The Synergy of Mindfulness and Psychotherapy – Part Two

The Synergy of Mindfulness and Psychotherapy – Part Two

The October 2011 e-newsletter, The Synergy of Mindfulness and Psychotherapy, looked at seven convergences (and three cautions) contributing to that synergy as the discipline of mindfulness – for training the mind to steady its capacities for attention, awareness, and insight – is now being welcomed into Western psychotherapies for its effectiveness in cultivating self-reflection and self-acceptance, two pillars of effective clinical work regardless of theoretical orientation.


* mindfulness and psychotherapy are both experiential processes that use various tools to intentionally re-direct and focus the mind’s attention (which “lights up” the neural pathways in the brain so those pathways can both strengthen and re-wire);

* mindfulness and psychotherapy both provide a pause where the practitioner/patient can step back and untangle from the personal story-drama, return to equanimity; the pause allows the brain to operate differently and thus respond differently;

* mindfulness and psychotherapy both enable the practitioner/patient to see that all experiences come and go; nothing is truly fixed or permanent, even when we’re stuck in believing that some things will never change;

* mindfulness and psychotherapy both increase awareness of how the mind itself operates, learning how the mind can both create and heal suffering;

* knowing how the mind works helps to counter-balance the brain’s innate negativity bias;

* mindfulness and psychotherapy both dance between turning toward safety and turning toward the sharp points: being both compassionately curious about and fiercely challenging of our personal dramas;

* both mindfulness and psychotherapy lead the practitioner/patient to subjective experiences of their essential resourcefulness, courage, worth and goodness.


* Suggestions of practices must be tailored to the individual needs and receptivity of the practitioner/patient; no one size fits all

* mindfulness practice could be used as a spiritual bypass of the messiness of personal lives;

* mindfulness practice could be de-stabilizing for folks with unresolved trauma and/or an insufficiently stable sense of self.

This list was based on discussions with leading practitioners in both paradigms: Jack Kornfield, Tara Brach, Ron Siegel, Rick Hanson, Dan Siegel, Michael Yapko, Richard Schwartz, Mark Epstein, Sharon Salzberg, Sara Lazar, Elisha Goldstein, and Ellen Langer in recent webinars with the Psychotherapy Networker and teleseminars with NICABM.

In this month’s newsletter, we explore the practical relevance of these seven convergences and three cautions in your own life, and explore an additional reflection on the dance between “being” and “doing” – accepting what is as what is, and pro-actively seeking to work with what is in ways that will re-wire the brain and evoke personal growth and transformation.

Further Reflections on the Synergy of Mindfulness and Psychotherapy

Both mindfulness and psychotherapy guide us to become present to the actual lived experience of the moment, experiencing our own aliveness and potential wholeness for real, not living out of touch with ourselves, not still reacting to suffering from the past, not stuck in the conditioning of old pathological stories about ourselves, nor pinning our hopes for happiness on some imagined future rather than the real present.

Both mindfulness and psychotherapy cultivate acceptance of and empathy for the very real pain human beings suffer, and both attempt to heal that pain by steadily unpacking it, steadily untangling our sense of who we are from the negative beliefs and stories we feel so gripped by, so stubbornly believe are true.

Both mindfulness and psychotherapy enable us to experience for ourselves the brilliant insight of Buddhist teachings – that all experience, all “truth,” all phenomena are impermanent. Everything changes in a dynamic flow of coming into existence, going out of existence, even the “self” we work so hard to make authentic and resilient.

One more thought stream to reflect on: the dance between “being” and “doing”. Certainly clinicians offer their patients a valuable opportunity to step off the wheel of “doing.” (The Chinese character for busy-ness is two symbols – heart and kill.) And to drop into the presence of simply being, where they can begin to experience their own innate wisdom, their own innate goodness. And for a therapist to allow the client’s own agenda for healing to emerge from that presence or being-ness can be freeing and empowering to both.

However, many practitioners of the many therapeutic modalities incorporating mindfulness today – Accelerated Experiential Dynamic Psychotherapy, Internal Family Systems, Sensorimotor, Hakomi, Dialectical Behavioral Therapy, Mindfulness Based CognitiveTherapy, etc. – move from a “witnessing” mode to a pro-active “working with” mode. If new experiences do re-wire the brain, and they do, and if generating new experiences to re-wire the brain helps re-wire neural pathways in a more adaptive direction, why wouldn’t we pro-actively seek to use our growing knowledge of how the mind works to pro-actively re-wire ancient stubborn automatic neural pathways that keep us stuck in suffering?

Mindsight is a lens where we can see the inner world of mental experience in ourselves, which you could easily call insight, and to see it in other people, which you could call empathy. But mindsight is more than just insight and empathy; it actually allows us to not only see the inner world but then to shape it.
– Dan Siegel

We don’t have to spend years on the couch or years meditating in a cave to find the experiences that can be transformative. We don’t have to be like sea anemones anchored on rocks, watching and waiting for the plankton to float by.

Both mindfulness and psychotherapy, as experiential processes, offer us the opportunity, maybe even the obligation, to pro-actively cultivate the wholesome and let go of the unwholesome (the wise effort of the 8-fold path of Buddhism). We practice the pro-social behaviors of gratitude, kindness, compassion because research shows that repeating those practices over time will lead to more trust, more belonging, more generosity, more altruism in our social relationships. We deliberately seek out relationships with resonant true others to our true self so that our brains can re-wire in the direction of self-empathy and self-acceptance. We deliberately unpack the sequence of events that led to the pickle we’re in so we can discern alternatives and choice points.

Witnessing and working with IS a dance: the yin-yang of being-doing. May this month’s reflections, tools and resources help bring balance and synergy to your practice.


A lot of people still think that meditation is sitting and spacing out, but we’re demonstrating that very specific brain regions are changing as a result of practice: the hippocampus which is essential for learning and memory, the temporoparietal junction involved in compassion and empathy. And it’s not just while you’re sitting and meditation; it actually persist throughout the rest of the day. It is the change in the brain structure which is allowing these changes to persist.
– Sara Lazar

* * * * *

Mindfulness practices in general, and then meditation in particular, change the brain momentarily in terms of the brain states and change the brain in enduring ways in terms of traits.
– Rick Hanson

* * * * *

Beginning to talk to patients about the fact of changes in brain structure and brain function brought about by mindfulness practice is highly motivating to folks. But we shouldn’t expect the magic of transformation to happen largely within the clinical hour. The magic of transformation really happens in people relating differently to their experience, in trying on new behaviors throughout the course of their lives.
– Ron Siegel

* * * * *

The power and beauty of meditation is that it actually trains us to pay attention in a way that we can use thoughts in an intelligent way. We can discover the sacredness and the love and the awareness that is way beyond anything that a thought could ever define or encompass. We discover a quality of wholeness and freedom.
– Tara Brach

* * * * *

So much of mindfulness involves deliberately focusing the mind in directions that are helpful for sanity: being present, practicing letting go, practicing gratitude, practicing moving toward that which is difficult rather than moving away from or defending against difficult experience.
– Ron Siegel

* * * * *

We can see meditation as a process of developing a different relationship to one’s thoughts, rather than abolishing them or annihilating them.
– Sharon Salzberg

* * * * *

Mindfulness is so helpful to the mental healthcare practitioner. One of the benefits is to hold the suffering that we work with on a daily basis in a bigger space of awareness. Another benefit is that when you are mindful, you are going to see more. You are going to pick up more details. You are going to read facial expressions more subtly. You are going to hear tone of voice, You are going to put two and two together in a new kind of way.
– Rick Hanson

* * * * *

Mindfulness practice is mostly about gaining insight into the workings of the mind, and using that insight to free ourselves from patterns that create suffering. When these processes work well, the person winds up with the old personality that they had, only with an entirely different relationship to it.
– Ron Siegel

* * * * *

Mindfulness allows us to de-condition the identifications with a small, deficient, afraid self, and re-open to a larger sense of identity with a lot more capacity.
– Tara Brach

* * * * *

Just that action of paying attention to ourselves, that I care enough about myself. I am worthy enough to pay attention to, starts to unlock some of those deep beliefs of unworthiness at a deeper level in the brain.
– Elisha Goldstein

* * * * *

If we want to help our clients learn – which is what we want to do in therapy – if we want the insights, the hard-won lessons, the realizations and breakthroughs to stick to their ribs, if we want that to happen, then we want to promote the executive control of attention, we want to promote a growing capacity to tune into themselves, and we want to promote the frequency of brain wave functioning that creates integration and learning. All three of those are promoted through mindfulness practices, including the building up of the neural structures that promote them.
– Rick Hanson


I’ve just watched the PBS Nova series on The Fabric of the Universe, perhaps you did, too, and perhaps you were struck, as I was:

We used to understand how the universe works through Newtonian physics about matter and forces like gravity. Then Einstein turned Newtonian “rules” upside down with his discovery that the speed of light was the one and only constant of the universe – “truths” like space and time were not constants but were dimensions that could warp each other’s “reality.” Neils Bohr turned Einstein’s theories upside down with his discovery – through quantum physics – that there were NO constants at the level of sub-atomic particles, only possibilities that at best become (astonishingly accurate) probabilities.

The “truths” of Newton’s physics still work very well to explain life at the level of human beings and the civilizations we build with those truths. Einstein’s truths still work very well to explain how the universe works at the macro level of stars and galaxies. Quantum mechanics is the most accurate map yet to explain how the “laws” of physics operate at the micro level of sub-atomic particles, which, apparently are the operating manual for the development of computers, the internet, cell phones, our modern digital, not mechanical, world.

Now string theory comes along to explain how Newtonian physics and Einstein’s physics and quantum physics could all be explained by the hypothesis that the smallest foundational units of existence are strings – looped vibrations of energy one billion times smaller than the smallest particles of an atom.

Major “truths” in physics have their day and then are superseded by newer truths, in our modern era at an ever-accelerating rate. I see here an analog to how the “truths” at the level of our selves – who we are, who we believe ourselves to be as we change over time – could be constantly challenged and overthrown, too, if we were open, curious, investigative, which is what both mindfulness and science teach us to be. With enough open-mindedness and investigation of our experience, we come to the insight mindfulness always brings us to – nothing is constant; nothing is fixed or permanent.

That even the “self” is an ever-changing dynamic process (verb) rather than a fixed entity (noun). That there are more probabilities in our unfolding than certainties. Even the most cherished beliefs about ourselves, or others, can be unpacked as the downstream result of all the conditioning we’ve experienced up until this point in our lives. That means we can choose new experiences we would like to have the most influence on our experience of self going forward, knowing that whatever new “truth” we settle into, for however long, will be challenged and transformed by more new experiences down the road. A very probable but uncertain journey.

EXERCISES to Practice the Synergy of Mindfulness and Psychotherapy

Impermanence – that all processes and all contents change over time – can be a tricky reality for our psyches to deal with. We would often prefer to count on certain phenomena, especially the hard-won and the truly yummy aspects of our selves – to reliably gel and reassuringly stay put.

With enough mindfulness practice, we eventually stumble upon deeply felt insight that impermanence is, indeed, one of the deepest “truths” of existence: all things come and go, no-thing is fixed or permanent. It takes a bit of courage and muscle to choose to work with impermanence as a tool to relieve the suffering inherent in living a human life.

But it’s the experiencing in our own breath and our own bones the reality that things do change; that no-thing is fixed or permanent, that allows us to relax our grip on The Truth Of The Way Things Are. We can begin to unpack our stories, our belief systems, our patterns of assumptions about who we are – how we operate, how other people operate, how the universe operates, and begin to create choices about how we want to be and live and love as we move forward.

The introductory exercises below help us get comfortable – even embrace – impermanence as a tool for skillful change and transformation.


Bring your awareness to your breath flowing gently in and out of your body, noticing changes in the rhythm, the intensity, the sound of your breathing. Notice your chest rising and falling; you may even feel your breath moving throughout your entire body, your whole body breathing. Notice how your breath changes moment-to-moment – quick or slow, deep or shallow. Notice that an inhale may last only five seconds, an exhale my last only another five seconds. The breath that sustain our very existence from the first breath to the last, is not itself fixed or permanent.

Exquisite attention to the ever-changing sensations of the body (the first foundation of mindfulness) is the basis for the use of Mindfulness Based Stress Reduction to alleviate the suffering of chronic pain. Even when breathing is labored, there can be a moment at the pause between the in-breath and the out-breath that can be free of pain. Even when the inflammation of arthritis causes unrelenting pain in this joint or that, there can be many areas in the body completely free of pain. We create spaciousness around the pain by find the experience of impermanence within it, and can cope with the pain more lightly.


We carefully notice how dramatically our moods can shift, too, to deepen our insight into impermanence. I was hunky-dory two hours ago, but now the bill for a leaky faucet that turned into a major re-plumb of the entire house leaves me deeply worried and unsure of what to do. This morning I was so aggravated with my nephew, I wanted to ship him to Australia, and now, watching him build a “green” airport out of Lego’s I can’t even remember what the fuss was about.

We can use our insight into impermanence to deliberately shift our moods. I get stuck in serious gridlocked traffic frequently enough and still get to work on time frequently enough, to know I could waste my time letting the adrenalin of aggravation stress my body and spoil my mood of gratitude for being alive, or I could use the time to send wishes for well-being to every driver I’m stuck in the gridlock with, choosing to shift my mood rather than stay stuck in a mood that is going to shift when I get out of the gridlock and into my office anyway.


We’ve probably all experienced a radical shift in mindset at some point or another in our lives, another awakening to the reality of impermanence. At some point we may have been an avid surfer or a staunch Republican or a fierce defender of the right to have an abortion or a stalwart defended of capital punishment. And then, ten years later, our life has taken a left turn into a completely different loyalty or identity. We are now up to our eyeballs in Dr. Seuss and diapers, or find ourselves a non-stop environmental activist, or happily tutoring adults in reading.

The “truths”, the values, the priorities, that guide our lives change over time, if we are open to learning and change. Refusing to learn or change, does not change the reality of impermanence one whit; our refusal only makes it that much harder to ride the waves of an ever-changing journey.


[a reiteration of the resources listed in the October 2011 e-newsletter on The Synergy of Mindfulness and Psychotherapy]


The Mindful Path to Self-Compassion: Freeing Yourself from Destructive Thoughts and Emotions by Christopher Germer, PhD. Guilford Press, 2009.

The Mindful Therapist: A Clinician’s Guide to Mindsight and Neural Integration by Daniel J. Siegel, M.D. W.W. Norton, 2010

The Mindful Way through Depression: Freeing Yourself from Chronic Unhappiness by Mark Williams, John Tasdale, Zindel Segal, and Jon Kabat-Zinn. Guilford Press, 2007.

Mindfulness and Hypnosis: the Power of Suggestion to Transform Experience. By Michale Yapko, PhD. W.W. Norton, 2011

Mindfulness and Psychotherapy, edited by Christopher Germer, Ronald Siegel, Paul Fulton. Guildford Press, 2005.

Mindfulness Based Stress Reduction Workbook by Bob Stahl, Elisha Goldstein, Saki Santorelli and Jon Kabat-Zinn. New Harbinger Publicatioins, 2010.

The Mindfulness Movement: Do we even need psychotherapy anymore? Psychotherapy networker, Sept.-Oct. 2011.

The Mindfulness Solution: Everyday Practices for Everyday Problems by Ronald D. Siegel, PsyD. Guilford Press, 2010.

Real Happiness: The Power of Meditation – a 28-Day Program by Sharon Salzberg. Workman Publishing, 2010

Wisdom and Compassion in Psychotherapy: Deepening Mindfulness in Clinical Practice by Christopher Germer and Ronald D. Siegel. Guilford Press, Feb. 2012.