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Mindfulness for neurologists
  1. Niels Bruce Detert
  1. Correspondence to Dr Niels Bruce Detert, Russell Cairns Unit, Psychological Medicine, Level 3, West Wing, John Radcliffe Hospital, Oxford OX3 9DU, UK; Niels.detert{at}ouh.nhs.uk

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After everything has been done medically to improve a patient's quality of life but they are left with a burden of symptoms and disability—and the loss, worry and stress that goes with this—what more can be done? From a psychological viewpoint, an awful lot. The premise of mindfulness training is that it is not so much one's situation that affects one's mental state, but the way that one either unthinkingly reacts to it or consciously responds to and works with it. This is potentially entirely in each person's control, and this knowledge is in itself a source of hope and empowerment. This is not a new idea or one limited to mindfulness; it is central to cognitive behaviour therapy and it was the core message in the writings of one of the 20th century's great heroes, the psychiatrist, psychotherapist and neurologist, Viktor Frankl, who, as a Holocaust survivor, tested this premise to the very limits. Mindfulness training offers a straightforward way to put this possibility into practice, and does not depend upon complex analysis or therapy but upon learning a simple method of working directly with ordinary experience.

What is it?

Mindfulness is simply paying attention to moment-by-moment experience in an open and non-judgemental way. So it is practising awareness of sensory and mental experiences as they happen. Although this is a natural capacity, doing it deliberately and repeatedly as an end in itself and building a practice of cultivating this mental mode is very different from what people usually do, which is to operate without conscious awareness on so-called ‘automatic pilot’ much of the time.

Mindfulness as a healthcare intervention is usually taught in a standardised 8-week format in groups often of 10–20 people, sometimes larger, with sessions of 90–180 min and with 45–60 min of daily home practice. Standard formats include mindfulness-based cognitive …

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    Phil Smith Geraint N Fuller