“I think I get it now. Yeah, I got it. Oh no, I didn’t get it all.”
When the founder of MCT, Professor Adrian Wells, published his renowned MCT book, many started reading it hoping to apply its principles to recover from mental illness. But although the book outlines a thorough step-by-step guide on how to apply MCT, many people apply the principles in counterproductive ways.
On the surface, MCT is a straightforward approach that appeals to many. But at its core, it carries an important message that can be misunderstood and misapplied. This is one of the main reasons why MCT can’t be self-administered without the guidance of an experienced professional.
So, can you learn to do MCT on your own? Let’s weigh the arguments.
It’s really important to remember that MCT is a kind of psychotherapy made to help with serious mental problems like anxiety, depression, and OCD. For it to work best, you need to have proper therapy sessions, just like you would with CBT.
| You can lean MCT on your own, if: | You can’t learn MCT on your own, if: |
| You overthink only a little | You suffer from a mental illness |
| You have already learned MCT in therapy | You understand MCT but you can’t implement it |
| You want to use it to get rid of thoughts | |
| You want to mix MCT with other therapies |
Reasons for doing MCT on your own
You overthink only a little
Some people who deal with mild overthinking can learn to apply MCT on their own and catch on really quickly. This client I had, for example, spent her afternoons worrying and wanted to stop. She had read a book on MCT before therapy and was already doing what she had learned.
For her, it took only a few small adjustments and she managed to reduce worrying in just a few sessions.
If you are the kind of person who understands things easily and can put them into action, you might want to try practicing on your own, especially if you struggle with mild overthinking. You can for example start with worry postponement.
Just remember that understanding the main point of MCT is important: MCT is not about getting rid of discomfort but learning to play by the rules of the brain.
For most of us, it takes a bit more practice and guidance to get there, and that is absolutely okay. But that is where expert guidance comes in. Sometimes, a few sessions with proper MCT guidance are all we need, and other times, we may need the suggested MCT treatment plan, which typically involves 8-10 sessions (1).
Did you know that the exercises developed in MCT have another and more important purpose than just reducing overthinking? They are also created to change metacognitive beliefs, which, according to MCT theory, are the reason why we get mentally ill in the first place.
You have learned the important basics in therapy
If you have already been in therapy and you can use strategies like detached mindfulness effectively, trying it out by yourself is a good idea. Many MCT therapists encourage this too.
When my clients understand and can implement important MCT elements, I suggest they practice on their own before we plan the next session. This gives them more experience and a feeling of being really good at MCT, which is important to prevent relapse in the future.
Learning Metacognitive Therapy is like learning any complex skill. To learn it quickly, you should practice what you have learned with an expert overseeing you, helping fix any early mistakes
Is there evidence for doing MCT on your own?
A research study conducted in the UK examined the impact of self-help MCT on patients with cardiovascular conditions dealing with anxiety and depression. The findings indicated that self-help MCT, supported by telephone guidance from professionals, proved beneficial for this group of patients (2).
However, the study was not purely self-help because the patients had telephone support.
This initial evidence suggests that MCT could be effective as a self-help treatment when coupled with professional support. However, as of now, there are no studies available that exclusively test self-help MCT without any external assistance.
Hopefully, more research projects will be initiated in the future, measuring the effects of self-help MCT against MCT interventions in a therapy setting.
Reasons for not doing MCT on your own
You suffer from a mental illness
If you are suffering from a mental illness such as anxiety, depression, or OCD, undergoing therapy is essential for your recovery.
While MCT identifies excessive overthinking as a root cause behind these mental disorders, therapy is designed to specifically address all the important mechanisms that sustain this overthinking. For example, research highlights how metacognitive beliefs play a more significant role in perpetuating overthinking than the actual content of thoughts (3).
MCT has created and tested disorder-specific manuals with the objective of challenging and transforming these metacognitive beliefs. If these beliefs are not changed, it can lead to relapse in the future.
You understand MCT but you can’t implement it
Have you ever known just how to do something, but found it hard to actually do it? Like knowing how to make a great presentation but struggling to present confidently in front of your bosses?
MCT is similar. Understanding what causes anxiety is one thing, but making the right moves based on that understanding is another.
As a therapist, I’m aware of this gap and always work to simplify the process for my clients, helping them turn knowledge into action. Once they make this connection, progress comes quickly.
If you understand MCT well but find it challenging to put into practice, attempting it alone might not give you the full benefit
You use it to get rid of thoughts and feelings
When I first started using MCT, I tried to push away my thoughts. In my years of practicing CBT and ACT, I had learned that I should change and transform negative thoughts. So, I misunderstood how MCT works and thought it would make negative thoughts disappear.
But it didn’t work. My negative thoughts were stubborn, and I felt overwhelmed trying to fight them. However, this experience taught me a valuable lesson and helps me understand my clients better when they face the same struggle.
It is natural to want to be free from distressing thoughts. Unfortunately, aiming for this often hinders real progress with MCT, because the goal of MCT is to change your relationship with thoughts and not change the thoughts themselves.
If you are struggling with making MCT work, you may have the wrong goal
You want to mix MCT with techniques from other therapies
“Is there anything else I could do? I want to practice more techniques“
I am always impressed by the readers on this site. Many of them have gone through various courses, self-help books, and different therapies before discovering MCT. It is therefore tempting to combine MCT with what you already know.
However, in my experience, trying to combine MCT with other methods does not work well and can actually hinder MCT’s effectiveness.
The reason is that most other approaches focus on eliminating negative thoughts and emotions, which is fundamentally different from MCT’s goal of cultivating a relaxed relationship with thoughts and feelings.
Trying to mix MCT strategies, like detached mindfulness, on top of practices such as mindfulness meditation or breathing exercises, unfortunately, does not integrate smoothly. It can leave you feeling hopeless, thinking that nothing will help you recover from mental illness.
Summary
- If you tend to overthink mildly and don’t have a serious mental illness, you can manage MCT on your own.
- For those struggling with mental illnesses like anxiety, depression, or OCD, a complete MCT treatment is necessary for effective recovery and long-term prevention of relapse.
- Some individuals need extra time to practice MCT independently after a few therapy sessions, and that is completely fine, provided you have grasped the elements accurately.
- If you’re using MCT to eliminate thoughts and emotions, it is advisable to seek therapy to truly understand MCT’s core goal
- MCT should not be combined with other therapies, as this can diminish its effectiveness.
Learning MCT with an experienced therapist is highly important to avoid wasting time and effort, ensuring you make real progress with your mental health
References
- Wells, Metacognitive therapy for anxiety and depression, Guilford press, 2009
- Wells A, Reeves D, Heal C, Fisher P, Doherty P, Davies L, Heagerty A, Capobianco L. Metacognitive therapy self-help for anxiety-depression: Single-blind randomized feasibility trial in cardiovascular disease. Health Psychol. 2022 May;41(5):366-377. doi: 10.1037/hea0001168. PMID: 35467904; PMCID: PMC9037049.
- Wells A (2019) Breaking the Cybernetic Code: Understanding and Treating the Human Metacognitive Control System to Enhance Mental Health. Front. Psychol. 10:2621. doi: 10.3389/fpsyg.2019.02621