CBT and Mindfulness

Jan 15, 2024 • 7 min

What is CBT and Mindfulness, and How Can It Help My Mental Health?

I am a huge fan of using CBT alongside mindful attention and meditation. Proven to be as effective as anti depressants; these ancient and cutting edge ways of looking after ourselves are being rolled out by the NHS, can be used prophylactically to maintain good wellbeing or in a crisis to ease suffering and promote a healthy recovery. 

CBT is a talking therapy which is more active than traditional forms of counseling. It’s known to be helpful for depression, anxiety, worry, trauma, sleep problems, obsessive compulsive disorder, social anxiety, addictions, ADHD, perfectionism, dysthymia, motivational issues, seasonal affective disorder, eating disorders, stress and other difficulties. It works by exploring patterns in thoughts and behaviors, looking at what is within our control in what might feel like an overwhelming situation, and invites us to gently and courageously experiment with doing and thinking about things differently. By looking at our beliefs about the world, our assumptions and corresponding behaviors we can instantly feel like we have a bit more efficacy, that we can navigate storms without being blown around in the wind feeling hopeless. 

Good CBT will always explore root causes of difficulties, but the emphasis and the work is in the here and now. We could spend a long time trying to work out how you got into this hole, or we could get you out - focussing on symptom relief - and then spend some time thinking about how to avoid future holes. There is a reason this is being rolled out by the NHS. It’s relatively cheap to deliver as it is effective and short term therapy, results are tangible and benefits are often felt within a few weeks. It’s really a self help model and there’s a lot that happens between sessions, you may be encouraged to keep diaries, notes and experiment. All learning over the week is rich and there are no wrong answers. All that is asked for is a spirit of experimentation and an open mind. You will always be the expert in your experience, your therapist will bring knowledge of CBT theory and an understanding of what has helped many others. This expertise is blended in a transparent and collaborative way, forming a plan together. It’s more fun than you might imagine and empowering as you learn and hone skills for life. 

Mindfulness boosts everything we do in CBT, giving you more for your moment and a chance to unhook from autopilot, enhancing your ability to change habits where necessary. This ability to unhook, is not dissimilar from the therapeutic use of psychedelic drugs or anti depressant medication to alter mental state but hopefully with fewer side effects. There are so many definitions of mindfulness and it has been likened to a many faceted diamond. I like John Kabat-Zinn’s definition; “paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally”. I.e bringing our full attention to the present moment, as best we can with kindness and curiosity. Simple but not easy. It involves a firm choice to be with our experience, noticing when we are adding layers of evaluation or thought to our raw experience and gently unhooking, coming back to the body, breath or another anchor such as sounds around us. The facets of the diamond - or the ways in which it is known to help - include attentional training, emotional regulation, decentering from our thoughts, an increase in bodily awareness and a change in perspective in the self. Not bad for a treatment which is paradoxically low cost and low tech. There is a reason it has stood the test of time and it fascinates me that ancient buddhist wisdom is being blended with cutting edge modern treatments and rolled out by the NHS. 

When we meditate we become aware of our habitual mental patterns. When meditation gets hard - and it does - what do we do? Do we get busy mentally? Worry more? Go to sleep? This tells us a lot about how we respond to difficulty in real world environments and gives us a chance to notice our patterns and start to tolerate doing things differently. It is extremely helpful in preventing depressive relapse as we are more able to notice early warning signs and respond wisely. By stepping out of autopilot we give ourselves an enormously better chance of escaping unhelpful patterns in behavior, noticing negative thoughts for what they are, observing where they begin and end. This teases apart the threads of disorders such as depression and anxiety and alerts us to signs and symptoms of trouble sooner. Allowing the wise mind some time to bubble up quietly, not so much in thought as in peace, can bring about huge changes. They say mindfulness is caught not taught. No amount of evangelical text can persuade you of this so much as tasting it for yourself so I’d like to invite you to take a seat and try a three step breathing space. 

By stepping out of thinking and doing, and into being and sensing, you are making an active step towards good mental and physical health. This soothes the fight or flight mode and fires up the parasympathetic nervous system, associated with resting and digesting. Establishing a regular practice means we can reasonably hope for better sleep, emotional regulation and an ability to respond wisely rather than react impulsively. In the busy, over stimulating and stressful world which we live, sitting quietly can feel like a radical act. I’d invite you to give yourself the gift of time and consider including this in your routine as a nourishing and gentle activity. Don’t expect it to be easy or relaxing or you will find yourself adding layers of judgment when sometimes it isn’t either. Show up as you are and keep your awareness as kindly and open as possible. 

I believe learning to meditate is as important as riding a bike or swimming. Weave your parachute before you need it, or get someone to help you if you are under pressure. Joining a local group or using online resources is a great place to start. I know I’m biased as this is my line of work and I care about it deeply, but I think we will all need help at some point with our mental health and there’s a real strength to being someone who gets it. Hopefully we don’t procrastinate hugely around dental appointments, opticians, getting the car MOT’d; a similar attitude to therapy when it is needed is healthy. You probably could ruminate through rough patches yourself but you could save some time and protect your relationships by asking a professional to help you.