The fields of psychology and mindfulness have started to converge. However, it’s been a long road.
THE FIELD of psychology originally developed along two broad, but distinct, paths: one that speculated on the inner workings—or ramblings—of the mind, and one that looked primarily at external behaviours that could be measured. We can put Freud and Jung, both of whom talked about dreams and the subconscious, in the former category and Pavlov, who famously trained dogs to salivate at the sound of a bell, Watson and Skinner, who experimented with rats, in the latter.
While both approaches are valid, the one that focused on external behaviours—known, unsurprisingly, as behaviourism—lent itself more easily to scientific study. Changes in behaviour as a result of a particular intervention, for example, giving a food pellet to a rat, or a sweet to a child, can be objectively measured and peer-reviewed.
It’s much more difficult—if not impossible—to scientifically verify the progress of a person as they go through psychoanalysis. The outcomes are too nebulous and, in any case, any study would rely on the person reporting on their own progress. That’s like relying on an unsupervised worker to be honest about how they’ve spent their day: highly unreliable from a scientific point of view.
Psychology and mindfulness: from behaviour to thought
The problem with behaviourism, however, is that human beings do have a linguistic framework—and therefore a more complex inner life—than animals. The thoughts and feelings that make up this inner life do influence outcomes and so a way was needed to access that black box—a way that could be measured.
The field of cognitive therapy emerged as an answer to this problem. It was developed primarily by American psychiatrist Aaron Beck, who noticed what he termed “automatic thoughts” in his clients’ and in his own mind. These are the thoughts that arise constantly in your mind—the same thoughts you learned to observe in Section A—and which you can recognise and act upon.
For example, if somebody tells you that your anxiety—and consequent inability to go out at night—is being caused by your fear of sunsets, you can look and see that, in fact, it’s being caused by your fear of meeting new people. With the right guidance, you can then make the necessary adjustments and change the behaviour.
Freud versus Beck: can people know their own mind?
Freud, on the other hand, would have insisted that the anxiety was being driven entirely by an “unconscious” urge, like guilt over your secret desire to have sex, and that you as the client simply can’t see or have access to those urges. You would have needed to listen to your therapist and accept what you were told about your own “unconscious” urges. Anything you said otherwise would simply have been brushed off as denial or resistance.
Beck’s approach—and he was supported by others, like Albert Ellis, Arnold Lazarus and David Barlow—gave people some credit for being able to look into and know their own minds, at least to a degree, and to be able to work effectively with what they found there. You can liken this to being able to see to the horizon from wherever you are on earth right now—you can’t see the whole earth, but you can see a fair bit; enough to function and make good decisions, which is all you need.
This evolution of the psychological model meant that, instead of just applying external stimuli to see what happens to the external behaviour, scientists could now work more objectively at a subtler level, at the level of ideas (beliefs, thoughts, cognitions) within the mind. They could apply an idea to a belief and see what behavioural outcome happened as a result. And they could standardise the treatment and measure it across multiple clients in a way that stood up to scientific standards.
Evidence in the mix: cognitive behaviour therapy (CBT)
Cognitive behaviour therapy (CBT) is the branch of psychology that has evolved out of the work of Beck, and those who followed him. It’s referred to as an “evidence-based” approach and can be applied with great effectiveness to managing extreme clinical states of emotion which have become disorders—such as Generalised Anxiety Disorder, Major Depression and others.
In practice, this means that CBT can be used to diagnose and treat an emotional disorder like anxiety, social phobia, OCD, addiction and even depression, within a finite number of sessions. It makes a noticeable difference to actual, observable behaviours, and it can get a person back on their feet without having to go through an interminable process of endless self-reflection.
Until recently, the emphasis in CBT treatments was on cognitions (your thoughts and beliefs) and behaviours (habits, habitual responses). It was not until the last few years that the role and function of emotion in the development and maintenance of these disorders became emphasised.
This followed the introduction of the Unified Protocol (UP) by David Barlow, who is widely recognised as one of CBT’s modern flagbearers and thought leaders. The UP introduces the concept of emotion-driven behaviours (EDB’s) as key to understanding and managing all of the mood, anxiety and addiction disorders. Insight into the nature and function of emotion, the value in grounding yourself during periods of intense emotion, as well as how to regulate your emotions across a range of contexts, is now central to CBT treatment programmes.
Psychology and mindfulness come together
In addition, these same behaviourists have come to recognise the importance of mindfulness in supporting people to accelerate their treatment even further. Awareness of thoughts, or cognitions, is naturally key to being able to work with them. Being present in the moment and nonjudgemental enables you to focus your attention on what’s real, instead of what’s not, and thereby gather better evidence about your reality. Naturally that can make a big difference to conditions like depression, anxiety, phobias, OCD. For example, mindful awareness helps to reduce the ruminating that comes with depression and being nonjudgemental, or objective, helps to reduce the catastrophising that accompanies anxiety. These mindfulness key elements all contribute to—and accelerate—the CBT process, which similarly results in being nonreactive.
Colinda is a practising clinical psychologist who has specialised in CBT for the past 25 years. To hear it from her: “I’ve experienced first-hand the value of CBT in getting to grips with dysfunctional thought patterns and behaviours. Having added the UP to my repertoire over the past three years, I’ve been pleasantly surprised—and, at times, astonished—at what a difference it makes when emotion (and its regulation) is directly addressed. The effect is exponential when you add mindfulness.”