Mindfulness

What is Mindfulness?
Jon Kabat-Zinn, founding director of the Center for Mindfulness in Medicine, defines mindfulness as “paying attention in a particular way: on purpose, in the present moment, and non-judgementally“.

Mindfulness-based ways of working offers several key benefits:

It helps people to learn how to step back from their thoughts, feelings and beliefs in a way that is helpful, making it easier to see that a particular thought or feeling is not the only way of seeing things

Whilst a person is engaged in a mindful way of attending, it blocks the ruminative thinking process. Over time, this decreases the strength of the ruminative process, much like depriving a fire of oxygen makes the flames go out.

An early warning system develops: as a person becomes more aware of their thoughts, feelings and bodily sensations in this particular way, it becomes easier to notice potential moments when they are at risk of switching into rumination

How can a mindfulness within a psychotherapy approach help?

Mindfulness-based psychotherapy (sometimes also known as mindfulness-based CBT), can be particularly effective.

“Over the years, a body of research has built up extolling the many benefits of meditation [of which mindfulness is one form]. Most recently the Mental Health Foundation said the NHS should prescribe meditation routinely for depression (at the moment only 1 in 20 GPs do). Scientific studies have shown that meditation – specifically, mindfulness-based cognitive therapy (MBCT), an NHS-approved, secular version of Buddhist mind-training – is at least as effective as antidepressants. Regular meditation can enlarge the parts of the brain that control emotion and reach right into the mind and strengthen it.” Sunday Times ‘Free Your Mind’ 16/5/10
Is mindfulness-based psychotherapy the same as Cognitive Therapy?

The mindfulness-based psychotherapy offered by Jacky Francis Walker embodies the latest thinking in Cognitive Behavioural Therapy (CBT), and is based upon research into the most effective components of cognitive therapy.

CBT has been particularly studied for its impact on anxiety and depression. Depression, for example, is a common experience for many people – studies have found that something like 17% of the population have experienced some degree of depression within the last 6 months.

How can mindfulness-based psychotherapy help with depression?

Mild depression and severe depression, which can be thought of as disorders of mood, are considerably more than the ‘feeling low’ that most of us occasionally experience and can significantly interfere with being able to go about one’s daily life.

Till recently, common ways of trying to treat depression included:

    • antidepressant medication, which generally seeks to increase the quantity of neurotransmitters (such as seratonin) in the brain
    • cognitive therapy, which aims to change a person’s thoughts, actions and the meaning they give to events
    • interpersonal therapy, which looks at increasing a person’s ability to tackle difficulties with others in a constructive way

Although these approaches appear to give good results in the short term, which is why they became popular, they do not work for everyone and it has recently been recognised that they may be less effective in preventing depression from occurring again.

The UK National Institute of Clinical Excellence (NICE) has recently endorsed Mindfulness Based Cognitive Therapy (MBCT) as an effective treatment for prevention of relapse, though it is not available as widely as might be needed through the NHS.

Research by Teasdale, Living Mindfully and others has shown that for people who have been clinically depressed 3 or more times (sometimes for twenty years or more) learning MBCT skills helps to reduce considerably their chances that depression will return. The evidence from two randomized clinical trials of MBCT indicates that it reduces rates of relapse by 50% among patients who suffer from recurrent depression.

So what are the key factors in depression?

Relapse: Research from scientists such as Martin Keller in 1983 and a review of research conducted by Lewis L Judd in 1997, concluded that as many as 50% of people treated in the traditional ways for their first episode of depression might relapse, and that preventing relapse was crucial, as this seems to be a key factor that leads to a long term condition of severe and recurring depression.

Negative Thinking: In the past, it was thought that depression was more likely to happen in people with a tendency to see themselves, the world and their future from a negative point of view. But studies have shown that this negative perspective may only be present during an episode of depression, so clearly something else is going on.

The ‘switch’: Several studies, according to researchers Seagall and Ingram, indicate that the key seems to be how a person reacts to everyday (mild) moods of feeling low or sad. For some people, these everyday moods reactivate a pattern of negative thinking, which itself then causes the mild low mood to become progressively worse, spiralling down into a state of depression. It’s as if the ordinary low mood throws a switch to move a person from an ordinary thinking pattern to a negative thinking pattern.

Rumination: Whether this ‘switch’ happens depends on how people handle a low mood. Professor Susan Nolen-Hoeksema found that people who tend to focus their attention inwards on the low mood (thinking about how low they are feeling, or trying to work out why they are feeling this way), may get caught up in this negative spiral. This is called ‘rumination’. In her words, “once you get into it [rumination], it leads a life of its own; it becomes a self perpetuating process…”.

Distraction Techniques: People who focus their energies outwards, on the other hand, such as looking for something positive in the situation or keeping active, tend not to trigger this ‘switch’. These are known as ‘distraction’ techniques. However, when people use distraction techniques to mask their underlying rumination, this leads only to a temporary respite from rumination, rather than leading them safely out of it. In these circumstances, distraction techniques are unlikely to be effective in lifting depression.

So how does mindfulness-based psychotherapy help?

“[Andy Puddicombe, a former Buddhist monk] believes that [mindfulness] really helps with profound issues. […] “I see people with anxiety, depression, issues of anger, insomnia and addictive behaviour. The bottom line is that most of these things are driven by really strong habitual patterns of thought. Yes, of course they stem from difficult times in people’s lives, but what keeps them going is not being able to step out of that pattern.”    
Sunday Times ‘Free Your Mind’ 16/5/10

Distancing techniques: The one thing that makes the crucial difference seems to be the relationship a person has with their negative thoughts and feelings, rather than what those thoughts and feelings are. Repeatedly being able to step back from negative thoughts in a particular way (‘distancing’ or ‘decentering’ techniques) seems to be the key to preventing that ‘switch’ into rumination from being triggered.

CBT or mindfulness-based psychotherapy?: Whilst the skills of being able to distance in this way might sometimes emerge as a by-product of standard CBT approaches, CBT does not specifically aim to help people develop these skills.

Mindfulness-based psychotherapy, on the other hand, recognises how distancing techniques directly address the factors that hold depression and other psychological concerns in place, and therefore helps a person develop these skills, drawing on the principles of mindfulness to do so, alongside the more traditional cognitive and counselling-derived ways of working.

Is mindfulness-based psychotherapy only helpful for depression?

Of course, mindfulness-based psychotherapy can be very effective for much more than stress, anxiety and depression – many of the psychological and emotional concerns that people bring to counselling, psychotherapy or cognitive therapy generally respond well from a mindfulness-based psychotherapy approach, and effective changes can occur within even a modest number of one-to-one sessions.  Mindfulness can also help to improve general levels of well-being and resiliance.

Book your session now with Jacky Francis Walker on 07796 904473
consult@theharleyconsultancy.co.uk

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