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Mindful : August 2016
ILLUSTRATIONSBYISTOCK.COM/ARTVEA it on since the program was founded, and centers in Toronto, the UK, and San Diego offer professional train- ing and certification. Thousands of people are taking MBCT at any given time and hundreds of teachers are offering it. It’s popular now not just with people who have been diagnosed with a mood disorder. Many people find the inquiry into thought pro- cesses and the reinforcement of habits powerfully helpful. One program in Toronto, for example, serves members of the arts community. Like MBSR, the eight-week pro- gram occurs in two-hour weekly classes with a mid-course day-long session. It combines g uided medita- tions with group discussions, various kinds of inquiry and reflection, and take-home exercises. “Repetition and reinforcement, coming back to the same places again and again, are key to the program,” Segal says, “and hopefully people continue that into daily life beyond the initial MBCT program, in both good times and bad.” Over the past several decades, Segal has become a dedicated mindfulness practitioner and a strong believer in the efficacy of regular practice, which is why he is skeptical about mindful- ness becoming rapidly integrated into the institutions that train clinicians. “I could not just suddenly inject med- itation into the clinical training pro- gram I lead. It’s not as easy as that. If a clinician wants to bring mindfulness into their clinical practice, they are going to need to develop and maintain a regular practice themselves. That’s a big commitment. How do we keep track of that? How do we measure that in the context of a professional training institution? Being a young aspiring clinician and knowing a little something about mindfulness is one thing. Being able to lead, model, and train patients in it is another matter altogether.” Right now, it is safe to say that in any local mental health community, many of the psychiatrists, clinical psychologists, nurses, and support staff would have heard of mindfulness, some might have a little experience and know a bit about it, but few would be trained to offer MBCT or MBCT- like therapy to patients. In some cen- ters, it is more widely available than others, but it is not integrated into the mental health system. That day is a long way off. Segal guesses that, over time, many therapists will have mindfulness as an element in their therapeutic practice. They will have a certain amount of personal experi- ence and will be able to follow proto- cols for providing some mindfulness practices to their patients. Others will have it as something they offer in a very robust way or as their sole or pri- mary offering. This is how it is now, at a small scale. For it to grow much big- ger—with integ rity maintained—Segal says, “It needs to be professionalized, with a widely accepted standardized accreditation that consumers could trust. Right now, it’s pretty easy for someone to offer MBCT. That’s been good enough for this birth period, but for mindfulness to be fully accepted as a mainstream intervention, more rigorous monitoring and standardiza- tion of the training will be required.” But there might be ways to reach more people who need help sooner... Helping to build the field of mind- fulness-as -a -mental-health-option for a greater number of people is not an academic exercise for Zindel Segal. And neither is it for his close col- leag ue, Sona Dimidjian. As I sit down with Dimidjian for breakfast in Boul- der, Colorado—where she is a profes- sor in the Department of Psychology and Neuroscience at the University of Colorado—her voice and manner exude caregiving. Dimidjian came to mindfulness first as a teenager, but her passion for it really took root in 1999 when she was a grad student at the University of Washington. Her advisor was set to give a keynote address at a conference, and he simply didn’t show up. He had died of a heart attack. “That incident began what was very painful time for all of us who worked together with him, and for his family. It brought me back to meditation prac- tice in a very concentrated way.” WHAT MBCT DOES FOR ME HOWARD 60, Self-employed I have Tourette’s, anxiety, depression, OCD. I’m a poster boy for mood disorders. I’ve done a lot: medication, exercise, talk therapy, CBT. I’ve been looking for the silver bullet. I’ve always been a catastrophe, but lately I’ve been able to see those thoughts as just thoughts and I managed to come out of my depression and anxiety. That’s when mindfulness star ted to become really effective. Instead of it being a challenge—something I didn’t look forward to—it became my friend. At some point, I stopped looking for the magic bullet. I have a toolkit. PERSONAL STORIES 52 mindful August 2016