Listening for the Truth Within Talk that Sounds Delusional: a Key Yet Rare Mental Health Method
January 29, 2012Telling my story on “Mad in America”
February 21, 2012One interest of mine is how people can learn skills so that they can better handle experiences like hearing voices. One key problem with voices is that people often alternate between either trying too hard to get rid of them, or listening to them too much. (There is a “bipolarity” to this, which I think connects with how the mental and emotional problems that get called “schizophrenia” and “bipolar” are not distinctly different.)
Anyway, the article below talks about skills people can learn to get over the side of the problem which is listening too much to the voices. If one can learn to avoid listening too much to the voices, then the fact that they exist at all is not so much of a problem, which naturally might also help a person become less obsessed with getting rid of them. And maybe help the mental health system get less obsessed with getting rid of them?
This article is available at
http://www.sciencedaily.com/releases/2012/02/120203092031.htm
3 Comments
The following is a comment by Paris Williams, posted here with his permission:
I find this article particularly interesting since it lends further validity to something I found extremely helpful in my own recovery and that I have also found helpful with a number of my clients, which is mindfulness: For those who aren’t familiar with this technique, it’s been around in various forms in the East for thousands of years, most closely related to the Buddhist tradition.
Essentially, mindfulness has two primary components: the cultivation of the capacity to direct one’s attention and sustain it with a particular focus; and the development of equanimity for one’s present experience. So, essentially, it helps one shift from being primarily reactive (with very little free will) to one’s present experiences (whether it be voices, obsessive thoughts, difficult feelings, etc.) to being responsive to it–gaining the trust that one can develop the capacity to allow the experience to be there without having to try to repress it/push it away on one extreme or obsess and be seduced by it on the other. In mindfulness practice, when one is training oneself to develop this kind of attitude and mastery over their attention and equanimity, the target of focus is typically either one’s natural breath or sensations within the body (although there are some other variations as well, but mostly body-based as we tend to get less swept away by bodily experiences than by mental experiences). I believe ACT (Acceptance and Commitment Therapy) has done some research using mindfulness for treating psychosis, but I haven’t looked into this yet.
My impression of this iphone app is that it is building one’s attention “muscle” in a way similar to mindfulness, and can certainly be helpful; but I think there’s something to be said for (also) teaching clients to learn to use something that is always with them (i.e., the breath and body).
Hi Paris,
I agree with you that the skill touched on in this article is related more generally to mindfulness skills, and there is something to be said for teaching people mindfulness skills in general.
I think the person who has done the most research on mindfulness for people with psychosis is Paul Chadwick, see
http://bit.ly/xcoYXE
Paul has worked within the CBT for psychosis tradition, though also influenced by ACT as well as lots of other stuff.
Many people believe that meditation in general is bad for people with psychosis, but research like Paul’s shows that it can be used in a helpful way. It can also be used in an unhelpful way, for example Will Hall notes that he got deeper into trouble when he was using mindfulness with the wrong intention, to try and hide away from his problems, but it is helpful when used in other ways. I think this perspective helps explain how people who go on long meditation retreats sometimes are triggered into psychotic breaks – they perhaps are trying to hide from some aspect of their mind, they aren’t in the habit of facing it, but then it pops up in the clear space of meditation practice in a way that they can’t hide from it any longer, and they “freak out.” Those who weren’t trying to hide in the first place see whatever comes up as just more “grist for the mill.”
Paul Chadwick suggests just short experiences of mindful meditation for those prone to psychosis, though people like Will Hall who have done a lot of recovery work are eventually fine with the longer meditation retreats as well.
Here’s a reply from Paris Williams, again posted here with his permission:
Hi Ron,
I’m always impressed with the breadth of your knowledge and resources. Thanks for the link to the mindfulness study.
I agree with all of your points. I’ve attended many long silent intensive meditation retreats, and I’ve assisted in putting quite a few of them on, and I have great respect for both the profound healing that can occur within intensive meditation and the potential to open oneself up to overwhelming experiences that are difficult to integrate.
To add to what you said, I think it’s also important to mention that the term “meditation” captures a vast range of practices, many of which have very different intentions and effects from each other. Some types of meditation practices, especially those that attempt to intentionally manipulate energy within one’s system (kundalini yoga,for example), have the potential to be particularly destabilizing and/or activating, especially when practicing them without the guidance of a very skilled teacher. Other practices are generally much safer and much more benign/grounding, such as mindfulness practices, which encourage the cultivation of awareness and acceptance of present experience (developing a middle ground between repression on one hand and getting lost within one’s experience on the other). But even with these, it’s important to have skilled instruction, especially for someone struggling with distressing anomalous experiences.
I also am in complete agreement with you in your emphasis on the importance of beginning with small doses and gently working one’s way up. I think it would generally be a really bad idea to suggest that someone struggling with such experiences dive right into a silent 10-day meditation retreat. Mindfulness meditation, when done properly, essentially increases both awareness of present experience and our equanimity with this experience. However, it seems that many people experience an increase in awareness more quickly than an increase in equanimity (especially in the earlier stages) and can find themselves feeling overwhelmed–experiencing more than they can tolerate. I’ve found that this risk is nearly always eliminated when beginning with small doses and working up (I usually recommend my clients begin with only 15-20 minutes a day of formal mindfulness practice as well as using it for a few minutes off and on throughout the day as needed). This is also a good reason why we therapists should make sure that (1) we are well trained ourselves in mindfulness practice before introducing it to our clients (or refer them to a teacher/training we trust if not), and (2) make sure to introduce it in session first before just sending them home with a CD, making sure that any questions or potential problems are addressed first.
Thanks for engaging me with this topic. I think it’s a very important one!
Paris