Theory Series: Mindfulness-Based Cognitive Behavioral Therapy
Mindfulness based cognitive therapy (MBCT) is a cousin to cognitive behavioral therapy (CBT), with less focus on changing thought patterns, and more emphasis on (you guessed it!) mindfulness. It was originally constructed by Jon Kabat-Zinn out of the University of Massachusetts and borrows from Zen Buddhist roots of mindful meditation. Kabat-Zinn originally taught MBCT as a 10-week course discovering an exceptional impact on physical pain reduction in volunteers. Soon after, his course was repackaged for people battling depression by three doctors by the name of Dr Segal, Dr Teasdale, and Dr. Williams. MBCT was then founded in 2001. The crux of the theory is centered around the idea that very subtle changes in thought can significantly impact a person’s mood. These changes sometimes result in debilitating depressive relapses. In other words, depressive ruminations can easily be kickstarted by a single thought. To combat this phenomenon, MBCT was designed to teach people to relate to their thinking in a new way, separating them from emotions unlike CBT which aims to strengthen the connection. Doing so follows a simple process of identifying trigger thoughts, being non-judgmental towards such thought/feeling states, and employing additional self-regulation methods also based in mindfulness.
Since its development aimed specifically at depression, this theory has been adapted for other cognitive disorders, showing effectiveness in clients with anxiety, bi-polar, PTSD, chronic pain and more. The program in its entirety spans 8 weeks, with weekly 2-hour sessions as well as corresponding homework assignments. Clients are taught to pay attention to their breath and body, educated on mindfulness concepts, and shown how to employ mindfulness techniques on emotional events to disempower them. Therapists who do MBCT are also expected to embody their work, leading by example instead of simply coaching such as in CBT.
Following is the typical paradigm for an 8-week MBCT program. Each of the 8 lessons are addressed in a respective 2 hour session.
1. Observing the automatic pilot and kind attention to the body
2. Gently dealing with barriers while practicing and befriending the breath
3. Gently learning to work with personal limits and befriending the breath
4. Discover that we can choose how to respond by opening gently to experience
5. Gently being with what is difficult
6. Learning to accept that thoughts are not facts
7. Taking care of ourselves
8. Going further, beyond fear
MBCT is highly adaptable; and works effectively for a variety of clientele. This includes men, women, people of any physical ability, sexual orientation, or socioeconomic status, and cultures around the world. It’s also worth noting that there is added appeal for those strapped for cash, since after all, it’s only 8 sessions long!
Critics of MBCT point to a relatively small (but growing) stack of studies which support its efficacy. They also point out that significant cognitive ability is necessary, making it a poor option for clients with psychosis. Lastly, it is also less powerful with those dealing with major life events or recent loss, as it can prevent the natural stress or grief response to take place. However, benefits are plentiful and, in my opinion, considerable. The brief nature of MBCT should not be undersold, as it can be cost effective and offer lifelong coping strategies that can be recycled through numerous life stages. Last, but certainly not least, it can greatly alleviate the burdens of traumatic memories, as trauma is typically stored in the body. Identifying these somatic responses through MBCT can help contextualize these feelings and loosen the grip of such negative past experiences.
For those of you interested in reading more, check out Wherever You Go There You Are by Jon Kabat-Zinn, for insights and a practical how-to guide for harnessing the power of meditation and mindfulness.
