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mindfulness

When it comes to treatment for psychosis, CBT and acceptance- and mindfulness-based approaches have, at times, been assumed to be incongruent with respect to the goals of “control” and “change.” However, in their integration these approaches can complement one another by emphasizing the understanding, exploration, observation, and acceptance of thoughts and feelings rather than the “stopping” and “controlling” of unwanted thoughts and feelings.

Psychotherapeutic modalities such as cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) have proven to be effective for a range of psychiatric and psychosocial difficulties including depression, anxiety disorders, substance abuse, eating disorders, and personality disorders. But when it comes to treating psychosis, CBT and other forms of psychotherapy have historically received less attention, owing to the traditional reliance on pharmacological strategies for treating psychotic disorders.

Any practicing therapist can identify with the feeling of flying by the seat of your pants in a session—banking on your experience and foundational clinical skills to see you through. But for the majority of us, flying by the seat of our pants can land us on our behinds when it comes to acceptance and commitment therapy (ACT).

Across the majority of contemporary psychotherapeutic modalities, mindfulness is used in one way or another. Whether your particular approach is entirely mindfulness-based or you simply incorporate mindfulness practice as a tool in treatment, there is an increasing demand for mental health professionals who can develop effective treatment protocols that incorporate mindfulness, suited to the needs of individual clients.

We’ve spent the last few weeks discussing the overlaps between Buddhism and psychodynamic therapy, citing the views of the Buddha and Sigmund Freud. Today we are wrapping up the series with some final comments comparing psychoanalysis and the therapeutic use of mindfulness meditation.

It was Freud’s belief that a successful psychoanalytic treatment resulted in a decreased amount of suffering, but also empowered the individual with the tools with which to cope with these remnants. Originally, Freud’s aim was to develop a theory of mind broad enough to encompass the fluctuations of human suffering. His project for a science of psychoanalysis saw its purpose as two fold: psychoanalysis as a science of mind, and psychoanalysis as a tool to help individuals overcome illness and suffering.

Their shared goal of alleviating mental suffering renders Buddhism and psychotherapy undeniably entwined. Last week we started to unpack the first two of Buddhism’s foundational Four Noble Truths, which examine the nature and cause of suffering, or dukkha. The first is simply that suffering exists; the second, that the human tendency to crave is what causes it.

Buddhism and psychoanalysis share roughly the same goal, the alleviation of mental suffering—one working from a highly personal and individual perspective, the other from a more universal point of view. As research supports the effectiveness of using both psychodynamic and mindfulness-based processes (rather than solely one or the other), it’s useful to examine some of the other ways Buddhism and psychoanalysis overlap.

Western society increasingly sees human suffering as grossly abnormal and typically generated from outside sources; it is a state to be eliminated as soon as possible. We vigorously seek external remedies, such as medications, a variety of addictions, and transient external pleasures over and above insight and understanding as cures for our unhappiness. These solutions to suffering are short lived, but we return time and time again to such supposed sources of happiness, as if they could possibly provide us with a stable state of well-being.

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