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Mindfulness, therapy and the Church

2012124132breath_1I sent out a tweet last week asking to interview someone who’d found mindfulness useful for coping with depression. Mary got in touch and told me her story, which was fascinating. I thought I’d share it for this week’s newsletter.

Mary is a 25-year-old ordinand-vicar, who uses mindfulness to cope with the Post-Traumatic-Stress-Disorder that developed after a car crash last year.

She tells me she had a sense of a vocation to be a vicar from the age of 19. ‘But I really didn’t want to do it. It wasn’t on my agenda.’ Instead, she studied physics at St Andrews and then trained to be a teacher at Cambridge. The priest of her college insisted she think about her vocation, and gave her a book by Michael Ramsey, The Christian Priest Today. ‘There wasn’t any mention of women priests in it.’

Finally, after three years of wrestling with her soul, she decided to give her life to God. ‘I was scared of doing it. I was giving up a good job and decent salary. My parents are still getting used to it. They think I’m a bit mad. It’s making a big statement. It’s not what most people do. It’s hard these days to be and do what you believe in – there’s always someone to knock you and mock you. Is it acceptable to be a Christian these days, to give your life to God?’

She went through the ‘discernment process’ by which the Church of England decides if you’re suitable to be a priest. This involved a 48-hour ‘residential interview’ (‘a bit like the Big Brother house’) in which you are interviewed by three different people, observed as you interact with your fellow wannabe-priests, and asked to fill in a ‘personal inventory’ with questions like ‘what would you have on your headstone?’

She passed the process, and won a place at a seminary college at Oxford for her priest-training. One week before she was due to begin the training, the car crash happened.

Angry at God

She was driving down an A-road into Harrowgate, when she had a head-on collision with another car. Her car was then hit again, and spent spinning across the A-road. She was rushed to hospital for surgery.

She says: ‘I thought I was going to die. And I wasn’t scared, I was annoyed. I was annoyed at all I had been through to commit myself to God, and now it was all going to be over before I had even begun.’

She was operated on for a perforated bowel and intestine. She spent the first two weeks of her ordination course recovering in hospital. ‘I wanted to be dead for quite a long time, in a way I felt rejected by God because He clearly didn’t want me in Heaven with Him!  It felt like I was being tested, in fact the whole year feels a bit like a test, a bit like Job.’

She says: ‘When I was in hospital I went to chapel, which was empty, and I shouted at Him and questioned what on earth was going on.  I then broke down in tears and could feel His presence and I knew I had to stay close, because He was all I had to get through the next phase. Initially, and I suppose for a few months I could not really engage with worship services, which was awful, because they and the Eucharist were what had sustained me through previous difficulties.  God felt rather far away, so I had to stay close and wait, regardless of how I felt.’

Then, in her first term, the symptoms of Post-Traumatic Stress Disorder emerged, like a bruise swelling. ‘I’d get flashbacks of the impact. I was very anxious, nervous a lot of the time. Any loud noise, I got palpitations. It led to me having very low self-esteem. I couldn’t really see beyond each day. My short-term memory was damaged – people would tell me their name and I’d forget it straight away. I felt hugely guilty, but couldn’t talk to anyone about it. I thought it would take less time to get better. My self-talk was like ‘come on, pull yourself together, you shouldn’t feel like this.’ It was like I had a noisy devil on one shoulder and a very quiet angel on the other. It seemed like an on-going torture.’

Mindfulness for depression

In January this year, she went to see a university counsellor, Dr Ruth Collins, who prescribed her anti-depressants, and also suggested she try mindfulness-CBT. She gave her a copy of The Mindful Way Through Depression, co-written by Mark Williams, the founder of the Oxford Mindfulness Centre.

0Williams, a psychiatrist and Anglican priest, is one of the developers of mindfulness-CBT, and has done more than anyone to bring mindfulness into the mainstream of British society – another of his books, Mindfulness, has been in the top 20 of Amazon for the last three years, selling thousands of copies a week.

His Oxford Mindfulness Centre has brought mindfulness into the heart of psychotherapy and healthcare, and also into public policy (there’s now an All-Party Parliamentary Group on Mindfulness), business, schools and higher education – in fact, Ruth Collins spoke at a conference on mindfulness in HE this week, arguing that university students should be offered free introductory courses.

Oxford already provides such free courses, and Mary went along to one earlier this year. ‘I was the only person there who said they had depression, so I wondered if it would work. But I found it interesting. We started with a counting exercise – you sit and count to ten breaths. Some could only get to 2 or 3 and they’d get distracted, but I could go further.’

She developed a daily practice, meditating for 10-30 minutes each day, sometimes counting the breath, sometimes doing a ‘body-scan’. She says: ‘It’s been very helpful with the depression. For one thing, I realized how important the body is to the mind. I realized how much tenseness was inside me, and I try to breathe through it. I’m now more aware of the signals from the body to the head. When things get stressful and I feel like I’m teetering on the edge of feeling bad, I try to go back into myself and keep saying ‘breathe, here and now’, and accept what I’m feeling, and try to deal with it or just support myself.’

She thinks this will ultimately make her a better priest: ‘I’m very good at looking after others, not so good at looking after myself. I now try to be kind to myself and say that it’s OK to be where I am. Mindfulness is something in the tool-box to support myself when I stop taking the anti-depressants in a few weeks.’

Mindfulness and the Christian way

How does she reconcile a Buddhist practice with her Christian vocation? ‘I’m quite flexible, I believe in using and learning from other traditions. I enjoy reading the Tao Te Ching, for example. I don’t see any conflict between mindfulness and Christianity – it also has the idea of the connection between the soul and breath [they’re the same word in Greek – pneuma].’

‘And of course there is a long contemplative tradition in Christianity – Jesus did go off to the mountains on his own, then the Desert Fathers developed forms of meditation, and St Ignatius and the Jesuits created a strong contemplative practice.’

19 DORE JESUS VISITS MARTHA AND MARY DETAILThere’s also the story of the two sisters, Mary and Martha, in the Gospel of Luke. Jesus visits their house, and Martha busies herself with the preparations, while complaining that her sister sits at Jesus’ feet, absorbed in adoration. Jesus replies: ‘You are worried and upset about many things, but few things are needed—or indeed only one. Mary has chosen what is better, and it will not be taken away from her.’ This verse has been taken by Christian contemplatives as a justification for the contemplative life versus the active life of ‘good works’. Still, it’s only one verse – not much of a foundation for a contemplative tradition.

Jesus has many more mystical sayings in the Gospel of St Thomas but, alas, that was excluded from the New Testament canon. Since then, the idea of bringing your mind and heart into union with God was often seen as heretically Gnostic or Platonic – and still is by some Christians.

I put it to Mary that contemplatives, monks and mystics always seem on the periphery of Christianity, suspected, cast out, and sometimes killed – much like the Sufis in Islam. There’s more of a mainstream contemplative tradition in the Orthodox Church, but even there it’s been controversial – witness the bitter fight in the 14th-century Byzantine church over whether the ‘hesychast prayer’ technique was heretical or not.  And the Protestant church seems particularly lacking in contemplative traditions and practices, beyond poets like George Herbert, William Blake and Emily Dickinson, forging their lonely furrow.

‘Yes, perhaps it’s not mainstream. The Church of Scotland is more Protestant than the C of E, and I’ve never witnessed any sort of meditation there. But perhaps it’s becoming more mainstream. Lucy Winkett [vicar of St James Piccadilly] is a big one for contemplative prayer, for example – she did a month-long Jesuit silent retreat. Even the Queen spoke of contemplative prayer in her Christmas message this year.’

Would Mary go on a mindfulness retreat? ‘I’d love to – there’s one in Snowdonia I want to go to.’ Would she say a prayer to the Buddha? ‘Well, no, I’d say a prayer to God. Like St Paul said, it’s what’s in your heart that counts, not the outer rituals.’

In two years, she finishes the ordination and becomes a curate in a church in her diocese. She says: ‘What am I most looking forward to about being a priest? Being able to try and reach out to people, to live the Gospel through my actions and allow God to work through me in ways I won’t understand. Also, being there for people at some of their most difficult times, and the most joyous.  I would hope to promote a greater sense of the need for spirituality of some sort (preferably Christian…!) What am I dreading?  Paper work, red tape and bureaucracy!  They will be the things that will prevent me from my ministry I fear…so I will just have to work hard to limit the impact.’

Good luck Mary! We think you will be a brilliant priest.

Philosophies for Life pilot: the results

11-10-13-mwc-1-1This year I’ve developed and trialled an eight-part course in practical philosophy, called Philosophies for Life. The pilot was financed by the Arts and Humanities Research Council via Queen Mary, University of London.  I trialled the course with three partner organizations: Saracens rugby club; New College Lanarkshire and HMP Low Moss prison; and Manor Gardens mental health charity.

The results were very positive –  the coaches of Saracens said the philosophy club was ‘the most popular thing we’ve done this season’; the participants at Manor Gardens philosophy club reported feeling more socially supported, more capable of coping with adversity, and much more interested in philosophy. And the participants of the prison philosophy club said they found the club more enjoyable and useful than the prison’s CBT courses, and became more interested in philosophy as a result.

I now plan to launch commercially, working with businesses, NHS mental health services and other organizations, and also developing an online course for the retail market.

The wisdom approach

I tried to develop a model of well-being education that balances evidence-based techniques with ethical discussion, approaching questions of the meaning of life in a pluralistic way.

At the moment, well-being courses in schools, mental health services, and businesses tend to be purely scientific / psychological. They teach evidence-based techniques for well-being, usually from Cognitive Behavioural Therapy (CBT). This is very useful from a practical perspective. However, a purely scientific approach either leaves out any questions of values or the meaning of life, or it simply assumes one definition of the meaning of life (for example, individual subjective well-being), and then imposes it uncritically and scientistically on participants. A purely scientific approach to well-being education easily becomes ethically illiberal and culturally insensitive.

On the other hand, the ‘critical enquiry’ method used by most philosophy clubs (and by organizations like SAPERE and the Philosophy Foundation in schools) is very good at facilitating group discussions of values and meanings, engaging people and respecting their perspectives. But it is perhaps too open and undirected –  it ignores the fact that ancient wisdom and modern psychology have discovered reliable hypotheses about how the mind and our emotions work, which it’s helpful to learn from the point of view of wisdom and cultural literacy. It leaves people adrift to rediscover wisdom from scratch, and does not teach any spiritual practices people can use.

And both the scientific and the critical enquiry approach to well-being education fail to teach people about the history and cultural variety of the pursuit of the good life, and how different wisdom traditions from various cultures have come up with differing answers to the question of the meaning of life. The Religious Education curriculum in England and Wales ticks this box – but RE tends to be entirely theory and dogma, rather than teaching spiritual practices people can use in their lives.

Philosophies for Life tries to combine the best of all these approaches. It teaches people evidence-based coping skills from modern psychology, and explores their roots in ancient wisdom traditions (Stoicism, Taoism, Buddhism, Sufism, humanism etc). Rather than just teaching instrumental ‘thinking skills’ emptied of ethical content, as CBT does, it gives people space to consider and discuss the original philosophical context for these skills, and the higher ethical goals they were designed to reach, such as inner peace, happiness, justice or oneness with the Tao / Logos / God.

Each session focused on a different ancient philosopher (Socrates, Epictetus, Epicurus, Plato, Aristotle, the Buddha, Lao Tzu and others), exploring one or two key ideas of theirs that we can use in modern life, and also whether evidence from modern psychology supports or undermines this idea. The session on the Buddha, for example, explores the importance of habits and training to the good life, and how CBT supports the Buddha’s claims about human nature and how to change it.

Then the second half of each session is a group discussion, both of the practical usefulness of the techniques we discussed, and of the philosopher’s broader ethical philosophy and the moral goal they were trying to reach (happiness, Nirvana, justice etc). The group discussion enables participants to accept or reject aspects of each philosophy, and to share their own stories and wisdom strategies. And it enables the course to cover various ethical life-goals and meanings without imposing any particular meaning onto participants.

I call my method the ‘wisdom approach’ and use the ‘wisdom tree’ as a symbol, because the course explores various wisdom traditions and how they share certain ‘trunk’ ideas about human nature, while then ‘branching out’ into various different life-meanings (happiness, social justice, Nirvana etc).

Tree_CM

Psychology now has good evidence for some of these ‘trunk’ ideas about human nature (like the belief we can use our reason to know ourselves and change our habits). However, when it comes to higher life-meanings, science can’t prove them or disprove them. It can’t prove that happiness is the proper goal of life, for example. That’s why we need philosophy to help us reflect, discuss and choose our own life-philosophy.

Results

Manor Gardens philosophy club

Manor Gardens Welfare Trust is a charity that works for the well-being of people in Islington. Our club met every Tuesday evening throughout March and April, initially attracting 15 people, which dropped to 12. Three quarters of the group were women, from their 30s to 50s, and were mainly Anglo-African and Anglo-Caribbean. The participants were mainly ‘mental health champions’ who do volunteer work for the charity.

I gave the participants a well-being questionnaire before and after the course, which asked them the extent they agreed to various questions, scoring their answer on a seven-point scale (with one being ‘strongly disagree and seven being ‘strongly agree’). This allowed me to get some sense of the impact of the course, however imprecise. It found the following

‘I lead a purposeful and meaningful life’  +12%
‘My social relationships are supportive and rewarding‘    + 21%
‘I am engaged and interested in my daily activities‘      + 6%
I actively contribute to the happiness and well-being of others   0%
I have control over my life and can move towards my goals   +6%
I am optimistic about my future  + 28%
When bad things happen to me, I can take steps to deal with them  +27%

The most significant impacts seemed to be in participants’ sense of social support, in their optimism, and their belief in their ability to cope with adversity.

I also asked participants for their own comments about what they liked and disliked about the course. Their comments can be grouped under four headings. Firstly, community: comments included ‘Tuesdays have been the highlight of my week for two months’, ‘a great sense of community, sharing, friendship’, and ‘great subjects taught and discussed in a very conversational manner that encouraged everyone to get involved.’

Secondly, the participants said they enjoyed learning about practical wisdom which they could use in their life. Their comments included: ‘I will take time to think about the bigger picture’, ‘relating theory to practice is what makes this course powerful’, and ‘the tools I have learned in this course and my belief in God will enable me to make major changes in my life’.

Thirdly, participants enjoyed the pluralism of the course – they felt they could learn about differing philosophies of life, without feeling their own faith or philosophy was threatened or undermined. This was a key aim of the course – to give participants a respect for various wisdom traditions, whether they are theistic, atheistic or agnostic. Participants’ comments included ‘Variety works well. It was interesting to hear how different people use different ideologies to guide their lives and how these ideologies can work well for different problems.’

Finally, all the participants said the course made them much more interested in philosophy – most of them having never read any before the course. Comments included: ‘I found the entire course inspiring; this motivated me to include more philosophy books in my reading list.’

Participants said they would have liked more of a range of philosophers, including black philosophers and female philosophers. They also said they would have liked the course to be longer, and to have a way to stay in touch with the other participants. Finally, they would have liked more materials to take away with them.

HMP Low Moss philosophy club

I taught the course over four Fridays in March to a group of 11 inmates in HMP Low Moss prison outside Glasgow. They were all male, mainly in their 30s and 40s, mainly white Scottish, and mainly long-term prisoners. The participants were already in a philosophy club run by Nikki Cameron of New College Lanarkshire, and my course benefitted from the thinking culture Nikki has created over the last year and a half. Nikki’s philosophy club explores questions through philosophical enquiry. I tried more of a ‘wisdom approach’, teaching practical ideas for life, and exploring their connection to modern psychology, particularly CBT.

CBT courses are already widely available in Scottish prisons and in other prisons around the world. However, these courses are usually compulsory, and either leave ethics out or include them in a quite dogmatic and non-criticizable form. I was interested in whether the participants would respond better to similar ideas presented in the context of philosophy, in which participants are not treated as malfunctioning brains to be fixed (low status), but as autonomous free-thinking philosophers (high status), who were not there just to take onboard ancient wisdom, but also to share their own wisdom. My sense was this made it more likely participants would engage with the course.

Feedback from HMP Low Moss philosophy club

I gave participants a questionnaire after the course, which gathered quantitative and qualitative feedback. It found that 66% of the participants said they found the course more useful and more enjoyable than the prison CBT courses (some of the group hadn’t done the CBT courses). When asked what they liked about the course, participants emphasized knowledge, wisdom and community. They liked learning about ancient philosophers and their relevance to modern life. They liked learning ‘coping skills’ to help them with the stress of being inside (Stoic philosophy was particularly popular). And they enjoyed the community of meeting up each week with the same people to hear each other’s views.

While I was doing the course, Kristine Szfiris, a University of Cambridge criminologist who is doing a PhD on philosophy in prisons, interviewed some of the participants. Here are a couple of quotes from them. The first shows one of the coping skills participants learned from Epictetus:

Jules Evans was in doing something about philosophy and he was talking about how we can jump to conclusions, and I do that when I play chess. I just look at the board and I’ll jump to conclusions and then I make a move and it’s been the wrong move kinda thing. I think it gave me a better understanding. I think it’s just about focusing on things I can control and not focusing on things I can’t control. I find philosophy really interesting and worthwhile being taught in prison.

And the second shows the benefit of a pluralist approach which doesn’t impose any particular ethical philosophy onto participants:

With Jules coming in, his views and opinions are set one way but he talks about all the different philosophers which we can disagree with or we can agree with if some of their points are valid. It allows you to take  snippets from each one and take something away from it. It’s impossible to take it all in, not in such a short space of time but if you can take a little bit of it away and practice it for yourself, it benefits you greatly.

Participants said they’d like more materials to take away and study in their own time, as well as suggestions for further reading that is available in the prison library. It’s also interesting to think about how ideas from prison philosophy clubs can be extended out into the rest of the prison, and also beyond the prison walls once prisoners are released (via probation organizations and community groups). Sometimes the group discussions were fractious, and discussion topics could sometimes have been better picked and facilitated by me.

Saracens philosophy club

Saracens FC are one of the world’s best rugby clubs. This season, they broke the record for most points scored in the Premiership, but sadly lost the Heineken European Cup final and the Premiership final in back-to-back weekends.

I ran the Saracens philosophy club as part of Saracens’ ‘personal development programme’. Saracens is unusual among professional sports teams in having an explicitly ethical mission, of focusing not merely on external results, but also on the internal goods of the well-being and character of players and staff. Saracens also have a willingness to try the new and unusual, hence the remarkable feat of getting 12 players and staff to attend and enjoy monthly philosophy sessions.

In fact, ancient philosophy seemed to me very applicable to professional sports – if you search ‘philosophy’ or ‘Stoicism’ in Google News, most of the results will be from sports. While many people in education are wary of talking about values, coaches are more prepared to do it. However, there can be a culture clash between an internal focus on character and virtue, and an external focus on ‘winning at all costs’. One even felt this clash at Saracens, despite their unusually ethical culture.

The timing of the sessions and the participants in the sessions were all somewhat fluid, due to the team’s schedule and fixtures. The philosophy club regularly attracted 12 or so participants, including first-team players and coaching staff.

Feedback from Saracens philosophy club

Feedback was quite haphazard from Saracens, as the players were very focused on two cup-finals at the end of the season (both of which they sadly lost), and then immediately went on holiday. However, the coaches, when interviewed in the Telegraph before the Premiership final, were kind enough to speak at length about the philosophy club. Alex Sanderson, the forwards coach, said “it has been the most popular thing we’ve done this season”.

Paul Gustard, the defence coach, said: “We spoke about the art of friendship, a higher calling – that could be faith or family – and it was nice to hear people speak openly about how they have changed along the journey that we are all on and where they sat on the ‘Golden Mean’. It was pretty cool.”

Kevin Sorrell, the backs coach, said: “It was an open forum for players to bounce ideas around. It was pretty enlightening to hear about how players felt individually about certain incidents over the last 12 months. Everyone left the room with a better understanding of what made that person tick and how they react to certain situations.” And Neil de Kock, Saracens’ scrum half, said: “I took an enormous amount of value out of Philosophy Club by having open and having frank discussions with colleagues on various topics very applicable to our game.”

As an organizational method, the philosophy club improved communication within the team, and also improved communication between the players and the coaches, helping them to see each other’s perspectives.

Again, the course would benefit from having more developed teaching materials, such as a handbook which participants could take away with them. Within an organization that has a very strong team-culture, like Saracens, it’s interesting to think of finding ways not just to reinforce that culture, but also to let people challenge it – otherwise group discussions just become ‘group-think’, rather than enabling people to think and speak for themselves.

Conclusions and next steps

The pilot was more successful than I expected. I initially wondered how philosophy would go down in these various communities (particularly the rugby club), and also how I would go down, as a plummy-voiced southerner. I think I went down OK, because I was open about my own vulnerabilities and flaws and didn’t claim to have all the answers. And the wisdom of ancient philosophies turned out to be very accessible to people from varying educational backgrounds, for many of whom this was their first exposure to philosophy.

The group discussions in the second half of each session worked well – people don’t want just to listen, they want to share their own ideas and experience. However, I think these group discussions were balanced well by the wisdom teachings of the first half of the course – people don’t just want to hear each other’s opinions, they also enjoyed learning about the ideas of Aristotle, Lao Tzu, Buddha, Epictetus and others.

The course worked particularly well with a demographic that is traditionally wary of group therapy – young men. Opening up about your inner life does not come particularly naturally either to rugby players or long-term prison inmates. However, both Saracens and Low Moss philosophy clubs were places where men could talk about what really mattered to them, and share life-strategies for coping with stress and adversity, without feeling ashamed or broken.

I now plan to launch the course commercially, by selling it to companies, to individuals, and to charities. It could either be sold as a full eight-part course, or as a one-day workshop, or as a two-hour session focusing on, say, Stoic wisdom.

There are two questions I need to answer: where would the course make the most money, and where would it do the most good?

Clearly, the most profitable way forward is to sell the course to businesses, business-people and entrepreneurs. Since the courses finished, I ran a workshop at a conference of business coaches in Spain, and the very positive feedback from that strengthened my sense of the commercial potential of running workshops on practical philosophy, resilience and flourishing for organizations. I’ve also joined the faculty of a school for entrepreneurs in London, called Escape the City School.

However, it would be an ethical mistake if the course was only taught to affluent businesspeople. I also think it has great potential to help people in schools, in prisons, in mental health services, and in the general population. I can afford to work with these groups if I subsidize it by working with business-people, and if I use technology to increase my impact.

The next steps, then, are firstly, building a strategy for the commercial launch of the course. I plan to work with a mentor and business coach to develop this in the next two months. Secondly, design and create teaching materials, such as online videos, handouts and activity sheets, and a website. I also plan to do this by September. Thirdly, expand my roster of clients and improving the course as I go on.

The best way to reach the biggest number of people is via the development of an online course. It will be important to find a technological infrastructure that can support this and take payments from participants. I may need to raise capital to design an online course and will discuss this with technology partners and possible funders in the coming weeks.

To read the 13-page report on this project, click here. If you’re interested in me running Philosophies for Life at your organization, as a workshop, a one-day event or as the full eight-part course, get in touch at jules dot evans @ mac.com