MiCBT Masterclass 6: Using MiCBT with Dissociative and Avoidant States


  • Dr Bruno Cayoun
  • 2 CPD
  • 2-hour video
  • Pre-requisite: completion of MiCBT Foundation Course


Dissociative and avoidant states are integral human survival strategies. However, these states are also found to be maladaptive responses to a perception of threat in chronic pain conditions and emotional disorders. Dissociation can range from common daily experiences of being on automatic pilot and absentminded, to clinical symptoms of derealisation and depersonalisation. Pathological avoidance may be seen as an analogue behaviour state, whereby the avoidance of contact with a stimulus prevents discomfort. Because MiCBT involves various forms of exposure techniques in each of the four stages, it is helpful for therapists to understand the deepest nature and mechanisms of dissociation and avoidance, and how to address the unpleasant effects of meditation—the so-called “adverse effects of meditation”. Therapists may also find their clients’ avoidance of practice difficult to address. This can range from a simple difficulty to adhere to treatment protocol to a regular absence at appointments and eventual dropping out of the programme.

This masterclass will provide a useful explanation of dissociation and avoidant states and assist you in adapting the MiCBT skills to minimise and overcome their effects. It will also provide ways of normalising avoidant habits with clients to prevent guilt and keep them engaged.

You will learn:

  • How to understand and case conceptualise dissociation and avoidance with the co-emergence model of reinforcement
  • A rationale for using MiCBT with dissociation and avoidance
  • How dissociation and avoidance act as mutual reinforcers in memory
  • How to better understand and address the so-called “adverse effects” of mindfulness meditation
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