How Mindfulness-Based Cognitive Therapy Works

Young woman sitting on couch at home meditating
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Mindfulness-based cognitive therapy (MBCT) is a type of psychotherapy that involves a combination of cognitive therapy, meditation, and the cultivation of a present-oriented, non-judgmental attitude called "mindfulness."​

History

MBCT was developed by therapists Zindel Segal, Mark Williams, and John Teasdale, who sought to build upon a form of therapy called cognitive therapy, developed by Aaron T. Beck in the 1960s. They felt that by integrating it with a program developed in 1979 by Jon Kabat-Zinn called mindfulness-based stress reduction (MBSR), therapy could, in turn, be even more effective.

MBSR, meanwhile, is based upon the mindfulness teachings of Buddhism, an Eastern religion founded by Siddhartha Gautama, who lived and taught in the northeastern Indian subcontinent some time between the 6th and 4th centuries BCE.

What Is Cognitive Therapy?

A primary assumption of cognitive therapy is that thoughts precede moods and that false self-beliefs lead to negative emotions such as depression. The goal of cognitive therapy is to help you recognize and re-assess your patterns of negative thoughts and replace them with positive thoughts that more closely reflect reality.

How It Builds on Cognitive Therapy

Mindfulness-based cognitive therapy builds upon the principles of cognitive therapy by using techniques such as mindfulness meditation to teach the patient to consciously pay attention to his thoughts and feelings without placing any judgments upon them, or without getting caught up in what could have been or might occur in the future. It provides clarity of thought and can give you the tools needed to more easily let go of negative thoughts instead of letting them feed your depression.

Basically, much like with cognitive therapy, MBCT operates on the theory that if you have a history of depression and become distressed, you are likely to return to those automatic cognitive processes that triggered a depressive episode in the past.

The combination of mindfulness and cognitive therapy is what makes MBCT so effective. Mindfulness helps you notice your feelings while cognitive therapy teaches you to interrupt automatic thought processes and work through feelings in a healthy way.

What It's Used For

The goal of MBCT is to help patients with chronic depression learn how to avoid relapses by not engaging in those automatic thought patterns that perpetuate and worsen depression. A study published in The Lancet found that MBCT helped prevent depression recurrence as effectively as maintenance antidepressant medication did. 

On average, MBCT was shown to reduce the risk of relapse for people who experience recurrent depression by nearly 50%, regardless of their sex, age, education, or relationship status.

Research has also shown that MBCT can also reduce the severity of depressive symptoms as well as help reduce cravings for addictive substances.

What to Expect

The MBCT program is a group intervention that lasts eight weeks. During those eight weeks, there is a weekly course, which lasts two hours, and one day-long class after the fifth week. During this time, participants might participate in what's known as the 3-minute breathing space technique that focuses on three steps, each one minute in duration.

  1. Observing one's experience (how are you doing right now?)
  2. Focusing on breath
  3. Attending to the body and physical sensations

Other MBCT techniques include body scan exercise, yoga, walking and sitting meditations, sitting with thoughts, sitting with sounds, and mindfulness stretching.

Much of the practice, however, is done outside of class. Participants are asked to do homework, which includes listening to recorded guided meditations and trying to cultivate mindfulness in their daily lives. This may mean bringing mindfulness to day-to-day activities like brushing your teeth, showering, washing the dishes, exercising, or making your bed.

As you perform these activities you apply the following MBCT skills:

  • Pay close attention to what is going on around you.
  • Participate without being self-conscious.
  • Take a non-judgmental stance.
  • Focus on the moment without distraction from other ideas or events.
  • Do what works rather than second-guessing yourself.

Though a lot of the hard work of MBCT is self-directed, those behind the concept stress that the classes themselves are important to the efficacy of the program. Still, there is not necessarily an established network of teachers around the globe or a single directory on which you can find someone close to home. If you're interested in learning more about MBCT, you can explore more on the official program website.

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