CBT & Mindfulness

CBT and Mindfulness Online

Both CBT and Mindfulness can be highly beneficial and to help as many people as I can I now offer both remedies online.

What is Online CBT?

Cognitive Behavioural Therapy (CBT) is a collaborative psychotherapy which involves a conversation between therapist and client to gain a shared understanding of the difficulties the client is facing.

CBT is based on research which shows that what we think affects what we feel and what we do. Problems can often develop a life of their own and can be hard to resolve without the help and support of a therapist or counsellor. CBT helps to create an understanding of how a problem keeps itself going and therefore how it can be interrupted and overcome.

Can CBT be done Online?

Since the first lockdown, I have found that online CBT is very effective. Clients who began therapy with me face to face easily made the transition to working online. Others, who began therapy online, had no difficulty in understanding and learning to use this therapeutic approach. There are also some advantages to working online: the screen can be shared and diagrams which capture the vicious circles a person may be trapped in can be worked on together and shared solutions found.

Mindfulness Online: An effective way to a calmer life

Both CBT and Mindfulness can be highly beneficial and to help as many people as I can I now offer both remedies online.

Mindfulness Based Cognitive Therapy

I offer mindfulness online via Zoom for individual clients. This is based on an integration of mindfulness online with cognitive therapy. It supports us to learn skills to be in the present moment and notice our experience without judging ourselves and without needing to act. In our often very busy world, it teaches us to step back and just be aware of our experience. It helps us to “be” rather than “do”. This enable us to be fully in the present rather than going over mistakes we’ve made in the past or getting locked into worries about the future. Mindfulness online and Mindfulness Based Cognitive Therapy are effective approaches for depression and anxiety and many other psychological difficulties.

Depression and Mindfulness

When someone is depressed, their thinking patterns change. Thoughts become more negative and the person may get stuck in repetitive patterns of self-critical thoughts, such as “I’m a failure” or “I can’t cope”. Their view of other people may also become unrealistically pessimistic such as “No one can be trusted” or “Other people always let you down”. Similarly, the future may feel bleak: “This will never change” or “The future is hopeless”.

Mindfulness online teaches us skills so that we are able to notice what is going on in our heads and in our bodies. For example, we might do a mindfulness online exercise to notice sounds. I might focus on the sounds going on in the room where I am and you would tune in to the noises in your environment. In this way you can begin to be aware of sounds as they come and go and to separate this from the stories you might tell yourself about the sounds, such as which of your neighbours’ dog it is barking and whether it’s the postie arriving.

Similarly, you can then move on to notice thoughts just as you noticed sounds – as events which come and go. You learn that you can step back from your thoughts just as you stepped back from sounds. This helps you to get some distance on your thoughts. It’s as if you’re no longer in the river with your thoughts – being tossed about in the rapids. Instead, you’ve managed to climb out on to the bank and from there you can notice the thought stream flowing past you. You no longer are your thoughts. You become aware that you are having a thought.

This is a very important skill to learn if you are depressed. If you are feeling low in mood and have the thought “I’m a failure”, you will probably believe it.

Suddenly, all the mistakes you’ve made, your regrets and missed opportunities will come flooding in to your mind. This strengthens the thought “I’m a failure”, which deepens your low mood and triggers more memories of times when you’ve feel you’ve got it wrong. Now you are in a powerful vicious circle which will increase your depression.

Mindfulness online teaches you how to break that vicious circle.

By noticing that you are having a thought, just like you can hear a sound, you are no longer identifying with the thought. You have stepped back and you can “just notice” the thought and the feeling of sadness it may cause. You let yourself feel the feeling and after a bit it passes, just as the sound of the dog barking passes.

Another way in which mindfulness online is thought to have a powerful impact in overcoming depression is what’s called the “kindling hypothesis”. If you have had episodes of depression over several years, you may be fearful about having another episode. So, if one day you get to coffee time and suddenly notice you are feeling a bit down, you might think to yourself “Oh no! My mood has dropped. Perhaps I’m becoming depressed again. It might get as bad as it did last time. Maybe I will be off work again, perhaps I will lose my job. If I lose my job then I might not be able to make the mortgage payments and I might lose the house!”

As a result of these negative and catastrophic thoughts your mood may plummet which will generate more of the negative thoughts and you are into another vicious circle. Mindfulness research calls this the “kindling hypothesis”. The person is vulnerable to their thoughts breaking into flame because of their previous history of depression. Whereas someone else, who has never been depressed, notices that they are feeling a bit low, says to themselves “I feel a bit low” and gets on with their day and the feeling passess. Crucially, there is then no vicious circle.

With mindfulness online training, the person with the history of depression, can learn to “just notice” the low mood, to let it be there and then pass and there is then no vicious circle to feed the fire of their potential depression.

A randomised controlled trial, a form of high quality research, was done into the impact of mindfulness on depression in 2000. It found that an 8 week mindfulness course could significantly decrease the severity and frequency of episodes of depression in people who had a history of depression.