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Applying Buddhist principles to mode deactivation theory and practice.

The concept of mindfulness as a core technique in meditation has been part of the Buddhist philosophy and practices since the early traditions of the Satipatthana Sutta--The Discourse of the Establishment of Mindfulness--almost 2,500 years ago. From those times the concept of mindfulness was understood to yield a pure cognition that is free from the discrimination that proceeds from deluded world and self views, aspects that were concluded to lead us to suffering and unsatisfactoriness as the prevailing human condition. By objectively looking at all things as they are now, including ourselves, our thoughts and feelings, and everything around us, the mind is predisposed and opened up to impressions of truth without dependence or judgment.

The traditional Four Foundations of Mindfulness--mindfulness of the body, of feelings, of consciousness, and of mental phenomena (emotions)--are the bases for maintaining moment-by-moment mindfulness. Recently, several modern psychotherapy approaches--in particular third wave therapies--have recognized that many of the concepts of traditional Buddhism apply to the development of cognitive schemas and the dysfunction that it can cause in daily life and functioning. The concept of mindfulness especially was embraced as behavior analysis, experiential psychotherapies, and contextual philosophies came together to refine current thoughts in cognitive behavioral approaches. Although there is no conscious attempt to base mindfulness-based therapies on Buddhism per se, the parallels in philosophy and principles were harnessed in therapy to achieve the same basic goal, namely reduce suffering and distress.

The so-called functional contextual therapies were derived from Cognitive Behavioral Therapy (CBT) in the early 1990s and 2000s and the concept of mindfulness was soon incorporated as it related to the cognitive dissonance and avoidance that typically underlie core beliefs and their problematic expression in post-childhood contexts. Therefore, the philosophy of mindfulness in Buddhism as "the first step toward emerging from such suffering is to accept the reality of it, not as a philosophical concept or an article of faith, but as a fact of existence" (Hart, 1987, p. 38) was enthusiastically adopted in contextual therapies such as Dialectic Behavior Therapy (DBT), Acceptance and Commitment Therapy (ACT), and Mode Deactivation Therapy (MDT) to defuse the attachment to negative beliefs, thoughts, and feelings that are often responsible for internal distress and behavior problems.

* Mode and schema theory

According to schema theory, all knowledge is organized into units, or schemata, in which information is stored. The theory of cognitive development was first introduced by Swiss developmental psychologist, Jean Piaget, in the 1950s. Through childhood, a combination of genetic makeup, biological maturation, and environmental experiences shape cognitive processes through a progressive reorganization of beliefs and views of the world around us. As such, the schema was defined as the basic building block of intelligent behavior, a "cohesive, repeatable action sequence possessing component actions that are tightly interconnected and governed by a core meaning", and follows that "every schema is thus coordinated with all the other schemata and itself constitutes a totality with differentiated parts. Every act of intelligence presupposes a system of mutual implications and interconnected meanings" (Piaget, 1952, p. 7). Therefore, schemata enables people to recognize and categorize an event whereby the most appropriate decision is made how to act in anticipation or react in response. Here, schemata is continuously reorganized, which gives an individual the ability to interact safely and beneficially with their environment.

By the time that Piaget's formal operation stage of cognitive development is reached around age 11, cognitive modes and schemata are already fairly enduring and stable as represented by personality traits. As such, the perspective is often held that most personality development occurs in childhood, and that personality is stable by the end of adolescence. Adolescents and adults are therefore inclined to recognize and acknowledge experiences that fit in with their cognitive modes while reinterpreting contradictions as exceptions or distorting them to fit their preconceived mental structures and beliefs. These processes can be largely automatic and driven by preconceived ideas and prejudices that are not a true reflection of reality. However, through repetitions of distressful experiences, people--especially children--adjust their beliefs as a coping and protective mechanism. As such, modes and schemata represent broad and pervasive themes or patterns that are made up of memories, feelings, sensations, and thoughts regarding oneself and one's relationships with others, which is ultimately expressed as behavior. It is when modes and schemata become overly protective if the environment is wrongly or exaggeratedly perceived as threatening, that behavior may become inappropriate and dysfunctional in the context that it is expressed.

As such, maladaptive schema modes are inherently associated with a failure to fulfill a child's development needs of safety, predictability, love, affection, attention, acceptance and praise, empathy, guidance and protection, and validation of feelings and needs. Examples include schemata of abandonment/instability, mistrust/abuse, emotional deprivation, and defectiveness/shame (Young, Klosko, & Weishaar, 2003). Under "normal" or satisfactory conditions, people assimilate (translate) incoming information into a meaning that they recognize and understand, but are able to accommodate and adapt their current knowledge and thought structures to reflect new information. Hereby a stable understanding is formulated that is appropriate and in harmony with their environment, and behavior is suitable and functional to the context. However, as maturity progresses, people find assimilation easier than accommodation. As such, events are interpreted in ways to maintain the integrity of schemas rather than resolving conflicts by changing or reformulating invalid schemas. According to Lebow (2008), in quoting Beck (1996), "this means that if a negative or dysfunctional schema begins to develop early in life, the child continues to interpret his or her experiences in a distorted way that may help to strengthen the schema" (p. 47). When a child reaches the operational stages of development, they engage increasingly with the outside world and early maladaptive and dysfunctional schemas that may have been valid and adaptive in previous distressful situations, are no longer helpful or appropriate. As such, these dysfunctional schemas generate high levels of anxiety, fear, general irrational thoughts and feelings, as well as aberrant behaviors. Hereby a fear and experiential avoidance response is triggered when aspects of distressful events are perceived or encountered. This system is self-reinforcing and protected by the development of a conglomerate of multiple clustered compound core beliefs--often interpreted as burgeoning personality disorders, which tend to supersede and inhibit more adaptive and functional interpretation systems.

In summary, schemata are enduring patterns of beliefs that determine our view of ourselves, the world, and relationships with others. Schemas may be valid in the context of past experiences as unconscious experiential and cognitive structural processing components, but tend to outlive their usefulness and appropriateness as a person matures and situations change. Modes as clusters of schemas are the moment-to-moment emotional states and coping responses that act as the interface between cognitive schemata and behavior through thoughts and feelings. Dysfunctional behavior is mostly associated with the activation of maladaptive schema modes that cause fears, and other unpleasant thoughts and feelings that are expressed in harmful behavior when emotion regulation fails.

* The applied technology of mode deactivation therapy

As we have seen, mode and schema theory attaches value to past experiences as the origin of the core beliefs and worldviews that determine behavior. Experiences, beliefs, thoughts and feelings, and behavior form a perpetual cycle that associates actual and anticipated events with previous experiences and reinforces behavioral patterns into durable traits. Nevertheless, with almost no exception, cognitive behavioral therapies are not concerned with the origins of the belief system, but focus instead on the present expression of those beliefs in the context of current triggers with an objective to change behavior through modification of cognitive content and processes whereby thinking is realigned with reality (Longmore & Worrell, 2007).

The mode deactivation concept was developed by recognizing that without tackling the underlying structures (maladaptive schema) that consistently organize the patient's experience, through its core belief system, the patient is likely to lapse back into unhelpful modes of relating to others and attempting to meet their needs. Especially with deeply troubled youth--the population that the MDT development centered on at first--the nature and origins of their dysfunctional core beliefs that are expressed through schema modes, have to be understood in order to develop positive alternatives and realign negative beliefs. In comparative studies, it was found that MDT consistently outperformed CBT-based treatment-as-usual protocols in outcome effect durability by a large margin at six months to two years follow-up (Apsche, Bass, Zeiter, & Houston, 2009; Apsche, 2006; Apsche, Bass, & Siv, 2006a; Apsche, Bass, & Siv, 2006b; Murphy & Siv, 2011). These results support the conviction that it is beneficial to understand and validate the origins of dysfunctional beliefs to produce a lasting positive change. The principles of MDT that are aimed at disabling problematic schemas while developing and reinforcing positive alternatives are as follows.

Psychoanalysis. Besides the inherited makeup of personality, a person's development is determined by events in early childhood. Attitude, experience, and thought is largely influenced by unconscious irrational drives. Problem areas are identified through a psychoanalytic-oriented evaluation process.

Mindfulness. It involves to be fully present and aware in the moment without judgment. Mindfulness encompasses the practice of a variety of Buddhist inspired techniques to be aware of self and one's environment in the present moment.

Acceptance. It means to accept self as who, what and where you are in life, including accepting pain, fear and suffering; to accept that the human condition is flawed, and that we all experience pain and suffering as part of it.

Cognitive defusion. Defusion is defined as a reversal of the fusion between instincts that accompanies maturity. The process of cognitive defusion allows the thoughts that imprisoned the adolescent to occur without resistance; to not experience experiential avoidance from painful thoughts.

Emotional defusion. It is to identify the exact area in the body of the pain and a complete description of the pain, numbness or "nothingness". The adolescent describes where exactly he feels emotional feelings that are attached to painful thoughts.

Balancing the functional alternative beliefs. The FABS are developed and balanced by the process of Validate, Clarify, and Redirect (VCR). Most likely the FAB will also be a functional alternative to either a life interfering or treatment interfering belief.

As such, the MDT methodology is structured to provide an understanding of the dysfunctional core beliefs and an awareness of its presence and impact without judgment, which forms the starting point of the process of realignment to positive and appropriate alternatives.

* Buddhist concepts and practices

The central concept of Buddhism is human suffering that is related to clinging to objects that don't last or have a dynamic state, such as feelings and the concept of the self. At this time, it has to be noted that the scope of this discussion is confined to "secular" Buddhism. Batchelor (2012) ascribed three overlapping conditions to the secular concept. The first stands in contrast to what is typically referred to as "religious", which is usually described as a system of belief in and worship of a superhuman controlling power. The second sense considers secular in its Latin etymological roots--saeculum--which has everything to do with this world and our personal, social, and environmental experience of it. Thirdly, in the Western, historical-political sense, secular refers to a separation of the power of the Church and State. Therefore, the current discussion only deals with a form of "non-religious, this-worldly, secularized Buddhism" (p. 87), which, according to Batchelor, may not encompass the full intention and meaning of traditional Buddhism, but "the only thing that matters is whether such a configuration of [seemingly] disparate elements is of any help in getting you across the [proverbial] water." (p. 106). I argue accordingly that the essence and meaning of Buddhism, especially as embodied in selected elements and concepts (e.g., mindfulness), is congruent with modern psychological theory and beneficial to therapeutic systems upon which it was conceptualized.

Modern science and Buddhist ideas about the human mind

Modern science in evolutionary psychology and psychodynamic and cognitive behavioral theories support the Buddhist principles and practices that pertain to the workings of the human mind. The basic premise of Buddhism teachings is that suffering is an integral part of the human condition. The basis of suffering--or dukkha--is attributed to persistent experiences of unsatisfactoriness that is borne from our intrinsic need to cling to and crave objects and states. Dukkha is commonly explained according to three different categories:

* The obvious physical and mental suffering associated with all human conditions between birth and death.

* The anxiety or stress of trying to hold onto things that are constantly changing.

* A basic unsatisfactoriness that pervades all forms of existence, because all forms of life are changing, impermanent and without any inner core or substance.

However, we are perpetually disappointed when impermanence and our lack of control become apparent, but it leaves us with an undercurrent of yearning that is pervasive in all our decisions and behavior. In clinging to things that do not last, we are evincing a kind of delusion. These concepts are defined by the first two of the Four Noble Truths, namely that ordinary life brings about suffering (dukkha), and that the origin of suffering is attachment (samudaya). The third and fourth noble truths address the remedy, namely that the cessation of suffering is attainable (nirodha), and that there is an eightfold path to the cessation of suffering (magga).

Our behavior is directly induced by our feelings that influence perceptions and thoughts. The Buddha has reportedly said: "All that we are is the result of what we have thought. The mind is everything. What we think, we become." Although this is often considered a free or liberal translation of the concept illustrated in the sutta called the Dvedhavitakka, or "Two Modes of Thinking", this sentiment is central to the broad Buddhist theory. As such, according to Buddhist thought, feelings are not reliable guides to reality and are therefore not trustworthy. Therefore, it does not reflect a clear view of ourselves or the world, which collectively distorts our relationship with and understanding of the truth. This framework of the mind is similar to the underpinning of Evolutionary Psychology's explanation of how the natural selection process "designed" our minds and how modern day cognitive behavioral therapies attempt to realign our beliefs and thoughts with less distorted alternatives. Feelings mediate our interaction with reality and motivate behavior in direct and indirect ways. In fact, they are judgments that can be true or false, about things that we perceive may impact us.

Here, the scientific evolutionary psychology concept of the modular mind offers a theory why our motivation and behavior often seems disconnected. According to Robert Kurzban (2010), we have a unitary sense of self that acts like a broadcast media to benefit ourselves only. As a result, we are "designed" to convince the world and ourselves that we have coherent motivations, although it may not feel "true" and supported by objective evidence, when in fact, there does not seem to be one decision-maker in our self. Kenrick and Griskevicius (2013) labeled the seven modular domains that drives our primary--and mostly unconscious--motivation as self-protection, mate attraction, mate retention, affiliation, kin care, status, and disease avoidance. Although these drives may have ensured our survival and gene transmission in primeval times, it suffices to say that different priorities exist today to which our mind's "design" has not adapted yet.

Therefore, this asynchronous cognitive process not only yields a distorted perception of the existence of a unitary self, but also distressful thoughts and feelings, and dysfunctional behavior. In this sense, the Buddhist conceptualization of the mind and modern psychological understanding of cognitive behavioral processes are almost perfectly aligned.

Modern science and the logic behind Buddhist meditation practices

It is time to look at the Buddhist practices of meditation and mindfulness in the context of modern psychology and cognitive behavioral therapy. Generally speaking, Buddhist meditation practices represent the culmination or practical aspect of the Fourth Noble Truth, as the prescription of the way that lead to the cessation of suffering. Similarly, in broad terms therapeutic practices aim to alleviate or resolve distress caused by unpleasant feelings and maladaptive behavior. According to Buddhist teachings, the natural process of the five aggregates leads to an eventual condition of suffering that is linked to a distorted view of the world and ourselves. The sutras describe five aggregates (skhandas), namely:

1. Form or matter (rupa): The physical world and material body.

2. Sensation or feeling (vedana): Sensing an object as pleasant, unpleasant, or neutral.

3. Perception or cognition (samnja): Registers whether an object is recognized or not.

4. Mental formations, impulses, or volition (samskara): All types of mental habits, thoughts, ideas, opinions, prejudices, compulsions, and decisions that are triggered by an object.

5. Consciousness or discernment (vijnana): Rapidly changing, interconnected, and discrete acts of cognizance that discern and support all experience.

According to Buddhist literature, the aggregates arise in a linear or progressive fashion, from form to feeling to perception to mental formations to consciousness. Although it is within the realm of the five aggregates that we attempt to define our self, our most basic premise of the self as a permanent and controlling agent does not hold up under scientific scrutiny. In mindfulness meditation, as a Buddhist or therapeutic practice, a kind of non-elaborative, nonjudgmental, present-centered awareness in which each thought, feeling, or sensation that arises in the attentional field, is acknowledged and accepted as it is (Bishop, Lau, Shapiro et al., 2004). Although Buddhism does not distinguish between emotions and other mental processes, three cognitive states are considered to be fundamental to a basic vulnerability to suffering and pain that is attributed to a misinterpretation of reality, namely craving, hatred, and a deluded impression of the self as a reified object. The misconception seems to start when concepts of permanence, singularity, and autonomy are imposed on an inaccurate psychological construct of reality, when in fact the self is profoundly interconnected with all other objects (Ekman, Davidson, Ricard, & Wallace, 2005). By grasping onto the self, a craving for other objects that are associated with advancement of the self is promulgated, all the while anything that is deemed to be threatening the self-promotion is rejected, hated, or feared. Hereby two inherent characteristics are denied, namely the dynamic and contextual nature of all things--including people and situations--and the nature of emotions themselves. Emotions are merely the result of our core beliefs that have developed from childhood based on our perception of our interaction with the world and how it affects our needs. As such, our equilibrium is disturbed and we are unable to recognize and respond appropriately to the true nature of reality. The nature of emotions are invasive and obtrusive and can easily influence the "battle" between reason and feelings. It is a state of arousal that is unconsciously activated by significance or value that we attach to something and initiate a tendency to act in a certain way. When these affective reactions are unpleasant and based on greed, hatred, or delusion, they form an obstruction to the achievement of insight and balance. Even when the conditions change, the personality structure and temperament of a person is slow to change, thereby creating adjustive problems and impaired mental health (De Silva, 1976). It is especially fear and anxiety that interfere with our ability to recognize the nature of reality as an impermanent and interconnected condition. Therefore, a process of self-understanding, diligent self-analysis, insight, and development of a new set of values are required to view emotions as they are and lose their overwhelming grip on the self. "This is not a process of repression by which you push them into a lower level of consciousness, but a process by which understanding, insight, and mindfulness lead one to control and restraint." (p. 12), and a new, balanced sense of reality. This is the essential dimension of Buddhism that is increasingly embraced by Western psychological practices, and theoretical research is following to establish an evidence base in support of the Buddhist principles. Already, psychological research have presented plenty of evidence that mindfulness meditation, even simple and brief exercises, is a very effective supplement to cognitive behavioral psychotherapy methods, which indeed provide more clarity and reduce suffering.

* Applying Buddhism to mode deactivation theory and practice

Mode Deactivation Therapy (MDT) is one such a psychotherapy approach--a third wave therapy derived from cognitive behavioral principles--that embraced the Buddhist essence. As such, feelings are viewed as functional emotional states that are linked to coping responses to environmental triggers which are impermanent and not a true reflection of external reality or the self. Dr. Jon Kabat-Zinn, one of the founders of mindfulness science, provided the landmark definition of mindfulness as "paying attention in a particular way, on purpose, in the present moment, and nonjudgmentally" (1994, p. 4). According to Brown and Ryan (2004), mindfulness incorporates two core components, namely (1) attention and awareness, and (2) acceptance. As a way to see things as they really are, as a "bare display of what is taking place" (p. 243) without judgment, mindfulness is providing an unattached view and experience of emotions. Hereby, they are not any more seen as defining us, as a permanent and unchanging millstone that condemns us as slaves to our emotions.

The golden thread of acceptance, non-judgment, and un-attachment is taken through the theory and practice of MDT, it is the crux at all stages. Because MDT was developed as an adolescent therapy, mindfulness practices and ingrained Buddhist concepts were adapted to fit the abilities and disposition of the adolescent audience. According to the developer Jack Apsche, there are "multiple paths to mindfulness", and exercises and terminology were simplified to be easy to follow and learn. Nevertheless, their underlying Buddhist principles are very evident in all stages of the methodology and required skill set of therapists. Brief mindfulness exercises are conducted throughout the MDT program and these include focused breathing, visual concentration, mindful walking, guided imagery, and other non-threatening methods (Jennings, in press). As previously mentioned, cognitive and emotional defusion are two essential processes in MDT that aim to de-link the adolescent from his thoughts and feelings by accepting his belief system as reasonable given his past experiences, but rebuilding a new functional set of values. Similar to Buddhist practices, the perception that the adolescent has of his emotions as a permanent and defining part of himself, is discarded in MDT. He is encouraged to observe and experience thoughts and feelings without attachment and evaluation. Rather than avoiding unpleasant emotions, they are accepted for their true nature--as subjective experiences that are triggered by events that remind us of a similar significance in the past. Although they are interlocked with our beliefs that involve dispositions to act by engagement or avoidance, they are habits based on perception-based appraisals of past events. In other words, we are programmed to act in a way that we believe best suit our needs; and our perception and interpretations are often fraught with inaccuracies and untruths.

Therefore, we see that the theory and practice of MDT incorporate Buddhist principles effectively to alleviate the distress of patients by accepting and defusing their experiences from our imperfect construct of reality. In the process, the perception of the permanence and defining character of emotions is unravelled. Ultimately, the control and expression of emotions are influenced by softening the boundaries between the self and others as the positive motivational side of emotions are better harnessed to encourage equanimity, kindness, and compassion.

* Mindfulness exercise

We have seen that the core ingredients of the MDT methodology are mindfulness and acceptance, which enable emotional and cognitive defusion through the Validation, Clarification, and Redirection (vcr) process. Mindfulness exercises are conducted to encourage and practice an unfiltered and nonjudgmental acceptance of thoughts and feelings. The following transcript is an example of such an exercise, which was adapted from Eifert and Forsyth (2000, pp. 140-143):

First, I would like to ask your permission to do an experiential exercise. Are you willing to do that? [Get the client's permission and continue.]

Go ahead and get in a comfortable position in your chair.

Sit upright with your feet flat on the floor, your arms and legs uncrossed, and your hands resting in your lap, palms up or down--whichever is more comfortable.

Allow your eyes to close gently.

Take a few moments to get in touch with the movement of your breath and your sensations in the body.

Bring your awareness to the physical sensations in your body, especially to the sensations of touch or pressure where your body makes contact with the chair or floor.

Now, slowly bring your attention to the gentle rising and falling of your breath in your chest and belly.

Like ocean waves coming in, and out, your breath is always there.

Notice it's rhythm in your body.

Notice each breath.

Focus on each inhale.

And exhale.

Notice the changing patterns of sensations in your belly, as you breathe in, and as you breathe out.

Take a few moments to feel the physical sensations as you breathe in, and breathe out.

There is no need to try to control your breathing in any way; simply let the breath breathe itself.

As best you can, also bring this attitude of generous allowing and gentle acceptance to the rest of your experience.

There is nothing to be fixed; no particular state to be achieved.

As best you can, simply allow your experience to be your experience without needing it to be other than what it is.

Sooner, or later, your mind will wander away from the breath to other concerns, worries, images, bodily sensations, planning, or daydreams.

Or it may just drift along ...

This is what minds do much of the time.

When you notice that your mind has wandered, gently congratulate yourself.

You have come back and are once more aware of your experience.

You may want to acknowledge briefly where your mind has been.

Ah ... there's thinking ... or, there's feeling.

Then gently escort your attention back to the sensation of the breath, coming in, and going out.

As best you ca, bring a quality of kindness and compassion to your awareness, perhaps seeing the repeated wanderings of your mind as opportunities to bring patience and gentle curiosity to your experience.

When you become aware of bodily sensations and feelings, tension other than tense sensations in a particular part of your body, just notice them, acknowledge their presence, and see if you can make space for them.

Do not try to hold onto them or make them go away.

See if you can open your heart and make some room for the discomfort, for the tension, for the anxiety; just allowing them to be there.

Is there enough space in you to welcome all of your experience?

Watch the sensations change from moment to moment.

Sometimes they grow stronger.

Sometimes they stay the same.

And sometimes they grow weaker.

It does not matter.

Breathe calmly in to, and out from the sensations of discomfort; imagining the breath moving in to, and out from that region of the body.

Remember: Your intention is not to make you feel better, but to get better at feeling.

If you've ever notice that you're unable to focus on your breathing, because of intense physical sensations of discomfort in your body, let go of your focus on your breath and shift your focus to the place of discomfort.

Gently direct your attention on and in to the discomfort, and stay with it, no matter how bad it seems.

Take a look at it--what does it really feel like?

Again, see if you can make room for the discomfort and allow it to be there.

Are you willing to be with whatever you have?

Along with physical sensations in your body, you may also notice thoughts about the sensations, and thoughts about the thoughts.

You may notice your mind coming up with evaluative labels, such as dangerous, or getting worse.

If that happens, you can thank your mind for the label.

And return to the present experience as it is, not as your mind says it is; noticing thoughts as thoughts, physical sensations as physical sensations, and feelings as feelings--nothing more, nothing less.

To help you experience the difference between yourself, and your thoughts and feelings, you can name thoughts and feelings as you notice them

For instance: If you notice that you're worried, silently say to yourself "worry, there is worry"; just observing worry and not judging yourself for having these thoughts and feelings.

If you find yourself judging, just notice that, and call it "judging, there is judging"; and observe that with the quality of kindness and compassion.

You can do the same with other thoughts and feelings, and just name them as planning, reminiscing, longing, or whatever you experience.

Label the thought and emotion, and move on.

Thoughts and feelings come and go in your mind and body.

You are not what those thoughts and feelings say, no matter how persistent or intense they may be.

As this time for formal practice comes to an end, gradually widen your attention to take in the sounds around you, notice your surroundings, and slowly open your eyes with the intention to bring this awareness to the present moment, and into the upcoming moments of the day.

Notice how the exercise systematically progresses from physical sensations and breathing to thoughts and feelings; how unforced the observations are; and how the client is encouraged to observe all emotions--pleasant and unpleasant--without restraint, to let them ebb and flow naturally. This creates an awareness without attachment, without the need to avoid unwanted thoughts and feelings, and without the need to identify with them. Therefore, it is a very natural and unconstrained way to experience the impermanence of each thought and feeling without becoming overwhelmed by it.

* Discussion and implications

In the course of this article, several important conclusions were supported by the principles and practice of Buddhism, psychotherapy, and Mode Deactivation Therapy (MDT) in particular. Buddhism aims to alleviate suffering and teach enlightening through mindfulness, un-attachment of thoughts and emotions from the concept of the self, and a sense that all things are impermanent and therefore not deserving of craving or hatred. MDT embodies the same goals and principles by way of mindfulness, acceptance, and cognitive and emotional defusion. Therefore, a growing evidence base proves that Buddhism and psychological science is compatible and that continued efforts are worthwhile to model Buddhist concepts in psychological theory and research, which could enable a richer understanding and synthesis of effective change agents.

* References

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Apsche, J. A., Bass, C. K., & Siv, A. M. (2006a). A treatment study of Mode Deactivation Therapy in an outpatient community setting. International Journal of Behavioral Consultation and Therapy, 2(2), 277-285.

Apsche, J. A., Bass, C. K., & Siv, A. M. (2006b). Summary of Mode Deactivation Therapy, Cognitive Behavior Therapy and social Skills Training with two year post treatment results. International Journal of Behavioral Consultation and Therapy, 2(1), 29-44.

Apsche, J. A., Bass, C. K., Zeiter, J. S., & Houston, M. A. (2009). Family Mode Deactivation Therapy in a residential setting: Treating adolescents with Conduct Disorder and multi-axial diagnosis. International Journal of Behavioral Consultation and Therapy 4(4), 328-339.

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Young, J. E, Klosko, J. S., & Weishaar, M. E. (2003). Schema therapy: A practitioner's guide. New York, NY: The Guilford Press.

* Annotated key references

Apsche, J. A., & DiMeo, L. R. (2012). Mode Deactivation Therapy for aggression and oppositional behavior in adolescents: An integrative methodology using ACT, DBT, and CBT. Oakland, CA: New Harbinger. This book is the inaugural and definitive book on the theory, practice, and evidence base of Mode Deactivation Therapy (MDT). MDT is an integrative model of treatment for adolescents with behavioral problems that draws from acceptance and commitment therapy, dialectical behavior therapy, cognitive behavior therapy, mindfulness, and schema therapy. Research that support the effectiveness of the conceptual model is included.

Joan Swart

Walden University
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Author:Swart, Joan
Publication:The International Journal of Behavioral Consultation and Therapy
Article Type:Report
Date:Jun 22, 2014
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