Mindfulness-based cognitive therapy is a psychological therapy designed to aid in
preventing the relapse of depression, specifically in individuals with Major
depressive disorder. It uses traditional Cognitive behavioral therapy methods and
adds in newer psychological strategies such as mindfulness and mindfulness
meditation. Cognitive methods can include educating the participant about
depression. Mindfulness and mindfulness meditation, focus on becoming aware of
all incoming thoughts and feelings and accepting them, but not attaching or
reacting to them. Like CBT, MBCT functions on the theory that when
individuals who have historically had depression become distressed, they
return to automatic cognitive processes that can trigger a depressive episode.
The goal of MBCT is to interrupt these automatic processes and teach the
participants to focus less on reacting to incoming stimuli, and instead
accepting and observing them without judgment. This mindfulness practice
allows the participant to notice when automatic processes are occurring and to
alter their reaction to be more of a reflection.
Beyond its use in reducing depressive acuity, research additionally supports
the effectiveness of mindfulness meditation upon reducing cravings for
substances that people are addicted to. Addiction is known to involve the
weakening of the prefrontal cortex that ordinarily allows for delaying of
immediate gratification for longer term benefits by the limbic and paralimbic
brain regions. Mindfulness meditation of smokers over a two-week period totaling
5 hours of meditation decreased smoking by about 60% and reduced their cravings,
even for those smokers in the experiment who had no prior intentions to quit.
Neuroimaging of those who practice mindfulness meditation has been shown to
increase activity in the prefrontal cortex, a sign of greater self-control.
Background In 1991 Philip Barnard and John Teasdale
created a multilevel theory of the mind called “Interacting Cognitive
Subsystems,”. The ICS model is based on Barnard and Teasdale’s theory that the
mind has multiple modes that are responsible for receiving and processing
new information cognitively and emotionally. Barnard and Teasdale’s
theory associates an individual’s vulnerability to depression with the
degree to which he/she relies on only one of the modes of mind, inadvertently
blocking the other modes. The two main modes of mind include the “doing” mode
and “being” mode. The “doing” mode is also known as the driven mode. This mode
is very goal-oriented and is triggered when the mind develops a discrepancy
between how things are versus how the mind wishes things to be. The second
main mode of mind is the “being” mode. “Being” mode, is not focused on
achieving specific goals, instead the emphasis is on “accepting and allowing
what is,” without any immediate pressure to change it. The central component of
Barnard and Teasdale’s ICS is metacognitive awareness. Metacognitive
awareness is the ability to experience negative thoughts and feelings as mental
events that pass through the mind, rather than as a part of the self.
Individuals with high metacognitive awareness are able to avoid depression
and negative thought patterns more easily during stressful life situations,
in comparison to individuals with low metacognitive awareness. Metacognitive
awareness is regularly reflected through an individual’s ability to decenter.
Decentering is the ability to perceive thoughts and feelings as both
impermanent and objective occurrences in the mind.
Based on Barnard and Teasdale’s model, mental health is related to an
individual’s ability to disengage from one mode or to easily move among the
modes of mind. Therefore, individuals that are able to flexibly move between
the modes of mind based on the conditions in the environment are in the
most favorable state. The ICS model theorizes that the “being” mode is the
most likely mode of mind that will lead to lasting emotional changes. Therefore
for prevention of relapse in depression, cognitive therapy must promote this
mode. This led Teasdale to the creation of MBCT, which promotes the “being”
mode. This therapy was also created by Zindel
Segal and Mark Williams, and was partially based on the mindfulness-based
stress reduction program, developed by Jon Kabat-Zinn. Theories behind these
mindfulness-based approaches to psychological issues function on the
idea that being aware of things in the present, and not focusing on the past or
the future, will allow the client to be more apt to deal with current stressors
and distressing feelings with a flexible and accepting mindset, rather than
avoiding, and, therefore, prolonging them.
Applications The MBCT program is a group intervention
that lasts eight weeks. During these eight weeks, there is a weekly course,
which lasts two hours, and one day-long class after the fifth week. However,
much of the practice is done outside of classes, where the participant uses
guided meditations and attempts to cultivate mindfulness in their daily
lives. MBCT prioritizes learning how to pay
attention or concentrate with purpose, in each moment and most importantly,
without judgment. Through mindfulness, clients can recognize that holding onto
some of these feelings is ineffective and mentally destructive. Mindfulness is
also thought by Fulton et al. to be useful for the therapists as well during
therapy sessions. MBCT is an intervention program
developed to specifically target vulnerability to depressive relapse.
Throughout the program, patients learn mind management skills leading to
heightened metacognitive awareness, acceptance of negative thought patterns
and an ability to respond in skillful ways. During MBCT patients learn to
decenter their negative thoughts and feelings, allowing the mind to move from
an automatic thought pattern to conscious emotional processing.
See also Acceptance and commitment therapy
Dialectical behavior therapy Mindfulness-based stress reduction
Mindfulness Further reading
Mindfulness-based cognitive therapy for depression: a new approach to preventing
relapse, by Zindel V. Segal, J. Mark G. Williams, John D. Teasdale. Guilford
Press, 2002. ISBN 1-57230-706-4. Mindfulness: Finding Peace in a Frantic
World by Professor Mark Williams & Dr Danny Penman" Rodale Books US. Piatkus
UK Mindfulness-based treatment approaches:
clinician's guide to evidence base and applications, by Ruth A. Baer. Academic
Press, 2006. ISBN 0-12-088519-0. Mindfulness-Based Cognitive Therapy for
Anxious Children: A Manual for Treating Childhood Anxiety, by Randye Semple,
Jennifer Lee. New Harbinger Pubns Inc, 2010. ISBN 1-57224-719-3.
Mindfulness Practice in the Treatment of Traumatic Stress, U.S. Department of
Veterans Affairs. id=Mindfulnet.org The independent
mindfulness information resourceInformation on MBCT., MBSR
Research, applications and resources References