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European Positive Psychology conference: 1st day - a disappointing start & caution on over-selling mindfulness

I'm in Angers, France at the 8th European Conference on Positive Psychology.  Yesterday I went to a couple of pre-conference workshops and then attended the Opening Ceremony and the first keynote lecture.  The conference venue is lovely, on the edge of Angers Botanic Gardens.  It feels too that the organising group here have put in a huge amount of work to try to make the conference a success ... so many thanks to them.  So why do I say that I found the first day disappointing ... and actually quite worrying?  

Well, apart from the warm-hearted opening ceremony, I went to three "scientific" presentations yesterday ... and I felt that two of them fell well short of the critical rigour I would have expected at a major conference of this kind. Not only that, but these two poor presentations were given by Itai Ivtzan, the programme leader of what I believe is the largest academic Positive Psychology MSc course in Europe and James Pawelski, the founding director of a major U.S. university Master of Applied Positive Psychology program (and senior figure in the International Positive Psychology Association).  Ouch!  I'm probably being pretty grouchy ... my Edinburgh-Paris plane had been delayed by three hours the day before and I didn't get into Angers until quite late ... but I still believe "It's important to keep an open mind, but not so open that your brains fall out".   And happily the third presentation I went to was with the rather fine (and scientifically more grounded) Barbara Fredrickson, so all was not lost!

Itai Ivtzan's workshop was on "Mindfulness programs in positive psychology".  The pre-workshop publicity stated "Mindfulness meditation is one of the most popular interventions in psychology, the interest in which grows year after year. Positive psychology (PP) is the fastest developing branch of psychology, whose expanding journey of investigating human flourishing has attracted great interest. What happens when these two are brought together?"  This is all well & good.  What got my goat though was the message seemed to be that mindfulness is the best thing since sliced bread and wonderfully effective for pretty much all the wide applications it's been tried for.  This is just not true.  Multiple meta-analyses show that current mindfulness training is an interesting and often helpful intervention, which typically hasn't been shown to outperform earlier cognitive and behavioural approaches (more about this below). 

The workshop was advertised as being "mindful and playful."  It's a fine line this one ... what's playful and what's self-indulgent?  We saw it later when James Pawelski gave the first keynote, put on a multi-coloured cape, had his five year old son speaking into the microphone, and tried to warm the audience up a bit like someone doing a comedy show.  Difficult. What's light-hearted fun and what's a bit messy?  I've spent a lot of time & money to get to this conference.  What I want is to learn how to better serve the patients/clients who come to me for help with how their lives are going.  There are endless ways of responding therapeutically to this suffering, confusion, and yearning for better lives.  Good science is a wonderful way of trying to make this response as helpful as possible. When Itai Ivtzan, who holds a major academic position, leads his audience to believe that mindfulness is some kind of stunningly miraculous advance on previous interventions ... is he unaware of the research? For example he lauded the wonder of mindfulness for pain treatment.  Yes current research suggests it's helpful, but Veehof et al's 2016 paper "Acceptance- and mindfulness-based interventions for the treatment of chronic pain: a meta-analytic review" concluded "ACT showed significantly higher effects on depression and anxiety than MBSR and MBCT" and "Current acceptance- and mindfulness-based interventions, while not superior to traditional cognitive behavioral treatments, can be good alternatives."

This is no miraculous advance - see too, for example, Khoury et al's 2013 "Mindfulness-based therapy: A comprehensive meta-analysis" with its conclusion "MBT did not differ from traditional CBT or behavioral therapies or pharmacological treatments" or Goyal et al's 2014 review "Meditation programs for psychological stress and well-being: A systematic review and meta-analysis" which comments "We found no evidence that meditation programs were better than any active treatment (ie, drugs, exercise, and other behavioral therapies)" or MacCoon & colleagues results from their careful work developing and testing an active control condition for mindfulness research or Shallcross et al's 2015 paper "Relapse prevention in major depressive disorder: Mindfulness-based cognitive therapy versus an active control condition" with its rather discouraging outcomes and its very valid conclusion "This study demonstrates the importance of comparing psychotherapeutic interventions to active control conditions."  

I'm a fan of mindfulness.  I've been practising it personally for over 40 years and several of my best friends are teachers.  My reading of the current research position is that it's great that so many academic centres have put a lot of money, time & energy into looking carefully at mindfulness interventions.  This has not only told us a good deal about mindfulness but also thrown light on many interesting related areas.  It's a pity that it took so long to develop & test a valid active comparison control, but this was challenging to do & it's admirable that it has now been achieved.  I think the relative ease of group & online delivery of mindfulness training is a big plus in its favour, especially with the lack of stigma attached to learning this kind of approach and its availability in a wide variety of lay settings.  I don't think that mindfulness is a major efficacy advance in the treatment or prevention of psychological distress ... it seems that most of what can be achieved through learning mindfulness can already be achieved by other pre-existing interventions.  If it is a major advance therapeutically, I think it's more about how easily it's accepted and taught.  I'm happy to be corrected if I've missed any important health applications of mindfulness and I'm not commenting here on its "spiritual" validity.  Mindfulness seems to me to be a welcome additional resource in responding to psychological distress of many kinds.  It's unclear at the moment how useful it is for nourishing wellbeing.  I think that over-selling this approach makes a future backlash against it more likely. It may be a little unkind, but the admirable Pim Cuijpers paper "How to prove that your therapy is effective, even when it is not: a guideline" is worth learning from.  And I believe that significant academic figures, with a special interest in mindfulness, should be more aware of what emerging research is showing.

Enough of my grump.  I wasn't too impressed by one of the pre-conference workshops at the last European Positive Psychology conference two years ago in Amsterdam either ... and the conference went on to be very worthwhile.   The second workshop I went to this year in Angers was with Barbara Fredrickson.  It was a little technical ... introducing two new questionnaires that researchers in this field might find helpful ... but it was good. I don't think I've ever regretted making time to listen to Barbara speak.  Interesting to hear her caution over obsessive prioritisation of happiness and how this can backfire ... but balancing this with the value of, to some extent, prioritising activities that promote 'positive', welcomed emotional states.  I'm sure I'm regularly guilty of steamrollering potential experiences of enjoyment with a drive to achievement.  Balance is where it's at.  A definite need though for bed and a fresh start in the morning. 

For how the much improved second day of the conference went, see the post "European Positive Psychology conference: better 2nd day - culture and use of strengths"


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