Accelerating Psychotherapy through Mindfulness

© Linda Graham, MFT

When Sue arrived for her regular therapy session, she was agitated and upset. Her son’s bicycle had been stolen two days before; the washer-dryer had gone on the blink; and suddenly her car needed new brakes. As a single parent, Sue had budgeted barely enough to cover seeing me each week. Now, with these unexpected expenses, she felt had to stop therapy right NOW.

On hearing her desperation, I noticed the fear arise in me for my own livelihood. However, instead of slipping through that trapdoor into a pit of mixed motives, I immediately turned a mindful attention to the fear, allowing it to be there without condemning myself. My genuine concern for Sue’s predicament took its place,  and together we set out to apply this practice of non-judgmental awareness to her current panic.

    I invited Sue to simply sit with the waves of anxiety rising up from her gut to her throat.

    “Does this feeling have any words, Sue?” I asked.

    “There’s no way out. We’re doomed,” she immediately responded.

    “Whose voice is that? Have you ever felt that particular feeling of doom before?”

    Sue reflected a moment, then looked up. “That was me when I was ten.  My dad lost his job and my mom was sick.  My parents saw no way out but for me to quit my piano lessons just weeks before an important recital.  That’s when I felt the doom.” 

    Mindfulness strengthens the observing ego of psychodynamic psychotherapy: the capacity to step back from experience and observe it without being hijacked, flooded, or triggered into repression or denial. With mindfulness, the implicit pattern Sue was confronting had come clear—no way out of financial catastrophe except to quit what seemed to be extra and nonessential. By bringing that pattern into awareness as a memory, without needing to believe it to be true now, Sue was able to arrive at a choice point about her dilemma and begin exploring her options in the present moment.

Psychologist Daniel Siegel in his latest book, The Mindful Brain, characterizes mindfulness as self-empathy, focusing attention on inner experience without judgment and coming to a clear and easeful acceptance of what is.  He proposes that the intra-personal empathy of mindfulness and the inter-personal empathy of psychotherapy both harness the same neural circuits in the brain, each strengthening the development and functioning of the other.

A critical complementarity in therapy is that, while empathy clarifies a sense of a personal self with a personal history, mindfulness leads the client to an awareness beyond the personal, not caught up in the personal self.  Sue could simultaneously pay attention to her response to a memory of fear and doom while holding it in a larger consciousness that created new perspectives and new choices.  Mindfulness thus accelerates the therapeutic process.

Mindfulness, used to dis-embed ourselves from the afflictive ego states without beating ourselves up for getting caught in them, is the cornerstone of a new alphabet of therapies: Dialectical Behavior Therapy (DBT), Mindfulness Based Cognitive Behavioral therapy (MBCBT), Acceptance and Commitment Therapy (ACT). All of these modalities are gaining credence in mainstream psychology because of numerous empirical studies validating the efficacy of mindfulness in the generation of positive clinical outcomes, especially in addressing anxiety, depression, substance abuse, eating disorders, OCD, and Borderline Personality Disorder. Clients resolve their own issues when they recover a sense emotional equilibrium and begin to reflect on their experience, and the causes of their responses, with clarity and self-compassion.

Sue could have abandoned therapy at a critical point in her process. Instead, she took steps to negotiate a fee payment schedule with me and thought through ways to shift household funds around to resolve the current cash flow crunch. In the process she recovered a sense of competence and resilience appropriate to the maturing adult she was, and created a more solid platform for her ongoing healing.

Websites:  www.mindfulnessandpsychotherapy,org

MBSR: www.umassmed.edu/cfm

DBT: www.behavioraltech.com

ACT: www.acceptanceandcommitmenttherapy.com

 

Linda Graham, MFT, is in full-time private practice in San Francisco and Corte Madera, CA, specializing in relationship counseling for individuals and couples. She offers consultation and trainings nationwide on the integration of relational psychology, mindfulness, and neuroscience. She publishes a monthly e- newsletter on Healing and Awakening into Aliveness and Wholeness, archived on www.lindagraham-mft.com, and is writing a book: Growing Up and Waking Up: The Dance of the Whole Self. Contact Linda through this website