by Zindel Segal, Mark Williams and John Teasdale
Guilford Press, 2001
Review by Peter B. Raabe Ph.D. on May 9th 2002
This is an easy to read book written in ordinary English. While
it contains references to research in clinical psychology and
several graphs, the authors have been careful to speak in a conversational
tone which prevents the book from becoming just another dry academic
The book is meant to be used as a guide by psychotherapists and
counselors in learning how to carry out a new sort of practice.
The first five chapters explain what the authors mean by "mindfulness-based
cognitive therapy," the next eight chapters are step-by-step
instructions for a series of eight group counseling sessions,
and the final two chapters and the epilogue summarize what the
authors have tried to accomplish with this volume. It also contains
work sheets for "patients," information hand-outs, homework
assignment summary pages, and carefully detailed instructions
to counselors and therapists in how to use each of these in their
Unfortunately, this book is what I would consider a "light"
book. By this I mean that the theoretical foundation on which
this new method is based is very insubstantial, there are more
pages than is necessary to say what was said, there are many repetitive
passages, and there is nothing new in the material to stimulate
the reader's thinking or imagination. The so-called new method
the authors are promoting is simply a reworking of what some might
call a New Age type of awareness, very similar to practices within
Taoism, Buddhism, and yoga. The practice of "mindfulness"
seems to be a combination of group meditation, phenomenology,
breathing exercises, and an intentional focus on awareness. The
authors explain that their approach involves a type of meditation
which helps the patient be able to "recognize difficult situations
early and deal with them skillfully" by "replacing the
old mode of fixing and repairing problems with a new mode of allowing
things to just be as they are" (95). The patient learns how
to achieve an "acceptance of what is" (93) and how to
"simply be with difficult and uncomfortable emotions"
(italics in the original) (78). The book is filled with various
attempts to explain the vague "accepting," "allowing"
and "being with," but, of course, the authors never
quite succeed in defining these terms adequately. They ultimately
resort to telling their readers "you've got to try it to
understand what we mean," which puts them in the paradoxical
position of having tried to explain in this book that which they
themselves admit can't be explained.
The authors cite some "scientific" research they have
conducted to substantiate their claim that their method is effective
in helping previously depressed individuals avoid relapsing into
depression, but they leave me unconvinced that this is indeed
something new or more effective than other methods. In fact, the
authors are very careful not to claim too much for their method,
stating that it is not meant to help people overcome severe depression,
that it is not helpful in preventing depression in those who have
only had one or two experiences of depression in the past, and
that it will only help a portion of those individuals who have
experienced multiple depressive episodes in the past to avoid
future recurrences. This leaves them with a very soft claim regarding
the efficacy of their method.
Not only is this a "light weight" book, it also contains
a number of technical problems as well. For example, the authors
show a lack of understanding of the neurological function of anti-depressant
drugs, and they seem to be unaware of the many serious problems
inherent in clinical drug trials involving placebos. They also
reveal an ambiguity in their reasoning concerning what they believe
to be the reasons for, or the causes of, depression, recovery,
and relapse in that they accept environmental influences as the
initial cause of depression, but then ignore this same cause in
their discussion of later relapse into depression. Instead they
claim that relapse depression results from the brain simply getting
stuck in some sort of "downward spiral" of thinking.
These are very surprising weaknesses in a book written by professionals
whose long list of impressive academic and research positions
are cited on the back flap for all to see.
There is no doubt that this so-called mindfulness-based cognitive
group therapy will help some individuals. But the description
of the method devised by these authors will seem very familiar
to anyone with even the slightest interest in group meditational
practices, and hardly warrants heralding the arrival of a "new"
therapy (the sub title of this book is "A New Approach to
Preventing Relapse"). Despite the book's weaknesses, I congratulate
the authors on their honesty in offering their readers an interesting
insight into their own trials and errors in the research they
conducted in the development of their method. If nothing else,
the authors offer their readers a fascinating insight into the
failure of their initial research hypothesis and how they then
reoriented their project so that there would be no interruption
in their research funding.
© 2002 Peter B. Raabe
Peter B. Raabe teaches philosophy and has a private practice in philosophical counseling in North Vancouver, Canada. He is the author of the book Philosophical Counseling: Theory and Practice (Praeger, 2001).