Is mindfulness based training a cognitive behaviour technique?

Abstract

The paper in this issue makes an innovative suggestion to treat diabetes-related distress using mindfulness based stress reduction (MBSR) training.1 Their retrospective study showed positive effects of MBSR on patients' psychological distress including tension/anxiety, depression/dejection, anger/hostility, fatigue/inertia, confusion/bewilderment and vigour/activity among people with diabetes. The authors called MBSR ‘a non-traditional cognitive behavioural intervention’. The procedures used in cognitive behaviour therapy and mindfulness based training seem to be similar. Both approaches work with paying attention to the thoughts, sensations and emotions which may lead to a reduction of emotional or physical pain and better self-management. However, it has to be stressed that MBSR ‘is not […] the next promising cognitive behavioural technique’.2 Mindfulness training has a different historical and cultural background from those of cognitive behaviour techniques and, hence, these two approaches differ substantially in their nature.3 Baer, in her comprehensive review of mindfulness based training,4 summarises these differences. Firstly, cognitive behaviour therapy aims at evaluating and challenging thoughts. MBSR in turn teaches how to pay attention to the thoughts in a non-judgemental way. Secondly, cognitive behaviour treatment usually aims at changing irrational thoughts and disruptive behaviours. In contrast, in an MBSR training the participants are asked to let go of any expectations and goals. The aim of mindfulness training is a non-striving observation of thoughts and bodily sensations, non-judgementally, moment by moment. Finally, MBSR requires that facilitators themselves practise the techniques they teach to the group. This is not the usual practice of a cognitive behaviour therapy.4 Mindfulness based cognitive behaviour therapy5 showed that these two approaches can be effectively integrated. However, an adequate recognition of the qualities of both cognitive behaviour techniques and mindfulness training is crucial for exploring their unique contribution.