Mindfulness Cognitive Therapy

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Mindfulness-based cognitive therapy (MBCT) is a psychological therapy designed to aid in preventing the relapse of depression, specifically in individuals with major depressive disorder (MDD).^[1] Its intent to address MDD specifically distinguishes MBCT from other mindfulness-based therapies such as mindfulness-based stress reduction which is applicable to a broad range of disorders, and mindfulness-based relapse prevention which is used to treat addiction.^[2]

MBCT uses traditional cognitive behavioral therapy (CBT) methods and adds in newer psychological strategies such as mindfulness and mindfulness meditation. Cognitive methods can include educating the participant about depression.^[3] Mindfulness and mindfulness meditation, focus on becoming aware of all incoming thoughts and feelings and accepting them, but not attaching or reacting to them.^[4] This process is known as “Decentering” and aids in disengaging from self-criticism, rumination, and dysphoric mood that can arise when reacting to negative thinking patterns.^[2]

Like CBT, MBCT functions on the theory that when individuals who have historically had depression become distressed, they return to automatic cognitive processes that can trigger a depressive episode.^[5] The goal of MBCT is to interrupt these automatic processes and teach the participants to focus less on reacting to incoming stimuli, and instead accepting and observing them without judgment.^[5] This mindfulness practice allows the participant to notice when automatic processes are occurring and to alter their reaction to be more of a reflection. It is theorized that this aspect of MBCT is responsible for the observed clinical outcomes.^[2]

Beyond its use in reducing depressive acuity, research additionally supports the effectiveness of mindfulness meditation upon reducing cravings for substances that people are addicted to. Addiction is known to involve the weakening of the prefrontal cortex that ordinarily allows for delaying of immediate gratification for longer term benefits by the limbic and paralimbic brain regions. Mindfulness meditation of smokers over a two-week period totaling five hours of meditation decreased smoking by about 60% and reduced their cravings, even for those smokers in the experiment who had no prior intentions to quit. Neuroimaging of those who practice mindfulness meditation has been shown to increase activity in the prefrontal cortex, a sign of greater self-control.^[6]