The metacognitive model of insomnia posits that the hyperarousal experienced during insomnia can be split into two areas. The first area is primary arousal, which includes the cognitive activities related to ones inability to fall asleep. The second area is secondary arousal, which refers to one’s relationship with their thoughts about sleep. 

Metacognitve Model of Insomnia

Metacognitive awareness is the acknowledgement that one's thoughts are only thoughts, and they may not be facts. When used as a definition of mindfulness, it is called mindful metacognition, and conceptualizes mindfulness as an information processing style.

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There are two types of awareness a patient can work to cultivate in therapy. They include:

- Metacognitive awareness
- Participatory awareness

Awareness in Therapeutic Mindfulness

Rumination happens when a person spends a significant amount of time thinking and worrying about a problem. The thought that is ruminated feeds itself continuously, so the person becomes stuck in a constant cycle of worry that eventually distorts their perception of the reality of the situation.

Rumination

Emotion regulation skills are developed through the promotion of metacognitive awareness as the individual disengages from cognitive actions, decreases rumination, and working memory capacity increases that allow for enhanced attentional deployment.

How Emotion Regulation is Developed Through Mindfulness Meditation

- Metacognitive Practice
- Mindful Metacognition
- Mindful Attention
- Trait/Dispositional Mindfulness
- Intentional Mindfulness
- Contemplative practices

Alternate Definitions of Mindfulness

Fabrizio, D. (ed.). (2009). Clinical handbook of mindfulness. Springer. 

Clinical Handbook of Mindfulness

Reina, C. S., & Kudesia, R. S. (2020). Wherever you go, there you become: How mindfulness arises in everyday situations. Organizational Behavior and Human Decision Processes, 159, 78–96. https://doi.org/10.1016/j.obhdp.2019.11.008 

Wherever you go, there you become: How mindfulness arises in everyday situations

Kudesia, R. S. (2019). Mindfulness as metacognitive practice. Academy of Management Review, 44(2), 405-423. https://www.researchgate.net/profile/Ravi-Kudesia/publication/320241109_Mindfulness_As_Metacognitive_Practice/links/5cbf1197299bf12097799927/Mindfulness-As-Metacognitive-Practice.pdf 

Mindfulness as metacognitive practice

Participatory awareness involves observing feelings and sensations as they happen. Patients who are more detached from their feelings may benefit from cultivating participatory awareness.

Participatory Awareness

Mindful Metacognition/Metacognitive Awareness

Rumination is an important mediator between MBCT and treatment resistant depression because its presence predicts maintenance of prolonged clinical depression. It is a cognitive  and distressing symptom that can be reduced through MBCT because MBCT teaches a detachment from thoughts, which helps prevent negative thoughts from escalating into rumination.

Mediators of the Relationship Between Mindfulness-Based Cognitive Therapy and Treatment Resistant Depression: Rumination

- increase in perceptual sensitivity and improved vigilance in a sustained visual attention task
- increased activation in the attention network (prefrontal cortex and anterior cingulate among other regions)
- less impulsiveness, tolerance to stressors, and heightened self-esteem
- increased response inhibition predicting adaptive socio-emotional functioning 
- reduced ruminative thinking and anxiety 
- increased empathy and self-compassion 
- reduced stress symptoms, helps in the process of positive reappraisal to deal with stress

Cognitive and Psychological Effects of Meditation Retreats

In the context of depression, rumination is defined as a repetitive and passive mental focus on one's depressive symptoms and the state of being depressed. This pattern of thought involves dwelling on the symptoms rather than actively engaging in problem-solving or distracting oneself from them.

Definition of Rumination in Depression

Working memory capacity is a psychological characteristic that refers to an individual's ability to simultaneously hold and process multiple pieces of information in their mind. In cognitive psychology, this capacity can be quantified using systematic measurement procedures.

Working Memory Capacity

Attentional deployment is a type of emotional regulation strategy in which a person attempts to alter their emotional state by shifting their attention in a particular way as the situation arises. 

Attentional Deployment

Metacognitive practice understands mindfulness to be a metacognitive process that is able to increase one’s ability to control their response to a situation, but mindfulness is dependent on context and specific beliefs of the person.  Metacognitive practice is a conceptualization of mindfulness coined by Ravi Kudesia and informed by metacognition and practice theory. 

Metacognitive Practice (Mindfulness)

This definition of mindfulness frames it as an information processing style, defined as intentionally keeping your attention on a current thought, rather than allowing your mind to spiral into different judgements or predictions. 

Mindful attention

This definition of mindfulness frames it as an information processing style, defined as continuously making distinctions between a current situation and past situations in order to be more aware of the uniqueness of the current situation.

Mindful conceptualizing

Trait mindfulness is centered around the idea of living in the present moment. It emphasizes living a nonjudgemental life, and it can also refer to the level of mindfulness experienced by a person during everyday activities. 

Trait/Dispositional Mindfulness

Intentional Mindfulness is simply conscious mindfulness practice. Any practice that involves consciously understanding the present moment in any and all aspects is considered Intentional Mindfulness. 

Intentional Mindfulness

These are activities that are structured and require those that participate to be able to master both their mental and physical activity. It can also be described as mindful meditative practices.

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