Mindfulness therapy comes at a high price for some, say experts
Much-hyped therapy can reduce relapses into depression – but it can have troubling side effects
This is my synopsis of an article that appeared in The Guardian
Enthusiasm is booming for mindfulness-based cognitive therapy (MBCT) courses. An Oxford University study claims that MBCT is as effective as taking antidepressants. Mindfulness therapy involves sitting still, focusing on your breath, noticing when your attention drifts and bringing it back to your breath – and it is surprisingly challenging. But, psychiatrists have sounded warnings that along with the benefits, mindfulness meditation can have troubling side-effects.
The concern comes not from critics of mindfulness but from supporters, such as Dr Florian Ruths, consultant psychiatrist at the Maudsley Hospital in south London, England. Dr Ruths has launched an investigation into the adverse reactions of MBCT, which have included rare cases of “depersonalization”, where people feel like they are watching themselves as in a movie. Sometimes you can feel as if you are floating above yourself, as a detached observer of your thoughts, feelings, or body. Some people also describe the experience of depersonalization as feeling separated from people or from the world as if by a glass wall.
Many people have a passing experience of depersonalization or derealization at some point. But when feelings of depersonalization keep occurring or never completely go away, it is classified in the DSM-V (Diagnostic and Statistical Manual of Mental Disorders) as a mental disorder. Chronic depersonalization can be psychologically harmful if not treated properly.
“While mindfulness meditation doesn’t change people’s experience, things can feel worse before they feel better,” Marie Johansson, clinical lead at Oxford University’s Mindfulness Center said. “As awareness increases, your sensitivity to experiences increases. If someone is feeling vulnerable or is not well supported, it can be quite daunting. It can bring up grief and all kinds of emotions, which need to be capably held by an experienced and suitably trained teacher”.
Falling For Magic Pill
“You sometimes get the impression from the enthusiasm about mindfulness helping with depression and anxiety that it is a magic pill you can apply without effort,” says Ed Halliwell, who teaches MBCT classes in London, England. “You start watching your breath and all your problems are solved. It is not like that at all. You are working with the heart of your experiences, learning to turn towards them, and that is difficult and can be uncomfortable.”
“There is a lot of enthusiasm for mindfulness-based therapies and they are very powerful interventions,” Ruths said. “But they can also have side-effects. Mindfulness is delivered to potentially vulnerable people with mental illness, including depression and anxiety, so it needs to be taught by people who know the basics about those illnesses, and when to refer people for specialist help.”
Mindfulness experts say extreme adverse reactions are rare and are most likely to follow prolonged periods of meditation, such as weeks on a silent retreat. But the studies and concerns of psychiatrists and supporters represent a new strain of critical thinking about mindfulness meditation amidst an avalanche of hype about its benefits.