Waxing lyrical on mindfulness
MEDICAL topics are frequently featured at the Edinburgh Fringe Festival, which finishes today. They usually “take the Mickey” out of doctors miscommunicating and making clinical errors. Yet psychiatry does not often figure in these performances. This year was slightly different, in that the Professor of Psychiatry at Edinburgh University, Stephen Lawrie, gave a talk on psychological and pharmacological therapy at one of the popular venues. This was not comedy.
However, the American-born comedienne Ruby Wax did perform a show in the comedy listings at one of the largest venues there.
Wax did a week-long show at the Fringe, the world’s largest comedy and arts festival, and also gave a talk at the International Book Festival on her latest book, How to be Human: The Manual. She has become a much sought-after speaker and mental health advocate since she developed depression and eventually had to be treated as in in-patient in the Priory Clinic in London a number of years ago. An earlier book, A Mindfulness Guide for the Frazzled, was written just after she obtained a
Masters Degree in Mindfulness Based Cognitive Therapy (MBCT), at Oxford University. Her new book deals with the need for mindfulness, its history and the physiology behind the technique. It presents techniques for basic mindfulness exercises also.
Her show is reasonably funny and consists largely of her interviewing herself and discussing various topics relating to mindfulness. The questions she poses to herself include: what is stress and frazzle, are we all more stressed than ever, what is the biggest problem people face and how can it be solved, what if you don’t have time to practice the mindfulness exercise and so forth.
She emphasises that, for her, “frazzled” is not the same as stress, which she rightly sees as beneficial to humans in dealing with the day-to-day challenges that we all face. These need a degree of anxiety for us to overcome them. The importance of adaptive stress is well recognised in psychiatry and psychology.
But, according to Wax, being frazzled is an emotional state that is excessive and is bound up with excessive worries of our own making.
In other words, we beat ourselves up for trivial reasons and overthink small things. The word “frazzled” is not used in clinical practice, but to a reader, or an audience it amply conveys the excessive nature of the emotion. She has become a strong supporter of MBCT for such states and has the imprimatur of Professor Mark Williams, a British psychiatrist in Oxford whose imprint on mindfulness is undisputed.
The answers to the questions she asked herself were not very tightly constructed and while they were frequently entertaining, I felt that this style did not really convey what mindfulness is about.
She involved the audience in some mindfulness exercises, but inevitably these were very brief. Neither did she overstep by suggesting that mindfulness was a cure-all. Yet, only once did she briefly mention her own depression, which could have provided an opportunity to point to the need for other treatments for depression rather than simply promoting a popular intervention.
This is a pity, because there is a danger that her advocacy of mindfulness, coupled with her clear wish to raise awareness about mental illness, will be taken as an endorsement of that technique as the only solution.
On a positive note, she understands the brain biology underpinning how mindfulness works and she explains this in one of the most clearly accessible pieces that I’ve seen written A Mindfulness Guide for the public in for the Frazzled.
Mindfulness is currently “kingpin” of therapies in the public consciousness. There are dozens of books available on the topic and for the public, trying to choose from this vast array can be daunting. Occasionally enthusiastic writers give a false, and overly positive, impression of the territory suited to mindfulness.
To her credit, Wax tries to clearly distinguish between normal and pathological anxiety. And she has the advantage of first-hand experience of the mental health services, having been hospitalised in the past.
Her honest approach means that her books are worth seeking out for anyone who wants to underestand mindfulness better.