comments pointing to the value of MBSR
Interesting comments which point to the value of what we are doing in MBSR… recognising our thoughts and feelings and how they manifest in our bodies, and practicing accepting the difficult feelings as well as the good.
“We have feelings, emotional feelings, sadness, anger and fear and so on and each of those has a bodily manifestation so we’re experiencing churning stomachs, sweatiness, fatigue whatever it is that might be somatic manifestation of our ordinary emotional feelings.
“A social force that I think is really important in shaping the epidemic of mental illness is our intolerance of uncomfortable feelings, our intolerance of suffering, our intolerance of ordinary unpleasant feelings. And it actually only takes you two weeks to get a diagnosis of depression, you don’t have to feel bad for very long to get that diagnosis. And there’s this whole idea of pursuit of happiness as an end in itself and in fact I think the Thinker in Residence is coming to Adelaide this year and makes it his business to have us all pursue happiness. And there’s a wonderful book by Barbara Ehrenreich called Smile or Diewhich talks about the pressure on people to be happy and in particular she was somebody who had breast cancer and really got the message that many people with cancer get which is the kind of Lance Armstrong view of it that if you’re a good enough person and you are strong enough and you are positive enough the cancer will go away, and if it happens to kill you that’s because you haven’t tried hard enough.
And I think Ehrenreich’s work is a wonderful antidote to that kind of thinking but it also taps into this idea that happiness is an end in itself, something that we should pursue, and I think that’s a real misperception of what it is as an emotional state. Happiness is a marker, it’s something that we experience in certain circumstances in life and it’s not something that we pursue for its own sake. What we should be pursuing is a good life whatever that is, and if we pursue a good life and we are successful and lucky in our pursuit of a good life then for large periods of our life we will feel happy.
But part of a good life is also to feel sad and miserable and upset and angry and all of those other feelings and I’m not advocating joy in suffering or any sort of extreme Calvinist approach to life but I am saying that we have to be much more open to and accepting of uncomfortable and unpleasant feelings. And not just in ourselves but also in our children. Most of us have had the experience of parents in getting panicky about our children feeling the slightest bit unhappy and feeling that it’s our obligation to make things right for them. Maybe that’s not the kind of parenting that they always need.
So with that background in mind I want you to imagine a child who’s in, I want to go back now to the idea of us having a range of symptoms that are available to us from our bodies, feedback from our bodies all the time and that if we’re in a state of what you might term disarousal, that’s some kind of intoxication, or unhappiness, or anxiety, or distress that we’re inclined to become preoccupied with those symptoms whether they’re coming from our body, or coming from our emotions, or our mind. And if you imagine a child who’s in some kind of predicament, maybe her parents are fighting a lot and she’s very uncomfortable about that, children have a really limited number of ways in which they can tell us that things aren’t right in their life and ideally we’d like this little girl to come to somebody, or go to her parents and say look, I can’t bear you fighting anymore, it makes me sick and gives me a tummy ache when you do it and I want you to stop.
But most kids can’t do that and maybe the tummy ache doesn’t go away when they do but let’s imagine that it’s a tummy ache for this girl, it might be behaviour problems for another child, or it might be withdrawal and apparent depression for a third child; and this little girl becomes increasingly preoccupied with her tummy pain which is very real and very distressing to her and if the cards fall in a certain way she finds herself in an emergency department or a doctor’s surgery and the doctor gets worried about the pain she has and investigates it extensively and we’ve got an illness. What we have is a series of symptoms which would be better thought about as symptoms of a predicament actually being interpreted as symptoms of an illness. And it’s not until somebody can grasp the meaning of those symptoms that this is a guts ache caused by mum and dad fighting that doing something about mum and dad fighting is the intervention that’s needed. It’s not until that happens that we’ve really explained what’s going on for the little girl. You can put all kinds of labels on her experience but they don’t constitute explanations.
“Depression explains nothing and at best it describes. Now depression as a description can be a relatively benign label if somebody goes to the doctor and the doctor says I think what you’re experiencing could be described as depression and this is a condition that is quite common in our society and it tends to last weeks rather than months and you’ve had it for several weeks now, so you can expect it to go away relatively soon but why don’t you come back in a couple of weeks and let me know how you’re going with it. It might sound like nothing but it actually has a name it’s called watchful waiting and it’s the recommended treatment for mild to moderate depression and that’s a relatively benign process because what’s being acknowledged there is that depression is a description of the person’s experience in much the same way that attention deficit disorder is not a bad description of a pattern of inattentiveness and over-activity and impulsivity.
“There’s very little doubt that many psychiatric drugs, whether they’re prescribed ones or ones that you buy in the pub or on the street, take away pain in the short term and do a good job of that and they enhance functioning in the short term and they do a good job of that. Many of them have few side effects for many of us who take them but there is increasing concern that that might not be the outcome in the longer term. That one of the reasons why there’s more depression around and more recurrence of depression might be that we’re treating it earlier and more frequently with antidepressants which while they may reduce and shorten that episode of depression may predispose us to further episodes of depression.”
Professor, disciplines of Psychiatry and Paediatrics, University of Adelaide
Head, Department of Psychological Medicine, Women’s & Children’s Hospital
Senior Research Fellow, Department of Philosophy, Flinders University of South Australia