Mindfulness-Based Cognitive Therapy

 The Teasdale (2004) discusses the thought process behind Mindfulness-Based Cognitive Therapy (MBCT) as well as the original efficacy studies. The article discusses how mindfulness can be used to prevent relapse for depression, but possibly only for groups who have had more than three depressive episodes. I like the MBCT theory in comparison to some others, for it seems like it focuses on a real-life problem (relapse for depression) and controls it to common alternatives. Often, I feel like relapse is seen as a necessary evil in the mental health field and in other therapies is remedied by things like maintenance sessions (IPT). The article also discusses some of the neurological conceptualizations of mindfulness, which is useful in understanding their analogies to the different cognitive modes and how one can switch back and forth. This is another aspect of the study I like, for again I feel like a lot of research for mental health focuses on symptom reduction and prevention (both good goals), but does not often look at quality of life when someone has a previous mental health disorder. Concerning the 'gear shift' analogy between the different cognitive processes (automatic vs. mindfulness), I would like to see more evidence that these two things cannot co-exist. Although the simplification may just be for a demonstration, it feels like someone may be able to be in a 'both and' state where they are doing problem solving, but in a mindful way. However, if this were true, this would seem to undermine some of the core concepts of the theory. Regardless of this issue, I really enjoy this theory and appreciate the point that wholistic mindfulness cannot always be adaptive, and nor can problem solving mode (where a lot more people are stuck). Also, sort of on an unrelated note, this article clarified more to me why cognitive therapy is effective for eating disorders. It was talking throughout about the idea of not having good or bad thoughts, and all I could think about was the black and white thinking that exists over a spectrum of eating disorders. Critically as well, I am wondering why this theory does not extend to other disorders, and if the shift they claim is the active ingredient would work for disorders like ADHD and bulimia. However, I can see it working for something like binge eating. 

In the Sipe & Eisendrath (2012) article, the authors review the evidence for MBCT and look at its effectiveness in other disorders. The studies recounted do overlap with the first article a little bit, but these authors provide some evidence for MBCT in GAD, and provide more neurological imaging studies. During this article, the authors discussed how this works for challenging clients and those with suicidality. If this is true, this lends credence to the original theory, for the idea in MBCT is that the shift between the control state and the mindfulness practice (not the technical terms) is the thing that allows people to get out of repetitive and maladaptive thought and behavior patterns. Again, I really enjoy this theory for it seems to focus on tangible issues such as cost effectiveness, challenging clients, people with suicidality, and those wanting to taper off meds. In many of the other theories, it has seemed like the evidence holds for many perfect clients, but that other side cases or more practical issues are ignored. Therefore, even if this is not the most applicable theory across diagnoses, I view it as the most practically significant, and view it in a very high regard for actual patient applicability. 

The Hall et al. (2011) piece discusses MBCT in Asian American populations, and makes the case that uniformly applied mindfulness techniques may backfire if they do not take into account client values that are less individualistic than mindfulness generally presupposes. One issue that I have with mindfulness is the idea of duty and obligation to one's community and society. I hold the view that engaging in important political and community work is tiring, and is not often in the best interest of an individual. Further, these things can cause stress, but can also hold a high level of value in a person's life. Therefore, I really enjoyed this paper and their explanation of how mindfulness can be applied in a variety of ways, but the administration needs to be sensitive to a client and their worldview. Some of the strategies suggested in this article included focusing on more maladaptive behaviors, modifying coping strategies, and talking about actions like avoidance in a more culturally sensitive way. I really enjoyed this article because they gave multiple case articles. I feel like often, articles will preach cultural responsivity, but will not clarify what it looks like. To me, I feel like a good approach would be to ask about the client's understanding of mindfulness, their story on what is going well and what is not going well in their life, and getting a complete understanding of their values. The values piece to me seems very critical, for if someone does have an obligation to their family, it feels like this would come up in their values. After being able to step into the client's worldview, metaphors, explanations, and cognitive reframing could be done in a way that is sensitive to how the client views what is important in their life. Overall, this article was enlightening to me, and demonstrated that I had a bias in the fact that I assumed mindfulness would work cross-culturally because it emphasizes the individual. Here, I did not think about obligation to one's own family, and was only thinking about community and society. Lastly, tangentially, I keep thinking with all of this coopting language (you took this concept from me) that I cannot believe that someone hasn't tried to use intellectual property with theory building. I am extremely critical of intellectual property as a theoretical concept for the future of our world and creativity, but I find it hard to believe that someone would not want to make bank off their theoretical idea and then use legal principles to argue that someone else is taking it, and then make money off everything they do. This feels like the route psychodynamic theory should have taken. (Not really, but you get my point). 

Grade: 24/25