Anxiety next to depression is the most common mental illness. Different forms of anxiety exist. Cognitive Behavioral Therapy and related therapies such as Acceptance and Commitment Therapy believe that a certain thing which people do called safety behaviors, maintain and underpin many anxiety disorders.
A socially anxious person may behave in a submissive / pleasing fashion or put on an act as they believe that social situations are threatening or someone frightened of heights may have a sip of whiskey before visiting a tower.
Many believe that doing these things is the only way they can engage with whatever scares them. Which accordingly maintains their anxious interpretations.

Therapists often address safety behaviors and thus can successfully treat many people. This is often done by allowing a stepwise decrease in safety behaviors whilst exposing clients to what frightens them long enough for their anxiety to at least go down (many also focus being present and not engaged in worries or ruminations).

Looking into the past and how safety behaviors developed can also put things into context and reveal interesting things. Socially anxious people for example were often bullied or experienced other kinds of trauma in the past (trauma memories). Interestingly a lot of research is currently being undertaken which is looking at how trauma memories memories can be passed down from generation to generation (think about how many people are scared of spiders without ever getting bitten).


Recent studies have shown that individuals suffering from schizophrenia and bipolar disorder have a lack of grey matter in their brain. Grey matter is a central component of the nervous system. A lack of it can cause numerous problems such as poor impule control, lack of concentration and so forth.

Studies have also revealed that mindfulness can increase the level of grey matter in the brain. This would therefore serve as a further clue as to why mindfulness is so effective in treating these serious disorders.

There are many aspects upon which mindfulness has a positive effect within the individual. It encourages oneself to be “in the moment” and accept any impulse with openness. Further to this, the focused state one achieves by i.e. focusing on the breath changes the relationship with distressing thoughts (seeing them as temporary states and not as inherent truths about the self or others). The last aspect I want to mention here is that mindfulness increases awareness which obviously helps in many ways.

These may be some of the reasons as to why mindfulness is so effective in combating relapse in depression. One can clearly appreciate how these aspects would help the individual that is suffering from depression deal with rumination and amongst other things, aid people with anxiety confront whatever they are anxious about more effectively.

This is not to say that one is trying to escape negative thoughts when practicing mindfulness. Being open and accepting towards all experiences just removes individuals from going on “auto pilot” and letting their unhelpful ways of behaving keeping them trapped.

Modern therapy has sometimes borrowed greatly from person centered (Rogerian) therapy. Most person centered therapies regard the basic tenets of unconditional positive regard, congruence (genuine reactions and behavior by the therapist) and empathy as very important. These tools are part of an arsenal that aim to aid the client in finding his / her true self whilst helping them to express their potential (self actualization).

Unconditional positive regard for example may aid the client in discovering that being liked by others was based on conditions (e.g. we love you if you bring home these grades) and how this way of thinking may effect them in the present. CBT’s concepts of core beliefs and rules for living refer to the most basic ideas people have of themselves and their environment (I am wonderful, I am unlovable or people can’t be trusted). Rules for living are guided by core beliefs and represent basic behavioral guidelines. Someone who for example has the core belief “I am unlovable” may start pleasing people in order to be liked. Therefore like Rogerian therapy, CBT understands that an upbringing that is heavily based on conditions can affect someones confidence.

Often in therapy the “wheel gets reinvented” like this and I will talk about further examples in the future.

Mindfulness is an ancient practice and represents an integral part within Buddhism. First evidence of it can be found in Vedantic texts. Its main idea is to concentrate on a phenomenon or sensation (i.e. the breath) whilst accepting and acknowledging any stimuli such as noise, thoughts and physical sensations with an open and non-judgemental attitude. One of its original purposes was therefore to foster deeper levels of insight, acceptance and focus. This is regarded as one of the prerequisites for reaching the Buddhist interpretation of enlightenment.

Mindfulness is also being recognized as an effective tool for combating numerous mental health problems such as anxiety, depression and substance misuse. Emerging psychotherapeutic approaches such as Acceptance and Commitment Therapy (ACT) and Mindfulness Based Cognitive Therapy (MBCT) lay a great emphasis on mindfulness. Governmental health care organizations such as the NHS often run treatment programs which implement mindfulness next to conventional treatment modalities (psychotherapeutic methods), such as Cognitive Behavioral Therapy (CBT) or Eye Movement and Desensitization Therapy (EMDR).

Since mindfulness opposes many aspects of (mainstream!) CBT, it is surprising that both are implemented simultaneously. In CBT for example, methods such as cognitive restructuring require the individual to recognize thoughts and adapt these should they cause distress due to a distorted perception of internal or external stimuli (i.e. their environment). The act of altering certain thoughts naturally entails that some are not accepted.

Mindfulness on the other hand emphasizes the acceptance and acknowledgement of negative thoughts. When negative thoughts are openly accepted, their occurrence can be non-judgmentally acknowledged. Practicing this gives individuals the freedom to engage in more adaptive behaviors instead of unhelpful ones such as avoidance (which can for example increase and maintains low self-esteem).

Both methods of dealing with mental illness have a solid evidence base and it will be interesting to see how they develop.