I'm missing the seventh session of the Mindfulness-Based Stress Reduction course that I've been attending because I've come down to our annual four day UK Men's Group in Cumbria.  I've written about these peer groups many times on this blog - for example, last year's Men's Group and the year before's, as well as Mixed Groups here in Cumbria and just last month a Scottish Mixed Group too.  I woke this morning and wondered - as a kind of thought experiment - whether maybe this four day interpersonal group is, in some ways, a "better" way of training mindfulness than the more traditional practice of sitting in meditation. 

At first glance this may seem a rather odd suggestion to make.  In the post "What is mindfulness?" I commented that "I find it helpful to see that there are at least two very different ways of approaching this question (what is mindfulness?). One way views mindfulness through its origins in Buddhist meditation practice. There can be many benefits from using this 'traditional lens' - not least the wealth of experience on teaching meditation skills to help people increase their ability to be mindful. A second helpful way of viewing mindfulness is more scientific and possibly even more open-minded. This latter approach seeks to understand what a mindful mode of being involves. What are the attentional abilities and attitudinal stances that characterise mindfulness? Are there some ways of practising meditation that nourish our ability to be mindful more effectively than other types of meditation practice? More radically, are there other methods of learning to be more mindful that don't involve meditation practice? If there are other methods of developing mindfulness, in what ways might they be more or less effective than using traditional meditation training? Fascinating questions. I think the Buddha would have approved!"  

Many experts would see mindfulness as being made up of two broad aspects, so Bishop & colleagues in their paper "Mindfulness: a proposed operational definition" write "The first component [of mindfulness] involves the self-regulation of attention so that it is maintained on immediate experience, thereby allowing for increased recognition of mental events in the present moment. The second component involves adopting a particular orientation toward one's experiences in the present moment, an orientation that is characterized by curiosity, openness, and acceptance."  These two aspects can usefully be subdivided into five facets - Observe, Act-Aware, Describe, Non-React and Non-Judge - for more about this see the post "A better way to measure mindfulness: a short form of the five facet questionnaire".  I've also written on "Mindfulness during daily activities: is it helpful to vary the proportions of the five facets?" and in posts like "Mindfulness: the missing facet 'Describe', and meeting at relational depth with self & others" I have suggested that traditional mindfulness meditation may be quite poor at nourishing some aspects of the five facets.

Interpersonal process group work focuses particularly on developing emotional and interpersonal intelligence. It involves both developing a greater ability to note & describe one's thoughts & feelings, and also developing increased ability to empathically tune in to others as well. This is very much the territory of Observe, Act-Aware, Describe and also Non-Judge - and to certain extent Non-React. We have a pretty good idea of how much change in the five facets is typically achieved through attending an eight week MBSR/MBCT course. It should be a fairly straightforward experiment to compare this with change achieved across a residential interpersonal group like this. Having both been to many groups and practised mindfulness meditation for many years, I'm not a typical subject. However if I complete the "Five facet mindfulness questionnaire" for my time at the group, at least four interesting points emerge.

One insight is that I have already created a ceiling effect for Describe & Non-Judge so there's no real space to see improvement for me on these two facets using this assessment method.  I'm very confident that my strong score on Describe is much more due to years of experience in groups rather than to years of meditation practice.  This hunch is backed up by the relatively poor improvements in Describe achieved by subjects going through MBSR/MBCT courses - see the post "Mindfulness: the missing facet 'describe', and meeting at relational depth with self & others" for more on this.  Similarly I suspect that my high score on Non-Judge is at least as much due to interpersonal group work experience as to meditation practice.  I gave a talk at a CBT conference a couple of years ago on the importance of the therapeutic alliance.   Slides 14 onwards describe the great value that health professionals reported both for themselves and for their work from participating in experiential groups.  It was noteworthy that right at the top of what they reported as valuable about this involvement was "Feeling more comfortable and accepting of myself" - very much the territory of Non-Judge.  Kristin Neff & colleagues explored this territory more rigorously in their 2007 paper "Self-compassion and adaptive psychological functioning" (available in free full text from Neff's website).  Here they described significant increases in self-compassion and decreases in self-criticism three weeks after a 20 to 30 minute Gestalt two chair dialogue exercise very like the kind of work done in the interpersonal group - and groups produce improvements by a whole stack of other pathways as well.  It certainly seems a big challenge to design a 20 to 30 minute meditation practice that, after one sitting, led to significant changes in mindfulness that lasted at least three weeks. 

A second point is the pretty startling improvement on Act-Aware occurring for me during interpersonal group work.  This is not an easy facet to shift and mindfulness meditation sometimes finds this quite hard going - it's all too easy to leave the 'mindfulness' in the meditation session.  I would frame the groupwork-driven change in Act-Aware as becoming more "authentic" and - at least with interpersonal interactions - I suspect groupwork is as powerful or a more powerful agent for change than meditation practice.  Again this is a testable hypothesis.  Thirdly, with the facet Observe, it's noteworthy that the questions are targetted at sounds, images, smells and sensations.  There is no attempt to measure Observe in relation to other people - for example in how well we notice how others look, move, hold themselves, speak, and so on.  Why should this be?  Mindful observation of others is at least as important as mindful observation of the environment when it comes to survival and flourishing.  If the facet Observe was extended - as seems sensible - to include interpersonal sensitivity, then I'm very confident that groupwork would do very well. 

And the fourth point that I want to make is another query about what the "Five facet mindfulness questionnaire" measures - this time in relation to Non-React.  The questions involved include "I watch my feelings without getting carried away by them", "When I have distressing thoughts or images, I feel calm soon after" and "Usually when I have distressing thoughts or images I can just notice them without reacting".  Note Non-React, as measured here, focuses mainly on unpleasant experiences.  It certainly does appear true that usually it's beneficial to be able to bounce back pretty quickly from difficult experiences.  What's less clear is how Non-React is meant to relate to our response to pleasant, 'positive' experiences ......  Barbara Fredrickson & colleagues recent paper "Positive reappraisal mediates the stress-reductive effects of mindfulness: An upward spiral process" highlights that people who are 'flourishing' in their lives actually get more of a boost out of positive experiences than do those who are struggling more.  This doesn't look like the Non-React mindfulness facet.  Maybe the next iteration of the "Five facet questionnaire" would benefit from both extending Observe to include awareness of others, and adapting Non-React to include greater savouring of positive experiences.