Academic journal article Journal of Cognitive Psychotherapy

Mindfulness and Cognitive Behavioral Therapy: Are They Compatible Concepts?

Academic journal article Journal of Cognitive Psychotherapy

Mindfulness and Cognitive Behavioral Therapy: Are They Compatible Concepts?

Article excerpt

Several therapies have emerged that include mindfulness as a central theoretical concept within a Cognitive Behavior Therapy (CBT) model. These include Dialectical Behavior Therapy (DBT), Acceptance and Commitment Therapy (ACT), and Mindfulness-Based Cognitive Therapy (MBCT). This article argues that mindfulness is contrary to many of the core principles of CBT, but more importantly, the concept of mindfulness lacks meaning, outside of the Buddhist religious tradition from which it arises. As part of a mystical ideology, mindfulness represents an antirational and prescientific worldview. As such, this article questions the assertion that mindfulness can be a part of a new scientific paradigm, representing a "third generation" of CBT, and suggests that CBT is in danger of becoming an all-encompassing term.

Keywords: mindfulness; cognitive behavior therapy; rational emotive behavior therapy; dialectical behavior therapy; acceptance and commitment therapy

Over the past decade, several therapies have emerged that have been described as the third generation of Cognitive Behavior Therapy (CBT; Hayes, 2004). These include Dialectical Behavior Therapy (DBT; Linehan, 1993), Acceptance and Commitment Therapy (ACT; Hayes, Strosahl, & Wilson, 1999), and Mindfulness-Based Cognitive Therapy (MBCT; Segal, Williams, & Teasdale, 2002). These approaches propose this "third wave" representing, not just an extension of existing CBT approaches, but a fundamental paradigm shift. Their conceptual roots are to be found in postmodernist philosophical theories, such as constructivism, dialectics, and functional contextualism that suggest reality is not fixed but in a process of continuous change, and that thought content is largely irrelevant to emotional disturbance. A central feature of these therapy models (although, by no means the only feature), and one that reflects these philosophical ideas, is that of mindfulness. This article challenges the assumption that there is a meaningful concept of mindfulness that can be incorporated into a scientifically based psychology. It is argued that mindfulness is essentially a mystical religious idea, based primarily on Buddhist theory and practice, and is incompatible with cognitive and behavioral theory and the CBT model of therapy. While CBT clearly incorporates a wide range of approaches derived from learning and cognitive theory, the authors specifically refer to Cognitive Therapy (CT; Beck, Emery, & Greenberg, 1985) and Rational Emotive Behavior Therapy (REBT; Walen, DiGiuseppe, & Dryden, 1992) as illustrative of traditional CBT.

The authors do not wish to dispute the possible value of meditation as a technique. Rather, this article questions the compatibility of the concept of mindfulness with a cognitive behavioral model. As such, an important distinction is required between the conceptual model underpinning a particular therapy and the techniques that this therapy might employ. Thus, techniques can be taken from a variety of approaches but still used consistently within a given theoretical model: Dryden (1987) has termed this "theoretically consistent eclecticism." For example, CT might employ hypnosis to enhance imagery, but this would be based within a cognitive model, rather than a hypnotherapy model that aimed to uncover unconscious memories.

Having said this, it is clear that mindfulness, as advocated by third wave therapies, is not simply an adjunctive meditation or relaxation technique, but an integral part of the conceptual model. Thus, mindfulness is described as being "at the center of DBT" (Robins, Schmidt, & Linehan, 2004, p. 37). Acceptance and commitment therapy also emphasizes that "ACT can be thought of as a mindfulness-based therapy at the level of process, in addition to using mindfulness techniques" (Hayes Strosahl, Bunting, Twohig, & Wilson, 2005, p. 10). Likewise, Mindfulness-Based Cognitive Therapy, as the name implies, considers mindfulness as central to its theoretical position (Segal, Williams, & Teasdale, 2002). …

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