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Cognitive Therapy meets Mindfulness Meditation
on April 5, 2002
If your interests include psychotherapy (especially cognitive therapies), or meditation (especially Mindfulness Based Stress Reduction), or if you are interested in research on depression, then I suspect that you will find this book as compelling as I did.
Here is what I found profound about this book, from a cognitive therapy perspective. Cognitive therapists have long known that automatic thoughts are related to various psychopathologies, but they typically theorized that CHANGING those thoughts was the royal road to psychological health. The alternative studied and developed by the authors is that carefully ATTENDING to cognitions fully as they arise and fall is itself healing. Rather than focusing on cognitive restructuring of thoughts and thinking, this cognitive therapy postulates that observing thoughts, feelings, perceptions, bodily sensations, and world events in a compassionate, "non-attached" manner liberates one from the suffering that accompanies them. The authors have begun to collect outcome data consistent with this unusual cognitive theory.
I found the authors' review of the depression literature quite informative, and the evidence in support of MBCT is described clearly. At the same time, I couldn't help noting that the MBCT approach is specifically designed to target recovering depressives, with an eye toward preventing relapse. So although MBCT is "for depression, " it is not currently intended to treat depression per se, and it is intended as an adjunct to other treatments (e.g., medication, individual psychotherapy, etc.). So, the authors focus, at least for now, on a narrowly defined population. This is not a criticism of the book or MBCT. But for now, MBCT is quite limited in scope by its infancy. I expect that someone eventually will attempt to systematize a form of MBCT for depression in general, for individuals, or for other clinical populations.
I'm always tempted to buy another book on meditation and psychotherapy. I have to be careful here. There is a glut of excellent, relevant books (e.g., books by Mark Epstein, Daniel Goleman, Ken Wilber). Buying or reading yet another book is the easy, habitual behavior when books are your drug of choice, and your cluttered house is screaming at you with volumes of printed matter. Practicing mindfulness continuously, noticing a habitual tendency, and attending fully to the present moment, presents itself as the mindful, non-habitual alternative choice. Did I really need yet another book?
Well, I'm glad I read yet another book on this topic. This book shares many elements with Mindfulness-Based Stress Reduction (MBSR), an influential meditative approach that has considerable empirical support and is finding its way into many medical and psychological settings (seeJon Kabat-Zinn's "Full Catastrophe Living"). Initially the authors attempted to bolt MBSR approaches onto previously existing variants of Cognitive Therapy. But as their methods and awareness evolved, MBCT increasingly came to resemble Kabat-Zinn's MBSR. Their current MBCT approach is an 8-week group program that strongly resembles the UMASS MBSR program, with some elements of traditional cognitive therapy added. I think that the MBCT variant of MBSR will be valuable in that it provides additional tools and strategies for running Mindfulness-based groups in a clinical setting. Additionally, I think MBCT nicely integrates empirically-validated components of CT with empirically-validated components of MBSR. It is worth noting that the MBCT approach is specifically psycho-educational, and takes place in a group setting. This could be the beginning of a beautiful psychotherapy.