Mindfulness and Psychoanalytic Psychotherapy: A Kinship

There is a profound common purpose shared between psychoanalytic exploration of the self and the self-discovery that occurs in mindfulness practice. Both are pursuits of aliveness, though “aliveness” may be conceived of differently. Both pursuits address the pain that comes from clinging too tightly to either outmoded or false ideas about the self. Both are, or can be, fearless and relentless in their examination of what it actually means to be “oneself.”

And neither is an intellectual pastime—on the contrary, both are to be pursued with the conviction and faith that they will lead to real, tangible self-transformation. Let us now consider this kinship as it manifests in the qualities of attention most often associated with mindfulness.

For decades, numerous major trends in psychoanalysis have been pointing toward the vital importance of the present moment in the session. These include the rise of the interpersonal and relational schools and the shift toward greater focus on in-session interaction, as opposed to a primary emphasis on genetic reconstruction; the shift in emphasis from the historical truth of childhood to the narrative truth that is meaningful now (Spence, 1984); and, of course, the vast and growing body of mother-infant research that has yielded much about the power of a moment in interaction (Stern et al., 1998; Stern, 2004). In these ways and others, our field has been evolving to emphasize the present moment, the aliveness of the here and now, as being at the heart of analytic work. The practitioner of mindfulness meditation immediately becomes aware of the astonishing extent to which his awareness is nearly always in a fantasized past or future or some other kind of nonexistent space. Most of us live at a little distance from our lives. This nearly universal way of living “somewhere else” than the present is a mental habit so deeply entrenched that most people have no idea they are doing it or that their lives could be lived differently.

As stated above, Freud prioritized his method of “evenly-suspended attention” (1912), advising his followers to give “impartial attention to everything there is to observe” (1909). Freud here sounds much like he is prescribing the fundamental Buddhist method of bringing “bare attention” to experience, a way of being in life that “simply sees what is right there and does not add any comment, any interpretation, any judgment, any conclusion. It just sees” (Merton, 1968). 

From Wendell Berry (1987), whose poetry is often cited in mindfulness training, comes “To Know the Dark,” echoing those words and also Bion’s (1970) emptiness of memory and desire:

To go into the dark with a light is to know the light.

To know the dark, go dark. Go without sight,

and find that the dark, too, blooms and sings,

and is traveled by dark feet and dark wings.

From many perspectives comes the idea that true insight and self-understanding can grow only if one begins with accepting experience unconditionally and unflinchingly. In this same way, analytic work will be truly alive to the extent that both parties are accepting, curious, open to whatever comes up. It is perhaps a desire for a lost sense in analytic work of truly bare and evenly hovering attention and a desire for the spontaneity and aliveness that would be found in “going without sight” or entering “without memory or desire” that now fuels many analysts’ interest in mindfulness practice.

More than other modalities, analytic work has an innately welcoming stance toward symptoms and other expressions of the patient’s conflicts. They are often regarded not as problems to be eradicated but as essential information that might be pointing toward a deeper truth. Two core analytic developments—the emergence of the negative transference and regression in service of the ego—can be painful, even frightening, for both parties, but are to be met with acceptance, openness, and curiosity on the analyst’s part so deeper understanding can be pursued.

Relatedly, the analyst is called upon to embrace with curiosity the often profoundly disturbing experience of being “the bad object” in this intimate and vulnerable relationship. Every analyst has been in a clinical mess in which the only choice is to sit with confusion and doubt and to simply look more deeply into the nature of the thing. In such moments, the powerful and nonconceptual focus of mindfulness practice offers a way to do that which is outside of any theoretical cul-de-sac, beyond even any verbal construction of the problem, and therefore can sometimes yield up a genuine solution.

The analytic relationship, more than any other type of treatment, fosters and encourages the patient’s exploration of the totality of himself. A basic working definition of healing, from an analytic perspective, has to do with healing of splits in the self, with the patient’s growing ability to acknowledge disowned feelings and aspects of himself. In the volume Mindfulness, Acceptance and the Psychodynamic Evolution, editor Jason Stewart cites a personal communication with psychoanalyst Sara L. Weber (2013) in which she states that the most powerful aspect of analysis is “to accept, but really accept, and feel compassion for, the patient’s—and your own—darkest, ugliest qualities.” Weber believes that through the practice of meditation, an analyst can achieve “a deeper acceptance, neutrality that is somehow bigger and can embrace more. Meditation expands what you can be neutral about.”

Weber (2003), applying Ghent’s concept of surrender (1990), has written of the analyst’s “surrender” to the process, a word that connotes an experience of greater vulnerability than simply acceptance. You can accept many things, including a slice of pie handed to you, but you only surrender to something larger than you, stronger than you, perhaps frightening and irresistible. You truly surrender when nothing else works. There are many ways by which you can arrive at that juncture with a patient where nothing works and all you have is your failure to fix “it.” To focus on just one way, sooner or later, we all have someone in our practice about whom we cannot escape a feeling of hopelessness—that they will ever find employment, love, any semblance of peace of mind.

In Buddhist terms, we all—“healthy” therapist and “ill” patient alike—have the same “Buddha Nature,” the same potential for a profoundly alive existence. Just sitting faithfully in this frame of mind with a tormented person might sound like doing nothing useful at all, but it can, at moments, lead to a softening, a sense of possibility, when it seems no other therapeutic strategy could.

In speaking of acceptance, a sense of detachment and letting go is implied. The other side of allowing a thought, feeling or self-representation to simply exist within you is that you will not cling to it. So in meditation, in mindfulness-oriented psychotherapy, in life, we are always letting the moment go and embracing the next one.

For more about the kinship between mindfulness and psychoanalytic psychotherapy, check out the new volume: Mindfulness, Acceptance and the Psychodynamic Evolution: Bringing Values into Treatment Planning and Enhancing Psychodynamic Work with Buddhist Psychology.

Works Cited

Spence, D. P. (1984). Narrative truth and historical truth: Meaning and interpretation in psychoanalysis. New York, NY: W.W. Norton.

Stern, D. N., Sander, L. W., Nahum, J. P., Harrison, A. M., Lyons-Ruth, K., Morgan, A. C., & Tronick, E. Z. (1998). Non-interpretive mechanisms in psychoanalytic therapy: The “something more” than interpretation. International Journal of Psychoanalysis, 79, 903–921.

Stern, D. N. (2004). The present moment in psychotherapy and everyday life. New York, NY: W.W. Norton.

Freud, S. (1912). Recommendations to physicians practicing psychoanalysis. In J. Strachey (Ed. & Trans.), The standard edition of the complete psychological works of Sigmund Freud (Vol. 12, pp. 109–120). London, England: Hogarth Press.

Freud, S. (1909). Analysis of a phobia in a five-year-old boy. In J. Strachey (Ed. & Trans.), The standard edition of the complete psychological works of Sigmund Freud (Vol. 10, pp. 3–149). London, England: Hogarth Press.

Merton, T. (1968). Zen and the birds of appetite. New York, NY: New Directions.

Berry, W. (1987). The collected poems, 1957–1982. San Francisco, CA: North Point.

Bion, W. (1970). Attention and interpretation. Northvale, NJ: Jason Aronson.

Weber, S. L. (2003). An analyst’s surrender. In J. D. Safran (Ed.), Psychoanalysis and Buddhism: An unfolding dialogue (pp. 169–197). Somerville, MA: Wisdom.

Ghent, E. (1990). Masochism, submission, surrender: Masochism as a perversion of surrender. Contemporary Psychoanalysis, 26, 108–136.

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