Mindful Therapy - Introduction
As psychotherapists, we know that how much our patients suffer often has more to do with the conceptual lenses through which they view their experience than with what they actually experience. Buddhist understanding takes this insight further, teaching us that when we free ourselves entirely from our concepts, we can experience reality in a new and wondrous way. That way is called nirvana, the direct perception of
Consider some simple, everyday examples. We tend to classify tasks as either things that we have to do or things that we want to do. Going to work, doing chores and running errands, cooking and cleaning, taking out the trash, mowing the lawn—these often fall into the category of things we have to do, while enjoying a meal, going to the movies, watching television or doing pleasure reading, drinking our coffee or tea—these are often seen as things we want to do. Frequently the list of things we have to do dominates us. It dominates us so much, that we may not notice that many of the things we have to do contain enjoyable elements. It dominates us in the sense that we often do not even question whether these tasks are really necessary. And it dominates us so much that we may rush through even the things we want to do without really experiencing them.
We may also classify all the moments in our lives as either time for ourselves or time for others. As psychotherapists, the time for our patients is their time, not ours. But that does not mean we feel the rest of our time is ours. The time spent with a spouse, a child, a family member, or a friend, when involving activities that are more their choice than our own, may also be seen as their time. Maybe at the end of the day we finally get to the time that is “our” time, but by then we may be too exhausted to do much.
One solution to this problem is mindfulness. Described by the Buddha over 2,500 years ago, mindfulness is a way of learning to see life as a unified whole. When we live mindfully, life is no longer divided between what we have to do and what we want to do. Life is no longer divided between “our” time and time for others. All of life becomes our time. All of life becomes an opportunity to be alive and aware. When we live mindfully, we learn to be happy and content, whether interacting with our patients, filling in an appointment time in our calendar, enjoying time with someone we love, or relaxing with a cup of coffee.
Mindfulness is a way of facing the truth. And one of the truths we must face as psychotherapists is this: psychotherapy is difficult work. It may not seem that way to our patients or lay peers. From the outside, it may seem as though we just sit and listen, and occasionally offer reflections, suggestions, interpretations, or advice. And yet to sit and listen that way is one of the most difficult things one can do.
Like many of our patients, we therapists may also be searching. Perhaps we are searching for a way to envision our work as a work of healing, beyond the technical proficiencies, beyond the theories we have learned. We may search for a way to be more fully present with our patients, one that can help us in helping them. Or perhaps we search for a way to defragment our work life and reunify it with the rest of our time. Others of us are looking for a way to approach therapy as a spiritual task while still following professional standards and without triggering fear in our patients that we are trying to convert them to our form of spirituality.
Mindful Therapy is designed to help with these concerns. Mindful therapy emphasizes that whatever else we have to offer, the most important thing we offer is our true presence and our deep listening. Yet since we are not ourselves enlightened, since we are torn and fragmented by the same suffering and by the same powerful cultural forces and conditioning that bedevil our patients, doing this is not so easy. To offer true presence and deep listening, we need ways to approach our work and our life that are free of clutter and distraction. We need ways to become more clear and centered. If we are not clear and centered, how will we offer these qualities to those who seek our help? For this reason, this book is as much about how therapists and counselors can take better care of themselves through mindful living as it is about how we can use mindfulness clinically.
Mindfulness offers us an approach to living and an approach to therapy that can help us deepen our presence and our listening. While rooted in Buddhism, mindfulness does not require us to “be a Buddhist,” or to share specifically Buddhist insights with our patients. Depending on our patients’ needs and our own style, we can do more or less of that. Since Buddhism teaches us to hold our opinions lightly—even our Buddhist ones—we can offer mindfulness simply and directly. We can offer mindfulness without religious or metaphysical assumptions, allowing us to talk comfortably with people of different religions or of no religion at all.
Mindfulness is also something we can offer ourselves. Since mindfulness is ultimately the art of living deeply and happily, this is not a burdensome task. One of the assertions of this book is that to practice therapy mindfully, we need to do our best to live mindfully in the rest of our lives. Mindfulness helps us integrate our professional and personal life, our time “for others” and “our own” time. By using mindfulness practice to care for ourselves in our non-work life, we can offer greater mindfulness in our work— and this in turn will help us to live with greater joy and with ease of well-being. Mindfulness helps us in both the private and professional areas of our lives by eliminating any rigid distinction between the two, helping us to be more at home wherever we are. It helps us both to find healing for ourselves, and to offer healing to our patients.
What This Book Offers
Mindful Therapy consists of three parts. Part one, “Revisioning the Role of the Psychotherapist,” puts the task of the therapist in the context of its ancient lineage of healing. The first chapter offers the perspective that, in a world of increasing alienation, fragmentation, and disconnection, we need therapists who are true healers rather than mere technicians. To become true healers, we therapists might consider trying to see ourselves in the context of the ancient roles of shaman, guru, and healer. While we may not be able to adopt these models wholesale into our twenty-first-century role, we can nonetheless find inspiration in them that goes beyond our technical training. This inspiration also helps to inoculate the therapist against the difficulties of the work.
The second chapter introduces the importance of the therapist’s self-care, or care of the self. Without care of self, care of others becomes ultimately impossible. A gatha (a kind of brief versified Buddhist teaching) from Zen master Thich Nhat Hanh is used to structure an approach to greater solidity, stability, and freedom.
Part two, “Buddha as Therapist,” shows how the teachings of the Buddha in general, and of mindfulness in particular, provide the therapist with a framework for understanding the therapeutic task. Chapter three discusses the practice of mindfulness in various terms: as radical acceptance, daily life meditation, surrender, reverence, acknowledging the truth of experience, and dwelling happily in the present moment. It shows how these qualities are important to the therapist. What is more, it also addresses how to share these qualities with patients and how to assess when and how it is appropriate to do so. Chapter four uses the basic Buddhist teaching of the “four noble truths” to open a perspective on suffering and its alleviation in the context of therapy. From the four noble truths we can derive a kind of practical, four-step, self-help exercise that can be surprisingly powerful. Chapter five examines the teaching of the “three poisons” of greed, hatred, and delusion, and their antidotes (love, compassion, and wisdom), and how these shed light on human suffering and the release from suffering in a clinical context. Chapter six considers the “three seals” that all things share—I will present these three as impermanence, no separate self, and nirvana—in the context of the general alleviation of human suffering and in clinical work. When the nature of reality as seen under these seals is accepted in a deep way and harmonized with rather than resisted, suffering ends.
Chapter seven turns from the nature of suffering and its causes to consider the antonym of suffering, well-being. Every therapist has at least an implicit, if unarticulated, view of what well-being is. This chapter offers the Buddha’s description of well-being as embodied in the teaching of the “noble eightfold path.” It suggests that the eightfold path can even be used diagnostically to help understand the causes of suffering in our own and our patients’ lives. Chapter eight offers a basic model for understanding and working with emotions based on Buddhist teaching. Several traditional practices are offered in the light of working with emotions.
To the reader who may be wondering, “Okay. But what do I do in my life and work as a mindful therapist?”, part three aims at offering specific suggestions. Chapter nine offers specifics about what the work of the mindful therapist might look like in terms of therapeutic technique. Techniques are offered in passing throughout the book, but are intentionally confined largely to this one chapter so the reader does not confuse a mindfulness approach to therapy with technique-driven approaches. This is an essential point. Since the mindful therapist works by producing her true presence and offering deep listening, she allows technique to grow organically out of the work. Technique is never imposed artificially or arbitrarily. By contrast, many books about psychotherapy offer a disclaimer that technique is secondary. Yet even in such cases, the disclaimer is often contradicted by the content—a fate I hope to avoid here. My intention is not to present a definitive or complete set of techniques, but simply to discuss how one therapist (the author) does it. Finally, in chapter ten, I offer reflections on the unification of work and life for the mindful therapist.
How to cite this document:
© Thomas Bien, Mindful Therapy (Wisdom Publications, 2006)
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