The integration of Mindfulness and Psychotherapy is a topic of fast-growing interest among clinicians and clients worldwide. The following is the first in a series of informal conversations between Trudy Goodman, Ph.D., Elisha Goldstein, Ph.D. and Steven Hickman, Psy.D., the teachers for a unique upcoming professional training retreat entitled "Mindfulness in Psychotherapy" to be held October 2-7, 2011 at the Joshua Tree Retreat Center in Southern California. Enjoy!
In the first of a series of conversations, Steve, Trudy and Elisha talk about the importance of mindlessness in the therapeutic session.
Steve: Today as I worked with a particularly frustrating client whom I experience as quite intransigent and unwilling (unable?) to make change despite constantly extolling his desire for things to be different, I was caught off guard. I had just pointed out his apparent lack of motivation to change (in appropriately therapeutic terms), and he replied by asking in a slightly defensive tone of voice, "Do you talk to all your patients like this?" I'm embarrassed to admit it, but he called me on my mindlessness in that session. Fortunately, I was able to make use of the moment clinically.
Call it countertransference if you like, but for that period of time I was not responding to the human being sitting across from me (and suffering, I might add), but was marching to the beat of some other drummer of my own mind's making. It strikes me now that it is in these moments of having our mindlessness become vividly apparent, that we actually become more fully mindful, just as when we notice that our attention has wandered in meditation, we are actually as present as we can be! It seems that mindFULness actually becomes most apparent against the backdrop of mindLESSness. What do you think?
Elisha: There’s a very common misunderstanding in the practice of mindfulness that the practice is to stay focused on whatever we’re paying attention to and deviation from that is “bad” mindfulness. In my personal experience in session with a client or out of session in my own life, it is these moments that I wake up to recognize that I’ve been drifting that seem the most valuable to me. Why? It is this precise moment that I wake up to the fact that I have a choice to intentionally practice cultivating a sense of presence once again and this, in my mind, is the foundation to mindfulness and psychotherapy.
Presence may be something that some people naturally have more than others, but the truth is, it’s a skill and we can all cultivate it through practice. For better or worse, our brains seem to make things more habitual after they are practiced and repeated. So we need the moments where we’re drifting off the path of being connected to the moment to exercise that intentional muscle of nonjudgmentally guiding our attention back to being present with what’s here.
Trudy: Since psychotherapy is a relational process, I look at the times of ‘mindlessness’ as a time of disconnection in the relationship. What’s interesting about drifting away from being present in the relationship is to look at what was happening the moment before, when I was still present? And what is happening now, when my attention has wandered away? Where did it go? And how might this be a mini/micro re-enactment of the client’s conditioned relational patterns, or my own?
Rather than see this temporary disconnect as a failure to practice either mindfulness or psychotherapy well, these times actually provide an opportunity to understand the relationship better. If, as the late psychoanalyst Paul Russell suggested, we define resistance as the therapist’s resistance to what’s happening in the clinical encounter, mindless disconnections can get much more interesting! What’s going on in the moment that makes us turn away in restlessness, boredom, frustration? What’s being revealed about the relationship?
As clinicians, we work to cultivate our own mindful presence in a way that is suffused with compassion towards oneself and others, so that we can choose more wisely how to respond to such moments of disconnection. Mindfulness offers us a bridge back to adjusting our stance as therapists to be more continuously curious, congruent and caring. Moments of mindful awareness are quite accessible, but continuity of this quality of compassionate presence has to be consciously chosen, intended, and developed through our own meditation practice.
For me, working with this kind of authentic attentiveness – while staying open to learning about myself in the process -- is an act of love. And love is part of what mindfulness meditation is all about! Wisdom and clarity without compassion and love is like a bird with one wing. We need two wings to ‘fly’ in all our relationships -- clinical, professional and personal. How wonderful that even moments of mindlessness can be a bridge to insight, to understanding what gets in the way of loving. Mindless moments of disconnection, when met with kindness and curiosity, can teach us how to connect and be wholeheartedly present with ourselves and all those whose lives we touch, just the way we are.
We invite you to join in this conversation. Please share your thoughts, questions and stories below. Your interaction creates a living wisdom from which all of us can benefit. As these conversations accumulate, we will collect them on a separate page of our blog for review and comment. Visit the UCSD Center for Mindfulness Professional Training site for information on this and other trainings offered.