How does Mindfulness in Cognitive Behavorial Therapy Help you

Published on November 5, 2012

" I've been I practicing mind-fullness all my life...I can multi-task, multi-think, and multi-stress with the best of them. What I'm not good at is mindfulness."

A few years ago, while studying some brain anatomy material for an upcoming exam, I had an epiphany. It occurred to me that my brain was actually engaged in the act of studying itself! As I read for example, about how the brain translates visual text into abstract thought, my brain was actually doing what it was reading about doing. This happened several times during those few months. For instance, when I am trying to master new knowledge, I have a study routine that works very well for me. After reviewing the relevant textbook, I write questions and answers on notecards to test myself. I also record myself asking those questions and giving the answers along with affirming remarks like "good job!"

My strategy was that I more likely to retain the information if I allowed my brain to process it using as many senses as possible. That is to say, I read it (visual), spoke it aloud (muscle memory of the tongue), and listened to the recorded Me (auditory). To boot, I found that I responded positively to the recorded Me affirmation even though I knew it was Me. It turns out that my brain (and yours) likes to hear nice things spoken abound me regardless of the source. If you disagree, think about the last time you gave yourself a pep talk just before a difficult undertaking, or talked yourself into getting out of bed in the morning.

In her paper “Mindfulness of the psyche, mindfulness of the self”2 , Loyola McLean explores these interesting phenomena.

McLean states "the capacity of our mind to observe itself (metacognition) is a property of the 'duplex' self and fosters the understanding of internal and external states. It grows in relationship and is fostered by a particular kind of relatedness.” She seems to have a real passion for trying to find a common underpinning for the fields of psychology, psychiatry and philosophy. She recognized that until recently, attempts to develop a model designed to "reintegrate notions of the self" have been dismissed as pseudoscience.

Accordingly, McLean stated that she "was interested to read the commentary Are we mindful of psychosis as it keeps on the agenda the issue of the potential utility of mindfulness approaches to psychotic and other symptoms." Mindfulness is a non-judgmental attention to your present state of mind. Although it was developed originally as part of the Buddhist belief system, it can be practiced with a secular approach. An increasingly researched form of mindfulness therapy is the Cognitive Behavioral Therapy. The technique, which was recognized as effective by the American Psychiatric Association, has been used to treat maladies such as anxiety, bipolar disorder and depression.

The goal of CBT is to change your relationship with maladaptive thoughts instead of changing the thoughts themselves. Evidence is beginning to converge around the usefulness of CBT, at least in patients with stable psychotic symptoms3. When the American Psychiatric Association issued an update on Obsessive-Compulsive Disorder treatment, it included CBT in its first-line recommendations.

Pharmacotherapy and cognitive behavioral therapy (CBT) are both acceptable first-line treatments for OCD. The choice between the two should be based on the nature and severity of symptoms, treatment history, patient preference, and the availability of a CBT practitioner. CBT focused on exposure and response prevention should be the first choice for patients whose symptom severity does not prevent them from participating in the treatment and for patients who prefer not to use medication.”4

There are a few obstacles that have nothing to do with the patient. The presumption of incurability by the healthcare practitioner; the lack of clarity of goals to be achieved; and little attention given to patients’ personal history and dysfunctional assumptions underlying their cognitive structure to name a few.5

Some CBT protocols used for the treatment of anxiety expose the patient to the anxiety-producing circumstance in an effort to extinguish it. The theory is one of classical conditioning in which the patient’s avoidance of the event negatively reinforces their fear response. This technique is of great concern as many healthcare institutions are (understandably?) overprotective of their live-in clients.

As mindfulness and CBT make their way into mainstream medicine, there are many hurdles to clear. We need to accomplish more research on the anatomical correlates, neural substrates and cognitive descriptions. We will also need to educate more healthcare practitioners who, until now consider illnesses such as psychosis as untreatable, especially since CBT has been shown to be effective.

If have an interest in mindfulness or CBT, we would invite you to comment. Until next time…KEEP THINKING!



2 McLean, Loyola. “Mindfulness of the psyche, mindfulness of the self” Australian and New Zealand Journal of Psychiatry, Vol 46(5), May 2012, 483. doi: 10.1177/0004867412443356

3 Kuipers, E., Garety, P., Fowler,D., et al. (1997). London-East Anglia randomised controlled trial of cognitive-behavioural therapy for psychosis: 1. Effects of the treatment phase. British Journal Psychiatry, 173, 319–327

4 American Journal of Psychiatry   2007;164:1-56

5 Pinto, Antonio. Mindfulness and Psychosis. Clinical Handbook of Mindfulness. Springer Science, LLC  2009


Category(s):Mindfulness Meditation

Written by:

Tony Brown

Tony Brown is a former U.S. Army (Reserve) Medical Officer, and currently completing his studies as an M.D./PhD/MBA candidate, with a research thesis titled, “Pharmacology and the Neurological Correlates of Consciousness.”