Spotlight with Brian Borre: Metacognitive Therapy

Before we get into theory, or how this approach might apply to you, let’s take a detour into language. When used as a prefix in the English language, “meta-”, stemming from the Greek for “after” or “beyond”, means something that goes beyond, to be all-encompassing, or become transcendent. When “Meta” and “Cognitive” are put together, the result essentially means “thinking about thinking.” For example, have you ever had an experience where you’re certain you know the name of something--a person, product, or place--but you can’t recall it? This “tip of the tongue” experience is just one example of how metacognitions work to inform our everyday lives--we’re thinking about how we’re thinking. While most of our meta-processes aren’t so conscious, our metacognitions are in the background actively controlling and influencing our conscious experience of the world, 

Metacognitive Therapy (MCT) focuses on targeting and modifying our deeply held beliefs--the thinking about our thinking--that fosters states of perpetual worry, rumination, and/or fixation. For example, if you say to yourself, “worrying about this keeps me safe,” or “I have no control over my thoughts,” you are both observing your own thinkingand having thoughts about thinking. The goal of MCT is simple: identify, challenge, and reduce what they dub, “Cognitive-Attentional Syndrome” (CAS). CAS is an umbrella term that refers to the kinds of beliefs that imply: we need worry, are incapable of stopping worry, and would be better off if we hyperfocus on tackling each individual worry.  

You might be thinking to yourself, “Birch Counseling, this is starting to sound a lot like CBT,” (Cognitive Behavioral Therapy). The truth is, you aren’t exactly wrong. In CBT, we are dealing with our thoughts. For example, if we were to use CBT to challenge our social anxiety, we might ask ourselves, “how likely will this outcome be, and will it be as bad as we’re thinking it will be?” Essentially, we identify an irrational thought and we challenge it with a more realistic lens. 

In comparison, with MCT, we are dealing with how we think about our thinking. We don’t give a lot of attention to the individual thoughts. Instead, we challenge the thinking around the thoughts themselves by asking ourselves, “should I spend my time worrying if the worry doesn’t make it less likely to happen? And if I already worried about it and made a decision, why am I re-worrying about this when I don’t have any new information?” This process, which encourages us to refuse to engage with unhelpful thinking, is called “Detached Mindfulness.” It works because it isn’t avoidance--it challenges people to view their worry and irrational beliefs as something that is outside of their core, observe the thoughts, stay non-reactive to them, and choose to respond without the preoccupation with worry about worried thinking. 

Why does Brian like it? Besides being a philosophical guy interested in all things “meta” (emotions, beliefs, and communication), Brian saw that CBT wasn’t always helpful with anxious, depressed, or addiction-driven thinking. From his perspective, it can be equally harmful to hyper-focus on our worry if we feel utterly incapable of controlling or changing it. He thinks about it like “giving in to a screaming toddler you know is just seeking attention because they want something from you, and you don’t know how to handle the upset anymore. Ultimately, it doesn’t help you, or them, to keep caving in or feeling totally helpless to stop it.” Instead, you can learn how to provide the tantruming child in your brain--the anxiety, depression, or addiction monster’s voice--the reassurance that you know what’s best, have a plan, can essentially “pivot” yourself out of the situation, or rebound if you make a mistake. It deflates the tantrum in your brain. And that’s a powerful tool. 

If you think Brian might be a fit for you, or have any additional questions about metacognitive therapy, please feel free to reach out to our team at BizOffice@birchcounseling.com

References:

  1. https://mct-institute.co.uk/therapy/

  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6246690/#:~:text=Conclusions%3A%20Our%20findings%20indicate%20that,psychotherapies%2C%20including%20cognitive%20behavioral%20interventions.

  3. https://mental-health-matters.com/what-is-metacognitive-therapy-and-how-can-it-help-anxiety/

  4. https://www.frontiersin.org/articles/10.3389/fpsyg.2017.00031/full