Mindfulness-based cognitive therapy (MBCT) for patients with medically unexplained symptoms: Process of change.

Author: van Ravesteijn HJ1, Suijkerbuijk YB2, Langbroek JA2, Muskens E2, Lucassen PL2, van Weel C2, Wester F3, Speckens AE4.
Affiliation: 1Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, the Netherlands; Department of Psychiatry, Radboud University Nijmegen Medical Centre, the Netherlands. Electronic address: hiske.vanravesteijn@radboudumc.nl. 2Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, the Netherlands. 3Department of Communication Sciences, Radboud University Nijmegen, the Netherlands. 4Department of Psychiatry, Radboud University Nijmegen Medical Centre, the Netherlands.
Conference/Journal: J Psychosom Res.
Date published: 2014 Jul
Other: Volume ID: 77 , Issue ID: 1 , Pages: 27-33 , Special Notes: doi: 10.1016/j.jpsychores.2014.04.010 , Word Count: 213



BACKGROUND:
A recent randomized controlled trial provided preliminary evidence for the effectiveness of mindfulness based cognitive therapy (MBCT) for the top 10% frequent attenders in primary care with persistent medically unexplained symptoms (MUS). This qualitative study aims to explore working mechanisms and possible barriers of MBCT in this population.
METHODS:
Twelve participants of the trial were interviewed about their experiences. This was done before and after the MBCT course, and 12months later. Written evaluations of participants and notes of participant observers were used for data-triangulation.
RESULTS:
In total, 35 qualitative interviews were conducted. MBCT initiated a process of change, starting with awareness of the present moment, the associated sensory experiences, thoughts and emotions and accepting rather than resisting these. Participants started to recognize their own behavioral patterns and change them, thus improving self-care. Self-compassion seemed to result from and facilitate this process. Main barriers were concurrent social problems and the inability or unwillingness to accept symptoms.
CONCLUSIONS:
MBCT can start a process of change in patients with persistent MUS. Awareness and acceptance of painful symptoms and emotions are key factors in this process. Change of unhelpful behavioral patterns and increased self-care and self-compassion can result from this process.
Copyright © 2014 Elsevier Inc. All rights reserved.
KEYWORDS:
Medically unexplained symptoms; Mindfulness; Qualitative study; Self-compassion; Somatoform disorders

PMID: 24913338