6. What's the Theory, Evidence and Where Can I Find Out More About This Stuff?

What is Mindfulness Based Cognitive Therapy and the Cognitive Theory Which Underpins the Approach?

MBCT is a combination of cognitive therapy and mindfulness meditation.Mindfulness-Based programmes have become very important in the Western medical and psychological community for helping people. Mindfulness-Based treatments are secular, in other words, they are non religious, meaning anyone can participate in the programmes.

MBCT is not a talking therapy. MBCT is a kind of ‘mental training’ (Williams and Penman, 2011), a manualised method of learning new skills. Rather than changing the content of the negative thoughts, MBCT participants learn to change their relationship to their thoughts, ‘seeing them as they are, simply, streams of thinking, events in the mind, rather than getting lost in them’ (Segal, Williams and Teasdale, 2002).

Everyone's mind wanders. Wandering thought is the form that likely consumes up to 50% of your day.In their study, Drs. Killingsworth and Gilbert revealed that people are happier when engaged in focused thought than when they are engaged in wandering thought, regardless of the focus of their activity. You've probably noticed that your mind has wandered a few times since you have been reading this page.

Negative cognitions or thoughts appear to automatically increase during periods of distress (see What Happens When We React to Stressful Events). When we engage with these negative thoughts and/or if we hold a belief that we can think our way out of this type of reactivity, our stress levels significantly increase.

Unfortunately this kind of coping style, thinking our way out of the problem, which works perfectly well when solving other problems, is not effective with this kind of emotional distress and often leads us deeper and deeper into a negative web of thinking.

Stress and negative thinking affects our feelings (worry, sadness, frustration, hopelessness and irritability) and body sensations (headaches, trouble sleeping and tension) which lead to a further intensification of the negative thoughts. A cycle of suffering is then created by a feedback loop between the negative thinking, feelings and body sensations.

We usually think of our thoughts and emotions as being us. As we practice mindfulness we start to realize a key insight: we may notice that thoughts just arise and pass constantly, and emotions are simply what we feel (and will pass rather being our entire existence). This basically means: thoughts and feelings are not us, they are not who we are. This is really helpful to know, because this means if we can learn skills to help us disengage from them, rather than getting entangled, controlled or overwhelmed by them, we can increase our choices and possibilities for change.

So, instead of believing the automatic thoughts (particularly when we are distressed) thinking that their judgements are real or that they are going to happen, mindfulness helps us to step back from the thoughts allowing them to pass.

When we become aware and accept that thoughts are just thoughts, we begin to notice the positive and pleasant events in our lives.

By learning to disengage from negative thinking, participants increase their mindful awareness, cultivating not only a different relationship to their thoughts, but also to their ‘feelings and body sensations’ (Semple and Lee, 2011).

Through mindful awareness, the affects of distress and suffering significantly reduces, which allows the opportunity to approach the cause of suffering with greater effect and resilience.

Mindfulness: An Overview of the Evidence

The Mental Health Foundation concluded in the Mindfulness Report (2010), that following extensive research, including three Randomised Control Trials, (Ma and Teasdale, 2004; Teasdale et al., 2000; Kuyken et al., 2008) Mindfulness ‘has proven to be effective in a wide range of mental and physical health applications, with significant benefits to general wellbeing and quality of life.’

In the comprehensive Mindfulness Report by the Mental Health Foundation (2010), the neuroscientific evidence for the benefits of practicing Mindfulness regularly is summarised:

Neuroscientific studies have found differences in the areas of the brain

associated with decision-making, attention and awareness in people who

regularly practise Mindfulness meditation. People undertaking Mindfulness

training have also shown an increase in activation in the left pre-frontal cortex,

an area of the brain associated with positive emotions that is generally less

activated in people who are depressed. Regular meditation also results in

increased brain size in areas linked to emotion regulation.’

For health professionals there is increasing evidence of Mindfulness Based interventions reducing stress and developing resilience in employees in the healthcare setting (Beddoe & Murphy, 2004; Bishop et al., 2004; Brenner & Homonoff, 2004; Galantino, Baime, Maguire, Sazpary, & Farrar, 2005; Mackenzie, Poulin and Seidam-Carlson, 2006; Shapiro, Astin, Bishop, Cordova, 2005).

The application of Mindfulness Based approaches have primarily been researched in clinical populations, but according to a systematic review by Cheisa and Serreti (2010), Mindfulness training was also found to bring significant benefits to healthy subjects.

Though there is increasing evidence to demonstrate that Mindfulness training is effective clinically at reducing stress and developing resilience in employees in the healthcare setting, there is at the moment limited robust evidence demonstrating the benefits to business.

However, Mindfulness Exchange Limited, which is a spin off of the Oxford Mindfulness Centre (University of Oxford), is currently collaborating with researchers to evaluate the effectiveness and value to business of a programme based on the cognitive scientific principles of Mindfulness: A Practical Guide to Finding Peace in a Frantic World (Williams and Penman, 2011).

Where Can I Find Out More About This Mindfulness Stuff?

To find out more go to:

• http://mindfulnet.org/
• http://www.nhs.uk/Conditions/stress-anxiety-depression/Pages/mindfulness.aspx
• www.bemindful.co.uk
• http://mindfulnessforstudents.co.uk/
• http://www.mindful.org/about-mindful
• http://www.exeter-mindfulness-network.org/
• http://mindfulnet.org/
• http://www.siyli.org/ (Search Inside Yourself-Mindfulness Programme for Google Employees)
• http://smilingmind.com.au/
• http://www.academia.edu/712338/Mindfulness_and_
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• approaches_in_
• sport_performance

Research

· Cheisa, A., and Serrenti, A. (2010) A Systematic review of neurobiological and clinical features of mindfulness meditations. Psychological Medicine, 40, 1239-1252.

· Holzel, B. K., Lazar, S, W., Gard, T., Schuman-Oliver, Z., Vago, D. R., & Ott, U. (2011). How Does Mindfulness Meditation Work? Prposing Mechanisms of Action From a Conceptual and Neural Perspective. Perspectives on PsychologicalScience. 6 (6) 537-559.

· Kuyken, W., Byford, R. S., Watkins, E., White, K., et al. (2008).

Mindfulness-based cognitive therapy to prevent relapse in recurrent depression. Journal of Consulting and Clinical Psychology. 16 (3), 334-336.

· Kuyken, W., Watkins, E., Holden, E., White, K., White, K., Taylor, R. S., Byford, S., Evans, A., Radford, S., Teasdale, J. D., & Dalgleish, T. M. (2010). How does mindfulness-based cognitive therapy work? Behaviour Research and Therapy. 48. 1105-1112.

· Ma, S. H., & Teasdale, J. D. (2004). Mindfulness-based cognitive therapy for depression: Replication and exploration of differential relapse prevention effects. Journal of Consulting and Clinical Psychology. 72 (1), 31-40.

· McLaughlin, K. A., & Nolen-Hoeksema, S. (2010). Ruminations as a

transdiagnostic factor in depression and anxiety. Behaviour Research and Therapy. 49, 186-193.

· Mental Health Foundation, (2010). Mindfulness Report 2010. Mental Health Foundation.

·Teasdale, J. D., Segal, Z., Williams, J. M. G., Ridgeway, V. A., Soulsby, J. M., & Lau, M. A. (2000). Prevention of relapse/recurrence in major depression mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 68 (4), 615-623.

Books

• Mindfulness: A Practical Guide to Finding Peace in a Frantic World by Mark Williams and Danny Penman.
• Mindfulness for Health: A Practical Guide to Reducing Stress and Restoring Wellbeing by Vidyamala Burch and Danny Penman (2013). Piaktus.
• The Mindful Way Through Depression: Freeing Yourself from Chronic Unhappiness by Mark Williams, John Teasdale, Zindel Segal and Jon Kabat-Zinn.
• Full Catastrophe Living: How to Cope with Stress, Pain and Illness Using Mindfulness Meditation by Jon Kabat-Zinn
• The Mindful Workplace. Developing Resilient Individuals and resonant Organizations with MBSR by Michael Chaskalson.
• Search Inside Yourself: Increase productivity, creativity and happiness by Chade-Meng Tan (Creator of the incredible Google Program).

If you have access to iTunes University then go to: UNIVERSITY OF OXFORD, The New Psychology of Depression Lectures by Professor Mark Williams and Dr Danny Penman.

The lecture series contains 3 audio podcasts and 3 videos explaining what mindfulness is and the current evidence for the intervention.

To watch a video about mindfulness and how the brain works to regulate our emotions andmood, then go to:

• Mindfulnet.org. Click on the Neuroscience tag. Then click on the Neuroscience Videos tag. From the list of videos and media clips, click on ‘Staying in the Now: Mental Health Through Mindfulness: The science of the mind: How the brain works to regulate mood, emotion, stress and sleep (Feb. 2010 Dr Stuart Eisendrath).