CBT & Mindfulness

Mindfulness for Anxiety, OCD, and Depression

Mindfulness meditation has been a part of Eastern spiritual traditions for many centuries. In these traditions, mindfulness was found to increase well-being and reduce suffering. In the recent past, mindfulness meditation has been modified for non-religious use in Western countries and these mindfulness practices have been incorporated into the evidence based counseling approach of Cognitive Behavioral Therapy (CBT). Incorporating mindfulness with CBT has been found to be effective for the treatment of anxiety disorders, depression, Obsessive Compulsive Disorder (OCD) and stress.

Conventional CBT teaches us to examine and challenge our unhelpful thoughts; mindfulness encourages us to also challenge our perspective toward our unhelpful thoughts. According to Jon Kabat-Zinn, founder of the Stress Reduction Clinic and the Center for Mindfulness in Medicine and Health Care, “Mindfulness is awareness that arises through paying attention, on purpose, in the present moment, non-judgmentally.”

CBT therapy that incorporates mindfulness teaches us to understand that our thoughts, bodily sensations, feelings and urges are not necessarily important events that warrant a strong reaction. Mindfulness instead teaches us to recognize these thoughts, bodily sensations, feelings and urges as temporary internal occurrences, and although they may be uncomfortable, they are not unbearable. We are encouraged to mindfully accept unwanted thoughts and uncomfortable feelings, sensations and urges instead of making an effort to control or avoid them and continue on with whatever we were doing instead.

According to a 2005 study by Otto, Smits & Reese, CBT for anxiety has demonstrated to be superior to medication for long-term symptom reduction. In recent years, mindfulness-based approaches have been combined with traditional CBT to further enhance the treatment of anxiety and depression.
When an individual suffers from an anxiety disorder (e.g. Generalized Anxiety Disorder, Social Anxiety, Panic Disorder, Phobia, Obsessive Compulsive Disorder), it is the individuals desire to avoid the thing that causes fear and anxiety. Mindfulness endeavors to create a wise, self-compassionate and accepting mind with one’s emotional, thinking and physical experience, even during times of anxiety, stress and fear. Research has shown that practicing mindfulness along with traditional CBT increases distress tolerance, reduces avoidance, promotes self-regulation and contributes to healthier mind/body functioning. Because of an ability to better self-regulate, a central shift in one’s relationship with one’s thought processes and the outer world occurs. Mindfulness practice causes a shift in awareness that has been termed “detachment” or “clear seeing” and has been described by researchers as “rather than being immersed in the drama of our personal narrative or life story, we are able to stand back and simply witness it.”

So what is mindfulness?

• Mindfulness is not zoning out, or having no thoughts. Mindfulness is being fully aware.
• Mindfulness is not avoiding thoughts, sensations, feelings or emotions.
• Mindfulness is not an attempt to think only good thoughts, feel only pleasant emotions or have only good experiences, but to be open and accepting to all experiences.
• Mindfulness is returning one’s focus to the present moment, whether it is pleasant, unpleasant or neutral.
• Mindfulness is returning your attention to difficult experiences or thoughts with a sense that it is “okay” to have these thoughts or experience these sensations or emotions.
• Mindfulness is not trying to push away thoughts, feelings or emotions, but allows them to “be” while gently refocusing on the present moment.

At GroundWork Counseling in Orlando, our counselors and therapists have found that many clients with anxiety disorders and depression have benefitted from incorporating mindfulness into their Cognitive Behavioral Therapy treatment. For many, practicing mindfulness complements and enhances CBT as it offers a healthy and effective way of relating to one’s inner experience of anxiety by learning to cultivate the ability to pay attention, on purpose with a curious, accepting and open attitude, not only toward oneself, but also to one’s outer world.

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