Mindfulness in the mainstream: an old solution to modern problems

by Robert Booth, The Guardian, 20 October 2015

Leading mindfulness expert Mark Williams will brief MPs on how meditation could drastically improve the UK’s wellbeing and productivity

London, UK - The Attlee Room in parliament will fall quiet on Tuesday to hear one of the country’s leading meditation teachers explain the basics of the 2,400-year-old tradition of mindfulness.

Prof Mark Williams’ explanation of how to control and measure your breath, thoughts and feelings will precede a call by a cross-party group of MPs and peers to roll out mindfulness-based meditation across the public sector in a bid to improve the nation’s mental health, education and criminal justice system.

After a year-long inquiry, the all party parliamentary group (APPG) on mindfulness has concluded that secular meditation courses should be made available to 580,000 people who suffer recurrent relapses into depression, at an initial cost of £10m; the state should train 1,200 new meditation teachers and there should be more mindfulness taught in schools following evidence that it reduces misbehaviour and can improve GCSE results. They also want prisons and probation services to test run programmes to reduce re-offending.

The legislators’ conclusions represent a new peak in public interest in the practice which was derived 40 years ago from Buddhism by professor of medicine emeritus at the University of Massachusetts medical school, Jon Kabat-Zinn. Amid claims the practice can help beat anxiety and depressive relapses, about 2,200 people have trained as mindfulness teachers in the UK, enough to teach 200,000 people a year. There are over 700,000 subscribers to the Headspace smartphone app which helps people meditate. Major employers such as Google, the BBC and Tata are hiring teachers to help staff while 115 MPs and peers have undergone eight-week courses in mindfulness-based cognitive therapy.

But as enthusiasm grows, so do the calls for caution. There are fears that a boom in corporate enthusiasm for the practice could see mindfulness misused to boost profits while research remains ongoing into possible “unusual, unpleasant or unexpected effects” of the meditations.

The best evidence for the impact of mindfulness is in its prevention of depression. People who have suffered three or more depressive episodes see the risk of relapse reduced by almost half after MBCT, an analysis of six randomised controlled trials showed. According to a review of 114 different studies, cited by the parliamentarians, consistent improvements in cancer patients’ mental health were found following mindfulness practice.

While MBCT is already approved by the government’s National Institute of Clinical Excellence and the large majority of GPs (72%) want to refer patients to courses, the APPG found only 20% have access to courses. MBCT should be available to 87,000 people a year who suffer recurrent depression by 2020 – 15% of the total, the parliamentarians said.

The group also want the education department to designate three schools to pioneer mindfulness teaching and establish a £1m fund to cover training costs for teachers. They have estimated that around one in 10 children aged five to 16 experience mental health problems and said adolescents with the most severe mental health problems – those being treated as psychiatric outpatients – have most to gain from courses of mindfulness-based stress reduction in terms of reduced depression and anxiety, better sleep and self-esteem.

Kabat-Zinn said: “The ramifications of this report in the UK will be profoundly beneficial. They will be addressing some of the most pressing problems of society at their very root – at the level of the human heart and mind.”

Britain's most dangerous prisoners to get meditation lessons
One company, Mindfulness at Work, taught 10,000 people last year, a four-fold annual increase. It has 25 trainers and its clients include Goldman Sachs, JP Morgan, Pfizer and American Express. Louise Chester, the company’s founder, said her organisation would not serve a client whose motive was bigger profits. “If we ever got a whiff of them wanting to squeeze more out of their employees we wouldn’t work there,” she said. “We have never had that. Our clients are coming from a place of compassion.”

But the APPG and other worker’s groups remain concerned about possible abuse of mindfulness in the private sector. “A large number of companies and consultancies have sprung up to offer mindfulness training, some with little experience or qualification to do so,” the report warned. “There has been criticism that mindfulness is being used to prop up dysfunctional organisations and unsuitable workloads.”

Hugh Robertson, senior policy officer at the Trades Union Congress, said: “Wellbeing programmes should not be used as an excuse to avoid addressing stressors in the workplace.” He added that research was going on into “unusual, unpleasant or unexpected effects” of mindfulness therapies, including whether it might trigger psychotic episodes in rare cases in predisposed patients.

Florian Ruths, consultant psychiatrist at the South London and Maudsley NHS foundation trust, has been gathering evidence from patients, mostly with mental health problems, who have been prescribed MBCT. Negative effects are rare, he said.

“Most of [the side effects] are largely harmless, but they can disturb the patient in that they think there is something unusual happening,” he said. “People might experience in the eye of their minds that their body is taking an unusual shape or is suddenly very small. There can be an increase in intensity in emotions.

“We know that people can feel a bit lower when they start focusing on their thoughts. These are generally not very frequent and usually subside after a few minutes. We would like to make those effects accessible to science, investigate them and train people up to deal with them.”