By ROB FISHER, MFT, co-developer and lead instructor of the Mindfulness and Compassion in Psychotherapy Certificate Program at CIIS. He is the author of “Experiential Psychotherapy With Couples, A Guide for the Creative Pragmatist.”
Most psychotherapists want to do excellent work with their clients. They take courses to study techniques that enhance their abilities to intervene in effective ways to promote human change and to alleviate the symptoms of suffering. Research studies show that more important to the successful outcome of psychotherapy than any technique is the relationship between the client and the therapist. Clients change when they are motivated and ready.
What can we do to inspire this readiness? Most graduate programs in the field provide abundant information and studies required for state licensure, but, given the time frame of graduate school, can only marginally address the issue of how one creates a relationship that inspires a client to evolve emotionally and psychologically. The Certificate Program in Mindfulness and Compassion in Psychotherapy at CIIS is one of the few programs in the country that addresses this issue. The program features internationally acclaimed speakers and researchers in the use of mindfulness and compassion in the realm of psychotherapy.
Mindfulness has recently become a popular approach that is used in a variety of ways in psychotherapy as well as in meditative practice. It has been researched and shown to be effective on issues as diverse as anxiety, depression, eating disorders, sleep disorders, and even psoriasis. Mindfulness involves attention to the present moment without attachment or judgment. Mindfulness involves welcoming and allowing, rather than resisting one's experience and trying to change it. Using mindfulness in psychotherapy can help the practitioner become more aware of the fine grain of their client’s internal experience as it unfolds moment to moment. It is like shining the spotlight of attention on one's thoughts, feelings, sensations, images, memories, and impulses in order to recognize the subtle details of what is available in the moment. Exponentially more information becomes available to both therapist and client alike by using this approach. It is also effective at transforming one's relationship to one's own experience so that we do not generate additional suffering by becoming adversarial to our own internal worlds. There are many approaches in therapy that use mindfulness. These include: Mindfulness Based Cognitive Therapy, Mindfulness-Based Stress Reduction, Hakomi Mindfulness-Based Experiential Psychotherapy, Acceptance and Commitment Therapy, Dialectical Behavioral Therapy, and others. In MCP we include all these approaches so that participants can develop their own portfolio of knowledge about how mindfulness can be used to deepen the therapeutic encounter.
We also focus on the emotional state of the therapist. How does one become a person with whom people want to expose their deepest and most delicate emotional parts? We need to cultivate qualities such as warmth, wonder, deep curiosity, and compassion.
Here's an exercise you can do to help develop the compassionate part of you; it’s taken from Tibetan Buddhism: Take a moment to close your eyes and turn your attention inwards. Take note of whatever you're experiencing right now and allow it. Don't try to change anything or to judge anything, just make room for whatever you notice right now. Let yourself be welcoming, curious, and warm about your experience. Imagine for a moment that you are sitting in front of yourself. As you look at yourself, notice and remember the ways in which you personally suffer. See it in your eyes, in the turn of your mouth, your posture, and in the emotional tone of your body. Let yourself see the ways that you have contracted in the face of the difficulties of life. As you look at yourself, imagine breathing your suffering into your heart, and then as you breathe out, imagine sending compassion and care to this person in front of you who suffers. With each breath, breathe in your suffering, transform it in your heart, and as you breathe out, extend the wish for your own well being. If you are having trouble doing this, if there is a part that does not wish you well, then imagine that part in front of you; breathe in its suffering and breathe out wishes for its healing. Now practice this imagining another person in front of you.
Exercises like this, as well as many other practices, can contribute to therapists’ internal state in a way that allows them to become the kind of person to whom people want to share their deepest secrets. Often, in the attempt to be professional, psychotherapists remove humanity from this deeply personal encounter. This is unfortunate, as it reduces the depth of connection between client and therapist. It diminishes the possibility for the client having a new experience of human attachment that can heal old wounds and inspire them to, once again, act and relate from a place more deeply in concert with their self. We therapists can unwittingly end up fostering a hierarchical relationship in which the therapist may try to be invisible and anonymous while the client is supposed to disclose their innermost feelings, fears, and longings. This creates a certain kind of container in which psychotherapy takes place that reduces the possibility of real connection and life changing exploration.
In addition to listening attentively, therapists can cultivate qualities such as warmth, acceptance, curiosity, and even a state of celebration and wonder about the client’s internal worlds. Practicing this can lead to a therapist’s sense of internal emotional and spiritual nourishment. This, in turn, affects the type of relationship they have with their clients. One practice that is often helpful in learning this internal craft involves paying attention to the present moment and finding sources of emotional and spiritual nourishment in the presence of the client. This might entail appreciation for their courage, their willingness to disclose sensitive material to you. It may be the way the sun shines through their hair, or the very humanness of their struggle to combine advocacy of themselves with advocacy for the well being of others. It could be their creativity, how they protect their spirits, or their dedication to their own freedom. By adopting an attitude of celebration and wonder, a therapist can feel nourished by their encounter with a client. They can then embody a kind of invitation that results in psychotherapy becoming a landing pad for the client’s soul.