Sixth and final instalment in the series on third-generation therapies applied to family business. This time: Mindfulness-Based Cognitive Therapy.
Series: third-generation therapies in the family business · 1 · 2 · 3 · 4 · 5 · 6
I remember the signing of a family protocol at which the father, when it was over, said “well, that’s that” and closed the folder the way you close a case file. We had been working on it for nine months. There was cava, there was a photo that I think is still on the company’s website, and we all went home feeling we had left something settled. Me first.
That was in the spring. In November of the following year one of the sons called me because at a Sunday dinner someone had brought up the beach house, which was not in the protocol and had no reason to be, and within twenty minutes the four siblings were arguing about something from 2006. The document was still in its folder. Nobody had breached it. It had not been of any use either.
I have been turning this over for years, and I think the flaw lies not in protocols but in what we expect of them. We draft them at the best possible moment, when the family has just reached agreement, and they do not provide for the one certain thing, which is that the conflict will come back. In psychology there is a therapy built entirely around that idea: that the hard part is not getting out of the problem but not falling back into it. It is the one I had left to tell.
A problem treatments did not solve
Depression has a peculiarity that makes it especially cruel: every episode a person goes through increases the likelihood of the next one. By the late eighties, treatments, both medication and Beck’s cognitive therapy, were getting people out of the hole fairly effectively. The problem came afterwards. A year or two later, a very high proportion of patients had relapsed, and nobody was quite sure what to do about it.
John Teasdale, in Cambridge, had for some time been observing something that did not fit the theory of the day. Relapses did not usually come from a misfortune. They came from very little. A grey afternoon, a silly comment at work, a small sadness of the kind anyone has. In someone who has never been depressed, that sadness passes on its own. In someone who has, it does not: that same mild discomfort wakes up the usual thoughts, “here we go again”, “I’m worthless”, “this is never going to change”, and those thoughts lower the mood a little further, which in turn brings more thoughts of the same kind, and the person finds themselves at the bottom again without having decided anything at any point. Teasdale described it as reactivation, an old circuit that switches back on with very little current.
If that was so, the question changed. It was no longer about arguing with negative thoughts, which is what classic cognitive therapy did, but about teaching people to notice the circuit while it is still starting up. Teasdale, Mark Williams and Zindel Segal, who worked in Toronto, set out to find something that would train that capacity to notice, and they found it in a place that quite a few colleagues considered eccentric: an eight-week programme based on meditation that Jon Kabat-Zinn had set up in 1979 at a hospital in Massachusetts for patients with chronic pain. They adapted it, added psychoeducation about depression and some elements of cognitive therapy, and in 2002 published the book that gave it its name: Mindfulness-Based Cognitive Therapy, MBCT for short.
I have to pause here for a moment over the word, because mindfulness has become one of those things nobody knows the meaning of any more. It is not relaxing. It is not emptying your mind. It has nothing to do with Tibetan singing bowls or with the wellbeing workshop some consultancy will have tried to sell some of you. It is, put with as little solemnity as possible, training your attention to notice what is happening now, inside and outside, without immediately starting to judge it or fix it. Training it, as you train anything else, with exercises and homework. Some of them are rather boring. That is part of the point.
Does it work? The first trial was published in 2000, with 145 people who had recovered from repeated depression and were followed for sixty weeks. Among those who had had three or more episodes, who were the majority, adding the programme to usual treatment clearly reduced relapses. Among those who had had only two, it did not, which is interesting because it suggests the circuit has to be well engraved for this to help. Sixteen years later, an analysis that pooled the data from nine trials and more than twelve hundred patients found a risk of relapse a third lower than with no added treatment, and around twenty per cent lower than with other active treatments. It is not a miracle. For such a stubborn problem, it is quite a lot.
And one thing I want to say before going on, because I think it is only fair. All of this was designed and tested to prevent relapse in depression, in groups of patients, with a highly structured eight-week programme. What follows is my translation of those ideas to a business family. I believe it is legitimate and useful, but the evidence stops at the previous paragraph. From here on, it is me speaking.
Autopilot
What I find most useful in MBCT, by far, is a distinction they draw between two ways the mind works. They call them doing mode and being mode, names that sound better in English than in Spanish.
Doing mode switches on when we notice a gap between how things are and how they should be, and sets about closing it. It analyses, compares, looks for causes, makes plans. It is the tool you use to fix a breakdown or balance the books, and it is formidable for that. The trouble is that faced with a wound it does exactly the same thing. It analyses, compares, looks for causes. And a wound does not close by being analysed; on the contrary, the more you go over it, the more open it stays. Depression, for Teasdale and his colleagues, is to a large extent doing mode working overtime on something that is not its business.
I have seen this in families so many times that it hardly surprises me any more. There is an ugly argument at a council meeting. What does the family do? It calls another meeting, this time “to analyse what happened”. Four hours going over who said what, who started it, what happened in 2009, what would have happened if. Everyone comes out exhausted and with the feeling of having worked very hard. Nobody comes out better. It is doing mode applied to a pain, and the result is always the same.
Being mode is something else. It consists of noticing what is happening without rushing to fix it in the same instant. Noticing that it hurt, that I am tense, that heat is rising up my neck, and staying there for a moment before doing anything. It is not resignation, nor is it standing still forever. It is opening a gap between what happens and what I do with what happens, which is precisely the gap that autopilot closes. It resembles what we discussed with ACT, it is true, and the authors themselves acknowledge it; the difference is that here all the training is aimed at one very specific moment, that of catching the circuit as it starts.
Three minutes
The best-known tool in the programme is called the three-minute breathing space, and I like it because there is no mystery to it. You stop. First you ask what is going on in there: what am I thinking, what do I feel, what do I notice in my body, and you look at it without trying to change it. Then you bring your attention to your breathing for a while, nothing more, like someone holding on to a handrail. And then you open it out again to your whole body and to the room you are in. That is all. Three minutes. It does not promise calm; what it promises is not answering from inside the circuit.
I have tried it, by the way, in a couple of tense meetings, and I must say that the first time it felt ridiculous and the second time not so much. The hard part is not doing it, it is remembering to do it when your brother has just said that thing. That is why you practise it when things are calm. Nobody learns to brake at the moment of the accident.
And here is a proposal that comes not from therapy but from my own profession. If three minutes work for one person, why not a pause period for a family, written into the protocol itself? A mandatory cooling-off period before triggering any formal mechanism: calling an extraordinary general meeting, sending a formal legal notice, voting on something that cannot be undone. Contracts are full of periods to think before moving money. Almost none have periods to think before moving a relationship, which is what really breaks in these companies. I have started putting clauses like this into the protocols I draft, and so far no family has told me it was unnecessary.
Knowing how it starts
There is one part of the programme that is hardly ever mentioned and that seems to me the best. In the final sessions, once they are well, participants write a plan with their own warning signs. How they, specifically, know that something is starting to go wrong. One sleeps worse. Another stops answering messages. Another becomes curt with his wife. They write it down while calm, with a list of things to do, for the day when nothing comes to mind.
Business families have their signs just as people do, and they are usually very recognisable if you take the trouble to look. Someone starts a sentence with “it’s just that you always”. A brother stops coming to lunches, or comes and does not speak. Emails become short and start copying in the lawyer. Someone calls on a Thursday afternoon with a very reasonable request, as I described in the previous instalment. Every family has its own way of starting to break, and sitting down together one calm day to put it in writing seems to me more useful than any dispute resolution clause I have ever drafted. And I have drafted a great many.
What writing this has taught me
I began this series by saying that I did not share the oft-repeated idea that a “united family” is a condition for the business to continue. I said I would explain it when the time came. I think I now can.
If I go back over the five therapies, none of them proposes eliminating conflict. Behavioural activation says you should not wait until you feel like it to get moving. Acceptance and commitment therapy says that what pulls a family forward is its values, not the absence of discomfort. Dialectical therapy says you can be a sibling and a partner at the same time, and that the work consists of holding both. Functional analytic psychotherapy says the adviser is also inside the mess. And this last one says that conflict will come back and that what matters is seeing it coming.
What they have in common, looking at them now, is that they all change the relationship with the problem instead of promising that it will disappear. It is a far less marketable idea than family harmony, I know. But it is the one that holds up against what we know, and it is, I believe, the one that most helps whoever has to sit down at a table with their family next Monday.
Thank you for reading this far. If any of these six instalments made you think “this is my house”, I would like to know which one. And if not, I would like to know that too.
This text is for informational purposes only and is not a substitute for therapy or psychological counselling. The models described here belong to the field of clinical psychology and are presented as a framework applied to family business governance, not as a diagnosis or treatment of any family member.
Do you recognise any of these patterns in your family council?
At Alta Mediación we combine law and applied psychology to work with business families, not just with documents. If in your council every corporate disagreement ends up being experienced as a family offence, let’s talk about how to organise the forums and the conversations so that decisions can be made without breaking the relationship.