Metacognitive Therapy

A growing number of studies indicate that Metacognitive Therapy (MCT) is more efficient than traditional Cognitive Behavioral Therapy (CBT).

Around 70-80% of clients with depression and anxiety fully recover following MCT, typically within merely 5-12 sessions.

MCT is a new third-wave therapy which comprises a paradigm shift in psychology.

MCT hypothesises that psychological suffering (e.g. depression and anxiety) is a result of spending hours everyday using CAS-strategies.

CAS

CAS (Cognitive Attentional Syndrome) is hyper-focus on negative thoughts, feelings, bodily sensations, and potential threats.

Typical CAS-strategies comprise worrying, ruminating, suppressing/controlling thoughts/feelings/bodily sensations, distraction, avoidance, rational and positive thinking, using alcohol, drugs, eating, screen time, breathing exercises etc. to soothe oneself.

The aim of the CAS-strategies is to try to remove uncomfortable thoughts, feelings, bodily sensations.

30 minutes daily or less on CAS is not problematic, but if one uses several hours everyday on CAS-strategies it leads to hyper-focusing on and exacerbating negative thoughts, feelings and symptoms.

This is why MCT often introduce 15 minutes of daily, scheduled worry time, where clients can use CAS-strategies, as a depression and anxiety rarely is capable of surviving if using less than 15 minutes on it daily.

FIGURATIVE LANGUAGE

MCT make use of lots of figurative language to illustrate this, for instance to view a negative thought as a wound or mosquito bite which merely gets worse from hyper-focusing and scratching on it.

Likewise, to illustrate the counter-productivity of one of the most common CAS-strategies, suppression, clients are asked to not think about a pink elephant, which either is impossible or extremely hard work.

This illuminates how exhausting and counter-productive it is using CAS-strategies for several hours daily.

METACOGNITIVE BELIEFS

CAS-strategies are sustained by three dysfunctional metacognitive beliefs: uncontrollability, dangerousness and usefulness.

In other words, if one for instance believes "I do not control whether I worry or not", "negative feelings are harmful to my body", and "ruminating is helpful" etc. – then it makes sense one uses hours daily on CAS.

Therefore, MCT aim at restructuring the dysfunctional metacognitive beliefs and minimizing CAS.

DETACHED MINDFULNESS (DM)

To replace CAS clients learn detached mindfulness (DM) which is simply observering one's inner weather continually renew – like sushi in running sushi.

MCT hypothesises that the mind, just like the body, is continually self-regulating, self-healing and renewing.

We cannot control our inner weather and trying to do so merely results in a never-ending hyper-attention on and hopeless fights with all the dark clouds.

DM offers a light and gentle exit out of the never-ending, negative roundabout doing the opposite of CAS (i.e. trying to get rid of negative thoughts, feelings and bodily sensations) – letting it be and shift.

Clients realize through experience that they do control whether one uses CAS-strategies or DM, that negative thoughts, feelings, and bodily sensations are not dangerous, and that CAS is counterproductive.

MCT gives clients tools to let their inner weather be and shift.