I. About Mindfulness
”Mindfulness – “positive thinking” (translated in mainland China and Taiwan, but in Hong Kong it is translated as “meditative observation”) – originally means A state of non-judgmental awareness of the internal and external experiences of the body and mind in the present moment. Dr. Joe Kabagin started the Stress Reduction Clinic at the University of Massachusetts Medical School in 1979, combining the ancient technique of “positive thinking” with modern medicine, stripped of its religious crust, to address the challenges of stress-related subhealth and chronic illness. This is how the standard Meditation-Based Stress Reduction (MBSR) program has evolved. For more than three decades, the spread of MBSR has been increasing in popularity and depth in non-religious frameworks and contexts.
As we all know, “depression” is one of the most common stress-related disorders and is becoming more and more dangerous for individuals in this era of rapid development! In the past, we often solved it through self-regulation or psychological counseling, but if depression is serious enough to be a disease, we have to rely on medication. Although antidepressant medications are commonly used to treat depression, there are inevitable side effects. At the same time, the biggest problem of depression is that it is easy to relapse, and drugs are almost helpless in this regard, except for long-term maintenance medication. For this reason, many people suffering from depression are also suffering from another kind of internal conflict – worrying about the psychological burden of being a “medicine jar” and the label of illness, or falling into depression for a long time and not being able to extricate themselves! So, is there a way to solve this problem?
In the 1990s, Mark Williams of Oxford University, UK, Jon Teasdale of Cambridge University, UK, and Zindal of the University of Toronto, Canada
Segal, three psychologists who met at the World Congress of Cognitive Therapy, had an uncomfortable eye on the problem of depression relapse – how to identify people who relapse and how to prevent it. In designing maintenance treatment for depressive symptoms in remission, they integrated attention training into cognitive therapy and began to move away from the “therapy” framework to emphasize the idea of “holding feelings and thoughts in awareness rather than trying to change them. In October 1993, they flew to the Massachusetts Center for Positive Thinking with curiosity and questions, and sat down with Jon
Dr. Kabat-Zinn’s class. After this historic meeting, the Positive Meditation technique began to be systematically integrated into classical cognitive therapy, resulting in today’s Positive Cognitive Therapy.
II. Why Depression Recurs
When it comes to solving the problem of recurring depression, it is important to first understand what “fuels” our depression or chronic sadness – and the latest research findings in Positive Cognitive Therapy allow us to understand this at the root.
When the mind begins to fall into a downward spiral, it is not the state of mind itself that causes us harm, but the way we respond to it.
We are accustomed to trying to get rid of pain, but instead of getting rid of it, these efforts can imprison us in the very pain we are trying to get rid of.
In other words, nothing we “do” when we start to feel depressed seems to help. Because trying to get out of depression with the usual problem solving approach, trying to “fix” our “problem” approach, only makes us sink deeper. So it is wise to stop trying to solve the problem of “feeling bad”, because almost all of our habitual ways of solving problems end up making things worse. As Albert Einstein said, “The problems of the world today cannot be solved by thinking, because it is this level of thinking that creates them.”
Of course, the solution is never to “give up” or “surrender” to depression. But the key to improving depression is not to be “always happy,” but not to let a short period of unhappiness develop into a long-lasting, unresolved depression. MBCT combines the latest understanding of modern science and meditation with different ways of understanding the mind and body, helping us to work with our “negative thoughts and emotions” with greater wisdom. We can establish a new relationship with our “negative thoughts and emotions”. Through such an attitudinal shift, you can find ways to break out of the “downward spiral of mindfulness” without allowing it to develop into lasting depression.
In recent years, there has been a lot of international empirical research on the MBCT technique, and the results have shown that MBCT is very effective in preventing relapse in patients who are recovering from depression. For patients who have had more than three depressive episodes, MBCT can reduce the relapse rate by half.
Just this year, in a study of positive thinking techniques conducted by our hospital’s Clinical III Positive Thinking Research Group in collaboration with the Center for Psychiatric Research, a small but promising sample was found – depressed patients who used positive thinking techniques alone had more significant self-referential The change in effect was more pronounced in patients with mild to moderate depression who used positive thinking techniques alone compared to those who used medication alone. In layman’s terms, the medication only improved depressive symptoms, but did not change the patient’s cognitive model, and if the patient’s own cognitive model was causing the depression, then stopping the medication would mean that the patient was re-exposed to the state that caused the depressive susceptibility. The core effect of the positive thinking technique is not only to address the symptoms themselves, but also to improve the participant’s stress coping patterns, so that we can become more “immune” to depression, and thus be more empowered to face the “resurgence” of depression.
Since 2015, the Clinical Department of Beijing Huilongguan Hospital introduced MBCT technology for the first time in the field of psychiatry in China, and carried out MBCT treatment for depressed patients with very satisfactory results. on January 28, 2016, we set up a positive thinking research group with the Clinical Department as a platform to study the intervention of positive thinking technology on stress-related mental illnesses. The aforementioned findings were obtained due to the initial results of the preliminary research on the physiological mechanisms of positive thinking techniques for the treatment of depression. In order to expand the sample size and obtain more reliable research data, the Positive Thinking Research Group decided to expand the recruitment of MBCT intervention courses for depressed patients in this year.
Third, does MBCT work?
We have held four MBCT courses since 2015, with more than thirty participants from all walks of life across China. Most of them are patients with mild to moderate depression, and also include some patients with bad mood and bipolar disorder. After the course, most of them benefited from the course. Some of the patients experienced improvement in their depression without medication. More importantly, the participants developed a more positive attitude towards life and gained the energy to resist the relapse of depression.
One of the participants, who was a secondary school teacher by profession, had been suffering from stress and anxiety for decades, and finally developed depressive symptoms during a family change. After attending the course, her greatest feeling was the feedback she received from one of her students: “Teacher, you have changed. You’ve become kinder.” She herself felt, “I used to never love myself, my family, or my students, but now I know how to love them, and I can feel the feeling of ‘loving’ and ‘being loved’. ” Six months later, she is still practicing every day, full of motivation for life, and still able to maintain a very optimistic and positive attitude in the face of her family’s difficulties, driving the whole family to also have more strength to face difficulties.
Another participant had repeated depression, and he was depressed in his status as a successful person, which made him unable to understand himself, and he could only use “cowardice” to explain it, and has been trying to overcome his “human cowardice”. Through the course, he first learned to experience his feelings in a non-judgmental and accepting manner – whereas in the past, once he had such feelings, they were suppressed by his own thoughts of “it’s not right to think this way, I can’t think this way”, so that He feels that it is impossible for him to have feelings. His greatest feeling was when he was walking through the garden on a positive thinking day, and suddenly he realized that every flower, plant, insect, and bird was a delight to him, whereas he had never noticed them before. On the other hand, he also discovered how his body felt when it was tired, whereas in the past, his “success” had come at the cost of suppressing his feelings of physical and mental exhaustion and overworking. At the beginning of the course, he was most worried that if he learned how to relax, he would become “decrepit”. However, six months after the course, his worries did not happen, but he learned to “rest in the busy”, “feel happy in the ordinary” state of life, so that his work efficiency is higher, but also understand “Instead of focusing on his own concerns about depression relapse, he should focus on improving the happiness of his life.”
According to previous global studies and our clinical observation, we found that MBCT course is the most effective in preventing relapse for simple depression, and the second most effective for bipolar disorder and atypical depression, but this does not mean that it is ineffective, but difficult. There was also a participant with bipolar disorder who encountered great difficulty in the learning process, some contents were difficult to comprehend and the exercises were difficult to stick to, but with the encouragement of the tutor However, with the encouragement of the instructor, the participant persevered with greater perseverance, and after six months, she now feels that she has gained understanding and is experiencing a “long-lost sense of fulfillment and happiness” in her life.
As a psychotherapeutic technique, the effect of MBCT is not directly on the symptom itself, like medication, but through the above-mentioned capacity building, the participants become “immune” to depression, making the effect of relapse prevention more sustainable. On the other hand, the effectiveness of the program comes from the participants’ participation rather than the program itself. The more participants actively participate in the course and complete the post-course exercises, the more they will benefit.
IV. Why does it come with scientific research?
Depression, as an important disease that affects the future development of Chinese society, is also an issue that the whole society is eager to solve. The perspective of our work is not only on treating a few patients, but also on coming up with some techniques that can be promoted by all people for the benefit of every national who is eager to heal and achieve happiness. Therefore, in the process of introducing new technologies, we also sincerely expect that each participant in the course will be both a beneficiary of the course and a contributor to the cause of psychiatry in our country!
At the same time, the participants themselves will also benefit from the research process. First of all, you can get a functional cranial MRI and a functional EEG for free. These examinations are non-invasive and radiation-free, and the above examinations are almost harmless to the human body as long as there are no metal implants. But these tests allow for a more systematic and in-depth assessment of one’s brain function – assessments that would not be covered in a usual outpatient clinic. Participants can quantify their learning outcomes and disease prognosis through pre- and post-course assessments. Included as an incentive to participate in research, the full course fee is waived if the course and research requirements for the session can be completed. The free course work plus the associated tests that come with it, indeed you will never find such a great price after the research is completed.
So, what does the research do to the course itself? –The first MBCT course is a free course with research, and the comparison between the courses is no different than without the research. Because the course itself is a standardized content, the research project is just like an external module and does not interfere with the course itself in any way. The only trouble is that you need to spend some extra time before and after the course to take some interesting research tests. There are many people who come not just for the course discount, but because they like the interesting tests in psychology research.