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Mindfulness training for people with multiple sclerosis and their carers

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Mindfulness involves learning to bring our full attention to our experience moment by moment in a kind and non-judgemental way so that we can be aware of what is really happening in our bodies, our minds and emotions and our environment.  Vanessa Hope considers how the approach might help people with MS.

Mindfulness is a skill that we all have and, like any skill, it takes practice. It involves learning to bring our full attention to our experience moment by moment in a kind and non-judgemental way so that we can be aware of what is really happening in our bodies, our minds and emotions and our environment.

Mindfulness practices come from the Buddhist meditative tradition. They not only teach ways of developing calm and concentration but also ways of investigating what happens in our minds and hearts as the backdrop and driving force of our daily lives.

I have taught the eight-week mindfulness programme for the last ten years to a wide variety of people including those with stress, depression and anxiety, chronic fatigue syndrome and other chronic health conditions (including some with MS) and also to carers. I therefore found it most interesting that a recent research study conducted in Switzerland by Grossman and colleagues suggests that there is now scientific evidence that mindfulness training may be of help to people with MS in easing fatigue and depression and improving quality of life. This is certainly my experience.

So how is it that this 2,500 year old practice from an eastern tradition has found its way into modern medicine?

The growth of mindfulness training

Mindfulness training began in the USA 35 years ago when Jon Kabat-Zinn started his Mindfulness- Based Stress Reduction programme (MBSR) at a hospital in Massachusetts. Here he taught skills based on his own experience of yoga and meditation to patients whom the healthcare system was failing to help, especially those with chronic health problems. The results, endorsed by research trials, were remarkable and the programme is now used in a variety of settings worldwide. There is also a programme in Britain adapted for people experiencing depression in the form of Mindfulness-Based Cognitive Therapy (MBCT), which is recommended as a treatment in the NICE Guidelines. Another programme is the Breathworks course for people experiencing chronic pain, whose co-founder, Vidyamala Burch, has had to work with her own chronic pain for over 30 years.

More recently, developments in cognitive neuroscience have shown that mindfulness meditation can interrupt negative thinking patterns and help strengthen more positive neural pathways in our brains6. Often, when we are experiencing low mood or difficulties in our lives, we get caught up in rumination and spiral downwards in increasingly desperate thoughts and emotions. By bringing mindful awareness to our negative patterns, we can develop the ability to clearly see that we are buying into a 'story' of our own creation and to step back from it, which can prevent it from driving our lives. The same research also suggests that mindfulness helps to strengthen the immune system, which could be welcome news to anyone with a chronic illness.

A simple mindfulness exercise to try

Find yourself a quiet place to sit and have with you a raisin. See if you can let go of 'knowing' that this is a raisin and see it with 'fresh' eyes, much as a child does... being, as far as possible, with the direct experience moment to moment. Bringing an attitude of curiosity and interest, slowly explore the raisin through each of your senses... seeing it from different angles, noticing how the light catches it, throws shadows on it... feeling it with your fingers... smelling it and perhaps noticing the build up of saliva as you anticipate eating it... eventually, putting it into your mouth... exploring it with your tongue and teeth... biting into it and finally chewing and tasting it... seeing how it feels to swallow... and sensing the remaining flavour once the raisin has gone. Pausing and savouring this moment before you move into the next moment of your day.

The eight-week course

Over the eight weeks of a mindfulness course, we investigate our experience in great detail, just as you did as you ate the raisin. This can help us to enjoy the pleasurable moments of our lives more fully. It also gives us the opportunity to become aware of difficult feelings and unhelpful thought patterns with the same gentle curiosity. Participants learn to incorporate mindfulness into their lives and continue to take care of themselves after the course is over.

How mindfulness can help people with MS and their carers

Firstly, being more fully in the present moment helps us to step out of the regret for the past and worries about the future that are so powerful for those who have a chronic illness and those who care for them. This allows us to find joy in the simple things of life that are always available to us, such as the breeze against our skin or the sound of birdsong or the smile of a friend. This can greatly increase the quality of our life.

Allowing ourselves to be honestly aware of what is happening in the moment also gives us the opportunity to see things as they really are. We begin to understand ourselves better and are able to step back and look at the bigger picture. It is then possible to respond more wisely to people and to situations rather than react in habitual and often unhelpful ways.

The course also emphasises learning to take care of ourselves - recognising when we are narrowing our world and becoming isolated or when we are doing too much. For example, one participant with chronic pain learned to alert herself every half hour to do some gentle movement to stop herself becoming stiff and uncomfortable. Mindfulness helps us to know our limits and to honour our needs - a vital skill for people whose health problems leave them vulnerable to fatigue and pain.

Written by Vanessa Hope, Centre for Mindfulness Research and Practice, Bangor University for Open Door May 2011

More references

  • Grossman P, et al. MS quality of life, depression, and fatigue improve after mindfulness training: a randomized trial. Neurology 2010;75(13):1141-1149. Summary
  • Kabat-Zinn J. Full catastrophe living: how to cope with stress, pain and illness using mindfulness meditation. London: Piatkus; 1996.
  • Williams M, et al. The mindful way through depression: freeing yourself from chronic unhappiness. New York: Guilford Press; 2007.
  • National Institute for Clinical Excellence (NICE). Depression in adults: The treatment and management of depression in adults. NICE guidelines [CG90] London: NICE; 2009. Read on the NICE website
  • Burch V. Living well with pain and illness: the mindful way to free yourself from suffering. London: Piatkus; 2008.
  • Davidson RJ, et al. Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine 2003;65(4):564-570. Summary