Indications That the Mental Health of Relatives of Long-Missing Persons Can be Improves with Mindfulness
By John M. de Castro, Ph.D.
“Mindfulness for grief is not about whitewashing your pain, or “getting over” your loss. It is about learning how to stay present, cultivate compassion, and make wise choices that will help you cope with this new normal known as life after loss.” – Mindfulness and Grief Institute
Grief is a normal, albeit complex, process that follows a loss of a significant person or situation in one’s life. This can involve the death of a loved one, a traumatic experience, termination of a relationship, relationship to a long-missing person, etc. Exactly what transpires depends upon the individual and the nature of the loss. It involves physical, emotional, psychological and cognitive processes. In about 15% of people grief can be overly intense or long and therapeutic intervention may become necessary.
Mindfulness practices have been found to help with coping with loss and its consequent grief. Mindfulness-Based Cognitive Therapy (MBCT) was specifically developed to treat depression. MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy That is designed to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. This would seem to be an ideal treatment protocol to treat the intense emotions that occur when a loved one goes missing.
In today’s Research News article “Cognitive behavioural therapy and mindfulness for relatives of missing persons: a pilot study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6642737/), Lenferink and colleagues recruited “adults who experienced the disappearance of a spouse, family member, or friend more than 3 months.” They were randomly assigned to a wait-list or to receive 8 weekly sessions of an adapted form of Mindfulness-Based Cognitive Therapy (MBCT). They were measured before and after training for grief, Post-Traumatic Stress Disorder (PTSD) symptoms, depressive symptoms, mindfulness, and presumed causes for disappearance.
This was a small pilot trial and as such there were insufficient participants to assess statistical reliability of the results. But the study proved that employing Mindfulness-Based Cognitive Therapy (MBCT) for people with long-missing relatives was feasible and acceptable. They found that on average following MBCT there were increases in mindfulness and decreases in grief, PTSD symptoms, and depressive symptoms.
These findings are encouraging although far from definitive. They demonstrate that providing Mindfulness-Based Cognitive Therapy (MBCT) treatment for relatives of missing persons is possible and appears to help relieve the suffering of these relatives. This suggests that a larger randomized controlled clinical trial should be attempted. These relatives of missing persons are suffering from grief, depression, and PTSD symptoms and MBCT may help ease this suffering.
So, there are indications that the mental health of relatives of long-missing persons can be improves with mindfulness.
“The pure practice of mindfulness is to bring your attention to exactly what is — whether that is pain or bliss, peace or torment — each moment, as it arises. At its core, mindfulness does not try to talk you out of anything, nor does it judge what you feel. It’s not a prescription for happiness. Mindfulness is meant to help you acknowledge the truth of the moment you’re in, even, or especially, when that moment hurts.” – Megan Devine
CMCS – Center for Mindfulness and Contemplative Studies
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Lenferink, L., de Keijser, J., Wessel, I., & Boelen, P. A. (2019). Cognitive behavioural therapy and mindfulness for relatives of missing persons: a pilot study. Pilot and feasibility studies, 5, 93. doi:10.1186/s40814-019-0472-z
Relatives of long-term missing persons need to deal with uncertainties related to the disappearance. These uncertainties may give rise to ruminative thinking about the causes and consequences of the loss. Focusing on tolerating uncertainties in treatment of relatives of missing persons might foster recovery. Adding mindfulness to cognitive behavioural therapy might serve this aim. The feasibility and potential effectiveness of cognitive behavioural therapy with mindfulness were evaluated in a pilot study. We aimed to detect changes in symptom levels and mindfulness from pre-treatment to 1 week, 12 weeks, and 24 weeks post-treatment.
Dutch adults who experienced the disappearance of a significant other more than 3 months earlier and scored above clinical thresholds for psychological distress were eligible to participate. Participants were recruited from January 2015 to July 2016. Participants in the immediate treatment group started treatment after 1 week after randomization, whereas waiting list controls started the treatment after 12 weeks of waiting. Data from self-report measures as well as clinical diagnostic interviews (tapping persistent complex bereavement disorder, major depressive disorder, and posttraumatic stress disorder) were gathered among 17 relatives of missing persons with elevated symptom levels.
The response rate (31.7%) was low, and dropout rate (47.1%) high. Cognitive behavioural therapy with mindfulness coincided with changes in psychopathology levels (Hedges’ g 0.35–1.09) and mindfulness (Hedges’ g − 0.10–0.41). Participants completing the treatment were satisfied with treatment quality and reported high treatment compliance.
Because of the limited research about effective treatments for relatives of missing persons and promising results of small and/or uncontrolled trials examining the effect of mindfulness-based treatment to target grief-related complaints, it seems valuable to continue investigating the effects of cognitive behavioural therapy with mindfulness on reducing post-loss psychopathology in future research. However, in order to increase the feasibility of future trials among relatives of missing persons, we recommend collaborating internationally and/or extending duration of recruitment phase, to maximize the sample size.