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Author: Dr Gemma KothariPrincipal Clinical Psychologist

When someone has previously experienced depression or anxiety, normal emotions can be triggered to return to that depressed or anxious state. MBCT is aimed at changing the relationship a person has with ‘negative’ feelings via the concept of mindfulness.


What is MBCT (Mindfulness-Based Cognitive Therapy)?

MBCT therapy involves two types of therapeutic approaches coming together. Cognitive therapy aims to help clients grow and find relief from symptoms of mental illness by changing dysfunctional thinking. Mindfulness enables you to be in the present moment and fully aware of your thoughts and emotions. Mindfulness also contributes to an acceptance of the self as it is, without attaching value judgments to our thoughts.

The marriage of these ideas is MBCT, a powerful therapeutic tool that can be successfully applied to depression, anxiety, bipolar disorder, and more.

Mindfulness is the process of bringing your attention to the present moment


What is MBCT used to treat?

MBCT is an National Institute of Clinical Excellence approved effective treatment for depression relapse1.

MBCT can be effective in the treatment of:

  • Depression – initially designed to help prevent relapse and for chronic depression
  • Physical health conditions, such as vascular disease and traumatic brain injury.
  • Anxiety
  • Bipolar Disorder

1NICE.org.uk


What should I expect from MBCT?

It can be useful to know what to expect from a therapy like MBCT, so you can make sure it is the right approach for you.

  1. Group or individual - MBCT can take the form of both individual and group therapy – some people will prefer the flexibility of working with a therapist one on one and others will prefer the company of others. Individual sessions will allow you to work in greater depth, have sessions tailored to your needs and may be more comfortable in terms of confidentiality.
  2. Learning techniques - during MBCT you will learn various techniques, such as meditation as well as principles that underpin cognitive therapies, such as the relationship between the way you think and how you feel.
  3. Managing triggers - through MBCT you will learn to manage the triggers that can send you spiralling into a depressed or anxious state – this happens through the concept of mindfulness, which is about staying in the present moment and not allowing your thoughts to wander into ‘what if..’ or catastrophe scenarios.
  4. Create new ways of thinking - gradually and with practice, MBCT will allow you to stop automatically responding to difficult or painful feelings as you once did and instead learn that there are other ways to react and respond.
  5. Practice makes perfect - mindfulness requires consistent and ongoing practice of mindfulness exercises so that mindfulness becomes a key skill a person can draw upon whenever ‘negative’ feelings recur.

After 40 years I have finally been able to let go of all my emotions and baggage. The help I have received has enabled me to deal with my feelings and helped me feel better about myself and not have so much anxiety. I now feel like a new person thanks to your practice.

Tim, Dorset


Is MBCT right for me?

It can be really hard to know which therapy is the right one for your current circumstances. It’s normal for people to find one type of therapy works at a particular time in their lives, but then change to another type later on.

  1. Mindfulness can help you discover your own thought and mood patterns.
  2. Mindfulness can help you learn how to be present and appreciate the small pleasures of everyday life.
  3. Mindfulness teaches you how to stop the downward spiral that can emerge from a bad mood or thinking about painful memories.
  4. Mindfulness allows you to “shift gears” from your present state of mind to one which is more aware, more balanced, and less judgmental.
  5. Mindfulness can give you access to another approach to dealing with difficult emotions and moods.

The key indicators that MBCT might be a good choice for you are:

  • You have suffered with depression or anxiety and want to learn skills to reduce the likelihood of returning to these states
  • You want to feel more in control of your emotions
  • You are open to the concept of meditation
  • You are happy to practice the skills outside of your sessions

Why might MBCT be wrong for me?

Before deciding to have MBCT, it might be helpful to think about the following:

  • Have you had suicidal thoughts or are you self-harming? It isn’t that mindfulness will not be helpful for people with these conditions – in fact we know it might very well be, but it would need to be delivered in a more specialist group.
  • If you are an alcoholic or using drugs, MBCT may not be the right choice for you as it requires you to be able to find time each day to complete your practice when you are not under the influence of alcohol, drugs or after affects. If this is likely to be difficult to you then the MBCT course may not be suitable for you at this time.
  • If you are currently depressed, to such an extent that it is difficult for you to manage your everyday life, it is probably not the right time for you to do the course. We know from experience that people coming on the course need to be reasonably well. The course involves some daily home practice and finding the motivation and energy to do this whilst feeling very depressed will probably be too challenging.
  • Have you suffered a recent bereavement? If you are recently bereaved, it is helpful to have come to terms with some of the grief before an MBCT course. It can be difficult to recognise and work with pre-existing and more longstanding habits of mind, when the bereavement is still very preoccupying. The 1 year period is a notional time (and people will differ a great deal in when they feel ready to begin a course) but our experience suggests it is often helpful to have gone through all the ‘significant’ dates of the person who has died before moving on to start something like an MBCT course.
  • MBCT involves a time commitment and adding it on top of another ongoing therapy or during stressful life events may not be practical.

If you are considering psychological therapy to address particular issues or difficulties, I would suggest taking your time to decide which therapy and which therapist might be the right fit for you. It is okay to have initial assessments with a few different therapists until you find someone who you feel you may be able to connect with. Research tells us that the therapeutic relationship is a key factor in the success of any psychological therapy.
BA, DClinPsy, PGDip

Principal Clinical Psychologist
Sheffield

Dr Gemma Kothari is an experienced Clinical Psychologist currently working as a Principal Clinical Psychologist in Yorkshire. She has a BA in Psychology, a Doctorate in Clinical Psychology, and a Postgraduate Diploma in Cognitive Analytic Therapy...

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