Mindfulness-Based Cognitive Therapy

Mindfulness-Based Cognitive Therapy, or MBCT, is an 8-week structured group for people who have previously dealt with one or more depressive episodes, or who deal with certain kinds of anxiety. MBCT was developed as a way to reduce the risk of having future depressive episodes, and the research evidence suggests that it does this very well – particularly for people who have had multiple depressive episodes before.

Major depressive disorder tends to be highly recurrent; over half the people who have a depressive episode will go on to have a second one, and over time depression can become a chronic condition. What makes us vulnerable to these recurrences? What mark does depression leave on us? There’s no one simple answer, but one major factor seems to be rumination – the tendency to get stuck in unhelpful patterns of thinking. Even when we recover from a depressive episode, it’s not like we magically forget the negative ways that we used to think and see the world – and when these old patterns of thinking show up when we’re stuck on the treadmill of rumination, it’s easy to slide into a worse emotional state.

The skill of mindful awareness gives us a tool for noticing when this is happening. The earlier we can catch our mind in the act of unhelpful rumination, the more choices and better choices we have about doing something different. MBCT offers one way of getting better at this skill, and teaching us more helpful alternatives that can help reduce the risk of becoming depressed again. The research base is excellent – MBCT seems to help reduce the risk of future depressive episodes by about a third.

Transference-Focused Psychotherapy (TFP)

I’m currently in the 2nd year of training in the Transference-Focused Psychotherapy (TFP) program through Columbia University’s Center for Psychoanalytic Training and Research. TFP is an intensive psychotherapy designed to treat personality disorders; it usually involves meeting twice weekly for around 2 years. It’s focused on helping you understand your habitual ways of seeing yourself, others, and the world so that you can be less rigid and more flexible.

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