From CBT to Mindfulness: MBCT

There are many therapeutic approaches that have been created to help decrease human distress and suffering. In this article, I will talk about two particular approaches, as well as a mindfulness practice, that have been influential and successful in understanding and treating many mental health and quality-of-life issues. Both are based in a present-moment orientation and represent a welcome joining of Eastern and Western thought. This joining continues to bring a sorely needed understanding of the issue of human suffering.

Thoughts Influence Our Emotions and Behavior

In the late 1970s, Dr. Aaron T. Beck popularized a cognitive psychological model based on his clinical observations. Beck’s simple but powerful idea was that thoughts influence emotions and behavior. This idea, while new to Western psychological practice, was not new to humanity as a whole. Buddha observed it over 2,500 years ago. In the competent hands of Beck and others, this idea has shaped Western conceptual and practical work with many mental health issues.

Distorted Thinking

In his cognitive model, Beck states that thoughts can be—in whole or in part—wrong or distorted. Such distortions cause needless distress. He continues by saying it is not a situation that causes us to react in ways that cause us distress, but rather our thinking and the meaning we have attached to that situation which causes our reactions. Our thinking, which includes a comprehensive structure of personal rules and beliefs, informs our overall perception of a situation. Finally, he posits that our distress can be mediated by correcting our distorted thinking, either by letting go or replacing non-useful thinking, or by switching to problem-solving if something tangible requires change.

Mindfulness Practice

As we continue to learn what best help people cope with distressing experiences, other methods continue to creatively evolve. Mindfulness practice and Mindfulness-Based Cognitive Therapy (MBCT) is the most recent method in the evolution of psychological strategies. Mindfulness-based treatments borrow from an enduring Eastern spiritual notion: it is wiser to step outside of the flow of thought, feeling, and sensation. Mindfulness practices allow us to observe the nature of our urges, while being present to the experience from a less reactive perspective.

Being Less Reactive

Being less reactive to the constant flow of thought and sensation provides us with greater psychological flexibility. We can learn to see rather than be our distorted thinking when needed. While our brains physiologically work to hold onto previous learnings as “facts,” at certain points we all need to make adjustments to the outdated, useless, or harmful “facts” our brains are holding onto. We update all kinds of information: for instance, we update our belief in the tooth fairy when we realize it doesn’t exist. As we learn and grow, we may change our political views and others beliefs. And, if we are wise, we also change unhelpful and hurtful beliefs or views about ourselves and others.

With practice, mindfulness gives us the means to be able to view our internal and external worlds more objectively. The aim is to be able to consistently see and experience life as it is, and to move beyond the errors and distortions of outdated learning. Mindfulness provides us the means to welcome the whole of our life experience with kindness, without judgment, and outside of learned constructs.

This does not mean that thinking or conceptual understanding isn’t important. It does mean, however, that thoughts are not facts. While we cannot control the thoughts we have or simply choose to ignore our beliefs and learned conditioning, we can decide—in each new moment—which thoughts and patterns are useful to the life path we value. In essence, we can learn to change our relationship with previous learning and the sensory world which accompanies it.

Comparing Beck’s Model and Mindfulness

Like mindfulness, Beck’s model is also based upon an orientation towards the present moment orientation. However, his model focuses less on the nature of how we relate to the complex mind-body relationship.

Beck focuses on the idea that thought and belief can be wrong or distorted, and that correcting these distortions can decrease distress. While that is true and very useful, mindfulness practice allows us to experience thoughts and beliefs connected with a sophisticated interplay between sense experience and thinking. Further, mindfulness helps us to experience and understand the ways in which our beliefs and conditioning can produce the notion of a “fixed self” which can trap us within harmful patterns.

Mindfulness and Self

Over twenty-some years, it has been my clinical experience that applying Socratic reasoning (rational questioning, the basic rational testing tool of cognitive therapy) to a person’s basic negative belief of self or core beliefs does not yield a satisfactory change in the relationship to underlying feelings, sensing, and emotion. When reality-testing a core belief in treatment, a client may say they “get it, but don’t feel it.” They understand that their thinking is wrong, but still feel less than others. For instance: “No matter what I do, I just can’t get past this feeling that I’m worse than other people.” If we are ultimately seeking out a long-term, lasting change, it’s not sufficient to limit our focus to just relieving emotional distress in the short-term.

Mindfulness helps us to understand that our world of past experience does not reflect who we are. Instead, a mindfulness practice provides an increased ability to be present in this moment. It helps us become aware that past learning, which at first appears as “fact,” is not a true representation but rather a smaller invention of our self, our ego. This learned, conceptual self does not reflect our true and complete nature. Instead, it reflects the “doing mind’s” summary evaluation of experience as self.

Personal Facts or Truths

A mindfulness perspective supports that we are not our thoughts, feelings, and beliefs in a permanent way, but that it is the nature of the mind to come to summary evaluations. For instance, consider the thought: “I have been sad and depressed so often that I am just a depressed person.” Does being depressed really make us unable to ever achieve an un-depressed moment?

If we experience something enough, our minds will consider the information as fact. It is very energy efficient, and thus beneficial to our bodies, for the brain to efficiently makes summary evaluations. Basically, if we relearn concepts each time we face an issue, we will use a vast amount of energy. Instead, the brain molds experience into repeatable, useable “facts.” Therefore, you can hold a concept (about self) as a belief, but have it act as a fact or truth. It influences choices at this moment. Beck would call this global reasoning and have use rationality to challenge this. When learning to drive a car so we can learn to be a “driver,” it is helpful for our brain to link or chunk information together. But it is not helpful when the brain links together multiple failed behaviors to categorize a whole person as a “failure.”

Socratic Reasoning and Personal Facts

The rational challenge or Socratic reasoning used in cognitive therapy illustrates that no person falls completely and solely into one category. For instance, someone may consider themselves a depressed person. However, if there are moments in which that person is not experiencing depression, are they still a depressed person? No one is totally depressed, thus anyone is capable increasing their moments of non-depression. Categorizing yourself as depressed (accepting it as a learned “fact”) flattens your understanding of self and lessens your capacity for change. 

The rational, intellectual explanation does not seem to manage the intricacy of the historical and sensory pieces of the problem, however. At the moment of rational challenge, people feel better when they believe that they are not a totally depressed person. But the next time they feel sad, if they have been feeling sad for a while, they will go down the old road of habit very quickly.

Mindful Approach to Personal Facts

A mindfulness approach would understand the idea of one’s whole self being depressed as a person’s belief which is presenting as a fact. But that is not the reality. It is a mental construct, the result of a mind’s energy-efficient but reductive learning process. Mindfulness understands the self to be infinitely larger than the elements of this mental construct, and to be connected to the sophisticated interactions between mind and body.

Thinking, Sensing, Feeling Cycle

Research in the ’80s found that, in addition to our thoughts, our sensations and feelings significantly influence our thinking. In fact, there is an inescapable cyclical link between thinking, sensing, and feeling. If we try to understand and manage our lives through one element of this complex system, we may be confounded by limited or short-lived results. We see this with conditions that tend to relapse or for individuals who do not respond at all to treatment.

A mindfulness practice provides a comprehensive means for personal objective introspection. It gives us a method for stepping beyond the constant flow of a full array of thinking, feeling, and sensing. Furthermore, we learn to be less reactive to our immediate perceptions of “reality” (colored by conceptual understanding and conditioning) that may or may not be accurate to this new moment. We all possess the ability to experience awareness of our thinking and sensing.

Improve Awareness of the Cycle

In this regard, a mindfulness practice produces more psychological flexibility. We are able to be aware of our internal and external world in a way that leads to a decrease in our immediate reaction to non-healthy patterns. It is natural and normal in our culture to believe that you are what and who you think you are. Remember, our mind does a summary evaluation for convenience. If not managed, any previous learning can become our guide for this moment. It may lead us with information that is less-than-useful for this moment and be active beyond our immediate awareness.

Developing a committed mindfulness practice helps us become less reactive to the initial internal thought or feeling that presents itself as fact. Through a mindfulness practice, we can learn that thoughts are not as solid and factual as they first appeared. Thereby allowing more space and time for thoughtful, present-oriented choice. A choice that is more in line with your personal value at this moment instead of a belief or pattern that we are reacting to automatically.

Remember that this moment, like breath, is always new—but your learning, habits, and patterns are not. With practice, you can better see your internal process rather than automatically reacting to non-useful past learning, patterns, and conditioning. Coming to know the circumstances through which our brain and body operate in tandem which produces suffering can help release us from normal, but distressing, mistakes of a misperceived reality.

Benefits of a Mindfulness Practice

Mindfulness practice can help us recognize:

  • That emotions are a fusion of thoughts, feelings, impulses, and bodily sensations that together form a general “state of mind”. Emotions have a virtual reality felt sense that can be congruent to reality or not.
  • Feelings and emotions are not in and of themselves dangerous. They are the result of a thought or image forming a perception of danger or a reaction to real and present danger.
  • Thoughts can influence our feelings, and feelings can influence our thoughts.
  • The mind does not exist in isolation and is profoundly responsive to many bodily systems.
  • ‘Affect’ is what shows on your face and your body in terms of posture. It affects mood and mood affects thinking and body reactions. The relationship is cyclical and complex.
  • Trying to fix or get rid of an emotion with thinking traps us in the emotion.
  • Experiencing the emotion generally allows it to pass.
  • Examining thought alone for error misses the complexity of the interaction between the mind and body.
  • We tend to depend on rational thinking to solve most problems in living. This leaves little room for emotion, all of our sense perceptions and behavior as influences.
  • We can, over time, learn to be present with things as they are, not as we want them to be. We all have the ability to be with the whole of our experience of being just as we are. This does not mean being complacent, though. It means being fully alive in each moment.

Conclusion

I will talk a bit about the practical problems with trying to think a feeling away in the next article. Practice mindfulness!

With Kindness,

Harold