BLUE MOUNTAINS MINDFULNESS TRAINING
“The hardest thing is to live richly in the present without letting it be tainted out of fear for the future or regret for the past.”
Mindfulness Based Cognitive Therapy (MBCT)
MBCT was developed by Zindel Segal, John Teasdale and Mark Williams as an adaptation of Jon Kabat-Zinn's Mindfulness-Based Stress Reduction (MBSR) program. Segal, Teasdale and Williams had been concerned to find a treatment for depression that would prevent the periodic relapses often seen in that condition, even after a course of treatment. It is known that as time goes by, depression becomes more easily triggered if left untreated. Like MBSR, MBCT is taught in an 8 week course, focusing on skills and involving daily meditation practices and including a Silent Day of guided practice.
MBCT shares with MBSR the perspective that perception and thought drive emotion and behaviour, so that if you change your relationship to thoughts, impulses, feelings and sensations, you can change maladaptive or deeply ingrained self-destructive patterns of thoughts and behaviour. Further, it is sometimes difficult to establish an exact causal pathway, but the skill of observation can assist people to notice the interplay between thoughts, emotions, sensations and behaviour.
In addition to the directly painful nature of an experience, we may sometimes add a layer of secondary reactions – thoughts, associations, judgements, criticisms, doubts, evaluations – that themselves can act to raise anxiety and lower mood, causing us to feel flat and apathetic, with poor concentration, less enjoyment of pleasurable activities, and generally less interest in the world. Of course, these are all classic symptoms of depression. This second layer of reaction creates fertile ground for rumination, or overthinking, which can in turn maintain existing depression. In anxiety, people’s thinking can likewise feed their stress reaction. Physiological sensations and other body functions of the stress reaction can be misinterpreted, and people can likewise generate a second layer of thoughts etc both of which can fuel a vicious cycle of fear, panic, anger, withdrawal and other problematic symptoms.
Participants learn to recognise and interrupt ruminative thought patterns that might otherwise lead to depressive relapse through:
- Moment-to-moment awareness of sensations, thoughts and feelings
- Developing a different way of relating to these by acknowledgement and acceptance rather than continuing with habitual automatic patterns that perpetuate difficulties
- being able to choose a skillful response to any unpleasant, or aspect of experience: responding rather than reacting. This also relates to pleasant experiences that if sought after too much eg foods or drugs, can have negative consequences for us
- There is less emphasis on changing the content of one's thoughts, and more emphasis on changing one's relationship to them.
A typical course program covers education about depression and some exercises from cognitive therapy that demonstrate connections between thinking and feeling, and how we might care for ourselves when we notice our mood changing or that we are feeling overwhelmed.
The weekly themes are:-
- Stepping out of automatic pilot
- Dealing with barriers
- Mindfulness of the breath
- Staying present
- Acceptance, holding, allowing, letting be
- Thoughts are not facts
- How can I best take care of my self?
- Using what you have learned to deal with future moods.
Research is now showing the effectiveness of MBCT in reducing the likelihood of relapse in subjects who have suffered three or more previous episodes of depression. (Hofman, 2010). Some data suggest that MBCT may help people who are actively depressed rather than merely in remission (Kenny & Williams, 2007). MBCT is more effective for treatment-resistant depression than treatment as usual (Eisendrath et al, 2008).