Methods in my practice
Metacognitive therapy
Metacognitive therapy (MCT) is a relatively new approach belonging to the third wave of cognitive behavioural therapy. It has proved particularly effective for generalised anxiety and for brooding, or rumination, in depression. In short: it helps you when the thinking goes on and on.
How you think, not what you think
Traditional cognitive therapy often concentrates on the content of the negative thoughts. Metacognitive therapy focuses on the thinking process itself. So we work with how you think, not what you think about. We zoom out and look at all the thoughts together: What do they do to you? What function do they have? Are they helpful or unhelpful for you?
It is particularly helpful for generalised anxiety and depression, where unhelpful thinking processes such as constant worry or rumination play the main role.
The worries about the worries
With metacognitive therapy you learn to recognise and change your metacognitive beliefs, that is, the thoughts you have about your own thoughts. If you have generalised anxiety, you may believe that constant worrying prevents something bad from happening. Worrying keeps you prepared, so to speak. Or you fear that the worries themselves are making you ill.
This is where we challenge and change those beliefs by putting them in perspective and looking at them from the outside. That reduces the tendency to ruminate and worry, which is the core of generalised anxiety and a large part of depression.
Tools for managing your thoughts
A thought is only a thought
It is not necessarily reality, and you do not have to act on it. You practise letting it be present without analysing it.
Productive or unproductive?
Can you act on the worry and solve it? Or is that impossible, because it is far from certain that it will ever happen? You can learn to set the latter aside.
Fast results
Once you are able to see your thoughts as just thoughts, you will often quickly notice that thoughts and worries have less power over your mood and wellbeing.
How I use it in my practice
Overall, metacognitive therapy is an effective method for generalised anxiety and for rumination in depression, because it targets the underlying thinking processes that drive these conditions and gives you tools to regulate your thoughts and feelings better. That is why I use the principles of metacognitive therapy in my treatment, especially when treating generalised anxiety, but also in other anxiety disorders where worry plays a large part, and in depression, where rumination goes round in circles.
The work is adapted to you. We follow up on whether the exercises reduce the time and energy the worries take, and adjust along the way. You can read more about racing thoughts, and how to stop them, on the anxiety page.