Mindfulness-based Cognitive Therapy
Mindfulness-based Cognitive Therapy (MBCT) is a program used widely by psychologists and counsellors today to treat patients suffering from depression, anxiety, and other forms of psychological and medical ailments. Based on Jon Kabat Zinn’s Mindfulness-based Stress Reduction program at the University of Massachusetts Medical Center, MBCT is a blend of traditional cognitive behavioural therapy and Eastern Buddhist meditation practises.
Cognitive Behavioural Therapy (CBT) is a psychotherapeutic approach that has been around since the 1970s. It focuses on changing one’s thoughts in order to change one’s behaviour. The approach is based on the theory that how we feel is largely determined by what we think, and that thus depression is the result of negative—and often inaccurate—thoughts and beliefs about oneself, one’s situation, and the world.
There are certain types of negative thoughts and beliefs commonly held by people who are depressed. The first is personalisation, which involves relating negative events to oneself, even when there is no basis in such a relation. Another is dichotomous thinking, or seeing things as black and white. The third is selective abstraction, in which a person focuses on only the most negative aspects of a situation. And lastly there is magnification-minimisation, or distorting the importance of events by either dismissing or exaggerating their relevance.
CBT’s aim to target the thought patterns in order to transform a person’s emotional state has been challenged by the mindfulness-based approach derived from Eastern meditation traditions. The goal of meditation is to increase one’s mindfulness, or ability to observe thoughts, images, and feelings in a way that does not engage with, interpret, challenge, or distract from them. In so doing, a person is able to be present with any emotion without reacting through negative thoughts or beliefs.
Since the 1990s, various researchers and psychologists have been working to combine these seemingly disparate approaches, and MBCT is one product of such efforts. Through an eight-week program of therapy courses, at-home audiotape sessions, and education about depression, MBCT participants learn how to recognise their mood patterns in order to decrease their instinctual reactions to them.
MBCT was originally developed for the purpose of preventing the relapse and recurrence of depression, the risk of which is very high without some sort of sustainable therapeutic intervention. Psychologists have observed that people who have recovered from a depressive episode are easily triggered by even small amounts of negative mood. Internally, these people react to the negative mood with excessive negative thoughts and bodily sensations such as weakness, fatigue, and unexplained pain. Such reactions are out of proportion to the situation because they are actually rooted in childhood or in traumatic experiences. Thus, maintaining one’s recovery from depression requires learning how to keep normal negative mood states from spiralling out of control.
In addition to preventing depression relapse and recurrence, MBCT has also proven effective in providing relief from the symptoms of medical ailments such as hypertension, chronic pain, and cancer, as well as from psychological issues including anxiety and panic attacks. MBCT is particularly well documented as an effective method of chronic pain relief. Being in constant pain leaves a person’s nervous system on high alert. In a negative feedback cycle, a heightened nervous system increases a person’s sensitivity and reaction to painful sensations. MBCT helps chronic pain sufferers to break that cycle by decreasing the nervous system response.
The results of this method of treatment have been more than promising. In a multi-centre research study of 145 participants conducted in Toronto, Cambridge, and Bangor, MBCT was demonstrated to reduce the rate of relapse from 66 to 37 percent in individuals who had three or more previous depressive episodes. Another study in Cambridge showed similar results, with MBCT reducing the relapse rate from 78 to 36 percent. And although the preventative capacity of MBCT for people who have experienced only one or two depressive episodes is quite low, there is still great use for the therapy for sufferers of chronic depression.