Last Thursday there was a documentary on the public television network (Dutch) here in my country about Mindfulness. In an hour-long documentary, this hyped phenomenon was presented in a rather nuanced way, with both the advantages and risks associated with this psychotherapy. Luckily there still are investigative journalists delivering this quality programming, because I had never heard of it.

Mindfulness is a technique developed originally to help people cope with chronic pain. It now has evolved into a big hype worldwide and is also proposed for depression, hyperactive children, and stressed-out managers. It is based on a meditation technique used in Buddhism, and has been made popular in Belgium by Edel Maex, psychiatrist.

And actually, meditation is exactly what it seems to be. We see Johan Braeckman of the Belgian Skeptics (SKEPP) following such a session, where one “has to let go”, listen to little bells ringing, etc. I got reminded of an episode of Penn & Teller’s Bulls-hit, where Penn Jillette doesn’t stop yelling “stretching” when someone explains the assumed benefits of yoga. Relaxing can help, and I don’t mind.

There is also a segment with kids (they don’t really seem hyperactive, just busy) where they have to blow soap bubbles and sit on a balloon. This is coupled with anecdotes from some known Belgians who have used this technique to overcome depression. At the end of the program, Braeckman is allowed the last word, indicating that indeed some studies suggest it may work on depressions, but it is far from being established science. Kudos to the journalists for allowing this skeptical viewpoint.

So a perfect therapy, right? Well, it seems great, but there was more. The journalist went undercover to a “psychotherapist” (not a legally protected title in Belgium) with a faked depression where he got weird advice relating to his genitalia. The psychotherapist indicated even that she would also touch them next time. That is an absolute scandal in a medical profession, but there is nothing that can be done. Indeed, the professional organisation of psychologists (BFP-PFB) in Belgium has already reacted, saying that there is, now more than ever, a need for a strict legal definition of psychotherapist  with strict quality controls. Given the experience of the journalist, that seems rather correct.

However, there is something missing. Science. This technique gets touted in bestselling books and blogs on the internet, people flock to it in group sessions and children get subjected to it. But the science is very thin. Even though it is promising (see the references on the Wikipedia), there are only preliminary results. I find the Wikipedia a bit biased, but even there it is indicated that there are methodological issues with the research. I find it appalling that a technique, no matter how promising it looks, is rolled out like that without some decent and large-scale studies. If you have a new psychiatric drug, you have to pass multiple and long, extensive stages of strict testing. The same should apply to this therapy. It seems to me that proponents of this theory seem to “feel” that it works and apply it to everyone, without waiting for more research. This is in contrast to for instance fecal transplants, on which I blogged earlier.

Because this lack of scientific basis is where the professional organisation for psychologists goes wrong, too. They insist on having a legal solution but forget to indicate or request scientific research. Belgium has (almost) a system to recognize homeopaths, but the fact of having a legalized and restricted title, doesn’t make it scientific per sé.

It is probably too much to request this from a documentary on television to point this out in full. But the fact is that, apart from a mention from Braeckman, science seems ignored in this topic. And in the end, that’s where we all lose.

Thanks to my friend Helmut for the topic and some interesting links.

Note: an earlier version of this post had the remark that the “science is very thin”. That is a factually incorrect statement that has been pointed out to me, and I barred it in the text. There is a lot of science going on, also in the context of Cognitive Behaviour Therapy (linked to relaxation). In a follow-up post later on I might discuss in more detail these scientific findings, but for now I still stand behind my remark that it remains preliminary.