Often therapists and clients fail to understand each other. The same way that the bedside manner of a doctor significantly affects the compliance and trust of the client, the various barriers to communication—lack of genuine curiosity about where the client is coming from; unrealistic or incongruent expectations; and failure to approach the whole person, not only the pathology exhibited—can significantly impact the effectiveness of therapy. Often clients do not fully understand the clinician’s explanation of what is needed and are unable to follow the advice given.
Mindful communication, or interpersonal mindfulness, begins with you. This means paying attention, with the intention to be present to what the client is saying, moment-to-moment, with affectionate curiosity and nonjudgmental awareness. It also means attending to the impact of the client’s words on your internal landscape of bodily sensations, emotions, and thoughts. Finally, interpersonal mindfulness involves practicing mindful listening as well as mindful self expression.
There are a few basic steps to the practice:
1. Taking a pause to connect with the present moment
2. Softening or relaxing the body
3. Opening oneself to what is in the moment, during the interaction
4. Trusting that what needs to emerge, will
5. Listening deeply
6. Speaking the truth with compassion and without blame
As a therapist you have been trained to listen, and most mental health professionals feel that they excel in their listening skills. But if you begin to carefully pay attention—with kindness and open-mindedness, with the desire to see rather than to judge—you will probably find that you are easily distracted by your loud internal chattering, that you listen selectively, and that you tend to interpret rapidly and make assumptions quickly, without taking the time to verify them.
You may often find yourself “lecturing” clients and their family members, asking unnecessary or repetitive questions, and judging your clients when they do not do their homework as prescribed. In your eagerness to help, you might feel frustrated and unsatisfied, and, if these feelings are not attended to and explored, you could eventually come close to or reach burnout.
When we listen to others mindfully, it is possible to observe with clarity and compassion not only our own narrative and habitual patterns but also those of others, and the possibility of finding gateways for shifts in these patterns arises.
Most of our pain tends to result from our interactions with others, or, more specifically, from our loud internal chattering about what others are doing or saying. By attending deeply to what is actually being said, and to the internal effects of what we hear, we can check to see whether our assumptions are correct and create a healing and refreshing synergy for both our clients and ourselves.
Next week we’ll explore the foundational principles for the practice of interpersonal mindfulness outlined in Treating Co-Occurring Adolescent PTSD and Addiction by Lisa Fortuna, MD, and Zayda Vallejo, MLitt.