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Both Mindfulness-based Stress Reduction (MBSR) and Mindfulness-based Cognitive Therapy (MBCT) address stress, anxiety and low mood. Jon Kabat-Zinn founded MBSR in 1979 and MBCT was developed from this and first taught in 2000. Both are based on the same approach of developing skills which allow us to relate more skilfully to life's ups and downs that no-one escapes, rather than avoiding or denying them, which is our more usual habit.
These Mindfulness-based secular education programmes are rooted in Eastern spiritual traditions and have been brought together with aspects of western psychology. Taught over 8 weeks, MBSR and MBCT programmes and other Mindfulness-Based Interventions (MBIs) promote self-awareness, personal development and general well-being.
The 8-week MBSR was developed in 1979 at the University of Massachusetts (UMass) by Dr. Jon Kabat-Zinn, a micro-biologist working at the university’s Medical Centre. A few years in he founded the Center for Mindfulness (CFM) there. He initially intended the programme to be used with patients at the hospital with a broad spectrum of physical and psychological challenges – chronic pain, chronic conditions, anxiety and depression related to illness and illness brought on by anxiety and depression, and so forth. The premise behind the programme is that, to paraphrase Jon Jabat-Zinn, there is more right with us than wrong with us, as long as we are breathing. So the issue is not our medical condition, whatever that might be, but rather how we are relating to the challenges in our lives, whatever they might be. Since 1979 the programme has grown and thousands of people have undertaken it in hospitals, clinics, schools, prisons, companies and various community and commercial settings all across the United States and Canada, and thence to the rest of the world. The original components of the course structure – adherence to the spirit of the original CFM curriculum, a pre-course orientation, 8 weekly classes of between 2.5 and 3 hours in length and a full Day of Mindfulness practice between weeks 5 & 7 of the 8 week course – have not changed in nearly 40 years.
Research has shown that MBSR is beneficial to patients with medical conditions (including chronic illness and pain, high blood pressure,cancer, vascular and respiratory disorders and many others), psychological distress (including anxiety, panic, depression, fatigue, and sleep disturbances) as well as in preventative medicine and wellness programmes. MBSR has become part of a newly recognised field of integrative medicine within behavioural medicine and general health care. A central tenet of MBSR is that we are active participants in our own well being, no matter what the condition of our body and mind.
This course was developed by Zindel Segal, Mark Williams and John Teasdale. Based on the MBSR programme and including some aspects of cognitive behavioural therapy (CBT), the MBCT course was originally designed specifically for people who experience recurrent bouts of depression. Participants are taught skills to assist them in disengaging from habitual ‘automatic’ unhelpful cognitive patterns. The pattern of mind that makes people vulnerable to depressive relapse is rumination, in which the mind repetitively reruns negative thoughts. The core skill that MBCT is teaching is to intentionally ‘shift mental gears’. These Mindfulness-Based courses are not group therapy, but are educational in nature.
Unlike conventional CBT, there is little emphasis in MBCT on striving to change one’s beliefs or the content of one’s thoughts. The focus is on training to become more aware, moment by moment, of physical sensations and of thoughts and feelings as mental events. This provides a ‘de-centred’ relationship to thoughts and feelings in which one can see them as aspects of experience which move through our awareness, rather that a fixed reality.
The UK National Institute of Clinical Excellence (NICE) endorses MBCT as an effective treatment for prevention of relapse. Research into MBCT has shown that people who have been clinically depressed 3 or more times (sometimes over a span of twenty years or more) find that taking the programme and learning these 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.” (Ma and Teasdale, 2004., Teasdale et al 2000).
Mark Williams, one of the developers of MBCT, set up The Centre for Mindfulness Research and Practice while working within the Department of Psychology at Bangor University. There was a great deal of collaboration and cross-fertilisation between the CFM and CMRP which led to the development of an amalgamated version of the two above named courses, called MBCT for Stress. The course relies heavily on MBSR and includes some basic aspects of cognitive behavioural therapy, such as learning about thinking patterns and the links between thought and emotion, and was designed to meet the needs of a broader population. In recent years there has been a tendency to move away from the amalgamated version towards teaching either MBSR or MBCT.
Mindfulness Based Approaches have also been used to treat or to augment or support the treatment of addiction (MBRP – Mindfulness Based Relapse Prevention), cancer, eating disorders, chronic pain, anxiety, suicide, psychosis, borderline personality disorder, relationship enhancement in couples (MBRE) and the list is still growing.
