Saturday, April 12, 2008

MBSR Conference -Day Two

6 pm

Drop into the moment that is now. No need to judge, no need to have an agenda as to what will be, no need to say, "I am meditating". Just be here, drink in all that this moment has to offer as if it is the only one that you have - because it truly is. Living fully demands that we pay attention, to this moment, with intention, acceptance and without judgement.

This the message of Jon Kabat-Zinn who led through an hour of practice of attending to this moment. He repeats this message in his important books that serve as introductions to this way of being and the titles are evocative of the importance of the experience of now:

Full Catastrophe Living (1990); Wherever You Go , There You Are (2005); Coming to Our Senses (2006)

Keynote Address: Mark Williams

Saki Santorelli introduced Mark Williams, Oxford Professor of Clinical Psychology, by reading the Rumi poem "Cry Out in Your Weakness". Mark Williams, like Marsha Linehan has spent his career finding ways to alleviate much suffering in the world - finding ways to prevent relapse in depression, that can and often does, lead to increased levels of depression and suicide.

Dr. Williams and is colleagues John Teasdale and Zindel Seigel have been important contributors to the treatment of depression, specifically the prevention of relapse. By combining many of the principles behind cognitive therapy with those of mindfulness practice, a powerful synergy has emerged that offers new hope for those suffering with chronic depression.

Dr. Williams spoke today about the role of the experience of psychological pain in preventing access to the specific episodic memories that are essential to problem solving. In effect the experience of a negative emotional state leads to a rapid flood of painful thoughts that cut off access to specific memories about how to solve the problem facing the individual. What remains are general memories that offer few, if any real solutions. Mark pointed out that mindfulness offers a way to reconnect with, and allow time for, specific memories to re-emerge promoting effective problem resolution and improved mood states.

Miriam "Miv" London, University of Vermont - Mindfulness programs for anxiety and depression for college students:

The effectiveness of a of 7-week mindfulness-based intervention for college students was discussed in this workshop. The net results were that the students benefited from the program through a reduction in their anxiety and depressed symptoms. The challenges with this group of clients was that they often were quite distracted by other priorities in their lives that the commitment to formal practice had often to compete with school work, social opportunities and space and time constraints. Despite this, many of the students were able to deal effectively with their anxiety and depression through incorporating many of the practices into daily life.

Arnold Kozak, University of Vermont - Curriculum course in the Psychology of Mindfulness:

Arnold spoke about a course he has developed and taught now for two years at the University of Vermont. The course includes the 8-week MBSR component, academic work in cognitive therapy, Buddhist psychology and clinical applications of mindfulness in psychology and health. The course includes both experiential and didactic components. The evaluation of the course has been positive, both in terms of student appraisals and in outcome measures that looked at whether students were incorporating the practices into their own lives. I would like to know to what an extent such a course might lower levels of stress for the students at Conestoga College. Anyone interested in working up a proposal with me?

Summary - conference themes in some of the informal discussions:

  • Has there been too much emphasis on mindfulness as technique in psychotherapy, when in the end it will be shown to be no more effective than other psychotherapeutic techniques accounting for only 15% of the variance in symptom reduction?
  • Is the benefit of mindfulness in its effect on the therapist, making them more empathetic, more non-judgemental, able to build better therapeutic alliances and less reactive? On this point, one meta-analysis shows that non-treatment aspects of the therapy (i.e. therapist listening skills) account for 30% of the symptom reduction.
  • What will it take to resolve the fundamental biases that exist within the two different ways of knowing between psychology and mindfulness? There was tension here at times between the agenda of the researchers who wanted to know about the randomized clinical trials and the therapists who were more concerned with the effect on the lives of their clients.
  • Finally, I sat in on a number of interesting sessions where the focus was on marketing mindfulness as a product. The cost of an eight week MBSR course has currently reached about the $2000 mark. Training of professionals can be substantial as anyone interested to investigate on the internet will find. This means that by the time the program hits the street, it will likely only be available to those who can afford a health club membership. It runs the risk of becoming "spa" treatment for the wealthy. And Buddha winces. So my question, how do we get mindfulness in the hands of those working with some of the most disaffected people in our communities?
  • Personal note: I have spent nearly 3 months now, offering my 30 years clinical experience for free, for a year. My sabbatical next year allows me to do this. My price: let me come and learn to hone my mindfulness clinical as part of the team. That means a net saving to your organization one senior clinician's salary and perhaps 20 - 30 clients off the waiting list. Total organizations that have jumped at the offer so far= 0. We need to look seriously, I think, at how we can massage the system to, as George Miller might say, "give mindfulness away". Anyone interested in setting up a volunteer list to assist with referrals for the treatment of depression, anxiety or trauma?

1 comment:

Daniel said...

Hey Barry,
I have one question regarding your offer during your sabbatical:
Is it restricted to a clinical setting?
Greetings from Germany,
Daniel Fenge