"Prescribing Mindfulness Allows Doctors to Ignore Legitimate Female Pain"

[Tom Kindlon]

https://slate.com/technology/2018/0...ing-mindfulness-on-chronic-pain-patients.html

"Prescribing Mindfulness Allows Doctors to Ignore Legitimate Female Pain

This trend offloads the responsibility of care from the medical system to the woman. And its efficacy is questionable at best."

[The critique can also apply to male patients]

"In my experience, in clinical settings, mindfulness is frequently disempowerment framed as empowerment, a way of placing responsibility for suffering squarely on the patient herself and a way for doctors to wash their hands of problem patients."

--

"This circular logic permeates the way mindfulness is currently being prescribed in medical settings: If it doesn’t work for you, it’s because you’re too anxious and too invested in your pain, which is in fact more evidence that you need to practice mindfulness."

--

"Mindfulness also happens to fit into a rhetoric of personal responsibility that has long infused American health care. Although ostensibly mindfulness originates in Eastern practices, Kabat-Zinn successfully reframed an Eastern practice in Western terms when he transformed meditation to mindfulness. Mindfulness fits in quite successfully with bootstrapping American values—through self-management, self-control, the right attitude, and daily practice, you can take control of your own life and illness. Of course the flip side of that logic is that if your pain is still debilitating, it’s your fault for failing to follow the protocol correctly."

#ChronicPain #chronicillness

 

[NelliePledge]

As with pacing something potentially useful is twisted and made to work against patients interest to serve the establishment agenda

 

[guest001]

Glad this nonsense is being debunked... not before time.

Fwiw: imo there is NO 'psychological component' to pain at all. Anyone who says that a) doesn't understand pain and b) has never suffered real intractable/ chronic/ severe pain.

 

[Trish]

Fwiw: imo there is NO 'psychological component' to pain at all. Anyone who says that a) doesn't understand pain and b) has never suffered real intractable/ chronic/ severe pain

I completely agree. The only 'psychological component' I have experienced related to pain is fear when I don't know the cause and suspect the worst. It doesn't make the pain worse, but it adds to my distress.

The only sensible treatment that works for this fear is proper diagnosis to rule out whatever I'm afraid of. Mindfulness would only compound the fear, giving me the messages that I'm being disbelieved, dismissed and it's all somehow my fault.

 

[guest001]

I completely agree. The only 'psychological component' I have experienced related to pain is fear when I don't know the cause and suspect the worst. It doesn't make the pain worse, but it adds to my distress.

The only sensible treatment that works for this fear is proper diagnosis to rule out whatever I'm afraid of. Mindfulness would only compound the fear, giving me the messages that I'm being disbelieved, dismissed and it's all somehow my fault.

But the important part about that is that your fear makes no difference to your pain. But I would wager if you told a doc that that was so, they'd vociferously disagree?

 

[James]

Mindfulness as "intentional, non-judgmental awareness of the present moment" cannot be the same thing that makes a judgement about the pain and decides that suppression of that awareness is the action necessary. Creates an oxymoron once an intention is used on non-judgmental awareness.

 

[Alvin]

The author is batting 1000 till the last paragraph, you don't need massage or chanting or other alternative treatments, this should only be used as part of spiritual enlightenment.
The jist of this "treatment" is that the patient suffers and the doctor feels godly. The power of easy answers. From the reality denying docs perspective thats a win...

 

[Londinium]

Not quite the same, but related: mindfulness seems to be highly in fashion in the corporate environment, for similar reasons. I've seen it be introduced by senior management in a way that basically says 'hey, we might have cut your team by 30% and doubled your workload, but we gave you all these mindfulness tools and if you still developed a stress-related illness, well, that's your fault'.

 

[Trish]

I gather there is a trend for companies to offer Resilience training to employees stressed by their working environment - as you say, @Londinium, it's a way of passing the buck for the blame from the bullies to the bullied, from the bad employers to the overworked employees.
I'd say it should be unethical for psychologists or whoever runs this stuff to be complicit in enabling bosses to pass the blame for work stress from boss to employee.

 

[Invisible Woman]

it should be unethical for psychologists or whoever runs this stuff to be complicit in enabling bosses to pass the blame for work stress from boss to employee.

It should be but....

It seems doctors, nurses, physios and other "healthcare professionals" can use their professional status for their own gain and knowingly lie about sick people, fully aware that what they are doing will inflict further harm. Yet the professional organizations they are members of do nothing.

Why should it be any different for psychologists?

When builders and tradesmen do this kind of thing the BBC like to film exposés, but its okay for healthcare professionals to demonstrate similar ethics to cowboy builders.

 

[Londinium]

I gather there is a trend for companies to offer Resilience training to employees stressed by their working environment - as you say, @Londinium, it's a way of passing the buck for the blame from the bullies to the bullied, from the bad employers to the overworked employees.
I'd say it should be unethical for psychologists or whoever runs this stuff to be complicit in enabling bosses to pass the blame for work stress from boss to employee.

Yep, it's done under the 'Resilience' banner at my work, something that I've pushed back on for my team because it often comes across as 'please suffer in silence'.

These fads come and go. First it was NLP, until that was shown by everybody (other than Bristol University) to be pseudoscience. More lately, it's been unconscious bias - which has recently also been shown to have some serious question marks over its methodology. Now it's resilience and mindfulness training, about which the best we can say is that it's unproven and claims of efficacy are generally underpinned by methodologically-flawed trials. What ties them together is that there is an unhealthy 'blame the recipient' mindset that runs through it, and that questioning it is discouraged, to put it mildly (When I stated that I thought an example on some unconscious bias training, about female-named hurricanes doing more damage because people took them less seriously, was probably just post-hoc reasoning applied to a coin-toss outcome, this was taken as proof that my innate sexism was showing through. It was a bit like if the Emperor's New Clothes story had ended with the child who pointed out his nakedness getting hanged for sedition).

There has always been a market for thinly-researched business books that senior leaders love to read because they boost their ego - that tells them there is some magic element that they, and only they, have. The truth - that one needs certain basic skills to get ahead in business but that luck still plays a massive role - is less marketable. Hence anything that says that the reason my direct report had a nervous breakdown is because they weren't sufficiently resilient, rather than because of my poor management, is always going to be popular.

What I hadn't realised before I got ill is that there is, in places, a direct linkage between the pseudoscience of management self-help books and mainstream psychology. That if CBT doesn't work then it might be down to an uncooperative patient. That medical authorities, like senior business leaders, are very open to cheap fixes that put the onus on the patient. That so much of it is based on studies that have basic methodological flaws and that fail to replicate. That when it's finally shown not to work, the proponents just move on to the next big thing with no acknowledgement that their previous advice had been nonsense. I had always known this about the spivs of 'leadership training consultancy'. I hadn't appreciated how much this also applied to more mainstream science.

 

[James]

Time and again in these situations, the APA has trumpeted its commitment to psychology's do-no-harm ethics but then retreated into the shadows when those principled words required principled actions. A close look at the APA's stance toward the detention center at Guantanamo Bay where 5 psychologists were involved in torture says more about ethical standards than the public relations exercise ever could.