Table 2 System of five overarching themes that emerged from qualitative content analysis

Being in a group

Other participants

10

Prior to the course, six participants had been doubtful regarding the group format. Over the course of the program, however, a sincere and trusting atmosphere developed and participants experienced the exchange with others as helpful. Connecting with the other participants affected by OCD served as an important self-validating experience.

MBCT trainers

11

Trainers were rated as authentic, committed and professional. Participants could especially benefit from the trainers’ own personal experiences with mindfulness that were repeatedly reported during the sessions.

Mindfulness Exercises

Evaluation…

8

Three participants found the three-minute-breathing-space especially helpful. Patients liked that mindfulness exercises were not performed with a defined goal in mind, and that it was said that wandering of the mind is a natural process. One participant distinguished outer and inner mindfulness, and found exercises referring to outer mindfulness especially helpful.

…practical implementation

10

The three-minute-breathing space was perceived as particularly feasible, whereas it was difficult to implement the longer exercises into everyday life. The bodyscan and the yoga exercises were often conducted before going to bed, in order to come to rest. Waiting periods were experienced as convenient for practicing mindfulness. Several participants have slightly modified the exercises to fit their own needs.

Effects

benefits

11

Nine participants described new strategies they had learned to deal with their OCD, most of them resulting in an increased ability to refrain from compulsive rituals. Reported benefits furthermore included an increased willingness to experience unpleasant emotions and insights into the nature of the mind, living more actively in the present moment, a calmer attitude, improved mood and improved sleep.

undesired outcomes

6

Four participants stated that regarding their OCD, the course had not been helpful. One patient repeatedly experienced a highly unpleasant state performing the body scan. Another participant suffered from the experience that compared to the other patients in the program, he was far more severely affected with OCD.

Struggle

11

Three participants described that OCD symptoms repeatedly conflicted with their mindfulness practice, making it difficult to get themselves into the exercises. Whereas most participants found it rather easy to do a three-minute-breathing-space at a previously defined time, a common difficulty was to remember the exercise early enough in difficult situations related to OCD. Further difficulties included dealing with one’s expectations regarding mindfulness as a fast “cure”, as opposed to being a fairly long-term, fundamental approach.

Modifications

9

Participants’ ideas to modify MBCT mainly concerned the length of the program: Several attendees suggested to either extend the length of the individual session beyond 120 minutes, or to add further sessions. One participant proposed to schedule longer meditation exercises towards the middle of the sessions, as he found it difficult to engage in meditation directly after arrival.