Mindfulness and the Wisdom of Advocates - Journeys in the Landscape of Health Care

Abstract

Service-user volunteers in a National Health Service (NHS) Mental Health Trust in the UK have made an unusual contribution to mindfulness teaching, training, research and governance as ‘advocates’ of mindfulness-based therapy interventions. We explore the nature of what has been named internally as the ‘wisdom’ of the ‘advocate’ group in this NHS Trust, and its impact on mental health provision. A clinician (clinical psychologist) and an advocate (anthropologist) conduct an investigative conversational journey using a grounded theory framework in an institutional-personal landscape. They look for roots of the ‘wisdom’ in the mindfulness-based therapy, in the practices of the Trust, and in the tradition out of which the therapy has emerged. The investigators find themselves focusing on matters of institutionalisation and professionalism (as forms of exclusion), on journeying and arriving (as expectations - in life, and in embarking on therapy) and on the advocates’ ‘wisdom’ as a deepening recognition of the intrinsic inclusiveness of mindfulness as a practice. The paper stands at a distance from typical healthcare presumptions of professionalism and delivery of treatment. This particular (mindfulness-based) therapy is presented as an intrinsically inclusive life-practice within a community of deepening capability, rather than a medicalised treatment. The method of writing the paper parallels the fluidity of professional/patient role and mutual contribution and journeying that the mindfulness-based approach itself embodies, and this offers an alternative model of ‘service-user participation’.