Meditation Training— Which intervention should you choose: MBSR or MBCT?

Through research, I learned that MBSR and MBCT are two different mindfulness-based approaches that are scientifically based and used. This article will look deeper into these two.

This Article Includes:

What is Mindfulness
Different Mindfulness-Based Approaches
MBSR
MBCT
Benefits of Mindfulness-Based Practices

What is Mindfulness?

“Mindfulness is paying attention to purpose moment by moment without judging”

Jon Kabat-Zinn

Mindfulness can be simply defined as a conscious choice to focus one’s awareness and attention on everything that is happening moment by moment. It is learning to see and look at our body and mental experiences without judging or reacting to it. Instead of being our usual self who are instantaneously reactive, one learns to first be attentive to the feelings, thoughts, and sensations, people learn this through meditation training.

Being more aware of our thoughts, feelings, and sensations may sound very simple and not so helpful, but learning about mindfulness helps us interrupt our judgment and self-criticism, which in turn is beneficial for us. Some people report that when they explored and discovered their inner strength and learning our inner resources that they can use has helped them make wiser decisions about their life and mental and physical health.

We are usually overwhelmed and occupied by a lot of ideas, thoughts, and feelings, worries, pressures, responsibilities; and admit it, most of the time we are thinking and wanting things to be different from how they are right now. Mindfulness can help us slowly achieve that change.

Using mindful practices is particularly powerful when we are faced with intense overwhelming feelings like pain; when having difficulties and when we are faced with an illness that confuses our attempts to find a solution or to feel better. Feeling stuck in this way can be draining. Mindfulness can help us to work directly with the struggle we sometimes have in relating to life’s experience and in doing so can improve the quality of our life.

Different Mindfulness-Based Approaches

There are different mindfulness-based approaches that one can choose from. These interventions teach people practical skills to help with people’s physical and psychological health problems and their ongoing life challenges.

Mindfulness-based approaches are a combination of ancient Buddhism practices, the philosophy of mindfulness, and the psychological understanding of it. However it may influence Buddhism, the practice of mindfulness-based approaches does not have any religious context to it. With the help of a meditation instructor, this can be a way to pragmatically and practically help in facilitation, realization, and access the understanding of our inner selves.

Mindfulness is taught through the practice of meditation especially through bringing attention to the breath and the body during stillness and movement. The two main approaches that were developed are taught in 8 sessions that last for 2 to 2.5 hours.

These are Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT).

Mindfulness-Based Stress Reduction (MBSR)

Jon Kabat-Zinn and his colleagues at the Centre for Mindfulness (CFM), from the University of Massachusetts Medical Centre, developed this group-based program for people who wants to manage their physical and mental health problems.

MBSR (Mindfulness-Based Stress-Reduction), is an eight-week program that aims to help people overcome their stress, depression, pain, and worry. It assists individuals to accept without judging the present moment or experience.

MBSR programs focus on giving its participants more meaningful happiness in their life and for them to learn how to access their inner strengths to help themselves heal and gain focus and clarity in what they want to do in their life. These programs are now offered in various facilities like hospitals, yoga centers, and others.

There have been scientific and medical researches that strongly recommended MBSR as an adjudicative therapy for patients with unipolar depression. It was also effective in treating anxiety and has been used in stress management in healthy individuals. It has also been tested and proven effective in treating mood disorders, ADHD, anxiety disorders, insomnia, and chronic pain, in both young, and old alike.

The MBSR program includes rigorous training in meditation that focuses on mindfulness together with an intensive discussion on daily life stress and skills. The research done with MBSR shows promising help for participants with chronic pain, fibromyalgia, multiple sclerosis, generalized anxiety disorder and panic, psoriasis, cancer, and health care provider self-care.

MBCT is an integration of MBSR with Cognitive Behavioural Therapy (CBT). It was initially developed to help people suffering from depression to help prevent recurrence by teaching them skills to disengage from their usual and habitual ‘automatic’ unhelpful cognitive reaction patterns.

This unhealthy pattern of mind that makes people susceptible to depressive relapse is called rumination (or when the mind repetitively re-runs negative thoughts). The core skill that a meditation instructor can teach you through MBSR is to consciously and intentionally ‘shift mental gears’.

MBCT (Mindfulness-Based Cognitive-Therapy) is a psychotherapeutic technique which utilizes cognitive behavioral therapy (CBT) methods, with the help of meditation. MBCT was originally designed for patients with major depressive disorder. Research has shown that MBCT and MBSR can help improve mental health and wellbeing.

MBCT was designed to avoid and reduce the risk of future episodes of depression in patients who have suffered previous mental breakdowns. This helps them and teaches them to stop criticizing themselves and to detach from negative thoughts and bad moods; teaching them to embrace themselves, no matter what.

Also, MBCT has been medically proven to help cravings, addictions, and people suffering from substance abuse. A study on using the therapy on smokers over two weeks showed that the level of smoking decreased by about 60% and the subjects gradually lost their craving for smoking.

The MBCT program lasts about eight weeks, with a weekly course, which runs for about two hours. The initiative behind the program is based on learning how to focus, pay attention, and concentrate fully in each moment.

MBCT differs from conventional CBT as it does not emphasize changing belief in the content of thought. The focus in MBCT is on systematic training to be more aware, moment by moment of physical sensations and thoughts and feelings as mental events. This facilitates a ‘decentered’ relationship to thoughts and feelings from which we can see them as aspects of experience which move through our awareness and which are not necessarily reality in any given moment.

The evidence base on MBCT shows that it can halve the relapse rate in recovered patients with three or more episodes of depression. It is effective in preventing ‘autonomous’ relapses but not those provoked by stressful events.

Other targeted versions of MBCT have now been developed. e.g. MBCT for chronic fatigue syndrome and oncology patients.

There is an intervention like MBCT which does not involve the practice of meditation. This is called the ACT or the Acceptance and Commitment Therapy or ACT.

What is the ACT?

ACT was developed to grow greater psychological adaptability and this throughout all areas of one’s life. It mainly focuses on accepting our negative emotions and thoughts without getting involved with them. Thus there is no formal meditation as ACT believes that mindfulness can be learned through a series of informal exercises.

Through a series of inquiries or strain of questions, people learn to diffuse and put negativity in its context, teaches them to step away and look at the big picture first before reacting and putting their emotions.

In the ACT, the participants are taught about the two parts to the self: the one that is thinking and the one that is observing. This interesting mindfulness practice can teach us that whatever is happening, part of us can always remain serene.

The key differences between MBSR and MBCT

Our meditation instructor even exclaimed that although the two programs are broadly similar, there are stark differences between the two. The following are:

• MBCT tends to target specific conditions or vulnerabilities (ex: depressive relapse) whereas MBSR has a more generic application and is applied to stress arising from a variety of life events including physical or mental illness.
• Both MBSR and MBCT promote psychological insights about our experiences and difficulties and aim to develop skills to deal with these differences. MBCT puts a greater emphasis on working with and understanding the psychological and cognitive aspects of our experience.
• Both MBSR and MBCT integrate the aspect of mindfulness with an understanding of the origins and maintenance factors of the unhelpful behaviors or psychopathology being dealt with. MBCT is taught within a cognitive understanding and framework since it is a psychotherapy approach.
• Both MBSR and MBCT draw on concepts and skills from other disciplines, for example, MBSR includes teaching on everyday communication and lifestyle, MBCT includes techniques and exercises from cognitive-behavioral therapy (CBT) and includes didactic elements, which give the participants information about a particular difficulty e.g. in the case of depression participants are given information on the universal characteristics of depression to facilitate them in recognizing and dealing with their relapse signatures.

The key difference in MBCT is an explicit focus on turning toward low mood and negative thoughts early in the program, this teaches people to gain experience in recognizing their reactions and symptoms, for them to have confidence in their ability to respond skillfully.

MBCT was developed to prevent future episodes of depression in people with a history of recurrent depression. It is based on the observation that recurrence in people who have recovered from a depressive episode is more likely when patterns of negative thinking are triggered by low moods encountered in the course of everyday life. Negative thinking leads to lower mood and this pattern escalates to bring on a relapse of depression.

Techniques from Cognitive Behavior Therapy are incorporated into the program to promote greater awareness of these patterns and mindfulness practices are used to disengage from them. The focus is on changing one’s relationship to unwanted thoughts, feelings, and body sensations so that participants no longer try to avoid them or react to them automatically, but rather respond to them intentionally and skillfully.

MBSR, MBCT, and ACT: Differences and similarities

All three programs last for 8-weeks and include, psychoeducation, home practices, and discussions.

In its first incarnation, MBCT was designed as a pure stress reduction technique for patients that had life-threatening diseases and chronic pain.

John Teasdale, Zindel Segal, and Mark Williams hypothesized that the technique could be adapted to also treat patients with depression. The thought that if standard CT (cognitive therapy) techniques would be combined with the insights gained by MBSR, their depressive patients could benefit greatly.

They contacted Kabat-Zinn and adapted his eight-week course to suit their needs. The major difference they introduced is that in MBCT, there is a focus on using low mood and bad thoughts to teach early on in the program, so that the participants will know, from experience, what these symptoms are and how to reacts/ respond to them.

MBSR, on the other hand, teaches its participants how to recognize habitual, unsupportive reactions and to incorporate accepting themselves, without judgment and criticism. MBCT replaces some of the teachings of MBSR and mainly focuses on patterns of negative thinking and helps its participants to overcome it.

ACT is very similar to MBCT but does not involve many meditations.

Which Mindfulness Practice Should You Choose

Nowadays, the differences between these forms of therapy have faded away as each has been incorporated into the other.

So taking a meditation training course, in general, is fine. ACT however does not use meditation although it focuses on developing mindfulness. Some people might be scared away by the mere mention of “meditation” which makes ACT perfect!

For depression, one can go through MBCT or ACT. But one should have a professional opinion about it and a recommendation from the psychiatrist before they do the therapy.

Mindfulness is a very powerful catalyst of thoughts and emotions. It can stir up both the positive and the negative. Mindfulness is not designed to make you feel good all the time. It is designed to teach you to cope with whatever happens in the present moment. And that could be positive or negative.

Note: Even as mindfulness is noted as a good and effective treatment course for depression be sure to only engage in it when you have the proper supervision since it would be hard to see its effectiveness when you are in a bad state of mind.

There are mindfulness training online courses if you want to learn more about mindfulness even about MBSR and MBCT before finally deciding on taking them, but most importantly you need professional advice before signing up for these programs.