Sunday, 23 February 2014

Guardian News: Should we be mindful of mindfulness?

On 23rd February 2014 The Guardian online posted an article in the News>Society>Mental Health section titled: Should we be be mindful of mindfulness?

Here are some key quotes:
"Mindfulness is everywhere at the moment. If you don't know someone who has done a course, downloaded an app or read a book, you will soon. Based on centuries-old Buddhist meditation practices and breathing exercises, it is prescribed to thousands of patients on the NHS each year to help prevent anxiety, depression and stress. Even more pay for private classes believing that they improve the quality of their lives and relationships. And over a million people looking for mindfulness on-the-go have downloaded apps such as Headspace. The mindfulness industry is vast, and growing weekly."
"A good example of how it can work is when you're kept awake at night thinking," says Williams. "You toss and turn and you get angry because you can't sleep. The anger doesn't help, but you can't seem to stop it. Mindfulness isn't about suppressing those thoughts, but about enabling you to stand back and observe them as if they were clouds going past in the sky. You see them and you cultivate a sense of kindness towards them."
A review of the research in Clinical Psychology Review last month by researchers at the University of Montreal looked at 209 studies covering 12,145 people. It concluded that mindfulness was an effective treatment for a variety of psychological problems, "and is especially effective for reducing anxiety, depression and stress". Other studies have shown that it is effective for preventing anxiety and mood disorders and may be good for other psychiatric conditions including bipolar disorder.

These are the best of the recent studies – but the published evidence goes back further. In 2004, Nice – the NHS's rationing body – was convinced enough of the benefits that it ruled mindfulness-based cognitive therapy was cost effective. Its most recent advice, updated in 2007, is that it can be prescribed for people with three or more episodes of depression. There is also growing evidence that it's effective for chronic long-term health conditions such as ME.
Oxford University and the Mental Health Foundation (MHF) have worked on a 10-session online course, available for £60. On its website, the foundation claims that "the effectiveness of the online course is the subject of a highly significant research paper by Oxford University published in BMJ Open". It adds: "The reported average outcomes for completers of the course show participants enjoying reductions of 58% in anxiety, 57% in depression and 40% in stress."
That is true, but only to a point. The MHF website glosses over an important caveat in the BMJ Open paper. The authors, who include Prof Williams, point out in the paper that the study had no control group, meaning there was nothing to compare the course with. More research is needed.
Williams is acutely aware of the dangers of overclaiming.
"A lot of people think it will cure everything. But we know there is nothing that cures everything. There is some interesting work in psychosis, bipolar disorder and schizophrenia but it's in its early days. There's a lot of hype around mindfulness and we need to be cautious because it doesn't serve our science or patients well if we're overenthusiastic. We have to make sure the science catches up with the enthusiasm."

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