A perfect day in mind

MIND MOVES: Last January, I extended an open invitation to people working in health settings to meet and explore how mindfulness-based approaches might be developed and taught to people with emotional and physical pain.

I expected that perhaps 20 or 30 people might get in touch and meet up. But I underestimated the interest in mindfulness among clinicians, therapists and educators in this country. More than 270 people made contact and expressed interest in meeting. On May 20th, we gathered in St Vincent's University Hospital, 170 of us meeting for what may well prove to be a significant milestone in Irish healthcare.

Mindfulness, as I said at the time of my invitation, is the practice of being attentive to whatever you are doing and whatever you are feeling in the present moment. When it comes to physical or emotional distress, mindfulness teaches you to use your breath to bring your attention to the present moment, and to cultivate an attitude of openness and kindness to whatever "symptoms" you may have.

It offers you a way to be with your bodily sensations, feelings and thoughts, however difficult they may be, without being overwhelmed by them.

Traditionally, many health interventions have focused on getting rid of, overcoming and controlling our symptoms. Mindfulness takes a different tack. It teaches people to steady and ground themselves, so that they can move towards rather than away from distress.

By learning to step up to whatever frightens them, rather than running away, people discover they can hold their experience in awareness and relate to it in a more liberating way. Whenever we hold our experience of pain in awareness, with acceptance and compassion, it is transformed.

The participants at St Vincent's included a wide variety of professionals: counsellors and therapists of different persuasions; psychologists; doctors; yoga teachers, health service managers and educators. Experience in the practice of mindfulness ranged from 0-20 years, with the majority of those present being new to the practice.

The morning was structured around a general overview of the theory of mindfulness, guided exercises, and a personal account of recovery by a long-term user of mental health services. In addition, there were two research presentations on the value of an eight-week training course in mindfulness to people in primary and secondary care.

A GP reported on the benefits experienced in a sample of people with chronic fatigue, to whom he had taught mindfulness, and a clinical psychologist reported on the outcome of a similar course with people in an oncology rehabilitation programme.

It was particularly inspiring to hear from someone who had previously experienced multiple psychiatric admissions in his mid-life, in addition to chronic physical pain. For him, mindfulness had been critical to his recovery.

In the past five years since he began practising mindfulness, he has not required admission. Recovery for this speaker was the recovery of a sense of his dignity as a person - someone with strengths and limits, but with a capacity to work with these limits and pursue a life that meant something to him.

He found in mindfulness that meditation was the ability to see he was more than his thoughts and feelings. "When you're in pain, it seems like your whole person is in pain," he said.

Through meditation, he found he was able to experience his pain as being confined to one part of his consciousness, to one part of his body and mind, rather than to his whole being. While it was a fact that pain was present, it was also true that many parts of his mind and body were healthy and well. The practice of mindfulness allowed him to bring a wider perspective to his distress and not be consumed by it. And he had found the practice of mindfulness was of greatest benefit when he felt most severely in distress.

This latter observation was echoed in the results of the research with people with cancer. These patients were in recovery, but lived with the understandable anxiety that their cancer might recur. The findings in this research revealed that mindfulness training was of greatest benefit to those people with the most severe levels of initial anxiety prior to starting the programme.

A tremendous buzz of warmth and enthusiasm filled the room throughout the day. Participants rekindled old friendships and formed new contacts with others who shared similar values and challenges in their work. There was a strong sense that something new was emerging on the health landscape that would benefit both providers and recipients of healthcare. Many creative suggestions - to establish a website, to arrange training days - were proposed in order to grow and develop mindfulness in healthcare in Ireland and to enable those interested to access training/supervision experience.

The day ended at 3.30pm as the organisers were mindful of another historic event that was taking place in Cardiff. This enabled everyone to at least catch the second half. After a refreshing conference, we shared with many others the joy of watching Munster mindfully snatch victory from the jaws of near-defeat. A perfect day!

Tony Bates is a clinical psychologist. He can be contacted at tbates@irish-times.ie