Background
Methods
Ethical approval and informed consent
Study participants
Intervention
Objective | Course contents |
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Becoming familiar with some characteristics of the mind | introducing “the autopilot” as a symbol for a state of mindlessness |
introducing “the spectacles of OCD” as a symbol for selective information processing and cognitive distortion
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Exploring new ways of refocusing attention and challenging dysfunctional meta-cognitive beliefs | the “body scan”, a 45-minute mindfulness exercise teaching participants to attentively and non-judgmentally become aware of their body and body sensations |
yoga exercises | |
dealing with arising thoughts and feelings during sitting meditation exercises | |
the three-minute-breathing-space, a short exercise in which patients are invited to focus their attention on their breathing and present momentary experiences, shifting from a “doing-mode” to a “being-mode” of mind | |
discussing the cognitive model by Salkovskis, emphasizing the impact of the subjective appraisal of thoughts
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diary of positive and negative events | |
discussing neurobiological correlates of OCD to encourage disidentification with obsessive thoughts and impulses
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Freeing oneself from dysfunctional habits and being kind with oneself |
identifying individual OCD triggers
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encouraging participants to perform the three-minute-breathing-space whenever they notice obsessive thoughts and impulses
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sharing poems, short stories and metaphors in order to invite participants to experience thoughts as passing events of the mind rather than reflections of reality | |
Relapse prevention | establishing individual schemes for dealing with difficult situations |
setting objectives for goal-oriented behavior | |
integrating pleasant activities into everyday lives |
Data collection and analysis
Results
Qualitative reports
Theme | N = | summary |
---|---|---|
Being in a group | ||
Other participants
| 10 | Prior to the course, six participants had been doubtful regarding the group format. Over the course of the program, however, a sincere and trusting atmosphere developed and participants experienced the exchange with others as helpful. Connecting with the other participants affected by OCD served as an important self-validating experience. |
MBCT trainers
| 11 | Trainers were rated as authentic, committed and professional. Participants could especially benefit from the trainers’ own personal experiences with mindfulness that were repeatedly reported during the sessions. |
Mindfulness Exercises | ||
Evaluation… | 8 | Three participants found the three-minute-breathing-space especially helpful. Patients liked that mindfulness exercises were not performed with a defined goal in mind, and that it was said that wandering of the mind is a natural process. One participant distinguished outer and inner mindfulness, and found exercises referring to outer mindfulness especially helpful. |
…practical implementation
| 10 | The three-minute-breathing space was perceived as particularly feasible, whereas it was difficult to implement the longer exercises into everyday life. The bodyscan and the yoga exercises were often conducted before going to bed, in order to come to rest. Waiting periods were experienced as convenient for practicing mindfulness. Several participants have slightly modified the exercises to fit their own needs. |
Effects | ||
benefits
| 11 | Nine participants described new strategies they had learned to deal with their OCD, most of them resulting in an increased ability to refrain from compulsive rituals. Reported benefits furthermore included an increased willingness to experience unpleasant emotions and insights into the nature of the mind, living more actively in the present moment, a calmer attitude, improved mood and improved sleep. |
undesired outcomes
| 6 | Four participants stated that regarding their OCD, the course had not been helpful. One patient repeatedly experienced a highly unpleasant state performing the body scan. Another participant suffered from the experience that compared to the other patients in the program, he was far more severely affected with OCD. |
Struggle | 11 | Three participants described that OCD symptoms repeatedly conflicted with their mindfulness practice, making it difficult to get themselves into the exercises. Whereas most participants found it rather easy to do a three-minute-breathing-space at a previously defined time, a common difficulty was to remember the exercise early enough in difficult situations related to OCD. Further difficulties included dealing with one’s expectations regarding mindfulness as a fast “cure”, as opposed to being a fairly long-term, fundamental approach. |
Modifications | 9 | Participants’ ideas to modify MBCT mainly concerned the length of the program: Several attendees suggested to either extend the length of the individual session beyond 120 minutes, or to add further sessions. One participant proposed to schedule longer meditation exercises towards the middle of the sessions, as he found it difficult to engage in meditation directly after arrival. |