Friday 23 May 2014

Is Mindfulness the New Prozac?

Mahatma Gandhi once said, “First they ignore you, then they ridicule you, then they fight you, and then you win”.  This sentiment might well be applied to the recent popularity of mindfulness as a means of treating common mental illnesses and as a method for stress reduction.

The practice of mindfulness – of stilling your thoughts, relaxing your body, and becoming focused on the here and now – has been around for several millennia.  Popularised in the west by the hippy generation, mindfulness aka meditation was largely ignored as a somewhat obscure practice that could have little useful impact for most people.  It was only when professor of medicine, Jon Kabat Zinn brought the meditation practices learned from yoga and Zen Buddhism into medicine that the potential benefits of mindfulness for people experiencing stress and mental health problems began to be realised.

The modern forms of Mindfulness-Based Stress Reduction and Mindful Cognitive Behavioural Therapy have only proven themselves in the last 20 years, and were largely ignored (and occasionally ridiculed) until about 5 years ago.  However, in the last 5 years, we have witnessed a growing interest in the application of mindfulness practice not just as a mental health therapy, but as an aid to educational and business success.

There is no doubt that the practice of mindfulness can be very helpful for thousands of people affected by common mental health problems.  But it isn’t a miracle cure.  Nor is it an entirely benign and peaceful practice – while the aim of meditation is to switch off your thought processes in order to become fully present, the practice often involves wading through traumatic memories, fears and worries.  Both Buddhist and yoga meditation teachers warn that your mind (like an unruly monkey) will fight hard every time you set out to tame it.  So mindfulness is a life-long practice, not a 6-week quick-fix for the often profound psychological and social causes of mental illness.

Like Prozac and Cognitive Behavioural Therapy (CBT) before it, Mindfulness has followed a path to popularity that will inevitably lead to mass disappointment.  This disappointment will come not from mindfulness itself – Prozac and CBT continue to help millions of people every year, and there is no reason why mindfulness should be any different.  Rather, the problems come when politicians and public health systems seek to use these approaches as one-size-fits-all mass treatments.

Prozac didn’t fail because it didn’t work.  It failed because it didn’t work for everyone.  CBT has not failed because it didn’t work.  It failed because it didn’t work for everyone.  Mindfulness won’t work for everyone either.

Antidepressants like Prozac failed in part because the pharmaceutical companies’ marketing departments grossly over-stated their impact on people with depression.  But a larger part of their failure lay with the millions of people who believed that all they had to do was to take Prozac. Similar failures are now emerging in relation to CBT.  Whatever its initial promise, the attempt to deliver it to a mass of patients through the English Improving Access to Psychological Therapies (IAPT) programme has resulted in a 58 percent failure rate.  And just like Prozac, far too many people have been led to believe that attending CBT sessions was all they had to do.

One thing Prozac, CBT and mindfulness have in common is that those using them to reduce their stress or treat their mental illness must also take action.  If they work for you, drugs like Prozac may lift your mood and increase your energy levels so that taking action will be easier.  Talking therapies like CBT can help you to work out what actions you need to take. Mindfulness can also help you to unlock the very core of your being, enabling you to develop core skills and realise your deepest dreams and wishes: But only if you take action.

The problem is that most of us either do not want to, or do not know how to take action.  So with mindfulness now emerging to eclipse CBT (just as it eclipsed Prozac) as the most popular treatment for common mental health problems, it looks set to follow the same trajectory from miracle cure to disappointment.

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