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Mind the gap on mindfulness

Is the trend over mindfulness going too far? Emma Espiner wonders if its possible negatives should be better known. 

Feeling down? Try some mindfulness. Your boss getting on your nerves? How about mindfulness? Looking for a way to cope with your reduced life expectancy owing to intergenerational poverty and societal factors beyond your control? Take 30 minutes a day to let your thoughts wash over you. Take responsibility for your own mental wellbeing!

I remember when resilience was the solution to all our problems. I was working in an office job at the time. It had been the era of ‘thought leadership’. Turgid odes to resilience as the elixir for a productive, happy workforce would appear on my cursed LinkedIn feed. It started to appear on job descriptions as a ‘desirable personality trait’. HR departments in the public sector were offering resilience workshops to their over-worked and under-appreciated employees. Instead of fixing broken work environments, unfair conditions and (the hardest one of all) incompetent managers, leadership teams thought they could just train their human units of production to be a bit more emotionally durable.

It’s subtle, how these things shift. Something which is objectively good - like the idea of individuals who can adapt to stress and life’s challenges - gets warped by constructs like the modern workplace which sees the first part of that statement as ‘individual responsibility’ and completely misses the ‘stress and life challenges’ part which hints at some external factors which should also be interrogated.

Notwithstanding the positive qualities of resilience, any trait taken to the extreme can become a negative. Too much resilience can become an inability to back down, or the aggressive pursuit of unachievable or inappropriate goals. The worm turned, and people began to consider resilience as a concept more critically. A professor of business psychology, Dr Tomas Chamorro-Premuzic, wrote in the Harvard Business Review last year that “Such [excessively resilient] leaders are not necessarily good for the group, much like bacteria or parasites are much more problematic when they are more resistant.” Chamorro-Premuzic further endeared himself to me by adding a small note at the end of the article about his upcoming book, encouragingly titled Why Do So Many Incompetent Men Become Leaders? (And How to Fix It).

I’ve been waiting for the cult of mindfulness to experience a similar exposure but, if this piece by Jess McAllen (one of my all-time favourite journalists, this isn’t a dig at her) about mindfulness being trialled in schools is any indication, we’re a long way off. At least in the instance Jess describes, those employing mindfulness techniques for children are under the guidance of trained researchers. At the other end of the spectrum you have a less structured approach. I found this advertisement during an ill-advised foray into a ‘women’s interest’ magazine at a cafe while waiting for my coffee over the weekend:

I’m not bagging the concept in it’s entirety. There’s some robust evidence that interventions based on principles of mindfulness can have a positive therapeutic effect in some settings. The Cochrane library has close to two hundred reviews tagged with ‘mindfulness’ as a key word. Some have positive, verified findings in areas such as post-operative recovery, therapies for people who experience autism spectrum disorder and insomnia.

But many of the other studies are inconclusive, and they impress upon you the importance of having a trained facilitator in leading mindfulness interventions. The definition is also slippery. Google says it’s “A mental state achieved by focusing one's awareness on the present moment, while calmly acknowledging and accepting one's feelings, thoughts, and bodily sensations, used as a therapeutic technique.” We’re not told how this mental state can be arrived at, which would explain why Cochrane includes yoga, music, meditation and religion in the mindfulness section. This is also where living with a journalist is occasionally trying - in the early days of learning about mindfulness I’d come home and try to discuss the concept. The aforementioned journalist in my house kept asking one, increasingly irritating, question. “But what the hell is it?"

I’ve thought about this a lot and decided that my primary discomfort comes from seeing the concept of mindfulness take on the allure of a silver bullet for all of society’s ills. What I’m seeing is a good idea playing well outside of its lane. What concerns me is that something which is genuinely beneficial in some settings, will become so ubiquitous that it ceases to have any meaning at all, and worse - could cause harm.

Dawn Foster wrote in The Guardian recently about people who have experienced the negative effects of mindfulness - a small minority of people who found that a mindfulness exercise triggered depression or a psychotic episode. Foster says that “Part of this is down to the current faddishness of mindfulness and the way it’s marketed: unlike prescribed psychotherapy or CBT, it’s viewed as an alternative lifestyle choice, rather than a powerful form of therapy.” The systematic reviews I considered in researching this piece confirm Foster’s misgivings. Many of the studies which have shown positive effects from mindfulness neglect to include negative effects, and for conditions like depression, while there was a positive effect compared to no treatment at all - there was significantly less impact compared to psychological treatment. It’s not a shortcut, people should not feel like failures if it doesn’t work for them and it certainly shouldn’t be used by funders as an excuse to not appropriately resource comprehensive mental health services.

And of course those bloody thought-leaders have now gotten hold of it and we have seen the inevitable incursion of mindfulness into management strategies to improve workforce productivity. On this front the evidence is even less robust.

A study recently published in Organisational Behaviour and Human Decision Processes found no improvement in employee performance in the group that undertook guided mindfulness exercises versus a group that just did something else that they felt like

doing that wasn’t work. If this study is found to have a consistent effect it will create an awkward dilemma for the mindfulness-as-a-productivity-intervention crowd. The authors of the study were interviewed in the New York Times where they commented wryly on the demotivating effect of mindfulness: "Mindfulness is perhaps akin to a mental nap. Napping, too, is associated with feeling calm, refreshed and less harried. Then again, who wakes up from a nap eager to organize some files?" When you combine this with the possible negative effects which have been under-analysed until now, you begin to get a picture that looks more like a fad than a panacea.

There must be a happy medium somewhere between the idea that the ‘solution’ is all within ourselves and a recognition that some things in the world are rubbish and it would be good to also divert some attention to fixing that. Responsibility also needs to be taken when promoting something that is not completely harmless for everyone. First, do no harm.

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