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Oxford: Berghabn, Detachment and engagement in mindfulness- based cognitive therapy Joanna Cook In her seminal work, The Powers of Distance, Amanda Anderson calls for a ‘defense of the critical, dialogical, and even emancipatory potential of cultivated detachment’ (2001: 177). For Anderson the cultivation of detachment is usefully understood as an ‘aspiration’ to a distanced view ~ that is, the intention to distanced perspective through ‘ongoing practices. In Anderson’s analysis of Vietorian writers, engage- ment and detachment are revealed to be dialectically constitutive. A ‘newly informed partiality’ results from practices in cultivated distance {Anderson 2001: 6), which impacts on impersonal goals and moral character alike, Her clarion call is for scholars to explore empirically the concrete aims, forms and effects of modern practices of detachment. ‘What might such a project look like? Tam involved in an ongoing ethnographic work on mindfulness-based cognitive therapy (MBCT) in collaboration with the Mood Disorders Centre at the University of Exeter. This research focuses on the MBCT course for participants, reunion meerings for participants who have completed the 8-week MBCT course, and training for therapists. In this chapter I take up the challenge of ethnographically unpacking the form, telos and value of cultivated detachment in the modern project of MBCT in the UK. In this context, MBCT is a therapeutic pathway for National Health Service (NHS) service users who have suffered from three or more major depressive episodes but who are currently well. Participants learn new modes of relating to experience and internal processes in order to prevent relapse into depression, Differently valorised forms of detachment are identifiable in the practice of mindfulness for the maintenance of mental health. On. the one hand, mindfulness is identified as a practice which is uniquely fit to address depersonalising, distancing and negative aspects of modernity220 Detaching and sit ting knowledge that contribute to the quite astonishing statistics on the increasing preva- lence of major depressive episode. On the other hand, the practice of ‘mindfulness demands that participants cultivate a detached perspective in relation to thoughts, feelings and bodily sensations in order to engage ‘more fully in the immediacy of life and avoid becoming lost in the rumina- tive thought patterns that contribute to relapse. I argue that detachment may be identified both as a symptom of modern malaise and a practice of reflection for practitioners. As a reflective practice it is cultivated intentionally in order to maintain a newly invigorated engagement with life and a healthy relationship with the self on the part of the participant. As such, my approach chimes with recent analytical approaches that explore detachment as a ‘social quality of engaged separation’ (Stasch 2003: 325), through ethnographic exploration of the ‘labour of division’ (Pedersen 2013: 203). The cultivation of detachment may be located in appropriate sociality with others, variously conceived, demanding forms of ‘inter-patience’ in a ‘pact of inaction’ (Candea 2010: 249) from all Parties, or simultaneously built into the ‘social architecture of relations’ and the reflexive work required for successful ethical practice (Cross 2011: 36). “Self-distancing’ has been identified as central in the pursuit of forms of knowledge and appropriate sociality. For example, the mutual implication of self-distancing (from the self, as variously under- stood) and social distancing (from the ‘object out there’) is one of the key tenets of the modernist scientific gambit (see Daston and Gallison 2007). Where my analysis must differ from these approaches to detach- ment arises from the particular quality and effects of internal distancing techniques in MBCT. MBCT participants develop particular kinds of distanced perspective, neither as a suppression of the self, nor as a ‘splitting’ from the self, Mindfulness training is primarily an in:rospection technique (Fronsdal 1998; Conze 2003). Inherent to the treatment model is a focus on learn- ing, on the capacity for change and on the potential development of a healthy relationship with the self on the part of the participant. The participant must make an ongoing and concerted effort to develop the self-reflexive detachment necessary to maintain the positions of ‘observ- ing subject and observed object’ in the dual tasks of self-knowledge and self-monitoring (Pagis 2009: 266; see also Mead 1934; Rosenberg 1979; Gecas and Burke 1995). A foundational premise of MBCT is that through dedicated mindfulness training, participants may develop a position of detached observation in relation to somatic, emotional and cognitive processes. This leads to a greater sense of control and self-acceptance. AS such, the locus of detachment here is primarily in the relationship that the participant has with his or her own internal responses. As I hope to show, Detachment and engagement in MBC’ 2 however, the ethical effect of such work is understood to be reflected in a re-engagement with the immediacy of experience of the world, for its own sake and on its own terms. Here, practices of detachment and ‘engagement are dialogically constitutive.' Through the cultivation of a detached perspective, participants strive to engage with the world ‘as it is’ in the present, unclouded by ruminative thoughts about the past or the future. Mindfulness and modern malaise Today, mindfulness is mainstream. Mindfulness-based cognitive therapy has been mandated on the NHS for service users who have suffered three or more depressive episodes; the Mindfulness in Schools Programme is bringing mindfulness meditation to primary and secondary schools across the UK, with a view to promoting the emotional well-being of students; targeted mindfulness initiatives are being trialled in the pro- bation service to prevent repeat offences by violent offenders and sex offenders; mindfulness programmes are being introduced into big busi- ness to address very real concerns about workplace stress and to reform institutional cultures in ways that prioritise workers’ well-being, An All Party Parliamentarian Committee on Mindfulness was established in May 2014 in Westminster to discuss the potential for introducing mind- fulness into public policy in the UK. Recent books on mindfulness cover topics such as teaching, politics, therapy, parenting, learning, self-compassion and depression. One of the originators of MBCT, Mark Williams, is number one in the Amazon Best Sellers List with his book Mindfulness: A Practical Guide to Finding Peace in a Frantic World (2011). Beyond this, mindfulness is a buz~ zword, It has been the focus of long editorial stories in Time magazine, The Huffington Post, The New York Times, and The Guardian, among others; some describing the current focus of interest as heralding a ‘Mindfulness Revolution’ (Time), Media reports are also referencing mindfulness as a way of selling very different stories. For example, a Channel 4 News feature on early morning raves in London, at which people dance hard for a few hours before going to work, identified the rave events as part of the ‘mindfulness movement’. In short, mindfulness is both ubiquitous and has cachet. Mindfalness appears to offer a targeted technique for addressing the malaise that plagues modern life: narcissism, atomisation, the collapse of cultural and moral hierarchies, the privatisation of life, the severing of the self from communal relationships and bureaucratisation. A recent editorial in Time (Pickert 2014) described the ‘Mindfulness Revolution’m2 Detaching and stuating knowledge as a way to ‘find peace in a stressed-out, digitally dependent culture’ a logical response to the contemporary disorder of ‘distraction’. In the Time article what distinguishes mindfulness from a ‘new age fad” is ‘smart marketing’ (and the common-sense approach of thinking of the attention as a muscle, that will be strengthened by repeated exercise) and science (here referring to the increasing evidence base exploring the neuroplasticity of the brain; see Davidson et al. 2003; Lazar et al. 2005). If we are able to rewire our brains, and this may be achieved through mindfulness exercises, then we can literally make ourselves ‘better’ people. By giving oneself fully to what one is doing One can work mindfully, parent mindfully and learn mindfully. One can exercise and even eat mindfully. The banking giant Chase now advises customers on how to spend mindfully. (Pickert 2014) Here, mindfulness becomes a practical and emotional tool for coping with the daily bombardment of information and demands on one’s attention. In an article in the Guardian, Jemima Kiss, the newspaper's Head of Technology, explored corporate interest in mindfulness, Kiss comments that in business and elsewhere, ‘Mindfulness is seen as an enquiry for objectivity, a way to claw back some of the equilibrium of how we exist in the real world, rather than the hyper-mediated place we create for parts of ourselves online’ (Kiss 2013). Mental health conditions account for at least 23 per cent of disease burden (DALYs)? in the UK, compared to 16 per cent for cancer and 16 per cent for cardiovascular disease (Mathers and Loncar 2006). Rates of reported depression are steadily and insidiously rising. Iv is esti- mated that around 10 per cent of the population will become clinically depressed over the coming year (Williams and Penman 2011: 17). The World Health Organization estimates that depression will be the second largest global health burden by 2020, teating contenders such as heart disease and many forms of cancer for the dubious honour. So, how is mindfulness understood here? While there are some disagreements about how it should be defined (see Mikulas 2011), in its current iterations in the UK it is understood broadly as ‘paying attention in a particular way: on purpose, in the present moment and non-judgementally’ (Kabat-Zinn 1994. 4). ‘Paying attention’ means developing awareness of patterns of thought, feelings and bodily sensa- sions. ‘On purpose” means changing the focus and style of attention, and ‘non-judgementally in the present moment’, means focusing on exactly what is in the present without erying to fix or change it. Here, mindful- ness isa practical activity, a way of becoming familiar and friendly with the patterns of the mind and emotional and somatic responses, thereby Det chment and engagement in MBC 2 gaining the possibility of choice in how one behaves, in response to those patterns, By developing perspective on these processes, one thereby transforms them. MBCT was designed to treat recovered recurrent depressive patients by encouraging dissociation from depressive thought patterns that play an important part in depressive relapse (Ma and Teasdale 2004). It has been widely promoted and supported by the NHS and the National Institute for Clinical Excellence (a non-departmental government body that provides national guidance and advice to improve health and social care) as a cheap and effective treatment for depression. It is taught in groups of 8-12 people led by a trained therapist, over an eight-week period. All participants on the course have a history of depression and have been referred there by their GP. The group meets once a week for two and a half hours, The sessions are built up of introductions, practices, enquiries and poems. They are highly routinised. Each session is followed by ‘homework’ - guided audio mindfulness practices that participants listen to at home every day, bringing mindful awareness to specified routine activities, and pleasant and unpleasant events calendars. In the penultimate week participants also complete a relapse signature chart and action plan. Key focuses of the eight-week course include developing awareness of what one is doing whilst one is doing it, rather than acting on ‘automatic pilot’, cultivating a decentred perspective on thoughts, recognising that ‘thoughts are just thoughts (even the one’s that say they are not)’, using awareness and perspective to develop the ability to choose how to respond to a thought or a situation rather than reacting to it in a ‘knee-jerk’ way, and cultivating a kindly relationship towards oneself, Reflexivity and self-cultivation The theory of consciousness that underpins MBCT is that our minds can operate in different modes (Segal et al. 2013). The originators of MBCT distinguish between two modes of mind: ‘doing mode’ and “being mode’. The problem-solving capacity that leads to cognitive rumination of avoiding painful or difficult states may in fact trigger and maintain depression. This is understood as a maladaptive aspect of ‘doing mode’, which maintains patterns that reinforce depression: the strategies that are employed in ‘fixing’ or solving during a negative mood can reinforce the negative thought patterns that lead to a depressive episode, In con- trast, ‘being’ mode is characterised by direct experience of the present without the need to fix or change anything. In order to enter “being mode’, practitioners must cultivate a decentred perspective and thereby