The Power of Mindfulness Based Programs

As a psychologist, I learned about mindfulness through my training in Dialectical Behavior Therapy (DBT), an evidence based psychotherapy developed in the 1980s to treat Borderline Personality Disorder. It combines cognitive behavioral change strategies with the cultivation of mindful awareness and acceptance. The mindfulness skills that are taught in DBT serve to increase distress tolerance so clients can face difficult thoughts and emotions, see situations more clearly, and choose wise responses. I was so intrigued and impressed by these foundational skills that enable people to tap into their own inner wisdom, I decided to do more research and start my own personal mindfulness practice. Over time, the changes I noticed in myself were compelling, so I decided to pursue professional training so that I could share these concepts and practices with others.

I chose a Mindfulness Based Cognitive Therapy (MBCT) training program as I felt my background in CBT would be helpful and it’s research backed results in preventing the relapse of depression would be relevant for the majority of my clients. MBCT is a Mindfulness Based Program (MBP – also called Mindfulness Based Intervention in clinical applications), which is an umbrella term for a family of evidence based mind-body curriculums that train participants in the cultivation of mindfulness in order to support wellbeing, address the causes of human distress, and offer pathways to relieving suffering. They are informed by theories and practices from contemplative traditions, science, medicine, psychology and education. I soon discovered; however, that my therapist skills could actually be a bit of a hinderance to developing competent mindfulness teaching skills. I had to learn to remove my therapist hat and meet participants as a co-traveler rather than as a healer. The embodied authenticity a mindfulness teacher brings to the learning experience is one of the most important determinants of effective teaching and something that can only be developed with practice.

MBCT combines cognitive behavioral strategies with mindfulness attitudes and practices to help participants develop a new relationship with experience – especially the ruminative thinking and painful emotions that tend to accompany depression and anxiety. Research has reliably shown a significant reduction in risk of relapse of recurrent depression with an efficacy that’s equal to long-term use of antidepressant medication. Completion of an MBCT program is also correlated with decreased anxiety symptoms, rumination, insomnia, and tension as well as increases in compassion, concentration, resilience, and optimism.

Brain imaging studies have shown that participating in an MBP is correlated with changes in the function and structure of the brain. For example, a 2015 systematic review concluded that an 8-week course of MBSR resulted in the following changes: “The prefrontal cortex, the cingulate cortex, the insula and the hippocampus showed increased activity, connectivity and volume in stressed, anxious and healthy participants. Additionally, the amygdala showed decreased functional activity, improved functional connectivity with the prefrontal cortex, and earlier deactivation after exposure to emotional stimuli.” A study of MBCT also showed similar changes in the amygdala and insula – areas of the brain which are associated with emotional regulation and monitoring and responding to the physiological condition of the body.

I’ve learned a lot over the years of training in and teaching MBCT as well as my subsequent professional training in Mindfulness Based Relapse Prevention (MBRP), participating in and co-teaching Mindful Self-Compassion (MSC), and taking Mindfulness Based Stress Reduction (MBSR). Witnessing the profound changes in self-understanding and skillful relating that can occur in participants has been a great honor. These programs can be powerful tools for launching a sustainable mindfulness practice, broadening perspective, and empowerment through expansion of choice.

At the Midwest Alliance for Mindfulness, we have attempted to place a high priority on offering MBPs, though there is still a lack of awareness about them in our area. The training to become an MBP teacher is intensive and costly – Midwesterners have to fly to the coasts or to Canada for several weeklong trainings, hire professional mentors to review our work, and complete continuing education requirements. In addition to MBCT & MBRP, we are very fortunate to have two trained MBSR teachers, two certified MSC teachers, and an iRest Yoga Nidra teacher in our organization. We hope that awareness of and interest in these programs will grow in Kansas City and the greater Midwest, so that their potential for decreasing human suffering can benefit us all.

References:

• Baer, R.A. (2003). Mindfulness Training as a Clinical Intervention: A Conceptual and Empirical Review. Clinical Psychology: Science And Practice 10(N2), 125-143.
• Beckerman, N. L. & Corbett, L. (2010). Mindfulness and cognitive therapy in depression relapse prevention: A case study. Clinical Social Work Journal, 38(2),   217-225.
• Bihari, J. L. N., & Mullan, E. G. (2014). Relating mindfully: A qualitative exploration of changes in relationships through mindfulness-based cognitive therapy. Mindfulness, 5(1), 46–59.
• Bondolfi, G., Jermann, F., der Linden, M.V., et al. (2010). Depression relapse prophylaxis with mindfulness-based cognitive therapy: Replication and extension in the Swiss health care system. Journal of Affective Disorders, 122(3), 224-31.
• Chang, V. (2004). The effects of a mindfulness-based stress reduction program on stress, mindfulness self-efficacy, and positive states of mind. Stress and Health, 20, 141-147.
• Cladder-Micus, M. B., Speckens, A. E., Vrijsen, J. N., A, R. R., Becker, E. S., & Spijker, J. (2018). Mindfulness-based cognitive therapy (MBCT) for patients with chronic, treatment-resistant depression: A pragmatic randomized controlled trial. Depression and Anxiety.
• Cullen, M. (2011). Mindfulness-Based Interventions: An Emerging Phenomenon. Mindfulness.
• Dimidjian, S. and Segal, Z.V. (2015). Prospects for a Clinical Science of Mindfulness-Based Intervention. American Psychologist 70(7), pp. 593-620.
• Gotink, RA et. al. (2015). 8-Week Mindfulness Based Stress Reduction Induces Brain Changes Similar to Traditional Long-Term Meditation Practice – A Systematic Review. Brain & Cognition, 108; 32-41.
• Shonin, E, Gordon, V. & Griffiths, M. (2013). Mindfulness-based interventions: towards mindful clinical integration. Frontiers in Psychology, (4) 194.
• Strawn, JR et. al. (2016) Neural Function Before and After Mindfulness-Based Cognitive Therapy (MBCT) in Anxious Adolescents at Risk for Developing Bipolar Disorder. Journal of Child and Adolescent Psychopharmacology, 2016; 26 (4): 372