More on Mindfulness:
"Everything flowers, from within, of self-blessing,
How is it that change happens in psychotherapy? Ideally, each of us as clinicians can articulate a response to this simple, yet truly essential question. In this paper, I will offer one response to the question by exploring the paradox of change--that movement toward healing and wholeness is born out of being with what is in the present. This article (a follow-up to "Befriending the Self: Mindfulness in Clinical Work" published in the May/June 2003 newsletter) draws upon somatic psychotherapy, psychoanalytic writing, and Buddhist psychology, as well as a clinical case example. As defined in the previous article, mindfulness is " the non-judging awareness of present-moment experience....a practice of non-doing, of gently bringing curiosity and acceptance to whatever is arising." Psychotherapists know how our presence and empathic holding offers a powerful opportunity for "reteaching," and for our client's to internalize this compassionate attention. Mindfulness, as an explicit practice, gives our clients a rich and renewable resource to draw upon. While the client practices mindfulness in the clinical hour, with the therapist as an outer witness, this seeing while being seen offers both an intrapersonal and an interpersonal corrective experience, as well as a valuable life skill. Mark Epstein, psychiatrist and Buddhist meditation practitioner, has called therapy a "two-person meditation." (Mindfulness is a central aspect of most Buddhist meditation practices.) During a talk on the subject of compassion , Gil Fronsdal, a local Buddhist (Vipassana) teacher, described how mindfulness practice can act as an antidote, many years later, to the hurt caused by parents who did not have the skills to truly see their children. He described how by being mindful, by simply being present with our own actual experience, we are loving and healing ourselves. When we help our clients develop the ability to bring "bare attention" to their sensations, emotions, thoughts, imagery, memories, movements and gestures--to any direct experience-- healing naturally occurs. One important caveat is that the notion of "organicity," (a term from Hakomi mindfulness-based somatic therapy) assumes that one's "organic self" unfolds toward wholeness when provided with a safe and holding environment. In clients where trauma has significantly impacted the nervous system, more care and skill is required to develop, and orient the client toward, inner (and outer) resources, and to maintain the work within a range of experience which avoids re-traumatization. In Going on Being: Buddhism and the Way of Change, Mark Epstein writes "People who are suffering want to change, but they do not know how. They feel...that they have to go into their problems, or get rid of them entirely. They do not know that to bring about true healing they have to learn to see themselves as they truly are." We have all watched our clients struggle with what they consider to be distasteful, unpleasant, and, so often, shameful, in themselves. In my clinical work, I see how self-judgement is among the most harmful energies of virtually each of my clients. In Epstein's words, "...powerful reactions have the capacity to take hold of us and drive our behavior. We believe in these reactions more than we believe in anything else, and they become the means by which we both hide from ourselves and attempt to cope with a world of ceaseless change and unpredictability." This self-judgement and self-rejection ("aversion" in the Buddhist language) creates a nearly impenetrable barrier from the actual experience and prolongs suffering. In Buddhism, this instantaneous layering of reaction on top of a felt experience is sometimes called "the second arrow." A long-term client, whom I will call Renee, has gradually learned to discern when she is heaping judgement (some version of "I'm defective" or "It's my fault") on her pure feelings of grief, related to childhood trauma, and her own chronic illness and a divorce. Through dialogue and mindfulness-based somatic exploration, we have worked explicitly with four aspects of mindfulness that can be summed up in the acronym, RAIN: Recognition, Acceptance, Interest and Non-identification. Early in our work, self-judgement nearly always paved over her painful feelings and my gentle attempts to shine a light on her harshness were met with reticence and/or more self-judgement. I helped Renee to recognize , to clearly see, judgement when it arose. She could simply name it internally and out loud as "judging," attempting the same softness as one would express in stroking a baby's face. Acceptance took the form of staying present with it rather than pushing it away or veering off into a negative story about herself, though these were important experiences to attend to with mindfulness, as well. She could manage to see judgement without jumping into its fire. Renee was quite daring as she brought interest , the active qualities of curiosity or friendliness, toward the judgement so that she could discover its textures. At this point, we began an important exploration of the "causes and conditions" which had encouraged her to adopt this habit. This step led to an understanding that "It's not my fault, AND I'm willing to do what I can to heal the impact of my conditioning." Looking at conditioning brought more compassion to Renee's sense of self and and had a normalizing effect, a beautiful bridge to the aspect of non-identification , which, in the simplest sense, helped Renee know that she is much more, and much less, than her thoughts and feelings of the moment. As Sri Narsagadata gracefully stated: "Love tells me I'm everything. Wisdom tells me I'm nothing. Between the two my life flows." Of course, when Renee applied RAIN to her judgement, it opened up the possibility of then practicing the same mindfulness with the underlying feelings, grief and others, that longed to be known. Over time, Renee has become very skillful at identifying her habit of self-rejection, and can identify "the second arrow" spontaneously. She self-identifies her reactions and can unravel them more easily, much of the time, both in therapy and on her own. Renee has nearly always felt great relief, as well as surprise, even awe, upon realizing that whatever the underlying feeling, it was more tolerable than she had anticipated. She often speaks of "pure grief" as an experience she feels confident to navigate, even if quite painful and unpleasant, whereas the beguiling self-judgement led to a paralysis and deflation that was difficult to move through. And she has expressed great delight in her ability to discern the pure experience of her actual body sensation and emotion from the "story" or "judgement" she had habitually retreated to. Epstein sees the work of analyst D. W. Winnicott as an interpersonal parallel to (mindfulness) meditation, most notably in his writing on "going on being," as "the uninterrupted flow of authentic self." According to Epstein, going on being implies "a stream of unimpeded awareness, ever evolving, yet with continuity, uniqueness and integrity. It carries with it the sense of the unending meeting places of interpersonal experience, convergences that are not blocked by a reactive or contracted ego...Going on being implies an intrinsic but elusive process of self-discovery and self-creation..." Writing about Winnicott, Dr. Simon Grolnick, psychiatrist and analyst, reiterates that the holding environment of the good enough mother (and the good enough therapist) allows a continuity of going-on-being feeling. Grolnick notes that "Winnicott prescribed being before doing , for action that feels authentic and not merely acting must take place from the platform of a sense of stability and continuity." (The Work and Play of Winnicott, 1990). Well-known author of The Interpersonal World of the Infant, Daniel Stern offers additional support for mindfulness practice in therapy in his comment that "psychodynamic treatments...rush toward meaning, leaving the present moment behind." He advises that "the longer the therapist can stay with the present moment and explore it, the more different paths to pursue will open up." Stern also writes, " I suggest that there is great clinical value in a more lingering interest in the present moment." (The Present Moment in Psychotherapy and Everyday Life, 2004). While the benefits of mindfulness can be gained by client and therapist regardless of spiritual or religious involvement (mindfulness is now taught as a stress-reduction technique in hospitals across the country), I believe that the practice of mindfulness invokes a sacred experience within and between us. Janet Adler, a dance therapist and one of the founding teachers of Authentic Movement (a Jungian-inspired form of movement/sacred dance) wrote, "One way mystical practice can be recognized is when individuals commit toward that which cannot be known by committing to a practice revealing that which can be known---conscious embodiment ( Offering from the Conscious Body: The Discipline of Authentic Movement , 2002).
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