불교 교학에서 본 MBCT(Mindfulness-Based Cognitive Therapy)의 치유 효과의 원리
A Buddhist view of healing mechanism in MBCT(Mindfulness-Based Cognitive Therapy)
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MBCT(Mindfulness-Based Cognitive Therapy, 알아차림에 근거한 인지치료)는 인지치료(Cognitive Therapy)와 존 카밧진(Jon Kabat- Zinn)의 MBSR(Mindfulness-Based Stress Reduction, 알아차림 명상에 근거한 스트레스 감소)을 결합한 것으로 우울증 재발을 방지 하기 위한 치유 프로그램이다. 불교적인 과점에서 MBCT의 치유원리를 살피고자 한다. MBCT의 치유기제로 논의되고 있는 상위인지 지각(meta-cognitive awareness)과 탈중심화(decentering)를 불교적인 관점에서 다룬다. 우울증 발생 및 재발의 주요원인은 부정적인 생각의 반추(rumi nation)에 기인한다. 반추는 부정적인 사건이나 자신의 모습을 반복적으로 생각하면서 자책하는 사고 작용이다. 우울증 환자는 반추가 습관화되어 스스로 벗어날 수 없는 상태에 빠지게 된다. 불교에서도 사고의 본성과 그 위험을 분명히 가르치고 있다. 고통을 야기하는 사고의 발생 과정 중 가장 핵심적인 부분은 망상(papañca)이다. 망상은 사고가 끊임없이 연속적으로 전개되는 인지과정을 의미한다. 상위인지 지각과 탈중심화는 자신의 생각과 감정을 수용적인 태도로 받아 들여서 마음에서 일어나는 현상을 왜곡하지 않고 있는 그대로 인식하는 것이다. 상위인지지각과 탈중심화는 불교 관점에서 볼 때 여실지견, 정념, 정견, 비파사나 수행과 유사하다. 모두 생각과 느낌을 객관적으로 있는 그대로 관찰하면 나(self)가 아니라는 통찰에 이르게 되고 이러한 통찰로 인해 생각과 느낌에서 자유롭게 될 수 있다는 공통점이 있다. 상위인지 지각과 탈중심화가 생각과 느낌에 대해서 나(self)가 아니라는 점이 강조되고 있는데 비해 무아의 통찰에 이르게 하는 여실지견 등은 유위법, 즉 오온이 무상, 고, 무아임을 가르치면서 육신도 무아임을 가르치고 있다는 점에서 불교 수행법이 더 광범위하고 철저하다는 것을 알 수 있다.
Abstract
Mindfulness-based cognitive therapy (MBCT) was developed with a specific focus on preventing relapse/recurrence of depres sion. MBCT is an 8-week group training class that combines Kabat Zinn’ Mindfulness-Based Stress Reduction(MBSR) progr am with techniques used in cognitive behavioral therapy. The c ore aim of MBCT is to increase psychological health by increas ing Buddhist mindfulness meditation. Rumination appears to contribute to a hopelessness about th e future and negative evaluations of the self, which many theor ists argue are key to depression Rumination, the tendency to s elf-reflect, focuses on bad feelings and experiences from the pa st. In Buddhism, conceptual proliferation (papañca) refers to con ceptualization of the world through the use of ever-expanding l anguage and concepts. Through the process of papañca, the age nt then becomes a victim of his/her own patterns of thinking. The root of the categories of papañca is the perception, "I am t he thinker." From this self-reflexive thought "I am thinker", th e division such as 'me/not-me', 'mine/not-mine' arises. Instead of keeping rumination, MBCT teaches patients to vie w these cognitions as events that pass through the mind, and t o non-judgmentally observe this process as it occurs. “Decenter ing,” refers to two basic concepts in MBCT: 1. “My thoughts a re not facts” and 2. “My thoughts are not the center of my bei ng.” Depression can be prevented through meta-cognitive awar eness. In meta-cognitive awareness, negative thoughts/feelings are experienced as mental events, rather than as the self or dir ect reflections of truth. In Buddhism, seeing and knowing thing s as they really are (yathabhutananadassana) is insight into the true nature of reality, that is, to see the five aggregates as i mpermanent, painful, non-self. Right view (sammā-diṭṭhi) is th e right way of looking at life, nature, and the world as they re ally are for us. Right mindfulness (sammā-sati) is to constantl y keep watching the body and mind. "Vipassanā" is insight into the impermanence and unsatisfactoriness and non-self. Seeing and knowing things as they really are, Right view (sammā-diṭṭ hi), Right mindfulness (sammā-sati), and insight meditation (Vi passanā) refer to direct experiential perception with no interfere nce of mental constructs such as interpretations or evaluations.
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