The impact of neurological disability and sensory loss on mindfulness practice

Finlay, KA, Hearn, JH and Chater, A (2022) The impact of neurological disability and sensory loss on mindfulness practice. Disability and Rehabilitation, 44 (15). pp. 3825-3833. ISSN 0963-8288

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Abstract

Objectives: Mindfulness-based approaches are increasingly recommended in the management of medical conditions associated with sensory loss and absence, such as Spinal Cord Injury (SCI), Multiple Sclerosis (MS) and Functional Neurological Disorder (FND). Yet the implications of undertaking practices such as body scanning when living with sensory loss have not been considered. This study aimed to explore the impact of sensory loss on the practice and experience of mindfulness in qualified mindfulness teachers with SCI/FND/MS. Methods: Eight mindfulness teachers (5 females, 3 males) with SCI/FND/MS, sensory loss and wheelchair use were recruited from mindfulness teacher databases. In-depth, semi-structured interviews were undertaken, lasting between 50 and 93 min. Interviews were transcribed verbatim and analysed using Interpretative Phenomenological Analysis. Idiographic analyses for descriptive, linguistic and conceptual themes were completed before cross-case analyses. Results: Analyses resulted in two superordinate themes: (1) Adopting your Body; and (2) Sensation without Loss. These themes reflected the challenge of overcoming initial resistance to areas of the body with sensory disruption, building a relationship with the whole body, such that sensory awareness could be visualised and experienced without proprioception. Conclusions: Mindfulness offers a unique approach to accepting and working with the body after paralysis or sensory loss. Fundamental to the use of mindfulness with such populations, is the prioritisation of inclusive sensory language and exploring sensory absence as well as sensory presence. The cognitive and emotional outcomes of body scanning may be uniquely elevated in populations with neurophysiological disorders, highlighting the benefits of mindfulness for adaptive and protective self-management.IMPLICATIONS FOR REHABILITATION Mindfulness-based practices which focus on the body and sensation are accessible to people with neurological limitations. Mindfulness techniques can be extended through the use of visualisation strategies to encourage (non-proprioceptive) awareness of paralysed limbs or areas of the body with sensory loss. The language used in mindfulness-based interventions may need adapted by practitioners so that it remains inclusive for people with sensory loss as well as sensory presence. Additional care needs to be taken when using body scans during mindfulness as they have the potential to exacerbate psychological distress in people with reduced sensory awareness.