WEEKEND COLUMNISTS I’m no slouch when it comes to professional lingo, but at a conference last week, I was outjargoned in 30 seconds. I heard: “intervention support worker”, “management advice counsellor”, “duty liaison officer”, and clients as “the service key”; I could be anywhere, I thought – a bank, a beauty counter, or, oh yes, the NHS.
I have a loathing for fancy opacity, especially when it confuses, bewilders or misleads. And so I come to “mindfulness meditation”, an intervention being touted in so many areas of healthcare that it makes my head spin. It involves (depending who you believe) “specific behaviours, experiential manifestations and implicated psychological processes”, not to forget “temporal stability, situational specificity” and a speculation on “the conceptual and operational distinctiveness of mindfulness” (all this from the journal Clinical Psychology: Science and Practice). Basically, it’s about concentrating on your breathing, thinking about the present, and relaxing. The aim is to produce a state of heightened awareness, focused on the moment, without getting caught up in anxiety or stress.
And mindfulness is very big. There are courses on it everywhere, and the potential applications – well! From treating chronic coughs to preventing depression relapse, from coping with cancer, attention deficit disorder, anxiety and bone marrow or organ transplants to insomnia, and from improving white cell counts in HIV sufferers to treating heart-failure patients. It is even recommended for improving “attentiveness, self-awareness, acceptance, wisdom and self-care in dentistry”. It sounds so nice, so free of side effects and so mystical, enabling us to leave mere medical professionalism behind for that precious role of “healer”.
But there is a problem with mindfulness: the evidence. After reading numerous academic papers on the subject, I began to suspect that the people researching mindfulness outnumber those being studied doing it. Even in the slightly larger (and potentially more useful) studies, there are no good comparison groups involved. Most studies just offer one group of subjects mindfulness training and the control group nothing, whereas I want to know how the results of mindfulness meditation compare with, say, cognitive therapy for depression, or relaxation techniques for anxiety. Equally, how do they compare with simple good care?
I ask the last question because we know that warm, trusting and professional relationships between patients and staff contribute towards getting people well. But in the brave new NHS, “interventions” with “clients” seem to have replaced personal care and obscured the need for kindness, wherever healthcare is delivered.
Margaret McCartney is a GP in Glasgow
For lively discussion of the latest medical issues go to Margaret McCartney’s blog at www.ft.com/healthblog
