Mindfulness-Based Cognitive Behaviour Therapy (MBCT), sometimes called Mindfulness-Based CBT, is a powerful evolution of traditional cognitive therapy. It was originally designed to prevent relapse in people with recurrent depression — but today, it is being used for anxiety, OCD, chronic stress, borderline personality traits, and even chronic pain.

Unlike standard CBT, which teaches people how to challenge negative thoughts, MBCT adds a crucial step:
learning how to observe those thoughts — without reacting, judging, or getting pulled in.

It shifts the patient from “How can I stop thinking this?” to “Can I notice this thought and let it pass, like a cloud in the sky?”

🧠 What Exactly Is MBCT?

Mindfulness-Based CBT is an evidence-based therapy that blends:

• Cognitive Behaviour Therapy techniques (identifying automatic thoughts, cognitive restructuring, behavioural activation), and

• Mindfulness meditation practices (breath awareness, body scan, acceptance, non-judgmental observation)

The core idea is simple:
We don’t need to suppress thoughts to heal — we need to change our relationship with them.

🔍 When is MBCT Particularly Useful?

MBCT was developed for recurrent depression, especially individuals who have recovered but keep relapsing. Research shows it reduces relapse rates by up to 50%, especially in patients with three or more depressive episodes.

Today, MBCT is widely used in:

• Major Depressive Disorder (MDD) relapse prevention

• Generalized anxiety and worry loops

• OCD (alongside ERP)

• Borderline personality traits & emotional dysregulation

• ADHD for attention training and emotional control

• Chronic pain conditions and psychosomatic illnesses

• Cancer survivorship, grief and burnout

🌀 How Is MBCT Different from Traditional CBT?

🧘‍♀️ Core Practices in MBCT

MBCT sessions typically include:

1. Body Scan Meditation

Lying or sitting still while gently scanning attention through different parts of the body — learning to observe sensations without reacting.

2. Mindful Breathing

Using breath as an anchor to return to the present whenever the mind wanders.

3. Thought & Emotion Awareness

Noticing automatic thoughts: “I’m a failure again,” “Nothing will change…”
Instead of fighting them, the patient learns to say:
“This is a thought. Not a fact. It will pass.”

4. Three-Minute Breathing Space (3MBS)

A quick rescue exercise:

• Acknowledge: “What am I thinking right now?”

• Anchor: Focus on breath.

• Expand: Notice body sensations without judgment.

5. Mindful Movement / Yoga

Gentle movements with awareness, improving sensory grounding and emotional regulation.

🎯 How Does MBCT Work in the Brain?

Scientific studies using fMRI and EEG show that MBCT:

• Reduces hyperactivity of the Default Mode Network (DMN) — the “overthinking/wandering mind” network

• Strengthens the prefrontal cortex, improving emotional control and impulse regulation

• Reduces cortisol and systemic inflammation linked to chronic stress

• Increases grey matter density in areas related to memory, empathy, and self-regulation

🌧 Why MBCT Helps Prevent Depression Relapse

People with recurrent depression often fall back into negative spirals automatically:
A sad mood → negative thoughts → hopelessness → withdrawal → relapse

MBCT breaks this autopilot loop by teaching:
✔ Awareness of early warning signs
✔ Acceptance instead of resistance
✔ Responding rather than reacting to emotions

🧩 MBCT is Not About “Positive Thinking”

It does not ask patients to “stay happy” or “think positive.”
Instead, it teaches:

• Thoughts are not facts

• Feelings are not permanent

• Pain is inevitable, suffering is optional

⚠ Who Should Avoid or Modify MBCT?

MBCT should be used cautiously or modified in:

• Acute psychosis

• Severe depression with suicidality

• PTSD with flashbacks (guided trauma-informed mindfulness is safer)

• Dissociative disorders

✅ Final Takeaway

MBCT is not an escape from thoughts.
It is an invitation to sit with them without drowning.
It helps patients stop fighting their minds, and start understanding them.

👨‍⚕️ Written by

Dr. Srinivas Rajkumar T
MD (AIIMS, New Delhi), DNB, MBA (BITS Pilani)
Consultant Psychiatrist – Mind & Memory Clinic
Apollo Clinic (Opp. Phoenix MarketCity), Velachery, Chennai
📞 +91-8595155808 | 🌐 www.srinivasaiims.com