Mindfulness for Life: Finding Peace Amidst Difficulties and Cultivating Joy, Compassion, Equanimity and Wisdom
By Willem Kuyken
Mindfulness-Based Cognitive Therapy (MBCT) is based on a cognitive science theoretical model of the mind1 and uses mindfulness practice, cognitive techniques and behavioural strategies to develop understanding and effect change. The approach is rooted in Cognitive-Behavioural Therapy2 and Mindfulness-Based Stress Reduction3. It has evolved to be used with a variety of populations, in a range of contexts4, but in each case with a clear intention and theoretical formulation1,5. This is what makes MBCT a mindfulness-based programme6.
Mindfulness-Based Cognitive Therapy was originally developed with a particular focus on people with recurrent depression who were at significant risk of depressive relapse7. It had a particular cognitive science formulation of depressive relapse and was carefully adapted to help people at high risk of depression learn skills to stay well in a safe learning environment. It has been shown to be effective in numerous randomised controlled trials8, and is becoming more widely available in healthcare contexts.
But what about the rest of the population who might also benefit from the transformative power of cognitive-behavioural therapies and mindfulness practice? The following figure represents the full spectrum of the population, from those who are at high risk of experiencing mental health problems, to the majority in the middle who are functioning well and enjoying good well-being, through to those who are flourishing. After all, mindfulness is a natural capacity we all have and the possibility of developing mindfulness is available to everyone.
Figure 1. Can mindfulness support the development of resilience and help the whole population realise their potential and move towards flourishing?
Can a programme that combines mindfulness and cognitive science help more of the population find peace in a frantic world, develop resilience, realise their potential and flourish? Can it serve to reduce stress and improve mental health for many and enhance resilience and human potential for all? Can it focus on universal mechanisms such as stabilizing and anchoring attention, opening to new ways of being and knowing and learning to respond (rather than react)? Can it be made as accessible as possible to people who might benefit?
Mindfulness: Finding Peace in a Frantic World.
The book Mindfulness: Finding Peace in Frantic World builds on the ideas and structure of MBCT, but offers a broader application of a cognitive science model of the mind and mindfulness practices as a vehicle for change 9. It offers everyday ways of applying mindfulness to improve well-being. The fact that it has sold more than a million copies and has been translated into more than 30 languages suggests it is meeting a need. The Oxford Mindfulness Centre has developed a face-to-face Mindfulness: Finding Peace course that is taught in many workplace settings including universities and the UK Parliament. It serves as an introduction to mindfulness for the general population and can be taught in 8 relatively short 60 to 90 minute group sessions, with ‘formal’ home practice lengths of between 10 and 20 minutes per day. Chris Cullen offers regular masterclasses for MBCT teachers who wish to teach this curriculum. We are carefully evaluating the acceptability and effectiveness of this course.
Mindfulness for Life [MBCT-L] is intended as a more in depth and transformative universal taught face-to-face programme, applicable to the general population. It offers mindfulness practices and cognitive-behavioural techniques in ways that are intended to be accessible to all. It guides participants in how to apply this learning in everyday life both to manage difficulties but also to cultivate joy, compassion, equanimity and wisdom. It offers a different way of living that supports people to work with distress and difficulties, but also to savour life, realise their potential and to flourish. Following the model of MBCT with 2-hour classes and about 40 minutes of ‘formal’ home practice per day. Compared with the Finding Peace in a Frantic World course MBCT-L is intended as a more in-depth programme to cultivate lasting and sustainable change.
MBCT-L is intended for community settings, where people can come to participate in the programme over 8 weekly sessions as well as a full day of mindfulness practice, which normally takes place between sessions 6 & 7.
The MBCT-L programme broadly follows a structure of:
- Developing mindfulness skills in earlier parts of the programme through a range of mindfulness practices. These are intended to enhance attentional control alongside the development of awareness imbued with attitudinal qualities of curiosity, care, patience, kindness and equanimity brought to pleasant, neutral and unpleasant experiences. In short, attentional control with a stance of befriending experience.
- Developing understanding and insight throughout the programme of how human distress is created and maintained, and how mindfulness training can address these maintaining factors. This is based both on foundational traditions and cognitive science accounts of the mind. Participants learn that habitual reactive patterns stem from unhelpful reactive habits of the mind; that fear, denial and discrepancy thinking create and re-create distress. They learn that unhelpful habits of the mind such as pushing away or ruminating about difficult experiences can maintain distress and that skilful ways of relating to experience can be developed through awareness and practice. The theme of recognising unhelpful reactivity and cultivating the capacity to respond with mindfulness and compassion is central to the whole programme.
- In the second half of the programme, there is a growing emphasis on helping participants apply this learning to everyday life, both to work with distress and difficulties, but also to savour the positive dimensions of life, realise potential and flourish.
Deepening and Extending Mindfulness for Life – A Curriculum for Beyond 8-Week Course
“It changed me in just about every way possible; but what do I do next to next?”
These sorts of quotes are is not untypical of what people say following an 8-week Mindfulness-based Programme 10,11. What does happen next? What sustains people beyond the 8-week programmes? How can we help people maintain their mindfulness practice? How can we support people to live with greater wisdom, balance and responsiveness in the myriad different moments of their real lives? Many people graduating an 8-week programme would like to continue the journey they have started and would like some additional guidance and support in this journey.
This new curriculum is for graduates of 8-week mindfulness programmes to:
- Reinforce and deepen their mindfulness practice.
- Deepen and broaden the learning of the key themes from the 8-week curriculum
- Extend the learning to include
- The explicit cultivation of the attitudes of mindfulness, in both formal and informal practice
- The development of the positive valence system to support well-being and flourishing.
- Support participants in applying all that is learned in their lives, in ways that are consonant with their values.
- Provide a shared community of practice.
- Develop participants’ capacity and confidence to deepen and extend learning independently.
The curriculum comprises twelve themes. Each is a theme that can be explored in its own right. However, like stepping stones, they can be sequenced to create a structured program comprising 12 steps. However, like stepping stones they can also be inter-locked to create different ways of exploring the themes, perhaps with several themes together being the basis for a residential retreat. This flexibility is designed in to enable Mindfulness teachers to have the flexibility to offer the curriculum in different formats (weekly over 12 weeks, monthly over a year, or in blocks of residential retreats).
Examples of the 12 stepping stones are: “Attention!”; “Inhabiting our bodies;’ “Appreciating the life you have;’ “ How can I best take care of myself and others?;” “Cool head, warm heart: The art of balance and equanimity” and; “Being the change you’d like to see in the world.”
A Map and Route Map
These three curricula use a map and route map drawn from ancient wisdom and modern psychology. They start from the premise that we all experience distress and this is an excellent place to learn experientially how distress is created and maintained through unhelpful habits of mind and behaviour. The curriculum and mindfulness practices reveal how responding differently can break up the cycles that maintain and exacerbate distress. This learning can then be translated to cultivating the positive and healthy, enabling participants to realise their potential and to flourish. By focusing on universal mechanisms, we hypothesize that small but significant changes will occur for people across the spectrum of well-being, from those who are currently experiencing difficulties to those who are flourishing, and everyone in between. Indeed, it is quite possible to flourish in one area of life, but languish in another and for this to change over time. The recent book Mindfulness, Ancient Wisdom Meets Modern Psychology co-written with Christina Feldman was intended to sketch this map and route map so as to support mindfulness teachers.
Teaching the Finding Peace in a Frantic World and Mindfulness for Life curricula requires having followed a recognised training pathway 12. Teachers should then have some further education specific to these curricula. The University of Oxford Mindfulness Centre is offering these trainings.
There is a robust evidence base for MBCT for depression 8 and much larger broader evidence for mindfulness-based programmes 13-15. The Oxford Mindfulness Centre and a number of other centres are evaluating these new curricula to establish their acceptability and effectiveness.
Willem is the Ritblat Professor of Mindfulness and Psychological Science and Director of the University of Oxford Mindfulness Centre. He is the Principal Investigator of NIHR, Wellcome, MRC funded research projects examining mindfulness and MBCT and co-author of Mindfulness – Ancient Wisdom Meets Modern Psychology. He receives no payment for public engagement or consultancy, and any remuneration is paid in full to the not-for-profit charity Oxford Mindfulness Foundation. He does receive royalties for his co-authored books.
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- Crane RS, Brewer JA, Feldman C, et al. What defines mindfulness-based programs? The warp and the weft. Psychological Medicine 2017; Manuscript in press.
- Segal ZV, Williams JMG, Teasdale JD. Mindfulness-based cognitive therapy for depression. Second edition ed. New York: Guilford Press; 2013.
- Kuyken W, Warren F, Taylor RS, et al. Efficacy and moderators of mindfulness-based cognitive therapy (MBCT) in prevention of depressive relapse: An individual patient data meta-analysis from randomized trials. Journal of the American Medical Association: Psychiatry 2016.
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