Mindfulness-based cognitive therapy (MBCT) is a therapeutic approach that combines elements of mindfulness based stress reduction (MBSR) and Cognitive Therapy. The founders developed mindfulness-based cognitive therapy to treat recurring depression. This integrative approach has gained significant recognition and popularity in recent years. Mindfulness-based cognitive therapy provides individuals with practical tools to manage stress, improve mental well-being, while also drawing from the empirically proven benefits of mindfulness and self-awareness.
Mindfulness Based Cognitive Therapy (MBCT) is an integrative therapeutic method that combines elements of mindfulness-based stress reduction method and the cognitive therapy approach to improve harmful thinking patterns leading to recurring depression.
History of Mindfulness Based Cognitive Therapy
Mindfulness-Based Stress Reduction Influence
Mindfulness, although rooted in ancient Eastern traditions, has spread to modern therapeutic practices. In the 1970s, Jon Kabat-Zinn, a renowned American scientist and meditation teacher, introduced mindfulness-based stress reduction (MBSR). “MBSR is based on rigorous and systematic training in mindfulness, a form of meditation originally developed in the Buddhist traditions of Asia” (2013). The MBSR program guides students through several mindfulness exercises (mindful breathing, full body scan, etc…) with an underlying goal to assist them cope with their various physical and psychological challenges. Kabat-Zinn theorized that by cultivating moment-to-moment non-judgmental awareness suffering would decrease.
Cognitive Therapy Influence
Early in the cognitive revolution, Aaron beck and others cognitive science pioneers discovered that negative thoughts play a leading role in depression. Our thoughts, they taught, significantly impact our moods. Beck theorized that “depressed persons have distorted negative perceptions of themselves, their world, and their future” and that by changing these negative perceptions the client could improve their mood (Murphy, 2022).
Beck defines cognitive therapy as “an active, directive, time-limited, structured approach used to treat a variety of psychiatric disorders…it is based on an underlying theoretical rationale that an individual’s affect and behavior are largely determined by the way in which he structures the world” (Beck, 1987). The cognitive techniques “identify, reality-test, and correct distorted conceptualizations and the dysfunctional beliefs (schemas) underlying these cognitions” (1987). Cognitive therapy for depression is a proven treatment. Consequently, many patients have benefitted from the cognitive revolution.
Thee Integration of the Two Approaches
Building upon the success of MBSR, cognitive therapists Zindel Segal, Mark Williams, and John Teasdale developed Mindfulness Based Cognitive Therapy (MBCT) specifically targeting individuals struggling with reoccurring episodes of depression. In regards to the development of Mindfulness-Based Cognitive Therapy, the founders wrote “we soon discovered that the combination of Western cognitive science and Eastern practices was just what is needed to break the cycle of recurrent depression” (Williams, et al., 2012). In general, this innovative approach combines the mindfulness practices of the MBSR program with cognitive techniques introduced by Beck that target thoughts contributing to depression. By creating a comprehensive framework of mindfulness techniques and effective cognitive therapy, practitioners alleviate depressive symptoms in clients and prevent relapse.
It is okay to stop trying to solve the problem of feeling bad
The Underlying Theory of Depression In Mindfulness-Based Cognitive Therapy
To better understand the mechanisms of Mindfulness-based cognitive therapy, we need to understand the founders conceptualization of the causes of depression. They, like Beck, believe that thoughts influence moods. However, in addition, they theorize that moods also influence thoughts. In a cruel cycle of thoughts and moods, depression thrives. In addition, studies have found that after experiencing a severe depression, individuals are more likely to relapse into more severe bouts with depression in the future.
According to the differential activation hypothesis, low moods activate negative thinking patterns that can magnify normal dysphoric moods into full blown episodes of depression. The hypothesis proposes that this pattern is strengthened with each succeeding episode of depression (Askey-Jones, et al., 2016).
Sadness and Depression
Our brain latches onto patterns. Once we go down a certain path once, it is more likely we will travel that same path under similar circumstances. According to this principle, once we move from normal everyday sadness to depression once, we are more likely to move from sadness to depression in subsequent experiences of sadness.
Williams explains “depression forges a connection in the brain between sad mood and negative thoughts, so that even normal sadness reawakens major negative thoughts.” He adds that simple sadness can trigger harsh negative views of ourselves that then impact both our mind and bodies. “Once the body reacts in this way to negative thoughts and images, it feeds back to the mind the information that we are threatened and upset” (Williams et al., 2012).
The nasty loop of mood, thought, mood cascades into deeper and deeper despair that ordinary problem solving thinking cannot resolve, leading to feelings of helplessness and depression. In essence, mindfulness interrupts this loop.
Problem solving is our main reactionary response to disquieting experience. We feel discomfort, find the cause, and pluck out the thorn. In depression, however, the discomfort is not caused by outside interference. There is no external elements to repair or remove. The depression is a reaction to internal mechanisms. However, as Williams explains, “sorting things out will always seem like the most compelling thing to do–figuring out what it is that is not good enough about us, sorting out what we need to do to minimize the havoc that our unhappiness will wreak in our lives if it persists…it simply fuels further unhappiness and keeps us fixated on the very thoughts and memories that are making us unhappy” (2012).
Mindfulness break the relationship between normal sadness and unfulfilling venture into problem solving, where no problems exist in need of resolution.
Similar to the way Eye Movement Desensitization and Reprocessing Therapy uses dual stimulation to create an environment for effective cognitive therapy to treat trauma, mindfulness-based cognitive therapy calms intense sadness so therapists can target distorted thinking contributing to depressive episodes. Basically, mindfulness changes our relationship with emotion. Emotions become something not to resolve but to non-judgmentally experience. Through mindfulness, we relate differently to our unhappiness.
At its core, MBCT emphasizes the practice of mindfulness, which involves intentionally paying attention to present-moment experiences with an attitude of curiosity and acceptance. Kabat-Zinn defines mindfulness as “paying attention in a particular way: on purpose, in the present moment, and non-judgmentally (2013).
Through guided meditation, body scans, and mindful movement exercises, individuals learn to observe their thoughts, emotions, and bodily sensations without judgment. This non-reactive awareness allows them to develop a deeper understanding of their internal experiences and break free from automatic patterns of negative thinking.
When we are able to mobilize our inner resources to face our problems artfully, we find we are usually able to orient ourselves in such a way that we can use the pressure of the problem itself to propel us through it, just as a sailor can position a sail to make the best use of the pressure of the wind to propel the boat.
In addition to mindfulness exercises, MBCT incorporates elements of cognitive therapy. The aim is to identify and challenge negative thought patterns that contribute to depressive episodes. By recognizing and modifying unhelpful thought patterns, individuals can gain a greater sense of control over their emotions and improve their overall well-being.
MBCT has shown promising results not only in preventing relapse among individuals with a history of depression but also in managing various mental health conditions such as anxiety, stress, and chronic pain. Its evidence-based approach has made it a sought-after therapeutic intervention in clinical settings worldwide.
A meta-analysis of six randomly controlled trials of 593 participants “concluded that for those people with three or more episodes of depression, and who were currently in remission. Mindfulness-based cognitive therapy reduced the likelihood of relapse by 43% (Askey-Jones, 2016).
A Few Words by Psychology Fanatic
In conclusion, Mindfulness Based Cognitive Therapy combines the wisdom of ancient mindfulness practices with the insights of modern cognitive therapy. By cultivating present-moment awareness and challenging negative thought patterns, individuals can develop greater resilience, promote well-being, and pave the way for a more fulfilling life.
For more information on this integrative therapy, explore the Mindfulness-based cognitive therapy website at MBCT.com.
Askey-Jones, R., & Flanagan, E. (2016). Mindfulness-based cognitive therapy in clinical practice. Mental Health Practice, 19(5), 28-35.
Ames, C., Richardson, J., Payne, S., Smith, P., & Leigh, E. (2014). Mindfulness‐based cognitive therapy for depression in adolescents. Child and Adolescent Mental Health, 19(1), 74-78.
Beck, Aaron (1987). Cognitive Therapy of Depression (The Guilford Clinical Psychology and Psychopathology Series). The Guilford Press; 1st edition.
Kabat-Zinn, Jon (2013). Full Catastrophe Living (Revised Edition): Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. Bantam; Rev Updated edition.
Murphy, T. Franklin (2022). Cognitive Triad. Psychology Fanatic. Published 8-19-2022. Accessed 8-18-2023.
Williams, Mark; Teasdale, John; Kabat-Zinn, Jon; Segal. Zindel (2012). The Mindful Way through Depression: Freeing Yourself from Chronic Unhappiness. The Guilford Press; Paperback + CD-ROM edition.