As therapists increasingly incorporate mindfulness into their work, they’re discovering what Buddhists have known for centuries: everyone (even those with severe inner turmoil) can access a state of spacious well-being by beginning to notice their more turbulent thoughts and feelings, rather than becoming swallowed up by them. As people relate to their disturbing inner experiences from this calm, mindful place, not only are they less overwhelmed, but they can become more accepting of the aspects of themselves with which they’ve been struggling. Still the question remains of how best to incorporate mindfulness into psychotherapy.
A perennial quandary in psychotherapy, as well as spirituality, is whether the goal is to help people come to accept the inevitable pain of the human condition with more equanimity or to actually transform and heal the pain, shame, or terror, so that it’s no longer a problem. Are we seeking acceptance or transformation, passive observation or engaged action, a stronger connection to the here-and-now or an understanding of the past?
Many therapeutic attempts to integrate mindfulness have adopted what I’ll call the passive-observer form of mindfulness—a client is helped to notice thoughts and emotions from a place of separation and extend acceptance toward them. The emphasis isn’t on trying to change or replace irrational cognitions, but on noticing them and then acting in ways that the observing self considers more adaptive or functional.
This shift from struggling to correct or override cognitive distortions to noticing and accepting them is revolutionary in a field that’s been so dominated by CBT. There’s a large body of research on ACT, from Jon Kabat-Zinn’s Mindfulness Based Stress Reduction, and from the ground-breaking work of Marcia Linehan’s Dialectical Behavior Therapy (DBT) with borderline personality disorder, suggesting that the shift is a powerful one. Clearly, learning to mindfully witness experiences helps clients a great deal, even those with diagnoses previously considered intractable.
A vivid cinematic example of this witnessing process can be found in the Academy Award–winning film A Beautiful Mind, in which we’re given a sense of what it’s like to be awash in an irrational thought system. In the beginning of the movie, the disturbed math genius John Nash (played by Russell Crowe) is so identified with the paranoid part of him (a black-suited FBI agent played by Ed Harris) that we, the viewers, are drawn into his scary world with him. Gradually Nash is able to separate from his paranoia—to observe his inner FBI agent with some distance and objectivity, rather than believing his conspiratorial rantings. With this mindful separation comes greater peace of mind and ability to function in his life. But while diminished in their intensity and their power to control his behavior, at the end of the film we see that Nash’s voices continue to reside in him. He’s simply learned to live with his extreme beliefs and emotions without being enslaved by them. But what if it were possible to transform this inner drama, rather than just keep it at arm’s length by taking mindfulness one step further?
The Second Step
As a therapist, I’ve worked with clients who’ve come to me after having seen therapists who’d helped them to be more mindful of their impulses to cut themselves, binge on food or drugs, or commit suicide. While those impulses remained in their lives, these clients were no longer losing their battles with them, nor were they ashamed or afraid of them any longer. The clients’ functioning had improved remarkably. The goal of the therapeutic approach that I use, Internal Family Systems (IFS), was to build on this important first step of separating from and accepting these impulses, and then take a second step of helping clients transform them.
For example, Molly had been in and out of hospital treatment centers until, through her DBT treatment, she was able to separate from and be accepting of the part of her that had repeatedly directed her to try to kill herself. As a result of that successful treatment, she’d stayed out of the hospital for more than two years, was holding down a job, and was connected to people in her support group. From my clinical viewpoint, she was now ready for the next step in her therapeutic growth. My goal was to help her get to know her suicidality—not just as an impulse to be accepted, but as a “part” of her that was trying to help her in some way.
In an early session, after determining she was ready to take this step, I asked her to focus on that suicidal impulse and how she felt toward it. She said she no longer feared it and had come to feel sorry for it, because she sensed that it was scared. Like many clients, she also began to spontaneously see an inner image, in her case a tattered, homeless woman who rejected her compassion. I invited her to ask this woman what she was afraid would happen if Molly continued to live. The woman replied that Molly would continue to suffer excruciating emotional pain. With some help in that session, Molly was able to embrace the woman, show her appreciation for trying to protect her from extreme suffering, and learn about the hurting part of her that the woman protected her from. In subsequent sessions, Molly, in her mind’s eye, entered the original abuse scene, took the little girl she saw there out of it to a safe place, and released the terror and shame she’d carried throughout her life. Once the old woman could see that the girl was safe, she began to support Molly’s steps into a fuller life and stopped encouraging her to try to escape the prospect of lifelong suffering through suicide. In this way, the “enemy” became an ally.
The Paradox of Acceptance
Years ago, Carl Rogers observed, “The curious paradox is that when I accept myself just as I am, then I can change.” In other words, carefully observing and accepting our emotions and beliefs, rather than fighting or fearing them, is a precursor for using that same mindful state to help them transform. Once people come to compassionately engage with troubling elements of their psyches, they’re often able to release difficult emotions and outmoded beliefs they’ve carried for years. For me, this process of compassionately engaging with the elements of our psyches is a natural second step of mindfulness. If you feel compassion for something, why just observe it? Why not engage with it and try to help it?
Actually, some prominent Buddhist leaders advocate taking this next step. Thich Nhat Hahn, Pema Chodron, Tara Brach, and Jack Kornfield all encourage their students not just to witness their emotions, but to actively embrace them. Consider this quote from Thich Nhat Hahn about handling emotions: “You calm your feeling just by being with it, like a mother tenderly holding her crying baby. Feeling the mother’s tenderness, the baby will calm down and stop crying.” So it’s possible to first separate from an upset emotion, but then return to it and form a loving inner relationship it, as one might with a child.
More than a Monkey Mind
All clients need to do to begin exploring this apparently chaotic and mysterious inner world is to focus inside with genuine curiosity and start asking questions, as Molly did, and these inner family members will begin to emerge. As the process continues, clients will be able to form I-thou relationships with their parts, rather than the more detached, I-it relationships that most psychotherapies and many spiritualities foster.
Once a client, in a mindful state, enters such an inner dialogue, she’ll typically learn from her parts that they’re suffering and/or are trying to protect her. As she does this, she’s shifting from the passive-observer state to an increasingly engaged and relational form of mindfulness that naturally exists within: what I call her “Self.” Having helped clients access this engaged, mindful Self for more than 30 years now, I’ve consistently observed that it’s a state that isn’t just accepting of their parts, but also has an innate wisdom about how to relate to them in an attuned, loving way. I’ve observed over and over clients’ enormous inborn capacity for self-healing, a capacity that most of us aren’t even aware of.
We normally think of the attachment process as happening between caretakers and young children, but the more you explore how the inner world functions, the more you find that it parallels external relationships, and that we have an inner capacity to extend mindful caretaking to aspects of ourselves that are frozen in time and excluded from our normal consciousness. This Self state has the ability to open a pathway to the parts of us that we locked away because they were hurt when we were younger and we didn’t want to feel that pain again. As clients approach these inner parts—what I call “exiles”—they often experience them as inner children who fit one of the three categories of troubled attachment: insecure, avoidant, or disorganized. Typically, once one of these inner exiles reveals itself to the client, their Self automatically knows how to relate to that part in such a way that it’ll begin to trust the Self. These inner children respond to the love they sense from the Self in the same way that abandoned or abused children do as they sense the safety and caring of an attuned caretaker. As parts become securely attached to Self, they let go of their terror, pain, or feelings of worthlessness and become transformed—a healing process that opens up access to a bounty of resources that had been locked away.
The Therapist’s Role
Therapists aren’t Buddhas and regularly get triggered by the intensity of their interplay with their clients, whether they wish to acknowledge it or not. Fortunately, as you become increasingly familiar with the physical experience of embodying this mindful Self, you’ll be better able to notice the shift in your body when a troubled part hijacks you (you have a “part attack”). With that awareness—and lots of experience doing this kind of clinical work—comes the ability to calm the part in the moment and ask it to separate and let your fuller Self return. In this way, our clients become our “tor-mentors” —by tormenting us, they mentor us, making us aware of what needs our loving attention.
Working in this way can be an intense and challenging task, which regularly requires me to step out of my emotional comfort zone and experience “parts” in myself and my clients that I might otherwise wish to avoid. At the same time, on my best days, I feel blessed to be able to accompany clients on inner journeys into both the terror and wonder of what it means to be fully human. At those moments, I can’t imagine a more mindful way to practice the therapist’s craft.
This blog is excerpted from "When Meditation Isn't Enough" by Richard Schwartz. The full version is available in the September/October 2011 issue, The Mindfulness Movement: Do We Even Need Psychotherapy Anymore?
Read more FREE articles like this on Mindfulness.
Want to read more articles like this? Subscribe to Psychotherapy Networker Today! >>
Illustration © Ralph Butler
Tags: acceptance and commitment therapy | behavior | Buddhism | Buddhist | Carl Rogers | cbt | cognitive behavioral therapy cbt | Countertransference | dialectical behavior therapy dbt | Dick Schwartz | IFS | inner parts | internal family systems | Jack Kornfield | Jon Kabat Zinn | meditation mindfulness | mind | mindful | mindful brain | mindful meditation | Mindfulness | Self | self-compassion | self-criticism | suicide | Tara Brach | transference and countertransference