Mindfulness-Based Cognitive Therapy

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SESSION 1: Stepping out of Automatic Pilot

Rationale

· Mindfulness starts when we recognize the tendency to be on auto-pilot

· Commit to learning how to step away from a situation or feeling and become aware of each moment

· Practice in purposefully moving attention around and through the body

Structure

· Class Orientation (Welcome, Format, Intentions)

· Ground Rules

· Introductions

· Raisin exercise (Eating Meditation)

· Body scan

Homework

o Body scan

o Mindfulness of routine activity

o "Noticing"

SESSION 2: Dealing with Barriers

Rationale

· Further focus on the body, slowly begins to clearly reveal the chatter of the mind, noticing this and letting go

· This chatter tends to control our reactions to everyday events:

Situation + Interpretation = Emotion, body sensations, behavior (thoughts are not facts)

Structure

· Body scan practice

· Home practice review

· Thoughts/feelings exercise

· Pleasant experiences diary

· Sitting Meditation introduction of posture

· Explanation of homework and handouts

· Closing

Homework

o Body scan

o Sitting meditation with focus on breath (10-15 mins)

o Pleasant experiences diary

o Routine activity

o ‘Noticing’

SESSION 3: Mindfulness of the Breath

Rationale

· Becoming familiar with the behavior of the mind (this is often busy and scattered)

· Awareness of the breath offers a possibility of being more focused and gathered (an anchor to the present moment)

· Categorizing experiences vs. describing bare sensations

· Mindful movement: Yoga, stretching, walking

Structure

· Mindful movement

· Home practice review

· Breathing space

· Stretch & Breathing

· Explanation of homework and handouts

· Closing

Homework

o Stretch & breathing/mindful movement

o Unpleasant experiences diary

o 3-minute breathing space

o Walking

o ‘Noticing’

SESSION 4: Staying Present

Rationale

· The mind is the most scattered when trying to cling onto some things and avoid others. Thus, staying present is another way of relating to experience

· Mindfulness offers a way to stay present by providing another place from which to view things

· To help take a wider perspective and relate differently to experience (including thoughts/feelings)

· Recognizing the territory of depression and rumination

Structure

· Hearing/seeing meditation

· Home practice review

· Defining the territory of depression

· Breathing space

· Mindful walking

· Explanation of homework and handouts

· Closing

Homework

o Sitting meditation

o Walking meditation

o 3-minute breathing space (regular)

o 3-minute breathing space (additional)

o ‘Noticing’

SESSION 5: Acceptance, Holding, Allowing, Letting Be

Rationale

· Relating differently, bringing to experience a sense of allowing something to be as it is without judging it or trying to make it different, accepting our experience, even if we don’t like it or would rather it was not there

· Such an attitude of acceptance is a major part of taking care of oneself and seeing clearly what, if anything, needs to change

Structure

· Sitting meditation: sitting with the difficult

· Home practice review

· The territory of despair

· Expanded breathing space

· ‘Vicious flower’ exercise

· Expanded breathing space

· Explanation of homework and handouts

· Closing

Homework

o Sitting meditation: sitting with the difficult

o Expanded breathing space

o ‘Noticing’

SESSION 6: Thoughts Are Not Facts

Rationale

· Negative moods and thoughts that accompany us color our ability to relate to experience

· It is liberating to realize that our thoughts are merely thoughts – we can choose whether to engage with them or not

· Thoughts are just thoughts – even the ones that say they are not

· Recognizing that the same patterns of thought recur again and again can help us to stand back from our thoughts, without necessarily having to question them and seek alternatives

Structure

· Sitting Meditation

· Home practice review

· Breathing space

· Identifying relapse signatures

· Breathing space

· Alternative perspectives (the office photocopier)

· Options for working with thoughts

· Explanation of homework and handouts

· Closing

Homework

o Selection of practices

o Regular breathing space

o Additional breathing space

o ‘Noticing’

SESSION 7: How Can I Best Take Care of Myself?

Rationale

· Specific things can be done when depression threatens to occur

· Find a breathing space first, and then decide what action (if any) to take

· Each person has his or her own unique relapse signature

· Participants in the classes can help each other to plan how best to respond to the signs

Structure

· Sitting meditation

· Home practice review

· Activity and mood (nourishing vs. depleting activities)

· Breathing space

· Identifying relapse signatures

· Breathing space

· Explanation of homework and handouts

· Closing

Homework

o Ongoing practice: choosing patterns that you can make a part of your life

o Breathing space and action step: "what do I need to do right now to take care of myself?"

o Experimenting with changing patterns of nourishing and depleting activities

o Relapse signatures: Concrete action plan

SESSION 8: Using What You Have Learned to Deal with Future Moods 

Rationale

· Maintaining balance in life exacerbated by regular mindfulness practice, preparing for the future, the end of the beginning, not the beginning of the end

· Good intentions can be strengthened by linking the practice with positive reasons for taking care of oneself

Structure

· Body scan

· Homework review

· Reflections on the course

· Preparing for the future

· Explanation of handouts

· Concluding meditation