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CBT: Mindfulness

Updated: Nov 20, 2020

Mindfulness CBT finds its origins in Eastern Buddhist meditation which began many centuries ago. Recent studies on CBT with mindfulness (Hayes, Follette & Linehan - Mindfulness and Acceptance Guilford, 2004) have shown psychological effectiveness across a wide range of clinical problems. These include anxiety, depression, stress management, OCD, social anxiety and personality disorders.

What is Mindfulness?

Mindfulness is a way of observing thoughts, images and feelings in an accepting way without either:

a) engaging with them, stepping back to interpret them in the traditional way. CBT steps back into an

observer hypothesis testing position to reality - test and challenge negative automatic thoughts,


b) using distraction techniques to try to suppress and/or escape from them.

How Does it Work?

When a client comes for CBT, their natural disposition is analyze and interpret their negative thoughts. They want to find a solution to problems in their thinking in the same way as they would want a practical solution to the problems faced in every day life, i.e. career, health, financial and external conditions in the world around them.

But thinking problems do not always lend themselves to a mechanistic, pragmatic problem solving exercise. This is generally because the emotional pain and negative thoughts are initially caused by events which happened a long time ago, in childhood, or at least have their roots or point of origin there. This makes them less amenable to standard CBT, where negative thoughts can be identified, and reframed in an alternative and more balanced way.

The trend in CBT into the realms of mindfulness, compassion and ACT (Acceptance and Commitment Therapy) is at the heart of this "third wave" of the behavioural therapies.

The normal thinking process reacts to a negative thought, image or feeling which presents itself to the mind, by engaging with that thought. In CBT the term MAGNIFICATION is used as an error in logic which means that, as one thought comes into the mind, we associate and chain it with another thought until it gets bigger and bigger.

If I think that I am going to fail a forthcoming exam, or make a fool of myself while making a

presentation, or be rejected by someone I ask out on a date, my mind will act like a computer in a negative feedback loop and give me all of the similar situations in my life when similar things have happened. This has a snowball effect because I fix my mind on these until these thoughts seem like an obstacle as big as Mount Everest would be to climb.

The alternative to fixing and magnifying negative events would be to DISTRACT myself from them by doing something different to try to escape from them. The problem with this is that, consistent with the literature of avoiding negative thoughts, the more we try to escape from them the more prevalent they become in our minds.

Mindfulness CBT - A Third Way

Mindfulness CBT works as a third way. Instead of engaging with negative thoughts, images and emotions, or trying to distance ourselves from them, the third option is to allow them to be there, to accept them, but to neglect them.

In Daniel Pink's book, A Whole New Mind, he states that out of 10,000 new bits of information presented to us at any one time, we naturally only pay attention to half a dozen sensory motor mega-bites at any one time. The mind works by the fact that paradoxically, as we accept these negative images and feelings, and allow them to be there without fixing on them, the mind moves on rather like a stream of consciousness, on to the next thing.

The great Zen master Hisamatsu said, "when nothing idle weighs heavy on the mind, this is man’s favourite season".

An example of this natural neglect would be like watching a television commercial. In a world of

television advertising, you have probably trained yourself to not hear, not see and not be engaged or

affected by what is on the screen.

In Adrian Wells’ book on Cognition and Emotion, he points to a processing area in the brain where we do just that, experience things around us without being aware of what we are taking in. This is something we already do in vast areas of our lives. Discovering that place where we have thoughts, but they do not have us - i.e where we are aware of them but not disturbed by them. This is of great value in coping with emotional/psychological problems.

Mindful Breathing

The primary goal of mindful breathing is simply a calm, non- judging awareness, allowing thoughts and feelings to come and go without getting caught up in them.

  • Sit comfortably, with your eyes closed and your spine reasonably straight.

  • Bring your attention to your breathing.

  • Imagine that you have a balloon in your tummy. Every time you breathe in, the balloon inflates. Each time you breathe out, the balloon deflates. Notice the sensations in your abdomen as the balloon inflates and deflates. Your abdomen rising with the in-breath, and falling with the out-breath.

  • Thoughts will come into your mind, and that’s okay, because that’s just what the human mind does. Simply notice those thoughts, then bring your attention back to your breathing.

  • Likewise, you can notice sounds, physical feelings, and emotions, and again, just bring your attention back to your breathing.

  • You don’t have to follow those thoughts or feelings, don’t judge yourself for having them, or analyze them in any way. It’s okay for the thoughts to be there. Just notice those thoughts, and let them drift on by, bringing your attention back to your breathing.

  • Whenever you notice that your attention has drifted off and is becoming caught up in thoughts or feelings, simply note that the attention has drifted, and then gently bring the attention back to your breathing.

It's okay and natural for thoughts to enter into your awareness, and for your attention to follow them. No matter how many times this happens, just keep bringing your attention back to your breathing.

*Artwork by Alejandra Salgado

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