Perceived changes in the self following an MBCT protocol: a qualitative study to inform further theory development

Purpose: Mindfulness-based cognitive therapy (MBCT) is a flagship intervention addressing depressive disorders that are distressing for the self and socially impairing. While psychological processes such as self-regulation, meta-awareness and self-transcendence account for its efficacy, these are often examined in isolation, and the social aspects of the self remain under-researched. Moreover, theoretical paradoxes in mindfulness – simultaneous strengthening and deconstruction of the self – call for more holistic and qualitative approaches. The purpose of this paper is to explore how MBCTs are experienced by individuals to inform selfrelated and social mechanisms. Design/methodology/approach This study explored these dynamics through ten post-interventional semi-structured interviews focusing on changes in psychological, physical and social dimensions of the self. Two independent coders used thematic analysis methods to blindly assess the verbatim transcriptions and extract themes. Thematic analysis revealed four main themes: 1) evolution of awareness, 2) evolution of the sense of self, 3) evolution of the connection to others, and 4) negative aspects, with the sense of self predominating. Participants reported that social connectedness evolved alongside differentiation, suggesting that MBCT strengthens intrapersonal self-regulation more readily than social identity processes, which are particularly impaired in depression.

Findings: A thematic content analysis revealed four main themes associated with changes involved in the MBCT: 1) evolution of awareness, 2) evolution of the sense of self, 3) evolution of the connection to others, and 4) negative aspects. Theme 2 was significantly predominant. A focus on theme 3 reflected participants’ common discourses of differentiation that coexisted with social connectedness, and a lesser importance of this theme compared to the first two. Research limitations/implications The findings contribute to theory development by showing that, despite mindfulness being associated with empathy and prosocial behaviors in the literature, the social dimension of the self remained subtle and ambivalent – torn between processes of differentiation and social identification – highlighting a theoretical blind spot and the need to explicitly address social identity in mindfulness-based interventions. These insights illuminate the complex interplay between individual and social dimensions of the self in MBCT and suggest avenues for enhancing both therapeutic and social outcomes. Practical implications The findings suggest that MBCT protocols could benefit from explicitly integrating social dimensions of the self which are often overlooked. Clinically this means adding modules or exercises that target social belonging and connection to others enhancing social support for depressed patients. Recognizing the limitations of MBCT for certain personality profiles calls for more personalized interventions. Addressing individual and social needs more effectively could improve treatment adherence and optimize overall therapeutic outcomes. Social implications This research highlights the crucial but underexplored role of the social self in mental health within mindfulness practices. It reveals a paradox of increased self-awareness coupled with limited social connection among depressed patients. Beyond clinical settings, these findings encourage rethinking group interventions to foster belonging and social identity recognition. Promoting the “social cure” through mindfulness could reduce social isolation, strengthen support networks and ultimately help prevent depressive relapse, producing significant societal benefits. Originality/value This study offers an original qualitative exploration of the social self-experience in MBCT an area rarely investigated. It challenges classical models by showing that an enhanced sense of self does not necessarily coincide with improved social connectedness. The holistic change-focused approach reveals a fundamental theoretical paradox and suggests integrating social identity processes more explicitly in interventions. This perspective advances the psychosocial understanding of mindfulness mechanisms and proposes innovative directions to enhance therapeutic protocols.