Using metacognitive therapy to break the habit of rumination (with Pia Callesen)
Aug 30, 2023
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Pia Callesen, a prominent Danish metacognitive psychologist with a PhD from Manchester, dives deep into the world of metacognitive therapy. She shares how it differs from other therapies like CBT and DBT, emphasizing the management of negative thought patterns. The discussion reveals insights on controlling responses to intrusive thoughts and the dual nature of worry. Pia highlights the dangers of rumination, its links to feelings of worthlessness, and introduces practical strategies like 'worry time' to foster healthier thinking.
Metacognitive therapy focuses on individuals' reaction to negative thoughts, teaching them to leave those thoughts alone and not engage in rumination or worry.
Metacognitive therapy emphasizes the role of uncontrollability and usefulness beliefs in mental health challenges, challenging them to reduce rumination and alleviate symptoms of anxiety and depression.
Metacognitive therapy differs from cognitive-behavioral therapy (CBT) by emphasizing leaving negative thoughts alone instead of changing them, potentially leading to better outcomes for mental health disorders.
Deep dives
Metacognitive therapy: a new paradigm in psychology
Metacognitive therapy is a new paradigm in psychology that challenges the traditional belief that thoughts are the cause of depression and anxiety. Instead, it focuses on the metacognitive beliefs about thoughts, specifically how individuals react to negative thoughts. The therapy teaches individuals to leave negative thoughts alone and not engage in rumination or worry. By reducing the time spent dwelling on negative thoughts, metacognitive therapy aims to alleviate symptoms of mental health disorders such as anxiety and depression.
The role of beliefs in mental health challenges
Metacognitive therapy emphasizes the role of beliefs in mental health challenges. It distinguishes between two sets of beliefs: the uncontrollability belief and the usefulness belief. The uncontrollability belief refers to the belief that individuals can leave negative thoughts alone and not engage with them. The usefulness belief refers to the belief that excessive rumination or worrying is beneficial in solving problems. By challenging these beliefs and teaching individuals to leave negative thoughts alone, metacognitive therapy aims to reduce the time spent ruminating and alleviate mental health issues.
Contrasting metacognitive therapy with cognitive behavioral therapy
Metacognitive therapy differs from cognitive-behavioral therapy (CBT) in its approach to thoughts and beliefs. While CBT emphasizes the importance of thoughts and focuses on restructuring them, metacognitive therapy maintains that thoughts themselves are not the problem, but rather the reaction to them. Metacognitive therapy encourages leaving negative thoughts alone, while CBT focuses on changing negative thoughts. Research suggests that metacognitive therapy may lead to better outcomes for mental health disorders compared to CBT, demonstrating the effectiveness of this new therapeutic approach.
Self-experimentation: Applying metacognitive therapy in daily life
Individuals interested in exploring metacognitive therapy can engage in self-experiments to test its principles. One approach is to set a specific time during the day as a designated 'rumination time' or 'worry time' and consciously leave negative thoughts alone during other periods of the day. This allows for increased awareness of the uncontrollability and usefulness beliefs associated with rumination. Additionally, individuals can practice being together with negative thoughts and feelings without engaging further, allowing the self-regulatory nature of thoughts and feelings to unfold.
The future of metacognitive therapy and its potential impact
Metacognitive therapy shows promise in the treatment of various mental health disorders, including depression, generalized anxiety disorder, OCD, and PTSD. While more large-scale trials are needed to establish its effectiveness and compare it to other therapies, initial findings suggest that metacognitive therapy can lead to significant improvements. The therapy's focus on challenging beliefs and reducing rumination offers a novel approach to addressing mental health challenges and has the potential to have a profound impact on the field of psychology.
What is metacognitive therapy? How does MCT differ from CBT, DBT, and other mental health therapy paradigms? How do we know we're spending time worrying about the right things? How much time spent worrying is actually useful? How aware are we of our own tendencies to ruminate on certain negative thoughts? Does MCT avoid all content-based problem-solving? What is the state of the evidence for MCT?
Dr. Pia Callesen is one of Denmark's most educated and experienced metacognitive psychologists. She has more than 25 years of experience as a therapist and has completed the official 2-year metacognitive certification training in Manchester at the MCT Institute and the subsequent 1-year advanced level masterclass in Oxford by Professor Adrian Wells. At the end of 2016, she completed her PhD at Manchester University with Professor Adrian Wells. The PhD contained a large randomised controlled trial with research into the effects of metacognitive therapy treatment for depression.
