April 23, 2016

Could we Live in a World where Mindfulness Replaced Psychotropic Drugs?


These days, the word mindfulness is everywhere. Mindfulness has been a game changer for both the medical world and the corporate world, and has everyone from athletes to lawyers, students to politicians touting its benefits. It is often portrayed as the gold standard for mental, emotional and physical health in today’s stressed out and overworked society.

I am an Acceptance and Commitment Therapist (ACT), which is a mindfulness focused form of cognitive behavioural psychotherapy, and I am also a yoga instructor. I am also somebody who has used mindfulness strategies to heal from my own sexual trauma, and through my work in both therapy and yoga, I have seen it aid in the healing process of hundreds of others as well.

Nevertheless, I’m here to have the important and necessary conversation about the limitations of mindfulness.

With the stigma of mental illness decreasing thanks to campaigns such as Bell Let’s Talk, I would say that the majority of people that I know have now sought help at some point in their lives, in some way. Both the Western medical system and the people who utilise its services have an underlying belief that a healthy person is a happy person, and if we’re not happy, we have to fix it.

Russ Harris, a prominent ACT psychologist in Australia, posits that there are nine primary human emotions: love, joy, surprise, fear, sadness, anger, pride, shame and disgust. Out of these, over half are feelings that we consider to be unacceptable. But not only are these emotions within the realm of what we can experience, they are things that we will experience—over and over again. To feel these emotions and be aware of them is inevitable and within the normal spectrum of human experience.

Now, if patients were only going to psychologists to gain a deeper understanding of the normality of pain, sadness, anxiety and confusion, I would say that would be a very positive thing. But what I find disturbing is the prevalence of the use of psychotropic medications as a first-line response. These medications cause emotions in a healthy person to flatline, numbing the clients and causing dependence.

Consider someone going through a deep, personal loss—perhaps a widow, or a man experiencing an unwanted divorce. They go to a doctor or counselor and say, “I don’t want to feel this pain anymore.” Too often, rather than helping the client grieve in a healthy way, the first response of the professional is to prescribe antidepressants or some other drug that numbs them. Taking away the ability to feel removes their ability to create meaning out of their experiences and find purpose once more. How are they ever supposed to feel better? Many of these clients never heal. Our emotions, both positive and negative, play a very important role in the restoration of wellbeing.

ACT says that it is precisely this notion of wanting to get rid of our negative experiences that causes so much suffering. The person not only has painful thoughts and feelings (which are completely normal responses to a traumatic life event), but is then faced with this notion that “I should not be feeling this way.”

Patients do not question these approaches because an ingrained aspect of Western medical culture today is to focus on alleviating symptoms. This has not always been the case; in the past, it was not always possible to avoid pain and we tolerated it. For physical pain, it may make sense to try to alleviate pain to the greatest extent possible with medications. Mental or emotional pain, though, is a different matter.

It would seem to make sense to take the pill to make emotional pain go away, except that pain repressed tends to function like a ball pushed underwater in a pool. The harder we push, the more of a splash it makes when it inevitably comes back up. Not only will it not stay down there forever, but because we pushed it down, it will pop out with a much greater force than if we just let it be there. Those who are on medication for life may never have to experience that, but with something bubbling under the surface, they may go through their entire lives experiencing the negative side effects of the drugs while also experiencing a certain feeling that something is missing.

For many people, mindfulness meditation is a beautiful and life changing tool to handle difficult emotions. We can’t control our emotions, and the more that we try to stop anxiety, or sadness, or fear from coming up, the more it comes up. With mindfulness, we gain distance from our thoughts and emotions, looking at them rather than from them. We begin to realize that our thoughts and emotions are not who we are, and from this observing stance, we begin to create space for these difficult experiences to be as they are, where they already are. This is the beginning of the true processing of difficult internal experiences, and with processing comes not only healing but positive growth. The amazing thing is that often, once they’ve stopped spending all their energy on fighting how they feel, and get clear on what they really want their life to stand for, they become free to do things that really matter to them. They become the people they have always wanted to be in their relationships, friendships, at work and with their health.

So, is mindfulness the one answer? Could we live in a world where mindfulness replaced psychotropic drugs? Given everything I’ve said so far, you might be surprised to hear that my answer is no.

Most non-scholarly articles on mindfulness don’t address cases where mental dysfunction is the result of a physical disorder or a biochemical imbalance in various parts of the brain’s chemical synapse and neurotransmitter systems. Their readers, who may be unaware of their mental health disorder, turn to holistic methods of healing and therapy which will do nothing to resolve their illness (although they might provide some temporary relief of symptoms).

Neuroscience has demonstrated the impact that a single chemical imbalance can have on an individual’s mood, memory recall and emotional balance. For these people, medication has been tremendously successful in treating resulting dysfunctions. This does not mean that solutions are simple. There may be several groups and subgroups of biological issues that are responsible for causing symptoms of mental health disorders. In addition, because of the variety of imbalances that a person may have, there are different medications used to alter different levels of chemicals in different areas of the brain and it may take considerable time for the medical professional involved to find the right combination and dosage of drugs to help any one individual.

The point is, many mental health disorders that result from physical factors are treatable with medication—often highly treatable. Such treatments, which may be able to get clients up off the ground and learning to function with their illnesses, should not be dismissed. Mindfulness is not enough to treat these types of biochemical imbalances. At most, it may help those who need to change their lifestyles after they begin medical treatment or help them deal with the frustrations they face as they try to find the right medication, balancing relief with side effects.

Both mindfulness and medication are potential solutions for individuals in emotional or mental distress. The real issue for psychologists is to take the time to fully assess the problem and determine the best approach. Too often, and sometimes it must be said at the client’s insistence, the client is already out the door with a package of pills before that determination is properly made.

If mindfulness is the first-line response in the treatment of mental or emotional difficulty, we are at least assured that we are not needlessly trapping clients in a lifetime of suffering and drug dependency. When mindfulness is not doing the job, we have a responsibility to ensure that traditional Western medicine takes its rightful place.

With the embracing of mindfulness, I believe we are getting closer to a fuller picture of what mental health really is and how it can be achieved. Being for either Western or Eastern medicine is not the answer. They each have their merits, and a big picture of healing honours aspects of both.





Author: Alexandra Birrell

Editor: Travis May

Image: Gratisography

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