Mindfulness therapy: definition, application, and effectivity

Mindfulness therapy is a type of conversation-based intervention (or talk therapy). The goal is to help people avoid their negative automatic thoughts. These thoughts can create emotions such as unworthiness, guilt, anger, and sadness. Mindfulness is about being present in the moment and being more aware while calmly accepting and acknowledging a person’s feelings, thoughts, and sensations. Mindfulness therapy helps people achieve a balanced mental state without being judgmental.

Mindfulness therapy is used for the management of anxiety, bipolar disorder, depression associated with medical illness, low mood, unhappiness, depression-relapse prevention, and treatment-resistant depression.

What is mindfulness therapy?

Mindfulness therapy is a type of talk therapy that teaches a person to be more aware of oneself and the environment by learning to be present in the moment. It involves conversations with a therapist that help develop greater awareness of one’s thoughts and the world around them. With improved awareness, a person can avoid automatic or destructive responses and habits. The term mindfulness-based cognitive therapy (MBCT) is also used.

Mindfulness-based cognitive therapy (MBCT) is a combination of meditation, cognitive behavioral therapy, and mindfulness. This type of psychotherapy incorporates elements of awareness, including non-judgmental acceptance of a person’s experiences.

It is seen as a potentially effective treatment for classic forms of psychological distress such as worry, anxiety, anger, and fear. Much of this psychological distress revolves around suppressing, avoiding, or over-engaging with one’s distressing emotions and thoughts.

Mindfulness-based therapy, as a type of cognitive behavioral therapy, teaches how to be open, curious, accepting, kind, and compassionate. To understand what mindfulness therapy is, it’s important to take a look at the very essence of mindfulness in therapy.

Mindfulness is both a practice and a skill. The practice of mindfulness creates the skill of staying mindful. The stronger the ability to have a mindful state through the ups and downs of life, the less painful these experiences can be.

Being mindful means rooting oneself in the here and now. The goal is to become a parent to the mind instead of letting it take the wheel. A mindful behavior can be achieved by cultivating a mindfulness state through different practices. For example, mindful sitting, breathing, mindful eating, and walking.

With the help of a mindfulness meditation therapy program, a person gets to learn different methods and techniques to practice mindfulness. People can find techniques that work for them and their current lifestyle so that they remain consistent in developing healthier habits.

Who created mindfulness therapy?

Mindfulness therapy was created by an American professor emeritus of medicine Jon Kabat-Zinn, who developed a mindfulness-based stress reduction program. Cognitive psychologist Zindel Segal and professor Mark Williams further developed mindfulness therapy as they partially based it on Kabat-Zinn’s program, according to an article by B.G. Shapero et al. in the Winter 2018 issue of Focus journal. However, it is important to mention that mindfulness is not a modern invention.

Mindfulness is a 2,600-year-old meditation strategy coming from centuries of Buddhist practice. The type of mindfulness used for mental health is mainly based on the Buddhist model.

Even though mindful behavior was closely associated with spiritual and religious practices, it wasn’t until the 1950s and 60s that the use of mindfulness in Western psychology and medicine gained notice. It was all thanks to the growth of Zen Buddhism in America, mainly through early writings like “The Method of Zen” and “Zen in the Art of Archery” by Eugen Herrigel. With works such as these, psychiatrists and scientists took an interest in the use of meditative strategies in psychotherapy, as per S-L Keng et al. in their article published in the August 2011 issue of Clinical Psychology Review.

Before mindfulness-based cognitive therapy (MBCT) became what it is today, clinicians through the 60s and 70s evaluated experimental psychology. The goal was to examine different means of improved awareness. When it comes to MBCT, the therapy is based on Mindfulness-Based Stress Reduction (MBSR) by Jon Kabat-Zinn, an American professor emeritus of medicine, as mentioned above.

When it comes to mindfulness, one efficient method of achieving that state of mind is through mindfulness meditation, as it allows people to expand the limits of consciousness and their awareness. The human brain is a system of neuronal pathways that exchange energy flow and information. Through mindfulness meditation, people create new neuronal tracks in the mid-insular regions of the brain and the prefrontal cortex. Simply put, when a person sits in a quiet room to meditate, they are firing up billions of brain cells. This is a great way of tuning in and listening to the wisdom of your unconscious or soul. This is where core creativity happens.

When did mindfulness therapy become popular?

Mindfulness therapy became popular in the late 20th century when mindfulness meditation practices started being widely used in Western societies. Psychiatrists initially planned to use it to treat mental and physical illnesses. Although studies on mindfulness meditation started in the 60s, it’s only in the late 70s that clinicians evaluated its impact on improving psychological well-being.

The use of mindfulness meditation as a behavioral intervention for clinical problems started with the work of Jon Kabat-Zinn. This is now referred to as Mindfulness-Based Stress Reduction.

Zindel V. Segal and his colleagues extended the use of mindful meditation into psychiatry. They developed a treatment program for preventing depression relapse. It was a mix of mindfulness and cognitive-behavioral therapy, known as mindfulness CBT.

Since then, many other practices and principles have been developed to create the mindfulness-based cognitive therapy of today and help patients develop mindful behavior. One such example is the relapse-prevention treatment for patients with MDD (major depressive disorder). Focusing on MDD and negative thought processes, like rumination and false beliefs, sets MBCT (mindfulness-based cognitive therapy) apart from other mindfulness-based therapies.

Where is mindfulness therapy used?

Mindfulness therapy is used in the treatment of disorders and conditions listed below:

• Anxiety disorders
• Bipolar disorder
• Depression associated with medical illnesses
• Low mood
• Unhappiness
• Depression-relapse prevention
• Treatment-resistant depression

1. Anxiety disorders

Anxiety disorders are types of mental health conditions that are characterized by feelings of intense worry, anxiety or tension, fear, or panic. Anxiety disorder is not a single, specific mental illness but a term that includes multiple conditions such as generalized anxiety disorder (GAD), panic disorder, post-traumatic stress disorder (PTSD), social anxiety disorder, or phobias. Therapy plays an important role in the treatment of anxiety disorders. For example, CBT mindfulness can ease anxiety by helping people turn inward. Mindfulness cognitive therapy for anxiety is meant to quiet the mind so a person can concentrate on what is happening right now rather than on future fears and past regrets.

Thanks to the impact of a mindful therapy group, patients can control their emotions and develop positive behavior. Guided meditation helps them become more aware. It also teaches them positive thought patterns that can influence their perception and actions.

A review by S.G. Hofmann et al. from the April 2010 issue of the Journal of Consulting and Clinical Psychology showed that by teaching a patient to respond to stressful experiences more reflectively and not reflexively, mindfulness-based cognitive therapy for anxiety can efficiently counter their avoidance tactics.

Anxious people can be vulnerable to avoidance coping mechanisms. This often seems to be the only way they know how to steer clear of anxiety-triggering situations and thoughts. But this makes it difficult for them to be proactive. MBCT training can help patients cope with difficult times. It can also encourage them to focus and improve their moments of joy. That way, anxiety won’t remain a focal point in their life.

It usually takes around eight weeks of regular practice of mindfulness techniques to experience significant improvements. However, how long it exactly takes to recover from anxiety with mindfulness therapy varies from one patient to another.

2. Bipolar disorder

Bipolar disorder is a mental health condition that leads to extreme mood swings. These mood changes can be recognized by emotional highs and lows. Scientists who study the brain, state that mindfulness might be able to change structures within the brain. These structures are part of normal stress management and emotional regulation. This intervention has the potential to treat clinical disorders and facilitate improved well-being and a healthy mind.

The effects of mindfulness-based cognitive therapy positively impact the mental state as well as physical health and cognitive performance. In a recent MBCT trial, authored by Jonathan P. Stange et al, in patients with bipolar disorder, participants with increased mindfulness had decreased residual depressive symptoms, including less attentional problems, improved emotional regulation, and better psychological well-being and functioning.

These results show that MBCT could be a viable treatment option used alongside medicine. It can improve cognitive functioning in patients with bipolar disorder.

In private practice, a person can start working on the act of self-care. Improvements in bipolar disorder with mindfulness therapy are usually observed in around eight weeks. Although it doesn’t offer a quick fix for bipolar disorder, it can help patients manage their symptoms over time.This makes mindfulness approaches a practical long-term strategy.

3. Depression associated with medical illnesses

Depression is a mental illness that causes a persistent feeling of sadness, hopelessness, and loss of interest in everyday activities. Depression can take a heavy toll on a patient’s mind and overall quality of life. Physical illnesses can also increase the odds of developing severe depression. People with chronic illnesses such as diabetes, heart diseases, and severe conditions such as cancers may develop depression.

Mindfulness-based cognitive therapy for depression can help prevent or treat stress-related physical symptoms. With proper training, patients can achieve better-coping mechanisms as well as improved quality of life and mental well-being.

Mindfulness-based CBT aims to help patients feel less stressed and calmer. With the techniques they learn through CBT meditation, they can become more self-aware. During therapy, patients can learn to cope with unhelpful and troublesome thoughts and choose a healthier way to respond to their feelings.

Most patients with depression experience the benefits of mindfulness therapy in eight weeks, but this often varies from person to person. Various factors influence how long it takes to recover. But, the longer people with depression practice MCBT, the better the results.

4. Low mood

Low mood is an emotional state characterized by sadness, low self-esteem, and anxiety. It is normal to feel low after a distressing event. However, low mood can become a daily problem that affects a person’s quality of life. Mindfulness-based cognitive therapy can manage low mood and help a person feel better. The therapy can treat mood disorders mainly because it can improve connectivity in certain brain areas. This makes mindfulness-based cognitive therapy training useful for people with low moods.

The therapy itself could also induce neuroplastic changes in specific regions of the brain that regulate feelings, behaviors, and choices, according to a paper that Dr. Edo Shonin and Dr. William van Gordon of Nottingham Trent University published in the May 2016 issue of the International Journal of Mental Health and Addiction. When a person pays close attention to the “here and now”, they incorporate different neural pathways. These pathways are different from the ones they use to think about experiences over time.

By working on their emotion regulation, people can alleviate stress and achieve a better mood. They tend to feel less agitated, irritable, or easily annoyed. They can also better handle the frantic and restless mind and avoid feeling flat or uninspired.

A mindfulness meditation therapy program is efficient in improving mood states in individuals with affective disorders, such as those with major anxiety and depression. During a mindful therapy group, individuals with mood disorders are encouraged to focus on their emotions and sensations and not their evaluative thoughts. This is very important when working with low mood states.

In four to eight weeks, a person can experience significant improvements in their mood using mindfulness therapy.

5. Unhappiness

Unhappiness is an emotion of great sadness that occurs due to a specific reason, such as breaking up a long relationship or the loss of a loved one due to illness. It is a normal reaction to negative events. Unhappiness can become persistent in people with depression and weigh them down. It can narrow their sense of perspective, thereby causing a lack of motivation. With mindfulness cognitive behavioral therapy, a person can improve, recognize, and access all the positive qualities of their mind. Consistent meditative practices are a great way of being in tune with heart, body, and mind.

Mindfulness therapy helps a person become more realistic, content, and at peace. It allows a person to access their inner natural happiness without depending on external things. Mindfulness-based treatment approaches, especially meditation, are not about getting rid of the “unhappy” emotion or feeling. It is about changing how a patient engages with that feeling.

To do that, practicing MBCT techniques can help. Mindfulness therapy teaches to let feelings and thoughts arise and let them go. A person can approach these feelings from a non-judgmental, clear, and calmer state of mind.

Mindfulness therapy helps a person sit with their feelings, bodily sensations, and thoughts so that they can take note of what they are. There is no need to suppress or deny those thoughts and feelings. Instead, a person learns to accept them and work through these difficulties. By meditating for 15 minutes, a person can cultivate mindfulness and work on the core of unhappiness.

6. Depression-relapse prevention

Depression can be a chronic problem with numerous relapses. Most patients with depression have 4 to 5 episodes in their lifetime.

Relapse is another depression episode. It occurs less than 6 months after receiving treatment for acute depression. Relapse can make those affected feel irritable, exhausted, and sad. It can have an impact on their sleeping or eating habits.

A mindfulness-based intervention can be an effective treatment for relapse prevention for people with recurrent depression, mainly those with more impactful residual symptoms, published in the JAMA Psychiatry Journal in a 2019 report.

Mindfulness-based cognitive therapy for depression teaches skills to stay well. This can be useful for people susceptible to depressive relapse. Patients get to focus on the present and practice self-kindness without over-identifying their self-perceived faults.

Both traditional cognitive behavioral therapy and mindfulness-based treatments can come in handy. Mindfulness and CBT share multiple characteristics. They decrease psychopathological suffering and use a combination of behavioral and cognitive therapeutic exercises.

The main difference between standard CBT and mindfulness for depression is that CBT revolves around restructuring beliefs and cognitions. This is done to achieve a more functional and practical way to view the world. On the other hand, mindfulness alters a person’s relation or attitude to their thoughts so they won’t have such a drastic impact on the subsequent behaviors and feelings.

With professional help, it’s possible to achieve the much-needed enhancement in well-being. A few weeks to several months of regular mindfulness therapy are necessary to recover from depression relapse, but making these techniques a part of your lifestyle is best for prevention.

7. Treatment-resistant depression

Treatment-resistant depression refers to cases when a patient receives treatment for depression, but their symptoms don’t improve. Standard antidepressant treatment isn’t enough, which can be taxing.

Mindfulness meditation therapy can offer beneficial results for treatment-resistant, chronically depressed patients. It can help them achieve a better quality of life, mindfulness skills, and self-compassion. This kind of therapy can curb remission rates.

Research on CBT and mindfulness for depression in treatment-resistant patients is limited. But the currently available data, such as a study by M.B. Cladder-Micus et al. from the October 2018 issue of Depression and Anxiety, shows that participating in a mindful therapy group can have a notable health benefit. Doing mindfulness therapy regularly and adopting techniques such as meditation into everyday life is best for treatment-resistant depression.

There is no specific timeframe during which mindfulness therapy helps people recover from treatment-resistant depression, but it can take several weeks to notice improvements.

What is the process of mindfulness therapy?

The process of mindfulness therapy starts with an assessment, during which a therapist evaluates a patient’s symptoms and needs. The main goal of the assessment is to determine the most suitable mindfulness therapy approaches to help a patient. The process of mindfulness therapy also involves psychoeducation, where a therapist educates a patient about the relationship between their thoughts and feelings or behaviors. The therapist also teaches a patient how mindfulness therapy helps them become more aware of these patterns.

The focus of mindfulness therapy is meditation, but it may also include practices or techniques such as deep breathing or mindfulness yoga. Patients may also learn about informal practices such as mindful eating and teeth brushing i.e., being more in the moment while doing everyday things.

The process of mindfulness therapy may also include attention regulation, i.e., maintaining the attention on a certain object on which a person can re-focus every time they get distracted when meditating. Body awareness is also a part of the mindfulness therapy process as it teaches a patient to focus on sensory experiences. Additionally, an important part of the process of meditation therapy is emotion regulation which helps manage mental and emotional problems.

How many sessions are required for mindfulness therapy?

Both short 4-week and standard 8-week mindfulness programs can be effective for improving well-being. Mindfulness-Based Stress Reduction (MBSR) therapy, often requires 8 weekly sessions. They can last 120 to 150 min, including a 1-day voluntary or half-day retreat, according to a controlled study by M. Demarzo et al. from the August 2017 issue of Frontiers in Psychology.

To get results, it is important to stick to the therapy. It is also suggested to have 20 to 45 min of mindfulness practice daily outside therapy. Many therapists have also tried to shorten mindfulness programs to make them more accessible to the general public.

For example, variations can be found in the number of sessions, such as from 4 to 7 sessions, and from 1-hour to 2-hour sessions, according to the abovementioned study. Only a mental health professional can determine the minimum number of sessions or hours of mindfulness-based (MBCT) a patient might need. It’s also useful to mention that in a paper by R. Wu et al. from the October 2019 issue of Frontiers in Neuroscience, brief sessions of 15 minutes a day for seven consecutive days were also effective at improving emotion processing, emotional memory, and emotional attention bias.

How is mindfulness therapy done?

Mindfulness therapy is done through many different CBT mindfulness techniques, such as body scan exercises, mindfulness practices, mindfulness stretching, yoga, and meditation. Meditation is a popular tactic for reaching mindfulness. There are several techniques that help people get the most from mindfulness meditation. These include guided imagery, breathing exercises, and body scan meditations.

Guided imagery is a type of focused relaxation that includes concentrating on a specific object or sound to calm one’s mind. A person intentionally thinks of a peaceful scenario to promote a calm state. The main objective is to make sure the body reacts to the person’s own thoughts. As the body and mind become calmer, it becomes easier to cope with mental, emotional, and physical stress, Healthline explains.

Breathing exercises allow for deeper meditation and stress relief. These can include focusing on every inhale or exhale, deep breathing, or holding the breath after inhaling or exhaling. The therapist teaches patients breathing techniques they can use when meditating or practice whenever they feel overwhelmed or stressed out.

Body scan meditation is a mindfulness meditation practice that involves scanning the body for tension, pain, and unusual feelings or sensations. This type of meditation helps a person become more connected to their physical and emotional self. As a person meditates, they open their awareness to sensations of pain, discomfort, and tension across the body from head to toe.

When it comes to mindfulness therapy, the best approach depends on the specific problem a patient has. For example, mindfulness-based stress reduction can help patients address anxiety, including stress, chronic pain, depression, and other chronic problems. Mindfulness-based stress reduction (MBSR) is an eight-week program that teaches a person to use mindfulness in order to deal with stressors in everyday life. The main components of MBSR are meditation and yoga. It is a customizable approach meaning a person can adapt it to their specific needs.

MBCT can work for recurrent depression, eating disorders, anxiety, reactions to trauma, and more. Mindfulness-based cognitive therapy combines cognitive therapy with mindfulness techniques to achieve greater effects. It teaches patients to identify negative or irrational thoughts and replace them with more rational alternatives. This type of therapy encourages clarity of thought and helps people tackle negative or irrational thinking that worsens their condition.

DBT (Dialectical Behavioral Therapy) mindfulness can treat patients with self-harm together with those who struggle with suicidal ideation, substance abuse, etc. Dialectical behavior therapy aims to help a person understand and accept their difficult feelings and learn skills to manage them. The core of DBT is mindfulness to encourage a patient to live in the present rather than focusing on the past or future. With DBT mindfulness, a person learns to non-judgmentally identify and observe their thoughts or emotions, describe situations in a way that is easy for others to understand, and effectively participate in value-based or goal-directed behaviors.

Who performs mindfulness therapy?

Mindfulness therapy is performed by an MBCT therapist, a mental health expert with extra training in mindfulness treatment and techniques. They have the right expertise to teach others mindfulness CBT techniques. An experienced practitioner in mindfulness in counseling can guide a patient to focus on the present moment.

Since a person’s mind is very likely to wander, it’s important that the practitioner instructs them to accept these wandering thoughts without judgment. They might also ask questions such as where these thoughts went before they reel a person back into the present.

During MBCT therapy, a mindfulness therapist should always assume a non-judgmental stance. The meditation therapist observes a patient’s behaviors and emotions, including anything else that might be hindering their process. They don’t become distracted. Instead, they are fully active and offer effective solutions that serve patients in the long run.

What does a mindfulness therapist do?

An experienced mindfulness therapist provides valuable insight into a patient’s psychological functioning. They offer talk therapy and teach patients to be more aware of their surroundings, emotions, feelings, and thoughts and decrease the automatic response.

To do mindfulness-based therapy, the therapist should treat and assess a wide range of mental health complications. The therapist treats teens, adults, and younger patients alike.

A good therapist must be competent in using research-based mindfulness therapy techniques.

Is mindfulness therapy effective?

Yes, mindfulness therapy is effective. Based on more than 200 studies on mindfulness, this type of psychotherapy was effective in managing depression, anxiety, and stress.

In April 2010, Science Daily reported findings of the study by researchers at the University of North Carolina at Charlotte which showed that a meditation technique known as “mindfulness” offered a drastic improvement in critical cognitive skills, especially in participants trained to meditate. After 4 days of meditating 20 minutes a day, participants experienced an improvement in focus, mood, and stress.

Mindfulness therapy helps decrease the odds of depression relapse and keeps physical health in good shape.