The Downside of the Here-and-Now

We have been talking about mindfulness in mental health for some time. It’s sometimes hyped as the universal panacea for all things anxious and depressed. Easy, cheap and with no side effects!

If you need help, please call

  • Lifeline- 13 11 14
  • BeyondBlue - 1300 22 4636
  • Suicide Call Back Service - 1300 659 467
Suicide Call Back Service Online Chat

We have been talking about mindfulness in mental health for some time. It’s sometimes hyped as the universal panacea for all things anxious and depressed. Easy, cheap and with no side effects!

How did we get so wrapped up in mindfulness?

Jon Kabat Zinn started the trend - his own Buddhist practice led him to teach mindfulness to help people cope with stress, anxiety, pain, and illness. This led to the development of a whole new therapy model – mindfulness-based stress reduction (MBSR). You can get a good taste of MBSR on the THISWAYUP website where the free Introduction to Mindfulness course might lead you to the $60 Mindfulness Based CBT course if you’ve a mind to go there.

Marsha Linehan helped consolidate mindfulness into therapy by including mindfulness training as a major strand of Dialectic Behaviour Therapy.

Segal, Williams and Teasdale were the first to show that regular mindfulness practice could be helpful in preventing depression relapse.

But does it work for everyone?

I’m sure you too have had the experience of meeting someone for whom mindfulness not only did not have any benefit but for whom it seemed to be a counterproductive activity. There is actually evidence in the research that mindfulness is not for everybody.

In 2016 in an Australian study 132 adolescents were provided with 8 weekly sessions of in-school mindfulness training. The study showed no significant improvement in anxiety, depression, weight and shape concerns and general well-being immediately after the intervention and again at 3-month follow up. In fact, the boys were more anxious than their unmindful peers in the control group, and more anxious than before the training.

There’s lots to be said about this study. Is in-school a good place to deliver mindfulness training? How seriously will adolescents taught mindfulness in a group setting with their peers take the whole process? Is this study really an assessment of the effectiveness of mindfulness training on the individual or a comment on the way mindfulness can be effectively taught and to whom? 

What else is there to fall back on?

I have met people who get more anxious when they try mindfulness. Many of these people simply refuse to keep trying. Many say that attempting mindfulness exercises simply draws their attention to their thoughts and makes their rumination worse.

Many of those people feel a failure if they cannot practice mindfulness. Their feeling of failure is often exacerbated by practitioners who insist that mindfulness helps everyone and all they need to do is keep practicing. 

Those people may do better with distraction techniques including progressive muscle relaxation, breath based relaxation, repetition of mantra, puzzles, creative activities such as writing or crafting or practices involving physical activity such as tapping or drumming.

People need to be reassured that if they can’t stay in the here-and-now they are not alone. They simply need to find the self-soothing and relaxing practice that is right for them. If they never get to mindfulness then that’s OK but some day they may find they are able to benefit from mindfulness as well – just not here and now.

 

Resources:

 

 

 

{{commentCount}} comment(s). You must be logged in and AHPRA verified to view and comment. Login here.
Dr Jan Orman

Dr Jan Orman

Jan is Sydney GP, private psychological medicine practitioner in Sydney’s inner west and a GP educator for Black Dog Institute.

The latest healthcare news from medcast

Can I have medical cannabis on PBS doctor?
Can I have medical cannabis on PBS doctor?

I’ve been asked this question twice in the last month. Once by a 70 year old patient who has taken up smoking weed to control her neuropathic pain, let’s call her ‘Rachel’. And the other a young man aged 26 (Sean) who is smoking cannabis to help control his chronic anxiety.

Standardising Emergency Numbers: The Push for 2222
Standardising Emergency Numbers: The Push for 2222

The move to standardise emergency numbers within hospitals, to make them similar to the standardised emergency numbers that are utilised in the community setting, is gaining momentum.

PODCAST: Acute Diverticulitis
PODCAST: Acute Diverticulitis

Stan, aged 80, comes to see you with left side abdominal pain and a low-grade fever. This is a classic example of a common problem doctors face in General Practice. In our Podcast we discuss Diagnosis, Assessment, Management & Referral.

Disempowering Pornography
Disempowering Pornography

At the RACGP annual conference this year (GP19) Dr Anita Elias spoke eloquently and persuasively about the psychological impact of young people’s access to, and use of, online pornography. It is no longer just a speculative idea based on clinical anecdotes. Research evidence confirms that viewing pornography at a young age is having a significant and damaging impact on young people’s sexual attitudes and behaviours and their emotional states.

Join Medcast. It's free and you'll get instant access to essential healthcare news, research and more.

Already a member? Sign-in