Metacognitive Theory of psychological disorders is based on the principle that most psychological disorder is caused by a pattern of extended thinking. This pattern is called the Cognitive Attentional Syndrome (CAS). It is made up of chains of verbal thought in the form of worry and rumination, a pattern of focusing attention on threat and coping strategies that have paradoxical effects. Rather than terminating negative thinking they extend it.These processes are linked to erroneous beliefs about thinking and unhelpful self-regulation strategies. It usually deals with repetitive thinking patterns that often lead to prolonged psychological distress.
MCT uses attention training techniques to develop skills in cognitive flexibility, teaches a special form of mindfulness (detached mindfulness) and guides cognitive and behavioural experiments to change meta-cognition. The underlying concept of MCT is that meta-cognitions must change in order for psychological treatment to be effective.Metacognitive Therapy focuses on removing the CAS in response to negative thoughts and experiences by raising awareness of this process and improving the selective control of it. In doing so, it also challenges the underlying metacognitive beliefs. By the end of treatment clients are more flexible in their response to negative ideas and less reliant on fixed patterns of thinking & mental control as a means of coping with emotional experiences.
How does it compare to CBT?
Metacognitive therapy (MCT) is another layer up from cognitive behavioural therapy. In CBT, we are dealing we thinking. In MCT, we are dealing we thinking about thinking.
In CBT the therapist is concerned with the content of automatic thoughts and invites the patient to test this content. In MCT, disorder is viewed as a function not of cognitive content but of processes such as perseverative thinking, attentional focus and internal control strategies that are counterproductive.
The 3 processes of MCT:
- Worry/rumination
- Threat monitoring
- Coping behaviours that backfire
All three are controlled by patients’ metacognitive beliefs, including the belief that such processes will help address their problems (although the processes ultimately have the unintentional consequence of prolonging distress.
How Does Meta Cognitive Therapy Work at Convocares?
Much like CBT, MCT comes with homework. There are various exercises that help us challenge our invalid beliefs. Each one is designed to challenge a specific belief, either positive or negative.
An example is Attention Training Technique. This is an exercise designed to challenge the belief that “I have no control over my thoughts”.
In this exercise by Therapist at Convocares, the client is given a series of sounds to focus his attention on. He then switches his attention between the different sounds as instructed. The idea is that he demonstrates to himself that he can control his attention, and that he therefore, has control over his thoughts.
In this aspect, MCT is similar to mindfulness. Many mindfulness-based exercises make one focus his attention in different stimulus or different areas of the body. And, in both cases, the exercise is not designed to suppress anxious or negative thoughts. Rather, the focus is on the fact that one should allow the thoughts to enter his mind but refuse to engage with them.