Mindfulness, psychosis and the fine tightrope

This chapter explores the tension between perspectives of psychology, biology and spirituality in the context of mindfulness-based therapies for people experiencing psychosis and distressing voices, a population whose voices (and anomalous experiences) have often been marginalised. Mindfulness-based cognitive therapy (MBCT), is an intervention with current popularity in the Anglo-American world, and is in the process of being specifically adapted for psychosis. This paper explores the intersection between anomalous experiences and the diagnosis and treatment of psychosis, particularly following the work of Isabel Clarke who calls for a positive re-conceptualisation of vulnerability to unusual experiences, which she compares to the mainstream perspective of many psychiatric services. These issues are being explored in my current research alongside a study being run by Sussex NHS Foundation Trust called; Mindfulness-based therapy groups for distressing voices (M4V): A pragmatic randomised controlled trial(RCT) . This study is funded by the National Institute for Health Research (NIHR)(£183,000) and aims to evaluate the effectiveness of a new kind of „mindfulness-based group therapy? which seeks to help people learn new ways of managing and living with distressing voices. It is a fine tightrope to walk between seeing one?s thoughts as just clouds moving across the sky of one?s mind (a metaphor commonly used in MBCT), and realising an inter-connectivity and connection with a wider whole, whilst remaining grounded in day-to-day relations with other people. This is a line that we all have to tread. I am interested in the potential for mindfulness to be a new way of working with this psychotic and spiritual threshold, and the potential for it as a therapy to help people form therapeutic alliances and develop a more autonomous relationship with their own bodies and selves.