Based Cognitive Therapy (MBCT) course run by my employer, a large NHS Foundation Trust, for both personal and professional development. Although I’ve practised yoga for many years, been on retreats and meditation workshops I’ve not managed to practice meditation consistently.

MBCT is amongst ‘Third Wave’ CBT approaches and has been increasingly recognised in medical and non-medical circles for its evidence base and potential for overcoming depression, especially when people have experienced recurrent episodes. Besides the NHS various other providers, such as the Mental Health Foundation, now offer courses, these costing around £300. The course is challenging because it asks for a commitment to about an hour’s homework daily besides weekly attendance at the 2 hour course. A maximum of one week away is permitted but anyone likely to be absent more often would probably be asked to attend a future course.

What is MBCT?

So what is mindfulness? Not what some of us thought! It’s not about relaxing or feeling better or creating good feelings: rather, it’s about being better at feeling and experiencing things and ourselves as they are, rather than judging or labelling them or wishing they were otherwise. Founder Jon Kabat-Zinn says: 'Mindfulness means paying attention in a particular way: on purpose, in the present moment and non-judgementally.' He explains that the automatic pilot way of living increases susceptibility to having our 'buttons pressed', leading our minds down familiar (often negative) pathways, which are unhelpful to us and contribute to worsening mood and self-blame. This relates to rumination, so common in depression.

We’re invited to focus on the breath as an anchor and haven, to bring us back to the moment, rather than what’s become normal for many of us – dwelling on the past or thinking about what we’ve got to do that day. Through focusing on the breath and/or movement, mindfulness aims to interrupt habitual, automatic pilot thinking and behaving. This can change experience by altering our perspective. The key skill is to maintain awareness in the moment – nothing else. It's quite liberating to be told we don't need to do anything or control our breathing in any way – just observe it and bring ourselves back to the breath when we realise we are wandering off.

Someone who had completed a course observed that it's not something you can just do half a dozen times – it had to be daily. There's something about commitment and perseverance without being self-lacerating about it.

What happens?

Embarking on this journey (a journey it indeed is, which doesn’t end when the course does!) feels like a big deal and I feel differently about myself for taking part. The programme involves exploring how breath can be used to deal with pain, anger, relationships or the stress of daily life. The teachers are all highly qualified and experienced psychologists, who encourage us to be kind and gentle with ourselves, not getting annoyed when our minds wander, because ‘that’s what minds do.’ It’s thought to be like planting a seed – you may plant it, forget about it, then see it flowering much later, perhaps into serenity. We’re encouraged to let go of expectations of what the course can do for us. This is surprisingly difficult - I’m normally quite disciplined and self- motivated but it’s hard to invest so much time and energy without hoping for some benefits. It’s a bit like the Nike maxim – Just do it.

The very first exercise in the course consisted of examining a raisin in detail, its appearance, feel, texture, colour, feel and so on, then placing it in the mouth to experience the sensations there, then eating it very slowly. It may sound strange but it makes us realise how different it is to actually experience an object in all its different facets instead of bolting our food - getting out of the chattering mind and into the senses and the moment, enhancing our awareness.

Each 2 hour workshop consists of several mindfulness meditations of one kind or another, discussing the homework and how it was for us in small groups, large group work and discussion, then explanation of the next week's homework.

‘Homework’ consists of practising breathing and moving meditation exercises on CDs lasting 45 minutes, plus writing diaries, performing one daily task mindfully, and if we can remember (!) eating at least one meal a week mindfully.

Over two consecutive weeks one diary was to first record a pleasant event then an unpleasant event the following week, noting the sensations experienced in the body, the thoughts and feelings associated with them, then thoughts about the experience at the time of writing. Responses evoked by the cleverly focused questions have been a striking learning exercise, revealing areas of thinking we may have been unaware of despite much self-exploration.

The other course participants are current or former clients of the NHS Trust, and most seem to have done CBT before. It’s a nice, friendly group, which is just as well since there’s quite a bit of sharing experiences eg of how we got on with the homework. Although we are not supposed to think of ourselves doing 'well' or 'badly' with the homework, inevitably those thoughts creep in and I realised how bad I would feel if I didn't do it, though with a busy schedule and late returns home in the evening are not conducive to finding the time. There was quite a mix of experience, some reporting feeling better, others struggling to do it and one asked whether she could listen to the CDs when cooking dinner. The answer was 'not really...', since we need to focus as much as possible on the exercise, rather than being distracted by thinking and doing.

So, how am I getting on? We’re now on Week 3 (4 if you count the introductory week). I felt I 'did well' the first week but less so the following two, owing to unexpected stresses and being away, although I did manage at least one 45 minute meditation and several shorter ones. The Body Scan is the first CD, practised for two consecutive weeks, focusing in turn on different parts of the body. It It gets us to practice becoming aware of where our attention is and repeatedly changing the focus of this attention. This can show just how much our minds wander from the breath and the focus. With a sitting meditation I found the bit about 'each inbreath a new beginning, each outbreath a letting be' quite inspiring.

Right now I feel I need to do more and better, though this attitude is contrary to the intended 'non-striving' and gentleness with myself – some way to go, clearly! Just off to practice now – I hope to write more further down the line about the remaining sessions and reflections on the whole thing...a close friend has already noticed a change in me so that's encouraging...