Mindfulness and Excoriation disorder

Cognitive behavioral therapy (CBT) is a form of psychotherapy that works to solve current problems and change unhelpful thinking and behaviour. The core belief is that the way we think affects our emotions and behaviour, and our behaviors and resulting feedback from the environement either reinforces or refutes our thinking. CBT helps people with conditions such as anxiety and depression change the content of unhelpful thoughts and maladaptive ways of coping, such as avoidance or addictive behaviour. However, there many different methodologies within the CBT frame of reference. Each method is effective in on its own and in conjunction with other methods, depending on the individual client and condition. One such method that has been receiving much interest recently is the concept of mindfulness-based CBT.

What is Mindfulness?

Mindfulness-Based Cognitive Therapy (MBCT) combines the ideas of cognitive therapy with meditative practices and attitudes. Central to mindfulness is that the individual becomes deliberately aware of the thoughts that characterize his/her emotions while simultaneously learning to develop a new relationship to these thoughts. Mindfulness involves paying attention to each event experienced in the present moment within our body and mind, with a non-judgmental, non-reactive and accepting attitude. In learning to be mindful, we can begin to counter many of our everyday sufferings such as stress, anxiety and depression because we are learning to experience events in a more impersonal and detached way.

Thoughts on thinking...

Minfulness-based CBT is based on the premise that it is not the negative thoughts and feelings we experience which is the enemy, but rather way we perceive and react to these thoughts. From a skin picking disorder perspective, the urge to pick often stems from the need to 'deal with' some negative thought or feeling such as anxiety, stress, anger etc. According to minfulness , the urge to pick is only a response to a greater need to control and surpress negative emotions. By becoming more aware of what we are thinking and feeling and recognizing the way we process these thoughts and emotions, we are better able to responin a more rational and accceptable manner. Mindfulness differs from traditional CBT methods in that focussed on changing the process of thinking, not just the content. It teaches the participants to focus less on reacting to incoming stimuli, and instead accepting and observing them without judgment.This mindfulness practice allows the participant to notice when automatic processes are occurring and to alter their reaction to be more of a reflection.

How is it used with excoriation disorder?

Mindfulness is used in conjunction with various other CBT methods in our 8 week online therapy program. The first part of the program guides the client to becoming more aware of the contexts and environments in which they tend to pick. Once the client has a clear understanding of their typical triggers and have developed a keen awareness of when they are experiencing the urge to pick, they are introduced to mindfulness. Here is becomes important for the client to link the negative thoughts and emotions that typically occur before the urge to pick. To do so the client is encouraged to be present and aware of their thoughts an emotions, but to observe these in a non-judgemental way. Mindfulness is less effective used in isolation of other cognitive skills such as Acceptance and Commitment Therapy. Once the client is able to identify unhealthy thought patterns, the next stage is to develop an acceptance of these experiences as part and parcel of a human experience and to then choose an acceptable way to respond to these rather trying to resist or control it. Besides its use in reducing depressive acuity, research additionally supports the effectiveness of mindfulness meditation upon reducing cravings in addiction.