Wk2-10 Kuyken - encountering difficulty
I think mindfulness teachers have for literally, hundreds and thousands of years known that when people stop and study the mind and stay with the mind, difficult things can happen, they're called the hinderances. So Ruth Bayer and I gave some thought to this and published a blog on the Oxford Mindfulness Center website very recently, and we tried to unpack this question. And I think the first thing we'd say is from a research point of view, with the possible exception of the work of Willoughby Britton, almost no work as been done in this field. It's, from a research point of view, a really uncharted territory. So what Ruth and I did was, we tried to set out a framework to begin to think about it and to begin to research it. And we think there are three key elements that need to be thought about. The first is the mindfulness practice itself and how intensive it is. And you can think about it as a dimension from very low intensity through to higher intensity. And that, I think, is key with safety. So very low intensity intervention would be for you and I maybe to think about some food that we both enjoy and to eat that food with real awareness. We think it's a low intensity mindful exercise, unlikely to create issues around safety or adverse events. An orange, a tangerine, a piece of chocolate, a raisin, whatever it might be. Then you go to halfway up the spectrum, and an 8 week class where you're asking people maybe to do 40 minutes of meditation, in a pretty standardized way throughout, we think that's in the middle of the spectrum. Then you ask someone to go on a retreat, so to take them out of their home environment to a different environment. And some of the retreat centers will have people meditating from 5:30 in the morning til 10 o'clock at night. That's a, we think, a very intensive practice. The more intensive the practice, the more I think there is risk for some of these kinds of mind states and these issues to come through. So that's the first thing, the intensity of the practice. The second is the vulnerability of the person. So somebody who is very prone, for example, you mentioned trauma, who has had a recent trauma or has had some degree of trauma that is still alive. They might have intrusive thoughts, flashbacks, nightmares, hyper-arousal. Somebody who's recently bereaved, somebody who uses a lot of substances to control their feelings, somebody who's prone to dissociative states or psychosis. These folks are more vulnerable. So I think these folks are folks that, if you combine that with a more intensive mindfulness practice, you need to really be thinking very carefully about safety. And then the third thing we thought was a key dimension is, who is the person teaching the mindfulness? How well qualified are they? What training have they had? Are they able to make, together with the person, a judgement about that person's vulnerability and the intensity of the practice? Now the very best mindfulness practitioners, do that extraordinarily skillfully. Take Paul Chadwick. Paul Chadwick's a professor at King's College London and has been working with people with psychosis. Over literally, I think probably now over ten years, he's thought about the sorts of practices you can introduce to people who are actually currently psychotic. Or experience psychotic symptoms in a way that is safe, so that they can actually begin to experience their minds, their bodies, in a way that's safe. Really grounded, really one-to-one when there's a relationship being built, and with lots of grounding exercises. But the practices are very, very short and very, very practical. So that's an example of a highly skilled practitioner working with a very vulnerable group. I think some of the less intensive practices with very resilient groups of the general population could probably be taught by somebody with less training.
