Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse

by Zindel V. Segal, John D. Teasdale, J. Mark G. Williams

Foreword by Jon Kabat-Zinn
I. The Challenge of Depression
Introduction
1. Depression: The Scope of the Problem
2. Cognition, Mood, and the Nature of Depressive Relapse
3. Developing Mindfulness-Based Cognitive Therapy
4. Models in Mind
II. Mindfulness-Based Cognitive Therapy
5. The Eight-Session Program: How and Why
6. Automatic Pilot: Session 1
7. Dealing with Barriers: Session 2
8. Mindfulness of the Breath: Session 3
9. Staying Present: Session 4
10. Allowing/Letting Be: Session 5
11. Thoughts Are Not Facts: Session 6
12. How Can I Best Take Care of Myself?: Session 7
13. Using What Has Been Learned to Deal with Future Moods: Session 8
III. Evaluation and Dissemination
14. Mindfulness-Based Cognitive Therapy on Trial
15. Going Further: Further Reading, Websites, and Addresses
Epilogue

Genres: Psychology, Nonfiction, Mental Health, Self Help, Health, Buddhism, Counselling

351 pages, Hardcover

First published November 1, 2001

Reviews

[Myridian · Rating 4 out of 5]

This book very cogently describes an intervention to prevent the recurrence of depression that the authors tested using randomized controlled trials. They found that the intervention is helpful for individuals who have had two or more instances of depression. Aside from brief forays into science, the book is very accessible. If anything I thought that there were too many testimonial-style stories. The thing that I did like was the great description of how to administer the intervention, complete with copies of the handouts. The authors really emphasized the importance of the therapists having a daily practice. I've tried to keep up with that, but it's hard. I've tried to just be mindful while I'm doing things in my daily life, particularly setting aside time while I'm exercising to be mindful, but I really don't think that's sufficient. I'm going back to meditating every day (sigh).

[Jen Marin · Rating 4 out of 5]

In Mindfulness Based Cognitive Therapy for Depression, the authors bring an Eastern approach to managing the increasingly common issue of depression. Just last week, an article in the news proclaimed that 1 in 10 Americans are on antidepressants , and that most of them do not seek therapy in conjunction with pharmaceutical treatment. This is unfortunate. "Antidepressants drugs do not provide a long-term cure. Their effects do not outlast their use." They can be instrumental in keeping a depressive episode from becoming severe, but it is important to do therapeutic work as well in order to change the way the brain is functioning. This is where MBCT has proven itself successful.

It turns out that "negative thinking could itself cause a depression… [and] could certainly maintain the episode once it started." This tendency to ruminate on negative feelings does not help, and is in fact, counterproductive. Unfortunately, people in depressed states have a tendency to do just that, which can feed their feelings of hopelessness and despair. Rather than feeding or fighting these feelings, MBCT helps people develop a new relationship with their thoughts.

Mindfulness based practice teaches people to watch their mental and somatic processes intentionally and non-judgmentally. This observation can help people to understand that their "thoughts are not facts." As Jon Kabat-Zinn explains, "It is remarkable how liberating it feels to see that your thoughts are just thoughts and that they are not 'you' or reality." In fact, a core skill of MBCT is "to teach the ability to recognize and disengage from mind states characterized by self-perpetuating patterns of ruminative, negative thought." This invaluable skill teaches people how to direct their attention and to reduce the amount of energy they expend in these self-defeating habits.

Although there are definite benefits to mindfulness based practice, it is important to remain non-attached to outcome. It is "easy to believe deep down that success is achieved when we are with the breath and failure occurs when the mind wanders." In fact, one of the most useful ideas in this book was the concept that "it is just as valuable to become aware that the mind has wandered and to bring it back as to remain fixed on the chosen object of attention." In our goal-oriented culture, it is easy to fall into the trap of self-judgment, even while meditating. One can become overly concerned with whether they are 'doing it right' as they internalize the 'God-as-Judge' meme. This is why it is so important to approach this work with a sense of acceptance and self-compassion. Even long-time meditators have wandering thoughts. They just have developed a different relationship with them. They are aware that "just because your thoughts are compelling, doesn't make them true." Once we understand this truth, we can stop identifying so strongly with our thoughts. This can take the charge out of our inner critic and help us tune in to a different channel that supports and nurtures our growth and healing.

Understanding that it is the process of returning to the breath itself that helps us remember to return to a grounded and centered state in times of stress. This practice of returning is the most useful thing I learned in this book.

[Sock · Rating 3 out of 5]

I do believe CBT isn't as useful without mindful attitudes, but this approach wasn't as inspiring as I'd hoped it would be. This is the clinical practice book. There is also a self help version which is more manageable if you don't plan to facilitate groups and aren't interested in the details of the thought process behind the program. I really liked reading the research part.

[Kathy Fogarty · Rating 4 out of 5]

I really liked this second edition. The authors did a great job of incorporating all the learnings that have emerged through experience and research since the first edition. I felt inspired to teach until I read requirement 4 of the Training Guidelines for teaching MBCT, and then I just felt tired! In some ways, I feel that this might not recognise that many mental health professionals aspire to be broadly (and deepishly) across a range of psychological interventions, rather than dedicated to one. Anyhow, a good read and an important approach for helping people learn to observe their inner world and cultivate a kindly attitude to the human condition.

[Shannon · Rating 5 out of 5]

This book and daily meditation have changed my life. (And I read it for class, not because I'm depressed). Being fully present in our lives can benefit all of us, not just those who have problems with depression. Life is short and there's so much out there to enjoy so stop thinking about the future or the past and be in the moment!

[Ceil · Rating 4 out of 5]

Written for teachers of MBCT, this is a terrific, practical, full of tools guide to using mindfulness-based cognitive therapy to manage depression.

[Lallers · Rating 3 out of 5]

Honestly a very mixed read for me. I read this while training in MBCT for OCD but I got a ton out of this manual's focus on depression as well. I was pleasantly surprised to see that many Buddhist teachings are part of Zindel's MBCT and the cultural origins credited. I think the relapse prevention/wellness piece is absolutely crucial so overall, Zindel is clearly onto something. And the way the authors' honest storytelling about how they got from 1st wave CT to 3rd wave MBCT is woven into the first and third parts of the book really helped me think about mindfulness for depression/OCD more broadly and how it fits into other intervention approaches and conceptual models of illness and healing. The kindness and self-compassion chapter was especially appreciated in this regard as this is a very different framing of treatment than more linear, outcome-focused treatment goals. Much like with other 3d wave CTs, the emphasis on the practitioner's experiential engagement with the practice is also key to MBCT and I'm into that.

That said, I experience a lot of spiritual conflict about secular mindfulness-based interventions. Clearly mindfulness is an incredibly effective intervention so there's conflict about withholding that from people on the basis of it being a spiritual practice. Like, I actually want these values and a wellness/joy/imperfection-accepting approach to become a part of clinical work!!

On the other hand, mindfulness-based interventions are by definition fundamentally removed from what I understand to be the core principles of the dharma/triple gem which is about a way of living and being, not a thing you can do to treat symptoms of living in a fucked up world. There already exist monasteries and temples, founded by teachers of these traditions, that offer these teachings, who are very explicit about the spiritual nature and purpose of these practices. Not clinical! Why do Western practitioners think it is acceptable to extract these teachings for clinical purposes? Also even within the clinical application I think it is ridiculous that the authors are so gate-keepy about practioners' mindfulness practice before beginning MBCT - not very beginner's mind!!

Idk, there's a huge tension between accessibility and transforming clinical models of wellness vs. spiritual/cultural extraction for me with this stuff. I'm not actually opposed to secular approaches to meditation or Buddhist modernism per se, but the disconnect between MBCT and even more "secular" teachings or practices like shambhala and vipassana doesn't sit right with me. Meaningful principles of this path are lost in the gap.

[Justin]

While it may work it does not resonate with me. it seems to focus general meditative practices and doesn't seem to add much cognitive therapy to it. as this is a specific framework that requires training.It seems like it is more likely to add an expense to the client that a benefit. in other words if I were to offer this I would have to get additional training and pass on the cost to the consumer. whereas if I were to discuss Buddhist practices like meditation and popular breathing techniques and relaxation techniques like body scans, I can do that without additional training. it's also a lot easier to bring the client into.This watch a good youtube video on body scanning and then we could discuss afterwards if needed. i'm not saying that this shouldn't be done, but I am much more drawn to ACT, DBT, Solution-focused brief therapy and person centered therapy. when I master those I can come back to this.

[Leena · Rating 4 out of 5]

Luin tämän suomenkielisenä "Mindfulness masennuksen hoidossa" (Segal, Williams, Teasdale) vuoden aikana vähitellen. Kirja oli hyvin ja selkeästi kirjoitettu ja kuvasi myös tutkimusta aiheesta sekä sisälsi hyviä harjoituksia ja tietoa niiden soveltamisesta.

[Nhi Trần · Rating 5 out of 5]

an interesting book

[Sandra LV · Rating 4 out of 5]

Práctico para tlp basado en la consciencia plena.

[Daniel Polansky]

I read this.

[Inez · Rating 5 out of 5]

This is a great book with LOTS of useful and detailed information on MBCT!

[Lise Baltzer · Rating 5 out of 5]

Lise Baltzer om: Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse

Her er mindfulness instruktørens bibel. Sådan sat lidt på spidsen, altså, for metoder skal selvfølgelig udvikles, opdateres og tilpasses ny evidens. "Mindfulness Based Cognitive Therapy for Depression" giver det fulde overblik over MBCT-programmets opbygning, indhold og rationale. Bogen indeholder desuden step-by-step anvisninger på, hvordan du - som mindfulness instruktør - instruerer det klassiske MBCT-´kursus: Curriculum, Q & A og sågar øvelsesark. Det er mig en gåde, hvorfor bogen endnu ikke er oversat til dansk, men det er formentlig også kun et spørgsmål om tid. Ellers er opfordringen hermed givet videre. Der findes en populærvidenskabelig MBCT-bog, der er oversat til dansk, men den har imidlertid ikke professionelle instruktører som målgruppe. Læs Mindfulness-Based Cogntive Therapy, hvis du er mindfulness instruktør, og tjek op på de aktuelle sessions, inden du går ind og underviser, helst hver gang. Så er du - sammen med den rette uddannelse - rigtig godt klædt på til at guide hver eneste session på en måde, er er ægte hjælpsom for dine kursister.

[Pansy · Rating 1 out of 5]

About half way through struggling to finish reading it, at first I was eager to learn about the combination of CBT and mindfulness, but the book feels like its a departure from CBT and embrace of eastern philosophy. Which is hard to call therapy, at least in my current position, where i answer heavily to medicaid. Hoping to finish and see it reconnect with CBT in a way that brings two ideas together.
Never finished.

[Vishvapani · Rating 4 out of 5]

The second edition of this book subtly revises the groundbreaking 2002 version. It retains its exemplary clarity and remains an essential guide for anyone wanting to teach mindfulness. The revisions mostly bring slight changes in the methodology stemming from experience, but they also fill important gaps, especially on Inquiry.

[Mark]

There is a newer ed. https://www.goodreads.com/book/show/1...

Has been on pause for a couple months and now I let it get overdue. Got to page 46; that is, through most of the history part but none of the actual stuff that can be applied. ::sigh::

[Adele · Rating 5 out of 5]

Really inspiring and dovetails nicely between my other 2 favourites: ACT and MBSR.

[Therese · Rating 5 out of 5]

excellent book- very informative- thoroughly recommend