Luckily, the practice of psychotherapy has a number of built-in qualities that present clinicians with ample opportunities to do mindfulness in sessions.
Steven Alper, LCSW, mindfulness teacher and author of Mindfulness Meditation in Psychotherapy says there are a number of ways we can think of our clinical work as a mindfulness practice in itself.
1. Be mindful of your motivations for doing therapy.
The motivations that drive us to want to practice mindfulness are the same motivations that support its development. Incidentally, the same motivations drive many of us to practice psychotherapy.
Consider the following motivations: Wanting to benefit others; wanting to avoid causing harm; valuing compassion and caring; wanting to be of service; interest in human psychology, particularly the psychological mechanisms that give rise to happiness and suffering; and wanting to help alleviate suffering and increase happiness.
All of the above motivations support the development of mindfulness. They area also important when doing psychotherapy.
The reality of mindfulness practice is that you are never free from practicing. Whether you are sitting in your meditation room, or in your office across from a client, the question is, what are you practicing right now?
What you practice in any moment, and how it shapes and conditions the next moment, depends a great deal on your intention and the qualities of awareness, presence, relatedness, discipline, and commitment that you embody. In that sense, doing therapy as mindfulness practice is no different than doing anything else in your life mindfully.
2. Think of listening as healing presence.
Listening is the most basic psychotherapeutic skill, so the term mindful listening may sound a bit strange. But the word “listening” connotes an action that requires effort, which goes against the definition of mindfulness as a mode of being and experiencing that involves ceasing from striving, or nondoing.
The act of putting effort into listening is somehow in conflict with the lived experience of being mindfully present with and attentive to a client in therapy. Recall the following lines from Franz Kafka’s Blue Octavo Notebooks:
You do not need to leave your room. Remain sitting at your table and listen. Do not even listen, simply wait. Do not even wait. Be quite still and solitary. The world will offer itself to you to be unmasked. It has no choice. It will roll in ecstasy at your feet.
What happens in the therapeutic relationship is both much more and much less than listening.
“I prefer the terms therapeutic presence or healing presence to describe the therapist’s stance in the therapeutic relationship. I say “stance” because healing presence is a mode of being rather than an action. Healing presence includes hearing and might resemble listening, but it is neither. It is not something you do. Rather, it is an expression of nondoing and an exquisitely sensitive, receptive quality of being that the therapist embodies in the therapeutic encounter,” writes Alper.
Healing presence is less than listening. It is a process of subtraction, not addition, of letting go of even the least hint of doing or striving, and instead just being.
The process that Kafka describes, in which you trust and feel safe enough in relationship to let yourself be seen as you really are, is at the heart of the therapeutic relationship. The therapist’s contribution to this process is healing presence, in a very real sense choosing to function as the mindfulness of the therapeutic relational field.
3. Practice being a healing presence by staying with the emotional experience of your client.
The ability to recognize, identify with, and vicariously experience the emotions of another is called empathic attunement. When you are practicing being a healing presence, you are able to attune to even the most distressing and painful experiences and emotions without shutting down or being overwhelmed. Healing presence remains openhearted, close, and connected, yet also solid, stable, unshakable, and composed. These attributes help the client feel safe.
Staying with the emotional experiences of your client is a way of practicing mindfulness that functions as an invitation for the client to also tune in to his experience. This is an incredibly healing process that you can facilitate by committing to staying mindful and present through these moments.
4. Practice unconditional friendliness, curiosity, and interest.
In some therapeutic traditions, therapists have been trained to maintain a degree of impartiality toward clients. In contrast, unconditional friendliness, interest, and curiosity require that you be equally partial to each moment, calling on the practice of mindfulness to relate to moments of the therapeutic process, rather than to the client, the relationship, or the process as a whole.
This partiality requires sustaining high levels of mindfulness and loving-kindness in each moment, which may at first seem daunting. But keep in mind that genuine curiosity and interest have a way of effortlessly focusing the mind, and driving concentration. Once firmly established, this kind of curiosity becomes self-sustaining. Effortless concentration then generates energy, which enhances and sharpens awareness, and further intensifies interest, curiosity, and concentration in a self-reinforcing positive feedback loop.
5. Ask: What’s needed?
Mindful inquiry is driven by two basic questions: “What is this?” And “what’s happening?” But doing psychotherapy as a mindfulness practice also involves a third question that arises from your role as helper and healer, and the genuine desire to alleviate the client’s suffering. That question is, “what’s needed?”
Often what’s needed is simply continuing to be mindful of the therapeutic process as it unfolds. Sometimes a more active intervention is called for, which may include further inquiry, psychoeducation, role-play, or even providing specific information or suggestions.
When you ask what’s needed you focus on resonance with and attunement to the client as a whole, from the perspective of fulfilling treatment goals; meeting the client’s developmental needs; developing client strengths, and understanding the risks, opportunities, and contingencies of that particular moment of the therapy.
For more about mindfulness, meditation, and psychotherapy, check out Mindfulness Meditation in Psychotherapy by Steven Alper, LCSW.