We (Annette and Tim) are volunteers with the Complementary Therapy Service at The Christie, a regional centre for cancer care in the Northwest of England, and we are working with the team there to develop a very accessible, free, mindfulness-based service centred around a series of 4 weekly drop-in sessions. It is a privilege and very rewarding to work with the patients and carers at The Christie and the incredibly supportive and insightful Complementary Therapy Service team as we develop this course.

The 4 sessions explore how mindfulness-based approaches can change the way we experience common hassles or struggles that arise around sleep, fatigue, worries and discomfort. Although these are the specific areas of focus for the course, what is learnt in these sessions can be applied to virtually any situation where we find we are getting bothered by difficult thoughts and feelings.

The aim of the sessions is to provide training for patients, carers and staff in mindfulness-based approaches that they can practice by themselves, supported by audio-tracks that can be used between sessions.  To further increase the accessibility of the service these tracks are freely available through this website (you do need to register which is free and automatic) – and once we have evaluated the first series, we expect to have more materials available to support the areas that the drop-in sessions focus on. Participants can attend any or all of the hour long evening sessions and can repeat the sessions when the course cycles around again. We anticipate that the course will run once in every 6 week period.

The course explores how we can get into a battle with what is difficult in life and how, in particular, we can get lost in endless and often quite distressing thinking, worrying, fantasising or ruminating about what is bothering us or what we are struggling with. Like a person stuck in quicksand, the difficulties we face may be quite challenging just by themselves but, if we add the exhausting and distressing effects of unhelpful struggling, we can end up sinking deeper and deeper into the ‘quicksand’ of overwhelming thoughts and feelings.

Mindfulness opens up the possibility of a different approach to how we face difficulties – an approach that has a very special quality of restfulness.This is a restfulness that arises from a specific and simple approach to how we choose to pay attention to what we are experiencing – how in this moment (perhaps just for this moment) we can begin to allow what is pulling and pushing at our attention just to be there, to do what it is doing, as we acknowledge what is present in a friendly way and then gently return our attention to what we choose to be engaged with.

This is like having been in a long, tiring and often frustrating tug-of-war with what we are struggling with and then just dropping the rope; stepping off the battle-field. When we drop that ‘rope’ we free up energy and resources that have been consumed by the unproductive struggle; these can now be focused on doing what matters to us and we can explore how to respond to the difficulties we are facing more creatively and effectively. The mindful approach we are exploring here is an active way of being with what we are experiencing and living our lives – it is also profoundly restful even while we are still being fully active during busy periods.

So Easing Struggle is not a course about fixing insomnia, fatigue, distress or pain. These may continue and there are other services that can specifically address these issues. This course is about easing the additional burdens that we can end up being utterly overwhelmed by – especially the burdens of getting caught up in endless loops of worrying or distressing thoughts about what has happened, is happening or might happen.

We are also intrigued about how the evaluation tool developed for this course, our ‘botherometer‘, will turn out. There is a major issue with measuring how people respond to mindfulness-based interventions.

Most measures of difficulties we are experiencing rate symptom reduction. But if we have more self-awareness and are more willing, even briefly, to notice what we are experiencing right now, we may find that we experience symptoms more intensely even though we will also typically feel less overwhelmed or less bothered by what we are experiencing. So someone who is struggling with trying to block out pain may find that mindful awareness enables them to notice the pain they are experiencing but not feel so overwhelmed by it. So a standard pain score may show a worsening compared to the person’s experience of pain prior to the mindfulness training even though the person might say they are now in a much better state as they are not drowning in the pain now, or spending all their energies struggling with it or resenting it.

We hope the botherometer will prove to be a simple way of capturing this shift in relationship to what we are struggling with.

In the longer term we hope that the approach we are developing will offer an easily accessible format for people to explore whether mindfulness-based approaches may be helpful, especially in times of difficulty.

More structured mindfulness courses, such as the ‘classic’ 8-week type formats such as Breathwork’s Mindfulness-Based Pain Reduction, Mindfulness-Based Stress Reduction or Mindfulness-Based Cognitive Therapy  typically require pre-course ‘interviews’ to ensure that participants are at an appropriate point in their lives to engage in quite an intense group process and able to make the commitment these courses require – typically 2-2.5 hours on the course each week and up to 45 minutes of home practice 6 days a week. While necessary to the integrity of these courses, such pre-course ‘interviews’ reduces accessibility for those not able to commit, or for whom a more intense group situation is not appropriate.

The format of Easing Struggle aims to be more open and accessible and is based around brief practices in the sessions that aim enable the participants to determine whether they are at a point to find mindfulness approaches helpful and, if they do find them helpful, to also explore how little or how much they want to integrate these approaches into their daily routines. The style is also more conversational and light so that those who might find a more intense group process overwhelming are less likely to be unduly unsettled. Once we have run a few of these courses we intend to explore how this drop-in format might integrate with a more structured course requiring more regular time-commitment  from the participants.

We welcome your responses and reflections on what we feel is an exciting project.