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A Professional

Journal of the EAP


E-Issue July 2016

in t e r nat i o n a l J ourn a l o f

Psychotherapy
Special Issue Editor: David Brazier

mindfulness and
psychotherapy

Articles by: Emmy van Deurzen & Digby Tantam, Elas Capriles, Mats Hilte, Francoise
Guillot, Sebastian Medeiros & Simon Guendelman, Jyoti Nanda, Frank Musten,
Mirjam Hartkamp, Andr van der Braak, G.T. Maurits Kwee & Peter T. van den Berg,
Manu Bazzano, Craig Mackie, Jessie Bosse, Brittany Gylnn & Lynette Monteiro

EAP special JOURNAL : Mindfulness and Psychotherapy -

about -

internationa l J o u rna l o f

Psychotherapy

Volume 20, Extra Special Issue, July 2016

he International Journal of Psychotherapy is a peer-reviewed,

INTERNATIONAL ADVISORY BOARD (IAB):

scientific journal and is published three times a year in March, July, and

A. Roy Bowden, New Zealand; Howard Book, Canada; Paul Boyesen, France; Shaun

November, by the European Association of Psychotherapy (EAP); a member

J.F. Brookhouse, UK; Jacqueline A. Carleton, USA; Loray Dawes, Canada; Rodolfo

of the World Council for Psychotherapy (WCP); and an International NGO member

de Bernhart, Italy; Terence Dowdall, South Africa; Gtz Egloff, Germany; Mony

of the Council of Europe. 2016 is our 20th year of publication and this is an Extra

Elkaim, Belgium; Richard G. Erskine, Canada; Dorothy Firman, USA; Maksim Gon-

Special Issue - our 1st e-issue - to celebrate this.

charov, Russia; Miles Groth, USA; Bob Henley, USA; Toby Sgrun Herman, Iceland;
Theodor Itten, Switzerland; Thomas Kornbichler, Germany; Eugenius Laurinaitis,

Journal Editor: Courtenay Young, Scotland, UK: courtenay@courtenay-young.com

Administrative Editor: Tom Ormay, Hungary: tomormay@t-online.hu


Associate Editor: Alexander Filz, Ukraine: filz.uuap@gmail.com

Executive Editor: Alicja Heyda, Poland: alicjaheyda@gmail.com


Assistant Editor: Marzena Rusanowska, Poland: marzena.rusanowska@gmail.com

Lithuania; Alan Lidmila, UK; Michel Meignant, France; Roberto Pereira, Spain;
Adrian Rhodes, UK; John Rowan, UK; Andrew Samuels, UK; Ganesh Shankar, India; Peter Schulthess, Switzerland; Ulrich Sollmann, Germany; Margherita Spagnuolo Lobb, Italy; Anna Szalanska, Poland; Emmy van Deurzen, UK; C. Edward

Abstract Translators: Andrea Zimpernik (D); Joanna Graham Wilson (Fr.);

Watkins, USA; Michael Wieser, Austria; Heward Wilkinson, UK; Joanne Graham

Victoria Orlova (Ru.)

Wilson, France; Herzel Yogev, Israel; Riccardo Zerbetto, Italy.

Editorial Office: admin@ijp.org.uk


IJP website: www.ijp.org.uk

All the affiliations of the members of the Editorial Board and the International
Advisory Board are now on the relevant pages of the IJP website.

IJP EDITORIAL BOARD


Godehard Stadmller, Switzerland

Rene Oudijk, The Netherlands

Snezana Milenkovic, Serbia

Heward Wilkinson, UK

Peter Schtz, Austria

Barbara FitzGerald, Ireland

Switzerland; Alexandra Chalfont, UK; David Kraft, UK; Cornelia Krause-Girth,

Milena Karliska-Nehrebecka, Poland

Vesna Petrovi, Serbia

Germany; Roberto Parrini, Italy; Daan van Baalen, Norway.

Anna Colgan, Ireland

Ingrid Pirker-Binder, Austria

Also (potential) IAB members: Richard Blamauer, Germany; David Boadella,

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2 | Extra Special Issue: Mindfulness and Psychotherapy

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Copyright 2016, European Association of Psychotherapy

ISSN 1356-9082

EAP | International Journal of Psychotherapy | 3

EAP special JOURNAL : Mindfulness and Psychotherapy -

Table of contents
08 Editorial | Courtenay Young

Table of contents -

146 Mindfulness, Equanimity and Cognitive Flexibility


Mirjam Hartkamp

162 Beyond kusala and akusala?


Mindfulness and Buddhist Ethics

0
15 Guest Editorial | David Brazier

Andr Van Der Braak

022 Abstracts

176 Buddhist Heartfulness:


Beyond Western Mindfulness

032 The Phenomenology of Mindfulness

Emmy van Deurzen & Digby Tantam

G.T. Maurits Kwee & Peter T. Van Den Berg

50 Mindfulness Training for


0
Psychotherapists and its Benefits in Improving
the Effectiveness of Psychotherapy

98 The Winner of the Race:


1
The Dharma in the Digital Age

Elas Capriles

066 The development of a relational and


dialogical ethics in therapeutic mindfulness
Mats Hilte
080 How can mindfulness be relevant or useful to the

psychotherapist and how should a practitioner


use mindfulness to their best advantage?
Francoise Guillot

94 Developmental Trauma from a Buddhist and


Relational Inter-subjective Perspective
Sebastian Medeiros & Simon Guendelman

114 Side Effects: A case illustration from a Mindfuness


Based Existential Therapy (MBET) perspective
Jyoti Nanda

132 The Mindful Bridge Back To Work


Frank Musten

4 | Extra Special Issue: Mindfulness and Psychotherapy

Manu Bazzano

10 Implicit Ethics and Mindfulness: Subtle


2
assumptions that MBIs are values-neutral
Lynette Monteiro

26 Developing a Mindful Moral Compass:


2
Ethics for mindfulness trained practitioners
Craig Mackie, Michele Chaban, Sarah Serbinski,
Dekyi-Lee Oldershaw & Robert J. MacFadden

44 Slow and Fast Cooking of Rumis Chickpea:


2
Issues in the Training of Teachers in
Mindfulness-based Interventions
Jessie Bosse, Brittany Glynn & Lynette Monteiro
2

About | IJP Editorial Board, Advisory Board, Imprint

Focus of the International Journal of Psychotherapy

262

Addenda | Other Internet Articles - available as PDF downloads

264

Books of further interest | about Mindfulness & Psychotherapy

272

Information and Guidelines for Authors

274

Journal Subscription

EAP | International Journal of Psychotherapy | 5

EAP special JOURNAL : Mindfulness and Psychotherapy -

about / Focus -

internationa l J o u rna l o f

Psychotherapy

Volume 20, Extra Special Issue, July 2016

he International Journal of Psychotherapy is a leading pro-

fessional and academic publication, which aims to inform, to stimulate

the political, the theoretical and the practical, the traditional and the developing

debate, and to assist the profession of psychotherapy to develop throughout

Europe and also internationally. It is properly (double-blind) peer-reviewed.

status of the profession


n

The Journal raises important issues in the field of European and international

Connections, communications, relationships and association between the related


professions of psychotherapy, psychology, psychiatry, counselling and health

psychotherapy practice, professional development, and theory and research for


psychotherapy practitioners, related professionals, academics & students.

Interactions between the psychological and the physical, the philosophical and

care
n

The Journal is published by the European Association for Psychotherapy (EAP), 3

Exploration and affirmation of the similarities, uniqueness and differences of


psychotherapy in the different European regions and in different areas of the

times per annum. It is working towards obtaining a listing on Citation Indices and

profession

gaining an Impact Factor.

Reviews of new publications: highlighting and reviewing books & films of parti-

The Focus of the Journal includes:

Comment and discussion on all aspects and important issues related to the clini-

cular importance in this field


n

Contributions from, and debates between, the different European methods and
modalities in psychotherapy, and their respective traditions of theory, practice
and research

Matters related to the work of European professional psychotherapists in public,


private and voluntary settings

A dedication to publishing in European mother-tongue languages, as well as in


English

Contemporary issues and new developments for individual, group and psychotherapy in specialist fields and settings

cal practice and provision of services in this profession


n

Broad-ranging theoretical perspectives providing informed discussion and de-

This journal is therefore essential reading for informed psychological and psychotherapeutic academics, trainers, students and practitioners across these disciplines and geographic boundaries, who wish to develop a greater understanding of
developments in psychotherapy in Europe and world-wide.

bate on a wide range of subjects in this fast expanding field


n

Professional, administrative, training and educational issues that arise from developments in the provision of psychotherapy and related services in European

We have recently developed new Editorial Policies that are available on the IJP
website on the Ethos page: www.ijp.org.uk

health care settings


n

Contributing to the wider debate about the future of psychotherapy and reflecting
the internal dialogue within European psychotherapy and its wider relations
with the rest of the world

Current research and practice developments - ensuring that new information is


brought to the attention of professionals in an informed and clear way

6 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 7

EAP special JOURNAL : Mindfulness and Psychotherapy -

editorial by courtenay young -

Editorial
Dear Readers and Subscribers to the IJP

You will also find lots of other definitions


and descriptions of Mindfulness and its

e are absolutely delighted to be able produce this Extra Spe-

connection with and uses in psychothe-

cial Issue of the International Journal of Psychotherapy es-

rapy as you read through the rich and

pecially as it is additional (Extra) to our usual three issues per

varied articles in this issue: we also hope

year; it is also a Special Issue devoted to a particular topic in this case

that you will be inspired to, and be more

Mindfulness and Psychotherapy; it is also Special because it is celebra-

able to, incorporate these ideas into your

ting our 20th year of publication; and it is even Extra Special as it going

professional psychotherapeutic practice.

to be produced as our first e-Journal. However, because it is so Extra

Special, we will be making the e-Journal version of this issue available

Although Kabat-Zinn has always stated that mindfulness-based stress

free of charge - via the IJP website.

reduction (MBSR) is not a therapy, as he feels that patients (people) should

Courtenay Young
Editor International Journal
of Psychotherapy

assume continuing responsibility for their own health, its influence on


You are probably aware that Mindfulness is a

overtly therapeutic interventions has been profound. It seemed to be

2,500 year-old Buddhist practice; however, it has

quickly assimilated into Cognitive-Behavioural Therapy as an evidence-

also been resurrected more recently as a (psy-

based form of treatment (MBCT: Segal et al., 2002); and then extended

cho)therapeutic technique especially useful for

and developed further into Dialectical Behaviour Therapy (DBT) (Welch

stress-reduction (Kabat-Zinn, 1990) and this sort of

et al., 2006) and Acceptance and Commitment Therapy (ACT) (Hayes et

therapeutic use has proliferated. So, we therefore

al., 1999). Mindfulness is now the flavour of the month: there are mind-

now have several operative definitions of Mind-

fulness courses in most major Western cities; celebrities like Gwyneth

fulness and paradoxically no one definition is

Paltrow and Russell Brand promote mindfulness; mindfulness apps are

completely right, neither is any one of them wrong:

now available for smart-phones (Tlalka, 2015); there are mindfulness co-

Mindfulness is: facing the bare facts of experience,

louring books for adults; so mindfulness may even go viral, take over the

seeing each event as though occurring for the first

planet, and bring about World Peace!

time (Goleman, 1988: p. 20); keeping ones consciousness alive to the present reality (Thich, 1991:

However, there is also potentially a huge gulf between some of these

p. 11); paying attention in a particular way: on pur-

different forms: if one takes out the Buddhist origins, in order to make

pose, in the present moment, and non-judgmentally

it more acceptable in a Western secular world, does one therefore lose

(Kabat-Zinn, 1994: p. 4); and awareness of present

the intrinsic ethical basis? Mindfulness is being taught to business people

experience with acceptance (Germer, 2005: p. 7).

(Apple, Google & Sony) and also to the US military: does this mean that

8 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 9

EAP special JOURNAL : Mindfulness and Psychotherapy -

editorial by courtenay young -

one can use mindfulness any way one wants to, or for anything? Some

We have tried to describe it better in this issue, though unfortunately we

will argue, Yes; others No.

have not been able to supply such a definitive case study, however I am
sure that you will find many things of great interest in this offering and

There are also some negative reactions to Mindfulness: there is a debate

maybe just maybe this might stimulate you, as a psychotherapist, to

about its effectiveness and the jury is still out (CADTH, 2015); some say

produce such a case study, and then we would be (of course) delighted to

that mindfulness in business is just another way to placate the workforce

publish this, in due course.

in the service of profit (Filar, 2015); Ileana Johnson (2014), an American By


Choice thinks it is another method of indoctrination: newspapers (like

Our last Special Issue was on Existential Therapy (Vol. 19, No 1, 2015)

the Daily Mail) print stories that state: 60% of us have apparently suffered

and to a certain extent this Extra Special Issue emerged out of that

at least one negative side-effect [ from meditation and mindfulness] (Craw-

one. One of the main protagonists of Existential Psychotherapy in the

ford, 2015); and there is lots more out there.

UK, Emmy van Deurzen, recommended someone called David Brazier as


a potential Guest Editor for this issue. I then got to meet him briefly at a

But we as psychotherapists are probably more interested in (or

Experiential Therapy conference in London and we clicked, so through

concerned with) what happens when mindfulness is applied in therapy?

his contacts he produced the wonderful people to write all these articles

Hopefully, that is what this Extra Special Issue is all about.

and so, this is what we have for you: I will now hand you over to him.

The practical challenges differ according to therapists current

Courtenay Young

practices and attitudes in ways that have also been illustrated.


Some psychodynamic psychotherapists have changed the way
they advise and instruct patients in order to help them develop mindfulness, but others have not. Some cognitivebehavioural psychotherapists have changed the way they attend to their
own inner feelings in order to work mindfully with patients, but
others have not. (Mace, 2007)

Courtenay Young is the current Editor of the IJP; he is a UKCP-registered


psychotherapist and counsellor. He works with GP referrals in the NHS, in
and around Edinburgh, Scotland, and also has a private practice. He has also
been heavily involved in the professional politics of psychotherapy, in the UK
and in Europe. He has written several published books: Help Yourself Towards
Mental Health (Karnac, 2010); First Contacts for People in Crisis and Spiritual
Emergencies (AuthorHouse, 2011); and has edited several books the latest

The fact that mindfulness practice is being used increasingly worldwide is quite a phenomenon, however, the cynical scientific world is not
yet convinced. Mace concludes that: These [desired studies] would pay far

being The Handbook of Body Psychotherapy & Somatic Psychology (North Atlantic Books, 2015). His many published articles can be accessed through his
website: www.courtenay-young.com E-mail: courtenay@courtenay-young.com

more detailed and inclusive attention to what happens within and between
therapists and patients in terms of awareness during therapeutic sessions.
At present, the clinical and research literature appears to lack a single case
study that explores this in real depth. Continuing attempts to establish the
role of mindfulness in psychotherapy seem likely to benefit from a more ca-

International Journal of Psychotherapy: 2016, Vol. 20,


Extra Special e-Issue, pp. 08-12: ISSN: 1356-9082
Author and European Association of Psychotherapy (IJP):
Reprints and permissions: www.ijp.org.uk

reful approach to its description.

10 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 11

EAP special JOURNAL : Mindfulness and Psychotherapy -

references
CANADIAN AGENCY FOR DRUGS & TECHNOLOGIES IN HEALTH (2015). Mindfulness
Interventions for the Treatment of Post-Traumatic Stress Disorder, Generalized
Anxiety Disorder, Depression, and Substance Use Disorders: A review of the Clinical
Effectiveness and Guidelines. Accessed 24-Mar, 2016:
www.ncbi.nlm.nih.gov/pubmedhealth/PMH0078358
CRAWFORD, H. (2015). The dark side of meditation and mindfulness. Accessed 24-Mar,
2016: http://www.dailymail.co.uk/health/article-3092572/The-dark-meditationmindfulness-Treatment-trigger-mania-depression-psychosis-new-book-claims.html
FILAR, R. (2015). The miserable cynics guide to mindfulness. Accessed: 24-mar, 2016:
https://www.opendemocracy.net/transformation/ray-filar/miserable-cynics-guideto-mindfulness
GERMER, C.K. (2005). What is mindfulness? In: C.K. Germer, R. D. Siegel & P. R. Fulton
(Eds.), Mindfulness and Psychotherapy, (pp. 127). New York: Guilford Press.
GOLEMAN, D. (1988). The Meditative Mind. Putnam.
HANH, T.N. (1991). The Miracle of Mindfulness. Rider.
HAYES, S.C., STROSAHL, K.D. & WILSON, K.D. (1999). Acceptance and Commitment
Therapy: An Experiential Approach to Behavior Change. New York: Guilford Press.
JOHNSON, I. (2014). Mindfulnes: Another Method of Indoctrination. Accessed 24-Mar, 2016:
http://ileanajohnson.com/2014/05/mindfulness-another-method-of-indoctrination/
KABAT-ZINN, J. (1994). Mindfulness Meditation for Everyday Life. Piatkus Books.
MACE, C. (2007). Mindfulness in psychotherapy: An introduction. Advances in
Psychiatric Treatment, Vol. 13, pp. 147-154. doi: 10.1192/apt.bp.106.002923. Accessed
24-Mar, 2015: http://apt.rcpsych.org/content/aptrcpsych/13/2/147.full.pdf
SEGAL, Z., WILLIAMS, J.M.G. & TEASDALE, J. (2002). Mindfulness Based Cognitive

Shifting Consciousness
in Politics, Economics, Ecology
and Relationships
APRIL 23-28, 2017
PORTO HELI, GREECE

Therapy for Depression. John Wiley & Sons.


TLAKLA, S. (2015). Three mindfulness apps worthy of your attention. Accessed 24-Mar,
2016: http://www.mindful.org/free-mindfulness-apps-worthy-of-your-attention/
WELCH, S.S., RIZVI, S. & DIMIDJIAN, S. (2006). Mindfulness in dialectical behavior
therapy (DBT) for borderline personality disorder. In: R.A. Baer (Ed.), Mindfulnessbased Treatment Approaches: Clinicians Guide to Evidence Base and Applications,
(pp. 117139). Academic Press.

The Athenian Institute


of Anthropos

12 | Extra Special Issue: Mindfulness and Psychotherapy

www.worldwork.org

EAP special JOURNAL : Mindfulness and Psychotherapy -

guest editorial by David Brazier -

Guest Editorial
By david brazier

n this Special Issue, we address the


question of mindfulness in psychotherapy, especially from the perspec-

tive of ethics. Initially, we issued an invitation to contributors to submit articles


on any aspect of the mindfulness phenomena that interested them. The majority chose, one way or another, to look at
the question of ethics. We are all aware
that mindfulness has become a matter of
widespread interest, but why has ethics

David Brazier
Guest Editor: IJP
Extra Special Issue
on Psychotherapy &
Mindfulness: May 2016

come to be so central a concern? I think


that an examination of this question tells us something of interest about
how our society works and the place of psychotherapy within it.

Mindfulness, we know, is an idea that has its origins in Buddhism. However, Buddhism is a religion, and in a contemporary society, especially
with intellectuals in the medical and paramedical fields, many are wary
of religion. To get it established in those domains, therefore, those who
propagated the medical and health aspects of mindfulness, needed to
distance the method from its Buddhist origins. The medical establishment
could not afford to be seen as propagating a religion.

new mindfulness

Mindfulness, therefore, was presented as a technique: in particular, as

The mindfulness phenomenon has

present to the senses, in a non-judgemental way. This definition skilfully

grown so fast that developments on


the ground have perhaps outrun the
theoretical base.

14 | Extra Special Issue: Mindfulness and Psychotherapy

a special kind of deliberate attention, in the present moment, to things


aligned mindfulness with a number of values that would be acceptable to
and approved by the professions that needed to be convinced.

EAP | International Journal of Psychotherapy | 15

EAP special JOURNAL : Mindfulness and Psychotherapy -

guest editorial by David Brazier -

The definition sounds a bit like the kind

from its original context and come to be

ditions, when, in fact, the fundamental

dified and commercialised. Mindfulness

of attitude that is required of an impartial

seen as useful by business, the military,

cause is the intrinsic meaninglessness of

has become a saleable item. The number

observer in a scientific experiment: Ho-

and a host of personal-growth practitio-

much that constitutes our lives. Instead

of self-styled mindfulness trainers is

wever, this made mindfulness acceptable,

ners, not all of whom operate within any

of living in a world where what consti-

now legion. Anybody can set up shop and

and, it is quite a long way from the original

established professional boundaries. The

tutes our life is itself considered mea-

sell it. This has, in part, been one of the

Buddhist concept of mindfulness which

original Buddhist mindfulness was in-

ningful, as was the case for our ancestors,

things that has made it suddenly so po-

was embedded in, and permeated by, a

trinsically ethical. The new mindfulness

we now live in a value-free environment

pular and widely distributed. The role of

deeply ethical spiritual path and practice.

is not. It relies upon an ethical bounda-

that is held together by various systems

a mindfulness teacher offers an instant

In Buddhism, mindfulness meant having

ry, provided by the users context. Ho-

of boundary ethics that are merely con-

road to a certain kind of status and brings

the mind and heart full of things that are

wever, the ethics of the military, the

ventional and so do not convey any sense

in customers. Some may lament this

intrinsically wholesome and improving,

medical world, and corporate business,

of deeper meaning, merely the necessi-

proliferation of services offered by peo-

whereas the new mindfulness meant im-

are all quite different. This contrast bet-

ty of administrative convenience. This

ple with little or no training. Others may

partially observing whatever showed up.

ween inherent ethicality and boundary

works at a utilitarian level, but does not

see this development as a potential libe-

The content was quite different.

ethics reflects an important difference

satisfy the soul.

ration, breaking the restrictive bounds


that could have been seen to be holding

between the society in which Buddhism


We can note that there is a certain par-

originally appeared and the social set-

Another important difference between

psychotherapy and related activities (and

allel with the history of psychotherapy

tings that prevail today. The problem of

the Buddhist mindfulness and the new

also Buddhism) in an overly conservative

and its relation to pastoral care. Pioneers,

modern life is, often enough, that there is

mindfulness is that the latter is now ge-

frame. However it is judged, it is certainly

such as Freud, were at pains to present

no inherent meaning in the things that

nerally regarded as a technique, and as

out of Pandoras box and it is not easy to

what they were doing as scientific, and

people spend most of their time and en-

one that can be learnt in a fairly short

predict where the modern mindfulness

divorced from religion, even though the

ergy upon.

period of time. A technique is, again, so-

phenomenon will eventually lead us.

mething that can be used in a diversity of

links to religious themes, both monotheistic and pagan-mythological could never

The dilemma emerging in the field of

contexts and that takes on a particular

As in the case of many other mushroo-

be completely erased. Freud also adapted

mindfulness, therefore, is not simply that

colouring from the context in which it is

ming fashions, we now find ourselves in

his theories to make them more socially

of the correct use of a new technique.

used. A technique for dying cloth could be

a position where the claims being made

acceptable.

It is also a symptom of one of the basic

found equally useful by a theatre troupe, a

for mindfulness far outstrip the evidence.

existential problems that psychothera-

group of Buddhist monks, people making

This does not mean, necessarily, that the-

Initially, the fact that mindfulness as

py itself a product of this same modern

uniforms, or campaigners in any number

se claims are wrong simply that we do

presented in a medical or health setting

world exists to wrestle with. Thus it can

of causes where coloured cloth might be

not know, one way or the other. One re-

was being secularised did not seem to mat-

(and often is) argued that alienation, in

useful. The technique itself is, as it were,

peatedly reads that there now exist a huge

ter, especially since the contexts within

one form or another, is the underlying re-

indifferent to the cause in which it is used.

number of scientific studies purporting to

which the new mindfulness was practised

ason for many modern psychological ills

Furthermore, in our modern information

demonstrate the benefits of mindfulness,

had their own ethical frameworks. Since

that then appear as symptoms that we

age, knowledge or know-how, including

to a wide range of client groups, in the so-

then, however, mindfulness has escaped

treat as though they were medical con-

technique, is being increasingly commo-

lution of an equally diverse range of pro-

16 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 17

EAP special JOURNAL : Mindfulness and Psychotherapy -

guest editorial by David Brazier -

blems, and these claims go well beyond

So what is mindfulness really good for

Terms of this kind catch on without the-

ones immediate state and circumstances

the therapy situation. It can seem that

and where and how does it fit in to the

re necessarily being a depth of thought

is something that has great benefit in cer-

mindfulness is good for the whole popu-

world of psychotherapy? Is it primarily

or meaning behind them and it can be

tain situations, but, if mindfulness is to be

lation and helps them to do whatever it is

an aid to the practitioner, a self-develop-

very illuminating to ask what the founda-

taken in this more philosophical way, then

that they want to do better. However, the

ment tool, that may increase sensitivity

tional meaning may be. The mindfulness

a good deal more work needs to be done

vast majority of such studies are of very

and concentration and other useful attri-

phenomenon has grown so fast that de-

on identifying when and where it is rele-

poor quality. Most rely upon self-report in

butes, or, on the other hand, does it help

velopments on the ground have perhaps

vant. In this context, it is an interesting

situations where it is transparently obvi-

to protect the worker from burn-out, or

outrun the theoretical base.

exercise to ask, What is not mindful?,

ous to the experimental subjects what the

the therapist from undue contagion from

experimenters want to hear from them.

distressed clients? Is it a treatment a

This is not proper science. Much of what


are claimed to be scientific studies are

What counts as non-mindful activity?


Sometimes, mindfulness is not presen-

Day-dreaming? Reminiscing? Sleeping?

medicine to be applied in cases of spe-

ted merely as technique: indeed, there

Worrying? Intellectualising? Surely all

cific syndromes such as PTSD, depressi-

does seem to be implied that subtly bu-

of these activities have their place. They

really much closer to being propaganda

on, anxiety and so on, and which? Or is

ried within it is a certain life philosophy.

each serve a useful function, at one time

or ways of promoting self-interests. The

it a general prophylactic, to be taught to

This has to do with living in the moment

or another. If the mindfulness movement

few genuinely rigorous studies tend to

as many clients as possible, irrespective

or being in the here-and-now. This is a

were dedicated to eliminating them from

show that mindfulness has some general

of condition or complaint, rather like a

strange phrase: taken literally, it is diffi-

the human repertoire, it would obviously

beneficial effects, but that these do not go

kind of psychological multi-vitamin ta-

cult to see what other option there could

be making a mistake.

further than beneficial effects from many

blet? What is meant by claiming that

be; therefore, implicitly, something more

other wholesome activities: walks in the

certain therapies are mindfulness-ba-

is intended than the obvious fact that the

Extending the argument of the last pa-

country, playing chess, or taking up knit-

sed? Or that the therapist does her work

here-and-now is inevitably where life

ragraph, it does appear that mindfulness,

ting might all be as effective in reducing

mindfully? Does it mean that mindful-

takes place. When looked at in this way,

in its modern form, implies a valuation of

anxiety, curing depression, or making one

ness provides an underpinning theory?

the matter invites philosophical reflec-

consciousness over the unconscious. This

better able to cope with the stress of mo-

Or that mindfulness is incorporated, in

tion. The suggestion seems to be that one

is a matter upon which psychotherapists

dern life.

some central way, into the methodology?

lives more effectively, or more happily, if

should certainly have something to say.

one disconnects in some way from the

One can envisage two quite different in-

past or the future. Doing so radically, ho-

terpretations of how it is that mindfulness

wever, clearly leads to a complete break-

works. On the one hand, it could be as-

down of normal life. It is similar to the

serted that deliberate conscious attenti-

condition of those suffering from severe

on in the present moment is the optimum

dementia.

way for the human mind to function. This


view would deny (or devalue) the uncon-

18 | Extra Special Issue: Mindfulness and Psychotherapy

Therefore, this is not a philosophy to be

scious. On the other hand, it could be

pushed to its limits. Is it useful, or wise,

argued that mindfulness is essentially a

in smaller doses? Undoubtedly, perceiving

distraction technique. It is in the intrin-

EAP | International Journal of Psychotherapy | 19

EAP special JOURNAL : Mindfulness and Psychotherapy -

guest editorial by David Brazier -

sic nature of attention that giving it to

ling age-old wisdom. The message seems

traditions may have functioned by effec-

one thing withdraws it from other things.

to be that recalling age-old wisdom

ting such training and ordering. The repe-

The way that mindfulness reduces stress

leads one to investigate things for one-

tition of a mantra, redolent with implied

may well be that it is a training in how to

self. This is distinctly different from the

meaning, may well constitute a means

distract your attention from the causes of

contemporary idea of mindfulness, but

of restructuring the brain along better

stress by focussing it on, say, the taste of a

no less relevant to psychotherapy. Most

lines. This could, perhaps, be considered

grape. Any hypnotist can tell you that this

therapists do rely upon a certain stock

as yet another kind of mindfulness. It cer-

may well work. However, when the gra-

of wisdom, often drawn from their psy-

tainly was so in the original traditions.

pe has been digested, the causes of stress

chological tradition. This is particularly

still remain to be dealt with. However,

true in psychoanalysis, but evidently it

These, however, are all methods of incul-

this distraction interpretation could have

also applies to humanistic and existential

cating wholesome-ness, which is to say,

more substantial effect if the distraction

therapists, and even cognitive therapists

inter alia, ethical patterns being newly

is, in fact, allowing the unconscious to

have a well-established collection of ideas

laid down within the brain. The original

operate without conscious interference.

about what constitutes right and wrong

Buddhist

And this is certainly a line of enquiry that

thinking, so that they try to be mindful

ly ethical and formed part of a personal

perhaps needs greater consideration.

of when relating to their clients. Perhaps

process that embedded ethicality deep

the study and application of mindfulness

within ones being. Contemporary mind-

These more philosophical and in-depth

would benefit from a greater incorporati-

fulness has, rather, conformed to the

considerations take us somewhat back to

on of some of the ancient understandings

modern preference for ethically neutral

Buddhism is a Religion: You can

the Buddhist origins. In Buddhism, mind-

of Buddhism and other wisdom traditions.

techniques, which can then be operated

believe it (2014).

fulness is the first of what are called the

All of those traditions are concerned with

flexibly within different contexts and that

Factors of Enlightenment. In this list, it

the ethics of life, in one way or another. In

are each circumscribed by their particular

is immediately followed by a factor called

the normal Buddhist presentation, ethi-

ethical boundaries. It is surely this change

investigation of dharma. Dharma means

cal behaviour flows from a well-ordered

that has made the question of ethics so

those things that are fundamental. We

mind, habitually trained to occupy itself

salient in relation to mindfulness prac-

can take it from this juxtaposition that, in

with wholesome mind-objects. Concur-

tice. Having taken the ethics out, are we

a Buddhist context, mindfulness is meant

rently with the upsurge in interest in

now trying to put them back in again, and

to give rise to such an investigation. This

mindfulness, we are also seeing a growing

do we know how to do that, given the so-

could be very relevant for psychotherapy.

interest in neuroscience and neurological

cial context that we are operating in, and

The term for mindfulness in Sanskrit is

plasticity. We are learning that the very

in which psychotherapy claims to have its

smriti and the basic meaning of this term

structure of the brain is relatively plastic

place?

is remembrance. Originally, therefore,

and can thus respond to training and or-

mindfulness did not mean confining ones

dering. It is easy to see how some of the

mind to the present, but, rather, recal-

methods used in the ancient mediation

20 | Extra Special Issue: Mindfulness and Psychotherapy

David Brazier, Ph.D.,


(Dharmavidya) is a psychothera-

mindfulness

was

inherent-

International Journal of Psychotherapy:


2016, Vol. 20, Extra Special e-Issue,
pp. 15-21: ISSN: 1356-9082

pist and is also well-known as the


author of many books on Buddhism
and psychotherapy: the most recent
of which are:
Love and its Disappointment: The
meaning of life, therapy and art
(2009); Not Everything is impermanent: Zen Therapy & Amidist
Teachings of David Brazier (2013);

He is the President of the International Zen Therapy Institute leader


of the Amida Order; and teaches
and lectures internationally in
Dharma centres, universities, and at
conferences. Email: dharmavidya@
amidatrust.com

Author and European Association


of Psychotherapy (IJP):
Reprints and permissions: www.ijp.org.uk
Submitted Sept. 2015; peer-reviewed twice
and reformatted, Nov. 2015; resubmitted
and accepted, April, 2016

EAP | International Journal of Psychotherapy | 21

EAP special JOURNAL : Mindfulness and Psychotherapy -

abstracts -

Abstracts
32

The Phenomenology of Mindfulness


Emmy van Deurzen & Digby Tantam

50

Mindfulness Training for Psychotherapists and its Benefits in Improving


the Effectiveness of Psychotherapy
Elas Capriles

Abstract: Mindfulness has taken the world of psychotherapy by storm. Somehow the simple idea of paying

Abstract: After my second workshop at FUNDIPP (Foun-

proper attention to what we do and think has taken

dation for Research in Psychotherapy and Personality)

root in the minds of many different types of therapists.

at the Foundations quarters in Santander (Spain), I was

We all know that we tend to rush around and that we

interviewed by Eugenio Gonzlez, who at the time was

are missing out on being aware of the (more detailed)

responsible for the section of communications of FUN-

reality of our lives. Therapists, who work with people

DIPP, and the interview was published in the Foundations blog. This pa-

towards greater awareness and understanding of human existence, are

per is an abridged version of that interview, which shows how practicing

particularly taken with this idea. It is an essential aspect of our work: to

mindfulness and other meditations makes therapists practice more ef-

be attentive. Mindfulness is a great reminder of the centrality of that idea.

fective, and places those practices in the context of a wider psychological

In terms of positive methods that are easily understood and transmitted

theorywhich I developed in several books, papers and book chapters

to clients and practitioners, we cannot really come up with anything more

based on Buddhism and on my experience in the spiritual emergence/

fundamental than an attitude of mindfulness to engage human conscious-

emergency refuges that I managed in India and Nepal in the 1970s. A cen-

ness in a new way.

tral idea in this paper is that an efficient practice of mindfulness and other
meditation practices can help therapists avoid what Freud called coun-

There has been an immediate wave of mindfulness research, especially in

ter-transference and (in general) cease making projections onto clients or

the USA, with some very interesting results, that have focused the atten-

patients, thus helping them to heal, instead of turning the processes that

tion of psychotherapists across the world, so that no psychotherapist who

they undergo into potentially chronic illnesses.

is serious about any of these new developments can afford to ignore the

Key Words: Mindfulness, Dzogchen, Anti-psychiatry, Psychotherapy,

subject (Hutcherson, 2008, Singh et al., 2007, Shapiro et al., 2005, Singh

Counter-transference, Shadow, Unconscious Fantasies

et al., 2007). The evidence that mindfulness practice, in itself, has considerable benefits is very convincing: and thus we do not have to become
mindfulness therapists in order to use these principles to good effect in
our work.

22 | Extra Special Issue: Mindfulness and Psychotherapy

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66

abstracts -

The development of a
relational and dialogical ethics in
therapeutic mindfulness

an attitude it is a state of mind, which can be explored and experienced.

Mats Hilte

carefully studied in the last decades.

The soothing and transformative effect of Mindfulness practice, as a part


of and accompaniment to different kind of medical treatments, has been
The purpose of this article is to discuss and explain how psychotherapists

Abstract: Mindfulness in the West is largely constructed

could integrate mindfulness as a protective and regenerative resource for

as a psychological and cognitive phenomenon. Critics

themselves on the one hand and, how they can use it as a precious skill in

have pointed out that Western mindfulness does not

their daily work with patient/clients on the other.

include an ethical dimension, and thus risks becoming

Key Words: Mindfulness, practitioner, trainingKey words: Therapeutic mind-

wrong mindfulness. These shortcomings need to be

fulness, Buddhist ethics, relational and dialogical ethics, Western psychotherapy

addressed. However, Buddhist ethical and normative principles will not


suffice because they are formulated against the backdrop of karma, rebir-

94

needs an ethic that is compatible with Western psychotherapy and the

Developmental Trauma from a Buddhist


and Relational Inter-subjective Perspective

conditions surrounding its practice. An outline of a relational and dialo-

Sebastian Medeiros & Simon Guendelman

th and the liberation from suffering. Therapeutic mindfulness therefore

gical ethics is presented, based on social constructionism, postmodern


therapy and on Martin Bubers relational and dialogical philosophy.

Abstract: This article explores possible integrations

Key words: Therapeutic mindfulness, Buddhist ethics, relational and

between contemporary psychotherapy and Buddhist

dialogical ethics, Western psychotherapy

psychology in conceptualizing relational trauma and

80

its treatment. Interweaving ideas from developmental


psychoanalysis, clinical neuroscience and insights from

How can mindfulness be relevant or


useful to the psychotherapist and how
should a practitioner use mindfulness
to their best advantage?
FRANCOISE GUILLOT

mindfulness meditation practice, it focuses on understanding trauma by neglect, i.e. the impact of chronic misattunement and
disconfirmation of self-experience during the childs body-mind development. We propose that developmental trauma might result from the unmediated and premature exposure to the three mark of existence (suffering, impermanence and no-self) during infancy. Mindfulness may foster

Abstract: Mindlessness causes suffering as Professor

healing and transformation of procedural memories through cultivation

Mark W. Muesse from the University of Stanford says in

of awareness and compassion towards painful embodied history. Healing

his introduction to a Great Course- Practicing Mind-

would occur, in part, through openness and acceptance of somatic pre-

fulness. Mindfulness training includes mental alert-

sent moment experience, in particular, the traumatic memory and its re-

ness, openness and receptivity without appraisal and judgement: It can be

actions that naturally emerge during the therapeutic encounter, during

described as a kind of gentle and precise awareness to pay attention, mo-

meditative practice and ordinary life.

ment by moment, about what occurs in oneself and around us. More than

Key Words: mindfulness, psychoanalysis, development, trauma, basic-sanity

24 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 25

EAP special JOURNAL : Mindfulness and Psychotherapy -

114

Side Effects: A case illustration from a


Mindfulness Based Existential Therapy
(MBET) perspective

132

abstracts -

The Mindful Bridge Back To Work


Frank Musten

Jyoti Nanda

Abstract: This paper describes an Eight Week Mindfulness


Based Program for military members and first responders

Abstract: Mindfulness and Existential Therapy share

suffering from full or partial Post Traumatic Stress Disor-

several foundational principles. This case study illus-

der (PTSD) or other trauma related disorders. These in-

trates Mindfulness Based Existential Therapy (MBET)

dividuals often experience chronic symptoms that limit

as an embodied integration of both practices within the

functioning and are unable to return to productive life.

being of the therapist (Nanda, 2010) and as a free flowing

The Mindful Bridge Back to Work (MBBW) is an adaptation

phenomenological enquiry into the lived experience of the client. It values

of the core mindfulness program offered at the Ottawa Mindfulness Clinic

a human-to-human, I Thou, relationship, respecting client uniqueness,

(OMC). Like the core programs at the OMC, MBBW is an ethics based ap-

and difference between therapist and client, in which there is mutuality,

proach to mindfulness. However, MBBW also includes practices that relate

openness, presence, and directness (Buber, 1947, 1958; Friedman, 2003).

mindfulness to developing a healthier relationship with oneself in the pre-

Mindful awareness of noticing contents of consciousness in the present,

sence of work and other stresses. As well, the program includes practices that

and letting them go, seamlessly creates space in which to hear the client.

are intended to foster a connection to the practice community between the

This is not dissimilar to what Husserl (1931, 2002) refers to as bracketing,

weekly group sessions. Stress and low support are known to be major con-

an attempt at putting aside ones prior assumptions and pre-conceptions,

tributors to the severity and chronicity of PTSD and other trauma related

in order to stay close to experience. MBET values Thich Nhat Hanhs (1998)

disorders. The effectiveness of this approach is illustrated in a case example.

focus on listening with presence and compassion, and Kramers (2007) at-

Key Words: Military, First Responders, Mindfulness, Posttraumatic Stress

tentive listening with heart. MBET also values tuning in to respond to the

Disorder, Return to Work

unique needs of each client. Interconnectedness of part and whole is one


of its foundational principles: it recognises that change in any one area of
persons life can bring unforeseen changes in other parts.
Key Words: MBET, interrelatedness, uniqueness, human-to-human,
openness, worlding, world-view

146

Mindfulness, Equanimity
and Cognitive Flexibility
Mirjam Hartkamp

Abstract: Mindfulness meditation is becoming more profoundly and widely implemented in Western clinical practices and Western daily life. However, clearly defining and
objectively measuring its mechanism and outcomes, poses
a challenge to research on mindfulness. A growing body
of literature affirms the positive effects, but recent metaanalyses show that many studies suffer from methodological limitations that

26 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 27

EAP special JOURNAL : Mindfulness and Psychotherapy -

undermine the reliability of this evidence. While most studies focus on its effectiveness as an intervention, underpinning neural and cognitive mechanis-

176

abstracts -

Buddhist Heartfulness:
Beyond Western Mindfulness
G.T. Maurits Kwee & Peter T. Van Den Berg

ms of mindfulness are given relatively little attention. A fuller understanding


of mindfulness is therefore needed to support the practice of mindfulness in
psychotherapy. The present paper argues for an integrative approach that is

Abstract: In this article, we propose that mindfulness me-

informed by both its contemporary Buddhist soteriological context (Vipas-

ditation (as it is widely practised in the Western way) is

sana) and its Western psychological understanding. Following this approach,

only a limited version of mindfulness, as it has been deve-

cognitive flexibility is identified as a feature of both Western and Buddhist

loped in Buddhism down the ages in the East. By combining

understanding of the benefits of mindfulness.

the best of Theravada, Mahayana, and Relational Buddhism

Keywords: mindfulness, meditation, cognitive flexibility, emptiness,


equanimity, Buddhism

162

(or Buddhism 4.0), we differentiate four stages and eight


states that culminate to full pristine mindfulness practice. These stages and
corresponding states are described and linked to their Buddhist origins. In
order to discern this pristine mindfulness, from the mindfulness that is cur-

Beyond kusala and akusala?


Mindfulness and Buddhist Ethics

rently being popularized in the West, it is here called heartfulness. The dif-

ANDR VAN DER BRAAK

are discussed with ramifications for in-depth training in heartfulness, par-

ferences between stress-reducing mindfulness and Buddhist heartfulness


ticularly for those psychotherapists who are interested in its Buddhist roots.

Abstract: This article investigates to what extent a

Keywords: pristine mindfulness, heartfulness, Buddhism 4.0, Relational Bud-

Buddhist ethical framework can contribute to the way

dhism, social constructionism

that mindfulness is being practiced in a contemporary


psycho-therapeutical context. It highlights some philosophical obstacles to the endeavour of building a bridge
between mindfulness and Buddhist ethics, and eliminates some preconceived ideas about Buddhist ethics. It argues that the

198

The Winner of the Race:


The Dharma in the Digital Age
Manu Bazzano

Buddhist notions of kusala and akusala (wholesome and unwholesome)


could be a promising enrichment to an extended secular discourse on

Abstract: Variously drawing on the Buddhist notion of

mindfulness-based interventions that takes into account ethical conside-

skandhas, with the connection to European philosophy

rations, without descending into a full-blown Buddhist single set of ethics.

between bad faith and speed, and on the notion of hystere-

The Dalai Lama has attempted to develop such a secular discourse in his

sis in physics, this paper will discuss some of the challen-

books, Ethics of a New Millenium and Beyond Religion: Ethics for a Whole

ges and rewards of attempting to implement the Buddhas

World.

teachings in the contemporary world.

Key Words: Mindfulness, Ethics, Dalai Lama

Key words: Dharma, digital age, speed, bad faith

28 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 29

EAP special JOURNAL : Mindfulness and Psychotherapy -

210

abstracts -

Implicit Ethics and Mindfulness: Subtle


assumptions that MBIs are values-neutral

embraced by the University of Torontos Applied Mindfulness Meditati-

Lynette Monteiro

professionals should make explicit the motivation, intention, values, and

on Certificate Program. Training in mindfulness-based interventions for


practices that are sometimes assumed aspects of mindfulness. The 16 Gui-

Abstract: Buddhist teachings place ethics at the core of

delines for Life (Murdoch & Oldershaw, 2009) provides a secular system

mindfulness: the intent is the cultivation of the Noble

that emphasizes contemplative practices that cultivate compassion and

Person who transcends self-interest and lives for the

wisdom. Through examination of this system and in combination with

wellbeing of others. Clinical, contemporary mindful-

the latest research on neuroscience, mindfulness practitioners can build

ness-based interventions follow the root injunction that

mindful moral compasses that will guide their application of mindfulness

the ethics taught are implicitly imparted. The rationale

in psychotherapy and beyond.

is to avoid imposing external values and action-guides upon participants

Keywords: Mindfulness, ethics, morality, education, professionals, con-

and to hold the individuals values foremost. However, this stance makes

templative

several assumptions about the unavoidable ethics brought into contact by


the teacher, program content, and participants. The assumption that im-

244

paper explores this fallacy of values-neutrality and re-affirms that expli-

Slow and Fast Cooking of Rumis Chickpea: Issues in the Training of Teachers in
Mindfulness-based Interventions

citly explored ethics in mindfulness-based interventions are crucial to the

Jessie Bosse, Brittany Glynn & Lynette Monteiro

plicit ethics shields the participant from external influence subtly upholds
the long-discarded concept that interventions can be values-neutral. This

cultivation of the Noble Person.


Keywords: mindfulness-based interventions, explicit ethics, values-neu-

Abstract: There is fast growing interest in and demands

tral, implicit ethics, spiritual, psychotherapy, psychotherapists, Buddhism

for mindfulness-based interventions and trained profes-

226

sionals. The process of training competent mindfulness


therapists is known to be a lengthy and extensive one. The

Developing a Mindful Moral Compass:


Ethics for mindfulness trained
practitioners

training raises many questions about the training process itself; should it be

Craig Mackie, Michele Chaban, Sarah Serbinski,

therapists? Or is it essential to keep it as it is, considering that different trai-

Dekyi-Lee Oldershaw & Robert J. MacFadden

ning periods are needed in order to allow full development of the vast skill-set

combination of high demands with the need for thorough


revised or changed in ways that would allow for greater number of trained

required to teach mindfulness? In other words, should we sacrifice quality and


Abstract: Psychotherapists, and other change agents,

length of training to produce more qualified therapists? In order to shed light

embody ethics through the adoption of theoretical fra-

on those questions, current training models are exposed, as well as a brief

meworks, professional practices and personal values.

review of the literature on training competent mindfulness therapists.

There is a growing need for ethics training to be in-

Keywords: Mindfulness-based Interventions; Teacher training,

cluded in mindfulness certificate programs, as has been recognized and

30 | Extra Special Issue: Mindfulness and Psychotherapy

psychotherapy, therapists

EAP | International Journal of Psychotherapy | 31

EAP special JOURNAL : Mindfulness and Psychotherapy -

The Phenomenology of Mindfulness -

The Phenomenology
of Mindfulness
Emmy van Deurzen & Digby Tantam

Introduction
Mindfulness has taken the world of psychotherapy by storm. Somehow the
simple idea of paying proper attention
to what we do and think has taken root
in the minds of many different types of
therapists. We all know that we tend to
rush around and that we are missing out
on being aware of the (more detailed) reality of our lives. Therapists, who work
with people towards greater awareness
and understanding of human existence,

Emmy van Deurzen


is a well-known clinical
psychologist, psychotherapist, author, trainer
and presenter, particularly in the field of
Existential Therapy

are particularly taken with this idea. It


is an essential aspect of our work: to be
attentive. Mindfulness is a great reminder of the centrality of that idea. In terms
of positive methods that are easily understood and transmitted to clients and

be attentive

practitioners, we cannot really come up

Mindfulness is a great reminder

attitude of mindfulness to engage human

of the centrality of that idea. We

consciousness in a new way. There has

cannot really come up with anything

been an immediate wave of mindfulness

more fundamental than an attitude


of mindfulness to engage human
consciousness in a new way.

32 | Extra Special Issue: Mindfulness and Psychotherapy

with anything more fundamental than an

Digby Tantam
is a psychiatrist, psychotherapist and is currently
emeritus professor at the
University of Sheffield

research, especially in the USA, with some


very interesting results, that have focused

EAP | International Journal of Psychotherapy | 33

Emmy van Deurzen & Digby Tantam -

The Phenomenology of Mindfulness -

the attention of psychotherapists across

die einfach verstanden und Klienten und

tendance nous dpcher et que nous

the world, so that no psychotherapist

praktizierenden Therapeuten vermittelt

passons cot dune pleine conscience de

who is serious about any of these new de-

werden, knnen wir wirklich mit nichts

la ralit (plus dtaille) de nos vies. Les

velopments can afford to ignore the sub-

Grundlegenderem aufwarten als einer

thrapeutes, qui travaillent avec les gens

. ,

ject (Hutcherson, 2008, Singh et al., 2007,

achtsamen Einstellung, um das mensch-

vers une plus grande conscience et com-

Shapiro et al., 2005, Singh et al., 2007).

liche Bewusstsein auf neue Weise zu be-

prhension de lexistence humaine, sont

The evidence that mindfulness practice,

schftigen.

particulirement enthousiasms par cet-

te ide. Cest un aspect essential de notre

in itself, has considerable benefits is very

convincing: and thus we do not have to

Besonders in den USA hat es eine unmit-

travail : tre attentif. La pleine conscience

become mindfulness therapists in order

telbare Welle an Achtsamkeitsforschung

est un bon rappel de la centralit de cette

to use these principles to good effect in

mit einigen sehr interessanten Ergebnis-

ide. En termes de mthodes positives qui

our work.

sen gegeben, die weltweit die Aufmerk-

sont facilement comprises et transmises

samkeit von Psychotherapeuten auf sich

aux clients et praticiens, nous ne pou-

zog, sodass kein Psychotherapeut, der

vons pas vraiment trouver quelque chose

Die Phnomenologie

der Achtsamkeit

diese neuen Entwicklungen ernst nimmt,

de plus fondamental quune attitude de

Kurzfassung: Achtsamkeit hat die Welt

es sich leisten kann das Thema zu ignorie-

pleine conscience pour engager la con-

der Psychotherapie im Sturm erobert.

ren (Hutcherson, 2008, Singh et al., 2007,

science humaine dune nouvelle faon. Il

Irgendwie hat sich das einfache Kon-

Shapiro et al., 2005, Singh et al., 2007).

y a eu une vague immdiate de recher-

zept, dem, was wir tun und denken an-

Die Beweise, dass Achtsamkeitstraining

ches sur la pleine conscience, surtout

gemessene Aufmerksamkeit zu schenken,

an sich betrchtliche Vorteile hat, sind

aux Etats-Unis, avec des rsultats trs

in der Denkweise vieler verschiedener

sehr berzeugend: daher mssen wir kei-

intressants, qui ont attir lattention de

Therapeuten etabliert. Wir wissen alle,

ne Achtsamkeits- Therapeuten werden,

psychothrapeutes travers le monde, tel

dass wir dazu neigen herum zu eilen

nur um diese Prinzipien fr unsere Arbeit

que nul psychothrapeute qui sintresse

und dass wir es dabei verabsumen, die

positiv zu ntzen.

srieusement sur ces nouveaux dvelop-

pements ne peut se permettre dignorer

le sujet (Hutcherson, 2008, Singh et al.,

(spezifischere) Realitt unseres Lebens


wahr zu nehmen. Therapeuten, die mit

La Phnomnologie

Menschen arbeiten, um ein greres

de la Pleine Conscience

2007, Shapiro et al., 2005, Singh et al.,

Bewusstsein und besseres Verstndnis

Rsum: La pleine conscience a remu le

2007). Les preuves que la pratique de la

der menschlichen Existenz zu erlangen,

monde de la psychothrapie comme une

pleine conscience, en elle-mme, apporte

sind von dieser Idee besonders begeistert.

tempte. La simple ide de faire correcte-

des bnfices considrables sont trs

Es ist ein grundlegender Aspekt unserer

ment attention ce que nous faisons et

convaincantes ; ainsi nous navons pas

Arbeit: Aufmerksam sein. Achtsamkeit ist

pensons a pris racine dans les esprits de

devenir des thrapeutes de pleine con-

ein groer Aufruf an die Zentralitt dieser

bon nombre de diffrents types de thra-

science pour utiliser ces principes pour

(Hutcherson, 2008; Singh et

Idee. In Bezug auf positive Methoden,

peutes. Nous savons tous que nous avons

obtenir de bons rsultats dans notre travail.

al., 2007; Shapiro et al., 2005; Singh et

34 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 35

Emmy van Deurzen & Digby Tantam -

al., 2007).

,

Neuro-imaging studies have proved even

acknowledged) in the Vedas, which were

more revealing. Some of the most recent


neuro-imaging studies of people when

Buddhists adapted these Vedic methods

meditating have provided a clearer in-

coffin in his arms to the grave is still in-

and spread them widely throughout Sri

dication of what keeping alert and fo-

tensely poignant. Shortly after this, he and

Lanka, India, Tibet, China and South-

cussing inward might mean. Focussing

his wife became devoted to the teachings

East Asia. Mantras are still used in many

inward is familiar to all of us, as it is the

of the Maharishi Mahesh Yogi, and threw

Buddhist meditation practices to keep

state that normally precedes sleep, and is

themselves into the campaign to have half

the mind alert and occupied whilst it is

also associated with day-dreaming. Func-

of the population of one English city (Der-

focused inward. Focusing on a simple

tional magnetic resonance images were

by, if we remember correctly) using Tran-

physiological process, especially on ones

serendipitously analysed in participants

scendental Meditation, in the belief that

pattern of breathing, is a recognised and

waiting to begin an experimental task in

this would bring some untold benefits to

widely-used alternative.

the scanner, and it was discovered that

the Maharishi were first described (as he


probably compiled around 1,500 BCE.

istory of Mindfulness
Many years ago, a colleague of
ours lost his daughter at a very

The Phenomenology of Mindfulness -

young age. The image of him carrying the

some areas of the brain are more active

everyonepeace, happiness, well-being,

during this default state than during task

was relief from suffering. Understandably,

Scientific
investigation of meditation
and mindful states

this was immensely attractive to our col-

The Maharishi, who was a physics gra-

The default network is active during in-

league, who could not understand why it

duate, encouraged the scientific inve-

trospection (Whitfield-Gabrieli & Ford,

would not be attractive to everyone.

stigation of the effects of TM, and this

2012); is important to an enduring sense

has been a tradition carried on by many

of self (Gruberger, Levkovitz et al., 2015);

The particular type of meditation that

Buddhist spiritual leaders, including the

but has also been linked to depression

the Maharishi popularized, transcenden-

Dalai Lama. EEG studies show a reduction

(Kaiser, Andrews-Hanna et al., 2015); and

tal meditation (TM), is based on repeating

in fast alpha waves associated with me-

to a preoccupation with ones own emo-

a mantra and adherents were given a

ditation training, but these did not help

tions and self or being. The network

special (supposedly unique) word or man-

to explain the effects of meditation. More

that is active during performance tasks is

tra, which they concentrated on repea-

recent studies, that enable the coupling

sometimes called the salience network

ting over and over, in order to ease their

of several EEG sources, and therefore the

or the fronto-parietal control network

transition into a meditative state. Man-

interaction between brain areas, show

(Chen et al., 2013). Activity of this net-

tras were not new when our colleague

that there is reduced linkage between the

work is linked to doing, rather than being,

became involved with TM, but they were

cortex and its sensory feeds in the mid-

with an inward focus on the self being

presented as if they were part of a new,

brain (Saggar et al., 2015) and this may

replaced by an outward focus on stimu-

and updated, psychological intervention.

explain some of the positive effects of

li relevant to the task being performed.

The meditative techniques promoted by

meditation.

The networks are normally reciprocal in

and low blood pressure were some of the


targets. What the Maharishi was offering

36 | Extra Special Issue: Mindfulness and

Psychotherapy

performance. These more active areas


are linked together in a default network.

EAP | International Journal of Psychotherapy | 37

Emmy van Deurzen & Digby Tantam -

The Phenomenology of Mindfulness -

activity: i.e. when the control network is

for participants to separate what they

na Yoga), or on posture (Hatha Yoga).

enlightenment: called Nibbana, Nirva-

more active, the default network is less

were seeing from what they imagined

Comparable Western religious traditions

na, or Satori depending on the language

active, and vice versa. Some tasks, such

they would see.

include: wordless prayer, sometimes ai-

in which ones traditions are taught.

ded by a rosary; contemplation of the di-

as recognizing emotions in faces, engage


bothbecause recognition is both a task,

On the other hand, the control network

vine; and even contemplation of corpses

In the explosion of many of these ideas

but it also involves a spontaneous emoti-

seems in some way to be linked to an un-

or bodily remains (especially in the Tu-

in the Western world in the 1960s and

onal experience as well. Interestingly, the

awareness of self, and therefore freedom

dong Forest Buddhist tradition).

1970s, when Zen was the inspiration, en-

more that the default network is inhibited

from self-preoccupation, with a focus on

by (or anti-correlated with) the control

tasks. The world is approached as it is,

Sitting meditation produces a wrench in

sitting meditation. Few of us knew what

network in this sort of task, in one stu-

rather than how one would like it to be.

ones normal activity patterns that facili-

enlightenment would be, other than that

dy at least, the more likely a person is to

There is, no doubt, a downside to this too.

tates the unusual state of mind in which

it was claimed that it could also be che-

report higher empathy and to be more

Mindfulness meditation arguably offers

both default and salience networks are

mically produced in the experimental

accurate in the interpretation of other

the benefits of both states: of the internal

partly activated. More physical methods

laboratories of Haight-Ashbury, in San

peoples facial expressions.

focus on being, and the salience network

may also be used: whirling; repeated

Francisco. Sitting meditations of suffi-

lightenment or satori were the aims of

focus on things as they are, rather than

chanting;

incorpora-

cient depth that could to lead to satori

The concept that the default network

as one would like them to be (Faber, Leh-

ting alcohol and other drugs; and ascetic

required much more time, effort, and

supports introspection, and perhaps also

mann et al., 2015). There is some evidence

practices like sleep deprivation, fasting,

discipline than many of us hippies could

the construction of narratives about the

for this, or (at least) some evidence for

or self-flagellation are other examples.

spare. So many of us went for the half-

self and others, seems very plausible. It

changes in the connectivity of the default

The teachings attributed to Sakyamuni

way house of tranquillity, or Samatha.

also seems plausible that this kind of in-

network, and the connectivity of frontal

(Gautama Siddartha), and then passed

Current treatments of mindfulness also

trospection can easily lead to a form of

lobes with other brain areas (Taylor, Da-

down in the Buddhist tradition for the last

seem to focus on this benefiton what

rumination; or even to potential break-

neault et al., 2013), especially in practised

2,500 years, went one step furtheror so

Epicurus called ataraxia in the 4th centu-

downs in the narrative, where some

meditators (Marchand, 2014).

it is arguedthan the previous traditions

ry BCE, rather than on the more deman-

of meditationsby adding an additional

ding aim of enlightenment.

wrong, loss, threat, or other apparently

religious

rituals

element to the internal focus. The focus

memory recall cannot be incorpora-

Mindfulness practice
in other traditions

should, so Buddhists are taught, be infor-

Meditation is a practice enjoined by

ted, or made sense of. Moreover, a lack

If these pointers are right, mindfulness

med by ones knowledge and ultimately

monks in many different Buddhist tra-

of anti-correlation between the salience

is an unusual state in which attention is

ones experience. The idea is that emo-

ditions. Theravada Buddhism is the

and the default network may result in a

focussed inward, as in day-dreaming, but

tions themselves are but veils overlaying

tradition that is most often cited in the

subjectivity bias. In one study of the in-

combined with alert attention on reality.

the true nature of reality and that emo-

literature on mindfulness, and so the

terpretation of facial expressions, incre-

This is where the mantra comes in: it pro-

tions are the consequence of the natural

text on meditation that is most often ci-

ased activity in the default network was

vides something to focus on that does not

human tendency to try to change, inter-

ted by mindfulness practitioners is the

associated with less accuracy (Xin & Lei,

require bodily activity. Other traditions of

pret or to control experience. Accepting

Satipatthana Sutta, although there are

2015), presumably because it was harder

meditation use a focus on breathing (Pra-

this insight, or Vipassana, leads one to

older variants of what is probably the

intolerable emotion triggered during

38 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 39

Emmy van Deurzen & Digby Tantam -

The Phenomenology of Mindfulness -

same original in Chinese Buddhist scrip-

seems to determine the outcome. Deta-

Kabat-Zinn (Kabat-Zinn, 1990). Kabat-

tures (Kuan, 2008). The Satipatthana Su-

ching oneself from emotional engage-

Zinns book had a foreword by one of his

tta is so named because it is about the

ment with actions can lead to tranquillity,

meditation teachers: a very well-known

state of mind that sitting meditation can

as we understand those claims. Applying

Vietnamese Buddhist monk and publicist

evoke which, it asserts, will bring relief

a rigorous challenge to its veracity might

of Zen Buddhism and mindfulness prac-

from suffering and grief, the overcoming of

lead to insight, enlightenment, and the-

tice, Thich Nhat Hanh. Kabat-Zinn blen-

sorrow and lamentation and the way for

refore freedom from the wheel of birth

ded this type of practice with science,

walking on the path of truth (Ibid). One

and deathif we understand the Buddhist

an irresistible combination for many

potential problem, at least to the analy-

claims correctly.

(Whitfield-Gabrieli & Ford, 2012; Taylor,


Daneault et al., 2013)

tic Western mind, is that the path of truth


may also be a path of sorrow and lamen-

But, of course, there is always the risk

tation. So, some of these aims may seem

that, far from detaching oneself from

inconsistent.

emotional engagement, the dreamy state

The phenomenology
of mindfulness

Phenomenology has been applied to psy-

associated with the default network may

It is very curious that the idea of mind-

chology and psychotherapy ever since

Sati, the state of mind that is the main

predominate. Far from distancing the self

fulness has been seen as such a new

Husserl formulated his original ideas of

topic of the Satipatthana means some-

and its preoccupations from what the

phenomenon, and that it has drawn so

revisiting scientific methods in relation to

thing between memory and attention.

mind drifts towards, and what one might

strongly on Eastern traditions, when the-

understanding human phenomena (Hus-

The original English translators of the Sa-

try to suppress or argue away, we may slip

re are many other forms of mindful prac-

serl, 1900, 1913, 1925, 1954). Karl Jaspers

tipatthana wanted to capture the special

into a reverie about this very thing and

tice that are more directly derived from

work in his magnum opus on general

quality of memory and attention that this

become even more firmly emotionally en-

within Western traditions (and therefore

psychopathology (Jaspers, 1913) was

Pali1 word connotes, and so used the term

gaged with it. This is the risk that Lazarus

potentially more familiar to Western psy-

an early application of phenomenology

mindfulness, in-as-much as the type of

warned about, when he was writing about

chotherapists). The practice of religious

to mental health. He aimed to use the

memory concerned could be described

the dangers of transcendental meditation

meditation (or prayer) already referred to;

phenomenological reduction, or epoch

as things coming to mind (but not calling

in 1976 (Lazarus, 1976): that TM was not

or the practice of philosophical contem-

(suspension of prejudice), to revisit the

things to mind), and the type of attention

always a panacea, but could cause seri-

plation, are obvious candidates to study

experience of mental phenomena that

as the kind of alert and thoughtful, other-

ous psychiatric disturbance in some peo-

in greater detail. But one philosophical

were classified as pathological, in order to

centered attention, that is captured by

ple (Farias & Wickholm, 2015).

method stands out and has been used by

understand them in a subjective, as well

existentially minded therapists for more

as in an objective manner. R.D. Laing, who

the words heed (of Germanic origin) or


mindful (of Latin origin) in the expressi-

The rise of mindfulness

than a century. It is the method of phe-

wrote a scathing review of Jaspers work,

ons taking heed or being mindful of so-

Mindfulness has now replaced TM, as the

nomenology (Moran, 2000, 2002), which

applied phenomenological thinking in

mething or someone.

best-known meditative technique in the

has long appealed to a more intense and

order to reconsider the phenomenon of

West, mainly following the publication of

evenly distributed intentional way of be-

schizophrenia, in his own book, The Di-

What one does with whatever comes into

two books (Dryden & Still, 2006); one by

coming aware of what we observe.

vided Self (Laing, 1962). Many others have

the mind during this type of meditation

Ellen Langer (1989) and the other by Jon

40 | Extra Special Issue: Mindfulness and Psychotherapy

similarly aimed to practice in a phenome-

EAP | International Journal of Psychotherapy | 41

Emmy van Deurzen & Digby Tantam -

The Phenomenology of Mindfulness -

nological manner and an entire and signi-

rather than as they became when we ob-

lize our tendency to put certain things in

Beauvoir (1948) have shown, and are also

ficant new school of existential psycho-

served them. We had to dare to grasp

the foreground over others, in order to

often paradoxical (Deurzen, 2012, 2010;

therapy was founded on these principles.

the reality of the world in a more direct

try to make fairer and more complete ob-

Deurzen & Kenward, 2005).

way, by using our intuitive grasp, as well

servations of what we are presented with.

Many psychologists in the field of coun-

as careful, mindful, observation of what

Then, there is the need to constantly re-

And this is not the end of the process of

selling and therapy are quite familiar with

is actually there. He devised several so-

turn to a process of verification, so as to

mindful phenomenology either: one can

phenomenological research methods, which

called reductions in order to achieve that

check and double-check what our mind

proceed to the transcendental reduction,

have grown out of the work of early

objectivity. The phenomenological reduc-

comes up with. It is a very disciplined

where we challenge ourselves to discover

pioneers in the field of qualitative research

tion consists of: (a) looking at the process

stage of phenomenology, where we begin

what our own mind is adding (or remo-

(Van Kaam, 1966; Giorgi, 1970; Van Manen

by which we approach the world; and (b)

to look at the world in a new and different

ving) from our observations, and where

1990, Deurzen, 2014). The work of Bins-

slowing down our mind in order to pay

way.

we can go beyond the subjective stance to

wanger (1963) and Boss (1963) must also be

proper attention to that process; and (c)

considered in this light, although the early

to renew our intentionality in its directio-

From the phenomenological reduction,

from a place where our point of view is

work of Franz Brentano (1874) should ne-

nal flow from subject to object. There are

we can then proceed to the eidetic red-

transcended and where our perspective

ver be forgotten, since it had a profound

obvious similarities between meditation

uction, which is the process by which we

takes on the view from eternity, as Spino-

influence on both Husserl and Freud.

and this phenomenological practice that,

aim to grasp essences, or the actual inner

za suggested, and where different subjec-

at the same time, focuses on: an object

shapes (eidos) of things. The eidetic aspect

tivities come together into one. This is the

The phenomenological
method and mindfulness

of our consciousness; on our subjective

of phenomenology (Wertz, 2010) is cru-

position where inter-subjectivity3 bridges

inner awareness; and on that conscious-

cial to the process of understanding what

any possibility of solipsism4. Whereas

Husserls work aimed at establishing a

ness itself. This tri-partite method for

our intentionality is actually connecting

concentrating just on meditative practice

more appropriate scientific method, that

engaging with the world in a more holi-

with. We observe that things change over

might enclose us inside a very private and

could bridge the gap between objectivi-

stic manner has not always been taken

time, that they come to us under different

cut-off world, phenomenology demands

ty and subjectivity, providing researchers

as seriously as it deserves to be.

aspects or adumbrations, and that our ob-

that we continuously return to the real

servations need to be made from different

world and check our conclusions with the


facts of reality and with others.

in all sciences with a radical and reliable

a position where we can consider things

method by which to proceed; one that

There are numerous ways in which

angles and (preferably) at different times,

would focus equally on body and mind,

this slowing-down of our intentionality

and by different people, in order to move

object and subject and which would ac-

is done within phenomenology, for in-

from subjective impressions to piercing

Conclusions

cept from the start the idea that all

stance, by describing what we observe,

through to the essence of something. Es-

Phenomenological work is mindful work

our observations are about an external

very carefully, and then continuously re-

sences are also always in a flow of move-

of a Western kind. It takes the view that

world, but are done from the ground

newing our engagement with that pro-

ment and change in time: they are dyna-

consciousness needs to be used more sy-

zero of a subjective mind.

cess of reflective observation. We also

mic. In this sense, they are quite different

stematically, more actively, more flexibly,

construct our observations of the world,

to Platonic essences or Ideas, which are

and dynamically, and that our regard of,

Husserl said that we had to return to the

against the horizon of all we can observe;

static and eternal. They are also ambiguo-

and research in, the world demands a new

things themselves, as they actually were,

and at the same time flatten or equa-

us, as Merleau Ponty (1942, 1945) and de

kind of discipline of thought and under-

42 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 43

Emmy van Deurzen & Digby Tantam -

The Phenomenology of Mindfulness -

standing. The words used in phenome-

Emmy van Deurzen

nology (in the place of mindfulness) are

is a well-known clinical psychologist,

usually those of intentionality or reflec-

psychotherapist, author, trainer and

BINSWANGER, L. (1963). Being-in-the-world. (J. Needleman, Ed.). New York: Basic Books.

tivity.

presenter, particularly in the field

BOSS, M. (1963). Psychoanalysis and Daseinsanalysis. New York: Basic Books.

of Existential Therapy and now runs

BRENTANO, F. (1874). Psychology from an Empirical Standpoint (A.C. Rancurello,

Many researchers are now used to the


phenomenological ideas of: the double
hermeneutic5, where interpretations are
always checked from multiple angles;

the New School of Psychotherapy &


Counselling. She developed a form of
existential-phenomenology, which has
provided a radical new departure for

references

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CHEN, A.C., OATHES, D.J., CHANG, C., BRANDLEY, T. ZHENG-WEI, Z., WILLIAMS, L.M.,
GLOVER, G.H., DEEISSEROTH, K. & ETKIN, A. (2013). Causal interactions between

therapists interested in the therapeutic

fronto-parietal central executive and default-mode networks in humans.

and the notion of heuristics, where we

search for value, meaning and purpose.

Proceedings of the National Academy of Sciences, Vol. 113, No. 49, pp. 199444-19949. doi:

go into our own mind, to deeply observe

She has written many books (translated

the source and bias of our own point of

into many different languages) and

view, so as to add that to the other per-

numerous chapters and articles, held

spectives. They are also more aware that


interpretations need to be multiple, and
have to combine both objective and subjective perceptions in order to become

many positions at universities


and in professional associations,
and has received several life-time
achievement awards.
E-mail: emmyvandeurzen@gmail.com

more reliable.
We believe that the time has come to
bring together the understanding of
phenomenology with the explorations of

Digby Tantam
is a psychiatrist, psychotherapist and is
currently emeritus professor at the University of Sheffield. His main research
interests are social and emotional well-

some of the readers of this Special Editi-

being, emotional contagion, nonverbal

on of the International Journal will pursue

communication, applied philosophy,

International Journal of Psychotherapy:


2016, Vol. 20, Extra Special e-Issue,
pp. 33-48: ISSN: 1356-9082
Author and European Association
of Psychotherapy (IJP):
Reprints and permissions: www.ijp.org.uk
Submitted Sept. 2015; peer-reviewed twice
and reformatted, Nov. 2015;
resubmitted and accepted, April, 2016

New York: Citadel Press.


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7 websites; 5 videotapes, and 9 books,
and is married to Professor Emmy van

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New School of Psychotherapy & Coun-

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E-mail: digby.tantam@gmail.com

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face stress, pain, and illness. New York, N.Y., Delacorte Press.
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46 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 47

Emmy van Deurzen & Digby Tantam -

advertisement

endnotes
1

Pali (Pli) is an ancient Prakrit language from the Indian subcontinent. It is the language of many of the earliest surviving literature of Buddhism, collected in the Pli
Canon or Tipitaka, and is now the sacred language of Theravada Buddhism.

Existential Therapy: see International Journal of Psychotherapy, Vol. 19, No. 1, 1915: A
Special Issue on Existential Therapy.

Inter-subjectivity: A form of consensual reality, where we can both agree that A


actually exists and B actually exists.

Solipsism: the view or theory that the Self is all that can be known or experienced.
It holds that knowledge of anything outside ones own mind is unsure; the external
world (and other minds) cannot be fully known and might not even exist outside of
our imagination.

Double hermeneutic: the theory that everyday lay concepts and those from social
sciences have a two-way relationship (Giddens, 1987).


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with Emma Philbin-Bowman & Josephine Lynch, on 1st October 2016 in The Mindfulness Centre, Dublin 2.
This is the first in a series of workshops exploring the relationship between mindfulness and psychotherapy.
There is increasing support in the literature indicating that the practice of mindfulness has significant benefits
for therapists own mental health, reducing burn-out and leading to improved therapeutic outcomes for their
clients. See www.mindfulness.ie or email us at info@mindfulness.ie for more details.
Mindfulness interventions and formulations arise naturally when, as therapists, we have tested their utility
for ourselves in the crucible of our own experience. P. Fulton in Clinical Handbook of Mindfulness, edited by
F. Didonna.


48 | Extra Special Issue: Mindfulness and Psychotherapy

www.mindfulness.ie
info@mindfulness.ie
33 Lower Pembroke Street, Dublin 2

EAP special JOURNAL : Mindfulness and Psychotherapy -

Mindfulness Training for Psychotherapists -

Mindfulness Training
for Psychotherapists and
its Benefits in Improving the
Effectiveness of Psychotherapy 1
Elas Capriles
Abstract
After my second workshop at FUNDIPP
(Foundation for Research in Psychotherapy and Personality) at the Foundations quarters in Santander (Spain),
I was interviewed by Eugenio Gonzlez, who at the time was responsible for
the section of communications of FUNDIPP, and the interview was published
in the Foundations blog. This paper is
an abridged version of that interview,
which shows how practicing mindful-

Elas Capriles
is a Professor at the
University of The Andes
(former Chairman of
Eastern Studies) & Santi
Maha Samgha teacher at
Dzogchen Community.

ness and other meditations makes therapists practice more effective, and places those practices in the context
of a wider psychological theorywhich I developed in several books,
papers and book chaptersbased on Buddhism and on my experience in
the spiritual emergence/emergency refuges that I managed in India and

spiritual emergence

Nepal in the 1970s. A central idea in this paper is that an efficient practice

An efficient practice of mindfulness

what Freud called counter-transference and (in general) cease making

and other meditation practices can

projections onto clients or patients, thus helping them to heal, instead of

help therapists avoid what Freud

turning the processes that they undergo into potentially chronic illnesses.

called counter-transference and


cease making projections onto
clients or patients.

50 | Extra Special Issue: Mindfulness and Psychotherapy

of mindfulness and other meditation practices can help therapists avoid

Key Words: Mindfulness, Dzogchen, Anti-psychiatry, Psychotherapy,


counter-transference, shadow, unconscious fantasies

EAP | International Journal of Psychotherapy | 51

Elas Capriles -

Achtsamkeitstraining fr
Psychotherapeuten und seine
Vorteile in der Effektivittserhhung der Psychotherapie
Kurzfassung:

Mindfulness Training for Psychotherapists -

zu machen, und ihnen so bei der Heilung

les annes 70s. Une ide centrale dans ce

helfen und nicht die Prozesse, die sie

papier est quune pratique efficace de la

durchlaufen, zu potentiell chronischen

pleine conscience et dautres pratiques de

Erkrankungen zu machen.

mditation peuvent aider les thrapeutes

70-

Schlsselwrter:

Dzog-

viter ce que Freud appelait le contre-

Workshop bei FUNDIPP (Foundation for

chen, Anti-Psychiatrie, Psychotherapie,

transfert et (en gnral) cesser de faire

Research in Psychotherapy and Persona-

Gegenbertragung, Schatten, Unterbe-

des projections sur les clients ou patients,

lity) in der Hauptniederlassung der Stif-

wusstsein, Fantasien

ainsi les aidant gurir, au lieu de trans-

former les processus travers lesquels ils

passent en des maladies potentiellement

chroniques.

Mots cls: Pleine conscience, Dzogchen,

anti-psychiatrie, psychotherapie, contre-

transfert, ombre, fantasmes inconscients

Nach

meinem

zweiten

Achtsamkeit,

tung in Santander (Spanien) wurde ich von

Dieser Artikel ist eine gekrzte Version

La Formation la Pleine Conscience pour psychothrapeutes et ses bnfices dans


lamlioration de lefficacit
de la psychothrapie

des Interviews, in dem gezeigt wird, wie

Rsum: Aprs mon deuxime atelier

die Anwendung von Achtsamkeit und an-

FUNDIPP (Fondation pour la Recherche

derer Meditationen die therapeutischen

en Psychothrapie et Personnalit) au

Anwendungen effektiver macht. Jene An-

sige de la Fondation Santander (Es-

wendungen werden in einen breiteren


psychologie-theoretischen Kontext ge-

Eugenio Gonzlez interviewt, der damals


bei FUNDIPP fr den Bereich Kommunikation zustndig war; dieses Interview
wurde im Blog der Stiftung verffentlicht.

pagne), jai t interview par Eugenio

Gonzlez, qui lpoque tait responsa-

, , ,

stellt, den ich in mehreren Bchern, Ar-

ble pour la section communication de la

tikeln und Buchkapiteln entwickelt habe,

FUNDIPP; et lentretien a t publi sur

die auf buddhistischem Gedankengut und

le site de la Fondation. Ce papier est une

DIPP - ()

meinen Erfahrungen beruhen, die ich

version synthtique de cet entretien, qui

(Euge-

whrend meiner Leitung von spirituellen

montre comment la pratique de la pleine

nio Gonzlez),

Erkenntnis- / Notfalls- Rckzugsaufent-

conscience et autres mditations rendent

halten in Indien und Nepal in den 1970er

la pratique des thrapeutes plus efficaces,

Jahren machte. Eine Grundidee in diesem

et placent ces pratiques dans le contexte

Artikel ist, dass die effiziente Anwendung

dune thorie psychologique plus vaste

von Achtsamkeit und anderer Meditati-

que jai dvelopp dans plusieurs livres,

onspraktiken Therapeuten helfen kann,

articles et chapitres de livres base sur le

Gegenbertragung laut Freud zu ver-

Bouddhisme et sur mon exprience dans

meiden und es (generell) zu unterlassen,

les refuges urgence/mergence spiritu-

Projektionen auf Klienten oder Patienten

elle que jai gr en Inde et au Npal dans

52 | Extra Special Issue: Mindfulness and Psychotherapy

.
: ,
, -,

FUN-

EAP | International Journal of Psychotherapy | 53

Elas Capriles -

Mindfulness Training for Psychotherapists -

Question:

philosophy, and I also train psychothera-

terpart of the persona and that the nor-

to a well, ready to draw water, the Buddha

What was the driving force behind

pists in mindfulness.

mal individual feels compelled to project

taught her to perform this activity with

outside of him or herself, in order to feel

total awareness of her movements, and

that he or she actually is the persona.2

without distracting herself with thoughts

your decision to train psychotherapists


dealing with personality disorders in

The difference between Buddhism and

the practice of mindfulness?

Western psychotherapy is that Buddhism

about anything else. Thus, he taught

regards conventional normality as a

The Shadow is that which Susan Isaacs

mindfulness.

Elas Capriles: From an early age, I

state of alienation and mental illness nee-

(1989) called an unconscious phantasy

became interested in Buddhism and also

ding to be healed, whereas, in the West,

[i.e., a fantasy that the individual is com-

But, what does this have to do with the-

in psychology and psychotherapywhich

only a very few psychiatrists and clinical

pelled to make and keeps unconscious],

rapy? This type of practice can allow the-

felt quite natural, since Buddhism is a

psychologists, including Erich Fromm

which arises as a result of the infant being

rapists to become aware of the impulse

special kind of therapy. At the same time,

(1955), the anti-psychiatrists (Cooper,

perceived as a shameful object, when

to make a projection on the patient or

I felt the need to help promote the socio-

1967; Laing, 1971), some transpersonal

punished in a civilized society for acting

client in the very instant that it arises,

economic and political transformations

psychologists and psychiatrists, and a few

in ways that the society around them

and in this way abstain from making

that would give rise to an ecologically vi-

others, ever viewed normality as being

i.e., the nomos3forbids. I have writ-

projections that might impair further the

able society, as such free from arbitrary

actually quite pathological.

ten about the abundant evidence of the

patients or clients identity or from put-

absence of violence, and the ecological

ting her or him in an untenable position.

inequalities, and to develop a philosophy


and psychology responding to all these

The key problem to which a training in

wisdom, knowledge, equality or equity,

Laing (1971, p. 48) clarifies this, by unte-

concerns: the latter is what I have done in

mindfulness for psychotherapists re-

plenitude and so on, that seems to have

nable, I mean that it is impossible to leave

the last nineteen books and in many other

sponds is the fact that psychotherapists,

prevailed among our remotest ancestors

and impossible to stay.

writings. As an ecological activist, I co-

since they have to treat the patient

(Capriles, 2012).

founded an association of environmental

or client, automatically tend to percei-

groups in Mrida (Venezuela). In Anjuna

ve themselves as mentally sound and the

Buddhist mindfulness was taught in

veloping mindfulness, would be that the

in Goa, and at Swayambunath in Nepal,

latter as somewhat ill. This itself is a case

the

Establishment

therapists would have also discovered

I founded and managed spiritual emer-

of the projection that Freud (1973) called

of Mindfulness (Satipatthna Sutta or

their true condition, which may not be

gency refuges where psychotics could

counter-transference

(Gegenbertra-

Smrtyupasthna Stra) and the Gre-

identified as this or that, or as being

go unhindered through the journey they

gung), and that he so scantly explored,

at Discourse on the Establishment of

this way or that way, for their true con-

had unwittingly embarked themselves

even though awareness of it is absolutely

Mindfulness (Mahsatipatthna Sutta or

dition is, in itself, inconceivable and in-

on. Then I spent years in retreat in cabins

crucial for the success or failure of a the-

Mahsmrtyupasthna Stra). Apparent-

determinate: that which Zen would call

and caves in the higher Himalayas, prac-

rapy. Being societally normal, therapists

ly, a village lady told the Buddha that she

ones original face before ones parents

tising Buddhist Dzogchen (rdzogs chen).

are (in fact) equally ill, and thus their

could not become a nun because of her

were born. In fact, if we could gain ac-

And now, having retired from the Univer-

projections may be an extension of their

family and household duties, but that she

cess to the condition in which we are not

sity of the Andes in Mrida, Venezuela,

own fears, or an exorcism of their own

wished above all things to receive a

someway determined, and which implies

I teach Buddhism and Dzogchen; I lec-

demons, etc.or, in Jungian terms, pro-

practice that would allow her to proceed

plenitude and fulfilment, we would not

ture on political ecology, psychology and

jections of the Shadow that is the coun-

on the Buddhist Path. Since she was next

need to become the Jungian persona,

54 | Extra Special Issue: Mindfulness and Psychotherapy

Obviously, much better than merely deDiscourse

on

the

EAP | International Journal of Psychotherapy | 55

Elas Capriles -

Mindfulness Training for Psychotherapists -

nor negate our Shadow side, and hence

Question:

transference, then they will make the

many years) that I began training thera-

we would also not feel compelled to pro-

In the past, you dealt mainly with

individual into an ill or crazy person,

pists to deal with these disturbances.

ject anything. Therefore, familiarization

psychotomimetic experiences and

turning the process into one of increasing

with this condition of mindlessness (i.e.

psychoses. How come that now you are

alienation. Having understood all this, in

Question:

absence of dualistic mind) progressively

training therapists to deal with perso-

my work in India and Nepal, I established

What do you deem most important in

neutralizes the Shadow, and hence the

nality disorders?

places where so-called psychotics could

the training of future psychotherapists,

go through their processes that they were

and why?

impulse to project it, until we reach the


point at which we no longer have a Sha-

Elas Capriles: Both so-called psy-

unwittingly (and, as a rule, unwillingly)

dow to project (an achievement that Jung

choses and personality disorders are

undergoing in such a way as to facili-

Elas Capriles: To begin with, that

deemed actually impossible).

spontaneous endogenous processes acti-

tate the de-alienation that in ideal con-

they understand all that has been ex-

vated by a set of dynamics occurring bet-

ditions the process could achieve.

plained above. Following that, that they

However, a trainer in mindfulness can-

ween individuals and their environment.

not force the trainee to tread seriously a

Jung saw neuroses as attempts at self-

Later on, I practised the Tekch of the

ness, so as to become much more aware

Path of Awakening, for this can only be

healing and, according to John W. Perry

Dzogchen Menngagd a particular form

of the counter-transferential impulse: it

the fruit of a calling, which either arises

(OCallaghan, 1982), he also pioneered

of Buddhist meditation, based on mind-

is imperative to give the latter the central

spontaneously in the individual, or does

the view of psychoses as potentially self-

fulness in which the mind spontaneously

importance that Freud implicitly denied it.

not do so. If that calling arises in thera-

healing processes: this view was, later

dissolves, again and again, in the non-

Finally, should therapists feel the calling

pists and if they follow it to its ultimate

on, developed by the so-called anti-psy-

dual, non-conceptual, direct realization

to do so, and were the conditions for it to

consequences, surely they will become

chiatrists. To a lesser or greater degree,

of the true condition of ourselves and

be possible given, that they discover the

therapists of the highest excellence, but if

such processes draw individuals out of

all other phenomena in a long series of

true condition of themselves and all phe-

it does not arise, then undergoing a trai-

the normality that was defined above as

three-month retreats in the higher Hima-

nomena, which is, as noted, inconceivable

ning in mindfulness can still help them to

a form of pathological alienation, and take

layas (see Capriles, 2006). It was therefo-

and indeterminatelike a nothing-ness

become better therapists.

them blindly in a direction that they can-

re quite natural that these experiences

that may become anything but that, even

not foresee. At this point, almost every-

would inspire me to train therapists in

when it has become something, continu-

thing depends on those who interact with

these forms of meditation, so that they

es to be nothing-nessso that, through

them: in certain psychoses, in particular,

could effectively help disturbed people,

familiarization with this, they may begin

if the people surrounding the psycho-

instead of causing the processes that they

freeing themselves from the propensity of

tic individual are reasonably wise people

have to undergo to further develop alie-

projection, which is at the root of counter-

and can control their environment, the

nation, or even result in self-destruction.

transference. As also noted, when we no

process may be one of gradual de-aliena-

However, my focus had hitherto been on

longer feel that, in the depths of oursel-

tion. On the other hand, if they are total-

psychosesespecially so-called schizo-

ves, we are the phantasy-monster of the

ly caught up in the powers of projection

phreniaand it was due to collaboration

Shadow, and when we are no longer com-

and the dynamics of the Shadow, and

with Dr. Carlos Mirapeix (who has focused

pelled to become a persona (or anything

in the case of therapists in counter-

on so-called personality disorders for

else), then we can be the nothing-ness

56 | Extra Special Issue: Mindfulness and

Psychotherapy

develop an effective practice of mindful-

EAP | International Journal of Psychotherapy | 57

Elas Capriles -

Mindfulness Training for Psychotherapists -

that is our true, original condition, and

For those with the necessary capacities,

a control group formed by individuals who

differ in any way with regard to other

we are no longer compelled to project a

I think that the practice of Dzogchen is

did not practise any kind of meditation,

approaches to mindfulness?

Shadow, and hence we are free from what

the most direct way to achieve this end.

and then analysing the results obtained

Gestalt therapy calls the dynamics of the

Other effective Buddhist practices are:

by therapists of the two groups with 124

Elas Capriles: I do not view myself

shadow.

Zen Buddhism; the Vajrayna Path of

interned patients treated by them for

as a master of anything, and (so far) no

Transformation5; and Pure-Land Bud-

eight weeks. Examining the results with

tradition has awarded me any such title,

Question:

dhism (especially good for initial instan-

the Session Questionnaire for General

but I am definitely a Dzogchen practiti-

What advice would you offer to all of

taneous awakenings, which, according

and Differential Individual Psychothera-

oner who knows (quite well) the princip-

those people who wish to become the-

to D.T. Suzuki (1972, pp. 146-148), it has

py (STEP), the Questionnaire of Changes

les of the practice, who has had a good

rapists and employ these mindfulness

yielded more abundantly than Zen Bud-

in Experience and Behaviour (VEV) and

personal experience of it, which was the

techniques?

dhism). Moreover, also outside Buddhism,

the Symptom Checklist (SCL-90-R), the

pivot of the retreats that I went into in

there are also several traditions that have

patients of the therapists trained in

the Himalayas for years, which I practice

methods conducive to the same end.

meditation obtained evaluations signi-

daily in meditation sessions, which I try

ficantly higher in individual therapy in

to maintain in my everyday activities, and

Elas Capriles: At the beginning,

they would need to devote themselves to


the practice of mindfulness and, in gene-

Question:

measurement scales 2-STEP, with regards

which I refresh in occasional mountain

ral, to Buddhist meditation, ideally based

During the workshop and seminar that

to: perspectives in the clarification and

retreats.

on the methods taught at the workshops

you led,7 students were introduced to

resolution of problems; in the totality of

and seminars that I lead, and on various

the practice of mindfulness as an

therapeutic results in the VEV; and in the

I view the Dzogchen practice as the most

other methods applied in frequent short

important part of their training as psy-

reduction of symptoms of various types.

effective antidote to counter-transfe-

sessions. Then, to extend that practice

chotherapists. Is there any empiric evi-

to all their daily activities, including the

dence that the training in mindfulness

However, I must warn that I am extreme-

to maintain uninterruptedly the mindful-

most ordinary ones.

improves the abilities of psychothera-

ly critical with regard to all measurement

ness that forestalls the occurrence of dis-

pists in the exercise of their profession?

scales in psychiatry and clinical psycho-

tractionthe teachings advise us, Let all

logy, because they are essentially the

your conduct be like that of a person with

When they are doing therapy, they

rence. In order to apply it, it is mandatory

should increase their state of alertness to

Elas Capriles: Research has been

results of the process of counter-transfe-

a concussion who is afraid of getting bum-

its maximum degree, in an uninterrupted

carried out repeatedly on this subject.

rence, and I quoted the results presented

ped, and conscientiously lead your life in

session of mindfulness, and maintain an

One of the papers assessing the results of

in that paper only because readers may

a meditative fashion (Padmasambhava &

un-interfering, open attitude. And then,

such training is, Promoting Mindfulness

take such scales seriously and may re-

Gyatrul Rinpoche, 2008, pp. 6-97)even

if they feel the calling, to seek for a te-

in Psychotherapists in Training Influences

quire such quantification.

though, each time that the thoughts li-

acher holding a lineage in a tradition that

the Treatment Results of Their Patients: A

they find effective for discovering and

Randomized, Double-Blind, Controlled Stu-

Question:

liberates itself, since mindfulness is the

maintaining our true condition, the face

dy (Grepmair et al., 2007), which reports

You are a Buddhist master in the

mental subjects continued attention on

we had before our parents were born.

the results of training a group of thera-

Dzogchen tradition. Does this

the object, and the subject-object duality

pists in Zen practice, and establishing

traditions approach to mindfulness

dissolves each time that the true conditi-

58 | Extra Special Issue: Mindfulness and Psychotherapy

berate themselves, also our mindfulness

EAP | International Journal of Psychotherapy | 59

Elas Capriles -

Mindfulness Training for Psychotherapists -

on of the stuff of thought is realized. And,

contents are poisonous, I could drink it

tempts to maintain Absolute (or instant)

Elas Capriles

in this condition, we are neither the Sha-

due to ignorancebut I could also drink

Presence or Awareness are instances of

is a Professor at the University of The

dow nor the persona.

it, even though I am aware that it is poi-

relative presence, which cannot co-exist

Andes (former Chairman of Eastern

sonous, if I became absorbed in some-

with Absolute or instant Presence or

Studies) & Santi Maha Samgha teacher

Question:

thing and while I am totally distracted I

Awareness, yet - in the initial stages of the

at Dzogchen Community. He lectures,

During the workshop-seminar, you spo-

got thirsty and took hold of the nearest

Tekch practice of the Dzogchen series

ke of various important concepts, such

glass, inadvertently drinking its conten-

of secret oral instructions relative pre-

as absolute or instant Presence or

ts. This is why, when we function on the

sence is indispensable in order for Abso-

Awareness, relative presence, and

relative plane, the combination of rela-

lute or instant Presence or Awareness to

responsible awareness. What is the

tive presence and responsible awareness is

become manifest, dissolving mindfulness.

difference between absolute (or instant)

mandatory. In dealing with a patient or

Presence or Awareness, and relative

client the poison is the counter-trans-

In the most advanced practice of that

recent and best known in English is the

presence? What is the importance of

ference; responsible awareness is to be

Dzogchen series, relative presence is no

four-volume, The Beyond Mind Papers:

responsible awareness in the practice of

aware of this, and the presence of respon-

longer necessary, but there is insuffici-

psychotherapy?

sible awareness consists in keeping from

ent space for this to be discussed here, so

becoming distracted because, as a result

please refer to other works, like my four-

Elas Capriles: Relative presence is

of distraction, we could become involved

tome, The Beyond Mind Papers: Trans-

the key element of mindfulness: sustained

in the counter-transference.

personal and Meta-transpersonal Theory

aesthetics; psychology; epistemology;

(Capriles, 2013).

sociology; axiology, etc. He sits on the

attention, free from any distraction. Responsible awareness is the knowledge of

Absolute (or instant) Presence or Awa-

the consequences of ones actions. On

reness is that which becomes manifest

a relative level, one has to keep the pre-

when the true condition of the stuff of

sence of responsible awareness in a su-

thought is realized in a non-conceptual,

stained, uninterrupted way.

non-dual way, and the dharmakya


mental dimension of Buddhahoodbe-

For example, there is a glass containing

comes manifest as the present thought

poison. Responsible awareness is aware-

and the subject-object duality at the root

ness that the contents of the glass are

of relative presence, instantly dissolve, li-

poisonous, and of the effects of poison;

berating themselves.

whereas relative presence is not to get


distracted with regard to that aware-

Therefore, the manifestation of Abso-

ness. The reason why the presence of re-

lute (or instant) Presence or Awareness

sponsible awareness has to be maintained

goes along with the instant dissolution of

is that, if I am not aware that the glass

relative presence, or mindfulness. All at-

60 | Extra Special Issue: Mindfulness and Psychotherapy

leads workshops and teaches courses


in several countries of the Americas,
Europe and Asia. Among his fourteen
published books, five Internet books,
over forty published papers and twelve
book chapters, among other subjects,
on philosophy and psychology, the most

Transpersonal and Metatranspersonal


Theory (Nevada City, CA: Blue Dolphin,
2013). His works deal with: political
philosophy; ontology; philosophy of history; Dzogchen and Tibetan Buddhism;

Board of the International Transpersonal


Association, and on the Editorial Boards

International Journal of Psychotherapy:


2016, Vol. 20, Extra Special e-Issue,
pp. 51-64 ISSN: 1356-9082
Author and European Association of
Psychotherapy (IJP): Reprints and permissions:
www.ijp.org.uk Submitted Sept. 2015; peerreviewed twice and reformatted, Nov. 2015;
resubmitted and accepted, April 2016.

of several international journals. His


work has been discussed in books on
philosophy in Europe and America and
in the Journal of Transpersonal Psychology. He spent several years in a Dzogchen retreat in the Himalayas. He also
managed spiritual emergency refuges,
where so-called psychotics could undergo the natural self-healing process
in which they had unwillingly embarked.
He is also an ecological activist.
E-mail: eliascapriles@gmail.com
Website: http://www.webdelprofesor.ula.
ve/humanidades/elicap/

EAP | International Journal of Psychotherapy | 61

Elas Capriles -

references

Mindfulness Training for Psychotherapists -

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http://www.global-vision.org/papers/JWP.pdf

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the dawning of a new era. Winchester and New York: O Books.

personal philosophy and psychology: A Critique of the systems of Wilber, Washburn and
Grof, and an outline of the Dzogchen Path to definitive true sanity. Volume III: Further

VAN DER DENNEN, J.M.G. (1995). The origin of war: The evolution of a male coalitional
reproductive strategy. Groningen: Origin Press.

steps to a meta-transpersonal philosophy and psychology: An evaluation of Ken Wilbers


system and of the ascender/descender debate. Volume IV: Further steps to a meta-transpersonal philosophy and psychology: An assessment of the transpersonal paradigms of

Endnotes

Grof and Washburn (and Appendices I, II, and III). Nevada City: Blue Dolphin Publishing.
CAPRILES, E. (2006). Beyond Mind II. International Journal of Transpersonal Studies,

This is an extract of an interview published by FUNDIPP and available on: http://fun-

Authors Note: The Shadow is not, as Jung (1968) believed, the remnant of the violent

2006, Vol. 25 (1), pp. 1-44.


COOPER, D.E. (1967). Psychiatry and Antipsychiatry. New York: Ballantine.

dipp.org/entrevista-a-elias-capriles/

DE MEO, J. (1998). Saharasia. Ashland: Natural Energy Works.

instincts of our animal ancestors, for paleopathology has shown that the farther

FREUD, S. (1910). The future prospects of psycho-analytic therapy. In: S. Freud,

back we go in time, the less signs of violence we findto such a degree that before
5,000 BCE or, in a few sites of the Nile Valley and Australia, 13,000 BCE, no evidence

Therapy and Technique, (pp. 77-87). New York, NY: Collier Books.

or signs or mass violence are found, and the deaths resulting from wounds provoked

GREPMAIR, L., MITTERLEHNER, F., LOEW, T., BACHLER, E. ROTHER, W. & NICKEL, M.

by humans are so scant that seem to be hunting accidents [Capriles, 2012; Lochouarn,

(2007). Promoting mindfulness in psychotherapists in training influences the

1993; van der Dennen, 1995; DeMeo, 1998; Taylor, 2003, 2005].

treatment results of their patients: A randomized, double-blind, controlled study.


Psychotherapy and Psychosomatics, Vol. 76 (6), pp. 332338.
ISAACS, S. (1989). The Nature and Function of Phantasy: Developments in
psychoanalysis. London: Karnac Books.
JUNG, C.G. (1968). Researches into the phenomenology of the self. In: C.G. Jung.

Nomos: (Greek) The so-called Sophists, the Cynics and the Stoics, among others,
contrasted nomos and physis, where the former referred to that which was established by convention, and the latter designated whatever was by nature. Obviously,
this distinction presupposes that some forms of behaviour are inherent in our nature,

Collected Works of C. G. Jung, Vol. 9, Part 2, 2d ed. (R.F.C. Hull, trans.). Princeton:

whereas others are artificially contrived by a society that is (sometimes or often) in

Princeton University Press.

disharmony with that which is inherent to our nature. Thus, this concept verges on

LAING, R.D. (1971). Le soi et les autres [The Self & Others]. Paris: Gallimard.

the problem of whether or not there is any such thing as human nature. It stands for

LOCHOUARN, M. (1993). De quoi mouraient les hommes primitifs [What primitive men

order, valid and binding on those who fall under its jurisdiction; thus it is a social con-

62 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 63

Elas Capriles -

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struct with ethical dimensions. It is a belief, opinion or point of view; it is a human invention.
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published in the Foundations blog in January 2013.

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EAP special JOURNAL : Mindfulness and Psychotherapy -

Relational & Dialogical Ethics in Therapeutic Mindfulness -

The Development of a

Relational and
Dialogical Ethics

Die Entwicklung einer beziehungsbasierten und


dialogischen Ethik in
therapeutischer Achtsamkeit

Le dveloppent dune thique


relationnelle et dialogique
dans la pleine conscience thrapeutique

Kurzfassung: Achtsamkeit ist im Westen

Rsum: La Pleine Conscience en Oc-

grtenteils als psychologisches und ko-

cident est largement comprise comme

gnitives Phnomen aufgebaut. Kritiker

un phnomne psychologique et cogni-

haben betont, dass die westliche Acht-

tif. Des critiques ont relev que la pleine

samkeit keine ethische Dimension enthlt

conscience lOuest ninclut pas une di-

und demnach Gefahr luft falsche Acht-

mension thique, et ainsi risque de de-

samkeit zu werden. Diese Mngel mssen

venir une pleine conscience errone .

thematisiert werden. Dennoch werden

Ces lacunes ont besoin dtre adresses.

buddhistische ethische und normative

Cependant, les principes normatifs et

Prinzipien nicht ausreichen, da sie vor

thiques bouddhistes ne suffiraient pas

dem Hintergrund von Karma, Wiederge-

cela, car ils sont formuls dans le con-

burt und der Befreiung aus dem Leiden

texte du karma, de la rincarnation et de

formuliert wurden. Therapeutische Acht-

la libration de toute souffrance. La pleine

Abstract

samkeit bentigt daher eine Ethik, die mit

conscience thrapeutique a donc besoin

Mindfulness in the West is largely constructed as a psychological and co-

der westlichen Psychotherapie und den

dune thique qui est compatible avec la

gnitive phenomenon. Critics have pointed out that Western mindfulness

Rahmenbedingungen ihrer Anwendung

psychothrapie occidentale et les condi-

does not include an ethical dimension, and thus risks becoming wrong

vereinbar ist. Es wird ein berblick ber

tions qui entourent sa pratique. Un cadre

mindfulness. These shortcomings need to be addressed. However, Bud-

eine beziehungsbasierte und dialogische

pour une thique relationnelle et dialo-

dhist ethical and normative principles will not suffice because they are

Ethik prsentiert, die auf Sozialem Kon-

gique est prsent, bas sur le construc-

formulated against the backdrop of karma, rebirth and the liberation from

struktivismus,

Therapie

tionisme social, la thrapie postmoderne

suffering. Therapeutic mindfulness therefore needs an ethic that is com-

und auf Martin Bubers beziehungsbasier-

et sur la philosophie relationnelle et dia-

patible with Western psychotherapy and the conditions surrounding its

ter und dialogischen Philosophie aufge-

logique de Martin Buber.

practice. An outline of a relational and dialogical ethics is presented, ba-

baut ist.

Mots cls: Pleine conscience thrapeu-

sed on social constructionism, postmodern therapy and on Martin Bubers

Schlsselwrter: Therapeutische Acht-

tique, thiques bouddhistes, thiques

relational and dialogical philosophy.

samkeit, buddhistische Ethik, bezie-

relationnelle et dialogique, psychothra-

Key words: Therapeutic mindfulness, Buddhist ethics, relational and

hungsbasierte und dialogische Ethik,

pie occidentale

dialogical ethics, Western psychotherapy

westliche Psychotherapie

in Therapeutic Mindfulness
Mats Hilte

Western midfullness

does not include an ethical


dimension, and thus risks
becoming wrong mindfulness. These shortcomings
need to be addressed.

Mats Hilte
is Associate Professor in Social
Work at Lund University, Sweden,
where he is involved in the training
and super-vision of social workers.

66 | Extra Special Issue: Mindfulness and Psychotherapy

postmoderner

EAP | International Journal of Psychotherapy | 67

Mats Hilte -

Relational & Dialogical Ethics in Therapeutic Mindfulness -

ntroduction

kind of attitude towards ones own expe-

the therapists own practical experience.

In the transformation from its Bud-

riences, meanwhile Germer (2005) cha-

In the third and last approach, mindful-

dhist origins to a scientific, medical,

racterizes mindfulness as awareness of

ness is being incorporated into, for exa-

present experience with acceptance.

mple, cognitive-behavioural therapy, as

and psychological context in the West,

well as other psychotherapies, which in-

the practice of mindfulness has mostly

been described as a psychological and

Mindfulness in the West is principally

cludes teaching patients various mindful-

cognitive construct. Through an em-

practiced psychotherapeutically in dif-

ness skills. Hickss (2008) understanding

phasis on mental dimensions such as

ferent kinds of clinical and individual or

of mindfulness in a therapeutic setting

attention and cognition, Western mind-

group therapy contexts. Besides its use in

is similar to Germers (2005) first model.

fulness has been constructed as a rela-

structured interventions, such as mind-

Like Germer, Hick (2008) describes thera-

tively isolated and solitary contempla-

fulness-based stress reduction (MBSR)

peutic mindfulness as a way of paying at-

tive practice, and thus seems to lack a

and mindfulness-based cognitive thera-

tention with empathy, presence, and deep

- .

relational and ethical dimension. The

py (MBCT), mindfulness can also be ap-

listening, which can be achieved through

cognitive and psychological interpretati-

plied to psychological work in many other

an ongoing meditation practice.

on of mindfulness has been represented

ways. Germer (2005) suggests that all

by many scholars (e.g., Bishop et al., 2004;

components of mindfulnessawareness,

Critics of mindfulness in the West have

Germer, 2005; Shapiro, Carlson, Astin

present-centeredness, and acceptance

pointed out that its practice should include

& Freedman, 2006). Shapiro et al. (2006)

can be used as criteria for identifying

an ethical dimension in order to avoid

delineate three fundamental components

mindfulness in therapy. According to

becoming counterproductive (Grossman,

of mindfulness: intention, attention, and

Germer,

psycho-

2010; Monteiro, Musten & Compson,

attitude. Their approach is summed up in

therapy encompasses all attempts to inte-

2015). Grossman (2010) contends that

the often-cited definition of Kabat-Zinn

grate mindfulness into psychotherapeutic

ethical behaviour reinforces mindfulness

(1994): Mindfulness means paying attenti-

work. He describes three different ap-

and that unethical behaviour is not con-

on in a particular way: on purpose, in the

proaches that are not mutually exclusive:

ducive to cultivating calmness and su-

present moment, and non-judgmentally

a mindfulness-practicing therapist, mind-

stained attention. Monteiro, Musten, and

(p. 4). In the model presented by Shapiro

fulness-informed

and

Compson (2015) explore the criticism

et al. (2006), mindfulness is understood

mindfulness-based psychotherapy. In the

against contemporary mindfulness and the

as a psychological and cognitive process

first approach, the therapist practices

question of whether the alleged absence

and this perspective is shared by other

mindfulness meditation or everyday mind-

of an explicitly taught ethic in mindful-

Western scientists. Bishop et al. (2004)

fulness using any theoretical frame of re-

ness-based interventions (MBIs) renders

, ,

propose a two-component model of

ference in order to relate mindfully to his

the practice into a wrong mindfulness.

mindfulness that involves self-regulating

or her clients. The second approach buil-

Although the question of what characte-

ones attention in moment-to-moment

ds upon the integration of ideas from both

rizes right mindfulness is an important

experiences as well as adopting a special

Buddhist and Western psychology and

one, it is not addressed in this article.

68 | Extra Special Issue: Mindfulness and Psychotherapy

mindfulness-oriented

psychotherapy,

EAP | International Journal of Psychotherapy | 69

Mats Hilte -

Relational & Dialogical Ethics in Therapeutic Mindfulness -

For several reasons, the role played by

of the inter-human relationship. Thirdly,

been criticized as being too individua-

Many writers emphasize the problems

ethics in mindfulness-oriented psycho-

the therapeutic relationship is also ba-

listic (Batchelor in McCown, 2013), given

associated with trying to reconcile Bud-

therapy cannot be reduced to a question

sed on power dynamics. Foucault (1982)

that the ideas of an individuals karma

dhist psychology with Western psycho-

of right or wrong mindfulness. Firstly, the

describes power in people-processing

and rebirth form such a central tenet of

therapy. Segall (2003), noting that Bud-

goals of psychotherapy and the practice

institutions as a product of subjectivity,

Buddhist thought. In order to formulate

dhist theory and practice revolve around

of mindfulness are admittedly not the

enacted between the poles of domination

an ethical framework for therapeutic

individual moral development and the

same. Psychotherapy is mainly directed

and self-modification.

mindfulness, one needs a more relational

cultivation of moral character, has for

and dialogical approach and, above all, an

that reason little to say about other

towards assisting clients who need help


or are seeking greater self-knowledge,

However, a Buddhist ethic does not ex-

understanding of the differences between

aspects of personal growth and change,

while a mindfulness practice aims at the

plicitly address the relational and dialo-

Western and Buddhist psychology.

such as enhancing intimacy in romantic

development of insights and understan-

gical nature of psychotherapy. Ethical

ding of the mind in relation to all expe-

action in Buddhism principally relates to

rience achieved by means of the cultivation

and sexual relationships, or supporting


the integration of alienated aspects of the

an individuals aim and hope of overco-

Western and Buddhist


Psychology and Ethics

of a moment-to-moment, non-judgmental,

ming suffering (dukkha); this means that

Western psychotherapies have over the

and Siegel (2005), mindfulness meditation

but highly discerning awareness (Gross-

Buddhism supports the cultivation of mo-

years been influenced by Buddhist psy-

and psychotherapy embody very different

man, 2010, p. 89). Secondly, mindfulness-

ral character as a way of awakening and

chology in many different ways. Lately,

interpretations of what personal growth

informed psychotherapy is practiced in

being liberated from the cycle of life and

the concept of mindfulness has been attri-

and development are all about.

an inter-subjective relationship between

rebirth (samsara). The Buddhists interest

buted a positive value in various psycho-

the therapist and client. Goodman (in Ly-

in ethics concerns a particular way of life

therapeutic models. But the implemen-

Fulton and Siegel also contend that

sack, 2008) calls this form of interaction

and describes an ethical path towards

tation of Buddhist theory and practice in

mindfulness meditation is a total psy-

with the client mindfulness-in-connec-

such liberation (de Silva, 1995). Conse-

Western psychotherapeutic settings must

chological, emotional, moral, and spiritual

tion, alluding to the therapists awareness

quently, traditional Buddhist ethics have

take into account quite different meanings

emancipation (p. 40) that strives towards

attributed to the concepts of well-being,

results beyond the idea of a healthy self,

suffering, and personal growth. Alt-

which is the main goal in clinical and de-

hough Western therapeutic mindfulness

velopmental psychology. In other words,

is sometimes practiced as a technique to

mindfulness is not about restoring a sen-

restore physical and psychological health,

se of self, or improving self-esteem. On

Fulton and Siegel (2005) remind us that

the contrary, it seeks to illuminate the

mindfulness was not originally practiced

impermanence and insubstantiality of

in order to restore a sense of self, or to

the self. The understanding of the self as

develop a healthy self. The original pur-

being insubstantial is perhaps one of the

pose of mindfulness was, rather, to culti-

most challenging notions for Westerners

vate insight into the idea of no-self and

who have been introduced to the practice

how the self is a construct.

of mindfulness, write Fulton and Siegel.

70 | Extra Special Issue: Mindfulness and Psychotherapy

clients personality. According to Fulton

EAP | International Journal of Psychotherapy | 71

Mats Hilte -

Relational & Dialogical Ethics in Therapeutic Mindfulness -

Clearly, the Buddhist notions of no-self,

because Buddhist thought is more practi-

ultimate goal, whereas Aristotelian ethics

terms of dialogue and therapeutic con-

karma, and liberation from the cycle of

cal in its nature. The reason for this, says

aims at eudemonia through moral excel-

versations.

life and rebirth are hard to reconcile with

Keown, is that the Buddha focused on

lence in the present life.

(2006) describe therapeutic conversati-

the nature of Western psychotherapy,

practical and empirical matters, particu-

where strengthening the ego and self-

larly on the problem of human suffering

realization are salient goals.

and its resolution. The Buddhas analy-

Anderson

and

Goolishian

on as the mutual search for understan-

sis and insights into ethical matters are

Towards a Relational and


Dialogical Ethics in
Therapeutic Mindfulness

Buddhist

dispersed throughout his discourses and

According to this line of argument, since

conversation. In their dialogical perspec-

ethics, must be understood against this

are never presented as a comprehensive

Buddhist psychology and ethics do not

tive, the therapist and client participate

backdrop of karma, rebirth, and liberati-

analysis of philosophical ethics (de Silva,

explicitly address the relational and di-

in the co-creation of new meanings, new

on from suffering. These ideas, along with

1995). His interest in ethics concerned a

alogical nature of psychotherapy, thera-

realities, and new narratives. Instead of

the Buddhas teaching of the Four Noble

way of life wherein he describes an ethi-

peutic mindfulness needs to be infused

being an expert on psychological pro-

Truths are, after all, fundamental features

cal path towards liberation from human

with a relational and dialogical ethics.

blems, the therapists role is to develop a

of traditional Buddhism and are therefore

suffering.

This is a type of ethics that depends neit-

free conversational space and to initiate a

Buddhist

psychology,

like

ding and exploration through dialogue of


problems. The goal is not to produce
change, but to create an open space for

her on normative principles, nor on a mo-

dialogical process in which newness can

va, 1995; Harvey, 2008). According to the

Buddhist moral thought has much in

no-logical concept of self as an isolated

emerge. An important precondition for

Four Noble Truths, life contains suffering

common with Aristotelian ethics, accor-

I. On the contrary, it treats relationships

this conversational approach to therapy

caused by delusion and by clinging to

ding to Keown (2001). The development of

as primary and fundamental, and aims

is the therapists adoption of a not-kno-

desired objects and states of being. One

moral character is an important dimensi-

at confirming our uniqueness as human

wing position. This means that the thera-

can achieve freedom from suffering only

on in Buddhism, as it is in classical Greek

beings by means of genuine meetings. It

pist is curious to know more about what

by letting go of those desires (Moffitt,

philosophy. In Aristotles works, eudemo-

is a kind of mindfulness-in-connection,

has been said and is always open to being

2008). The aim and hope of overcoming

nia designates the highest human good.

where components of mindfulness, such

informed by the client. Shotter (1994)

suffering, both in one`s self and in others,

It is the aim of practical philosophy to

as awareness, present-centeredness, and

depicts the position of not knowing as

is a central preoccupation of Buddhism:

consider and experience what eudemonia

acceptance, are applied in order to make

the institution of a space of partial toge-

and ethical action is supposed to contri-

means and how it can be achieved. Mo-

the client present in his concreteness. In

therness, where clients have the oppor-

bute to that end.

ral excellence, or virtue, is the means to

my outline of a relational and dialogical

tunity to show their genuine otherness


in relation to the therapist. According to

of central importance to its ethics (de Sil-

achieve a good and happy life. But there

ethics, I have been inspired by postmo-

McCown (2013) describes Buddhism as

is an important difference between Bud-

dern and constructionist therapy, as well

McNamee (2009), each unique model of

one of the most moral religions in the

dhist and Aristotelian ethics when it co-

as by Martin Bubers relational and dialo-

psychotherapy provides its own special

world, even though it lacks an explicit

mes to the aim and context of cultivating

gical philosophy (Buber, 1970; McNamee &

vocabulary for categorizing and explaining

set of ethics. This perspective is in accor-

moral character. The development of mo-

Gergen, 2006; McNamee, 2009).

the problems clients bring to the therapeu-

dance with Keowns (2001) statement that

ral character in Buddhism is set within a

Buddhism has many ideas about morality,

soteriological frameworki, liberation from

In the post-modern orientation to the-

of a psychotherapy grounded upon dia-

but very little to say about ethics, partly

the cycle of birth-pain-death being the

rapy, therapeutic work is understood in

gnosis and problem solving talk because

72 | Extra Special Issue: Mindfulness and Psychotherapy

tic context (p. 58). The author is critical

EAP | International Journal of Psychotherapy | 73

Mats Hilte -

Relational & Dialogical Ethics in Therapeutic Mindfulness -

it falls short of an ethical and responsible

ledge. Gergen and Kaye (2006) argue that

is just one of many possible alternatives.

interaction. She introduces the concept

this kind of relationship is based on the

According to the author, there is no justi-

of social construction, as an alternative

assumption of the individual knower.

fication for trying to force the clients

to the traditions of diagnosis and pro-

Within this perspective, the therapist is

complex and richly detailed life to fit a pre-

blem talk, contending that it opens up the

therefore cast in the role of an expert,

fabricated narrative. Consequently, Gergen

therapeutic conversation to many more

an individual knower who is supposed to

and Kaye suggest the formation of a dia-

potential issues and expands the range of

possess the capability to know the world

logical relationship to which both thera-

resources for action. McNamee refers to

and act accordingly with that know-

pist and client bring their own resources.

this as a relationally engaged stance with

ledge. The therapist therefore stands out

clients (p. 60). The suggested construc-

as a subject who observes and delibe-

Additionally, as Anderson and Goolishian

tionist model is grounded in a relational,

rates, but, at the same time, transforms

(2006) argue, the attitude of curiosity and

postmodern ethics with the objective of

the client into an object of his or her

openness to the clients story generates

being attentive to the process of opening

expert knowledge. In that process, the

an understanding that is locally (dialogi-

viable possibilities and potentials for those

professionals point of view replaces the

cally) constructed using a local (dialogic)

with whom we work (p. 60).

clients story. In this kind of professional

vocabulary. The word local refers here

and impersonal relationship the client is

to the language and the understanding

treated as an object.

developed in the dialogue between thera-

The constructionist stance also embra-

pist and client. Instead of relying on the

ces the concepts of diversity and change.


It acknowledges the existence of multiple

The author is somewhat critical of this

general psychological models to attempt

and conflicting moralities and suggests

modernist view of therapeutic work be-

to understand the clients narrative, the

that exploring diverse moralities could be

cause it is not politically or morally neutral,

therapist explores the meaning of memo-

a focus in the interaction between thera-

and because it separates the individual

ries, perceptions, and histories, in a local

pist and client. The moral orders are un-

and his or her problems from the social

and dialogical relationship with the cli-

derstood as historical and cultural artef-

context. As advocates of a constructionist

ent. The author describes this difference

acts, that are negotiated and constructed

orientation, Gergen and Kaye (2006) also

in attitude towards the clients narrative

in day-to-day interactions, and not simp-

challenge the idea of a singular and ob-

using Bruners distinction (in Anderson &

ly abstract principles.

jective truth and introduce an alternative

Goolishian, 2006) between a paradigma-

and postmodern view of the clients par-

tic and a narrative posture.

The therapeutic relationship has tra-

ticular narrative. Characteristic of this

ditionally been perceived as something

postmodern orientation to therapy is that

The

between an expert and a person suffering

it undermines the therapists assumed sta-

psychotherapy has a great deal in com-

from some sort of inadequacy. The client

tus as scientific authority as well as que-

mon with Martin Bubers notion of dialo-

can therefore only attain their well-being

stions his or her privileged knowledge of

gue and the inter-human space. Bubers

by giving way to the therapists know-

cause and cure. The therapists narrative

dialogical perspective captures the in-

74 | Extra Special Issue: Mindfulness and Psychotherapy

constructionist

perspective

on

EAP

International Journal of Psychotherapy | 75

Mats Hilte -

Relational & Dialogical Ethics in Therapeutic Mindfulness -

terrelatedness of human beings and the

perienced and used. Living in the I-Thou

Conclusion

portant dimension in both perspectives

mutuality of the I-Thou relationship.

attitude is something completely diffe-

Western mindfulness and therapeutic

and it safeguards ethical and responsible

The inter-human realm is an effect of a

rent, according to Buber; it is predicated

mindfulness are therefore largely con-

interactions between therapist and client.

persons opening to dialogue. A precondi-

upon a mutual relationship between two

structed as psychological and cognitive

Being relationally engaged and responsi-

tion for such a dialogue in meetings bet-

subjects, where nothing conceptual in-

phenomena. Critics have pointed out that,

ble entails being open and attentive to

ween two human beings is that the other

tervenes. The relationship to the Thou is

when mindfulness is constructed in this

the uniqueness and concreteness of the

happens as the particular other; that is,

direct and unmediated.

way, it does not include an ethical dimen-

Other. By joining therapeutic mindfulness

sion, contending that this could lead to the

with a relational and dialogical ethics, one

the Other cannot be regarded as, or used


as, an object. In a dialogue, the Other

Buber (1965) describes this way of rela-

practice of a wrong sort of mindfulness.

can therefore acknowledge the existence

needs to be treated as a partner in living.

ting as imagining the real and making

It is clear that there is an absence of an

of multiple and conflicting moralities and

Buber elaborates his dialogical perspec-

the other present. In a psychotherapeutic

ethical dimension in Western mindfulness,

this opens up the therapeutic conversati-

tive when he argues that a prerequisi-

context, it refers to a therapist imagining

but, when it comes to therapeutic mindful-

on to diversity. This type of ethics agrees

te for genuine dialogue is that I accept

what the client, at this very moment, is

ness, just complementing it with Buddhist

more with modern life in the West, than

Thou, the Other, in the definite, unique

wishing, feeling, perceiving, and thinking

morals, and therefore normative princip-

with the normative and ethical principles

way which is peculiar to him, and I accept

in his very reality. But, in therapy sessi-

les will not suffice. The primary reason for

stipulated by Buddhism.

whom I thus see (p. 79).

ons, there is always a risk that we turn to

this is that Buddhist ethics stem from the

theory or diagnostic classifications when

contexts of karma, rebirth, and libera-

Mats Hilte

But human subjectivity is not lived only

we feel uncertain or insufficient. This

tion from human suffering. These objec-

is Associate Professor in Social Work at

in an I-Thou relationship. Bubers (1970)

grasping after reason and/or psychologi-

tives are hard to reconcile with Western

Lund University, Sweden, where he is

basic philosophical contention in his

cal models separates us from our client.

psychotherapy, which embodies other

involved in the training and supervision

book, I and Thou, is that the world is two-

Sternberg (2012) suggest that, in cases of

goals, such as self-realization, restoring a

fold for man in accordance with his two-

defensive conceptualisation, we practice

sense of self, and improving self-esteem.

fold attitude (p. 53). This basic attitude

relational wisdom and use the impulse

is generated by the two basic words that

to start theorising as a reminder to come

Therapeutic mindfulness therefore needs

man can speak. In this proposition, Buber

back to the present moment and recon-

an ethic that is compatible with these

argues that human subjectivity is directed

nect with the client. Another dimension

goals and recognizes that psychothera-

towards otherness and is lived out in one

of relational wisdom is the creation of an

py is mostly practiced within institutions

of two ways: I-Thou, or I-It. Each atti-

ethical space, with the goal of engaging

and within relationships of power. Accor-

tude reflects a different way of addres-

both therapist and client in the co-crea-

dingly, it is proposed that a relational and

sing otherness and, ultimately, existence.

tion of new meanings, new realities, and

dialogical ethics for therapeutic mindful-

new narratives.

ness is developed in order to address the-

Adopting the I-It attitude objectifies

se issues: an ethics inspired by construc-

the Other, or otherness, in the sense of

tionist therapy and Bubers dialogical

turning the Other into an object to be ex-

philosophy. Dialogue is therefore an im-

76 | Extra Special Issue: Mindfulness and Psychotherapy

of social workers. In his work as a


gestalt therapist, he practices mindfulness in order to develop therapeutic
and ethical skills. He also gives courses
and teaches contemplative practices in
higher education.
E-mail: mats.hilte@soch.lu.se

International Journal of Psychotherapy:


2016, Vol. 20, Extra Special e-Issue,
pp. 66-79: ISSN: 1356-9082
Author and European Association of
Psychotherapy (IJP): Reprints and
permissions: www.ijp.org.uk
Submitted Sept. 2015; peer-reviewed
twice and reformatted, Nov. 2015;
resubmitted and accepted, April 2016.

EAP | International Journal of Psychotherapy | 77

Mats Hilte -

Relational & Dialogical Ethics in Therapeutic Mindfulness -

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McCOWN, D. (2013). The Ethical Space of Mindfulness in Clinical Practice. London: Jessi-

BISHOP, S., et al. (2004). Mindfulness: A proposed operational definition. Clinical


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ca Kingsley Publishers.
McNAMEE, S. & GERGEN, K.J. (2006). Therapy as Social Construction. London:

BUBER, M. (1965). The knowledge of Man. New York: Harper & Row.
BUBER, M. (1970). I and Thou. New York: Charles Scribners Sons.

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McNAMEE, S. (2009). Postmodern psychotherapeutic ethics: Relational responsibility

DE SILVA, P. (1995). Buddhist ethics. In: P Singer (Ed.), A Companion to Ethics,

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(pp. 58-68). Oxford, UK: Blackwell.


FOUCAULT, M (1982). Afterword by Michel Foucault. In: H. Dreyfus & P. Rabinow (Eds.)

20 (1), pp. 57-71.


MOFFITT, P. (2008). Dancing with Life: Buddhist insights for finding meaning and joy in

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MONTEIRO, L., MUSTEN, R. & COMPSON, J. (2015). Traditional and contemporary mind-

FULTON, P.R. & SIEGEL, R.D. (2005). Buddhist and Western Psychology: Seeking
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fulness: Finding the middle path in the triangle of concerns. Mindfulness, 6, pp. 1-13.
SEGALL, S. R. (2003). Psychotherapy practice as Buddhist practice. In: S.R. SEGALL (Ed.),

chotherapy, (pp. 28-55). New York: Guilford Press.

Encountering Buddhism: Western psychology and Buddhist teaching. New York: State of

GERGEN, K.J. & KAYE, J. (2006). Beyond narrative in the negotiation of therapeutic
meaning. In: S. McNamee & K.J. Gergen (Eds.), Therapy as Social Construction,

New York Press.


SHAPIRO, S., CARLSON, L., ASTIN, J. & FREEDMAN, B. (2006). Mechanisms of

(pp. 166-185). London: Sage Publications.


GERMER, C.K. (2005). Mindfulness: What is it? What does it matter? In: C.K. Germer,

mindfulness. Journal of Clinical Psychology, 62(3), 373-386.


SHOTTER, J. (1994). Conversational realities: Constructing life through language.

R.D. Siegel & P.R. Fulton (Eds.), Mindfulness and Psychotherapy, (pp. 3-27).
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STERNBERG, R.J. (2012). The science of wisdom: Implications for psychotherapy.

GOODIN, R.E. (1995). Utility and the good. In: P. Singer (Ed.), A Companion to Ethics,

In: C.K. Germer & R.D. Siegel (Eds.), Wisdom and Compassion in Psychotherapy,

(pp. 241-248). Oxford, UK: Blackwell.

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GROSSMAN, P. (2010). Mindfulness for Psychologists: Paying kind attention to the


perceptible. Mindfulness, pp. 87-97.

Endnotes

HARVEY, P. (2008). An Introduction to Buddhist Ethics: Foundations, values, and issues.


Cambridge, UK: Cambridge University Press.
HICK, S. F. (2009). Mindfulness and Social Work. Chicago, Ill: Lyceum Books.

Soteriological: pertaining to the study of religious doctrines of salvation. Salvation


theory occupies a place of special significance in many different religions.

KABAT-ZINN, J. (1990). Full Catastrophe Living: Using the wisdom of your body and mind
to face stress, pain, and illness. New York: Delta.
KEOWN, D. (2001). The Nature of Buddhist Ethics. New York: Palgrave.
LYSACK, M. (2008). Relational mindfulness and dialogic space in family therapy.

78 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 79

EAP special JOURNAL : Mindfulness and Psychotherapy -

How can mindfulness be relevant


or useful to the psychotherapist

How can mindfulness


be relevant or useful
to the psychotherapist
and how should a practitioner use
mindfulness to his best advantage?
FRANCOISE GUILLOT
Abstract
Mindlessness causes suffering as Professor Mark W. Muesse from the University of Stanford says in his introduction to
a Great Course- Practicing Mindfulness.
Mindfulness training includes mental
alertness, openness and receptivity wi-

FRANCOISE GUILLOT
is a book-author and
therapist specialised in
eastern traditional
methods, Shiatsu and
ear-acupuncture.

thout appraisal and judgement: It can be


described as a kind of gentle and precise
awareness to pay attention, moment by
moment, about what occurs in oneself
and around us. More than an attitude it
is a state of mind, which can be explored

and experienced. The soothing and transformative effect of Mindfulness

Mindlessness

practice, as a part of and accompaniment to different kind of medical

causes suffering

treatments, has been carefully studied in the last decades. The purpose of

Mindfulness training can be

mindfulness as a protective and regenerative resource for themselves on

described as a kind of gentle and

the one hand and, how they can use it as a precious skill in their daily work

precise awareness to pay attention,


moment by moment, about what
occurs in oneself and around us.

80 | Extra Special Issue: Mindfulness and Psychotherapy

this article is to discuss and explain how psychotherapists could integrate

with patient/clients on the other.


Key Words: Mindfulness, practitioner, training

EAP | International Journal of Psychotherapy | 81

FRANCOISE GUILLOT -

Wie kann Achtsamkeit fr einen Psychotherapeuten


relevant oder ntzlich sein,
und wie sollte ein Therapeut
Achtsamkeit in der
Praxis am besten anwenden?

How can mindfulness be relevant

or useful to the psychotherapist

Wirkung von Achtsamkeitsbungen ist als

peut tre explor et vcu. Leffet relaxant

Teil oder Ergnzung verschiedener Arten

et transformatif de la pratique de la plei-

. , ,

medizinischer Behandlung in den letzten

ne conscience, comme partie intgrante

Jahrzehnten sorgfltig analysiert worden.

et complmentaire de diffrentes sortes

Dieser Artikel stellt eine Diskussion und

de traitements mdicaux, a t soigneu-

Erklrung dessen dar, wie Psychothera-

sement tudi ces dernires dcennies.

peuten Achtsamkeit einerseits als eine

Lobjectif de cet article est de discuter

schtzende und regenerierende Ressour-

et dexpliquer, dune part, comment les

ce fr sich selbst integrieren knnten,

psychothrapeutes pourraient intgrer

und wie sie sie andererseits als wertvolle

la pleine conscience comme une res-

Fhigkeit in der tglichen Arbeit mit Pati-

source protectrice et rgnratrice pour

enten/Klienten einsetzen knnen.

eux-mmes et, dautre part, comment ils

Schlsselwrter: Achtsamkeit, Thera-

peuvent lutiliser comme un outil prci-

peut, Training

eux dans leur travail quotidien avec des

patients/clients.

Mots cls: Pleine conscience, praticien,

formation

Kurzfassung: Unachtsamkeit verursacht

Comment la pleine conscience


peut tre pertinente ou utile
pour le psychothrapeute et
comment devrait-il lutiliser
son meilleur avantage?

Leiden sagt Professor Mark. W. Muesse

Rsum: La pleine conscience cause de la

von der Universitt Stanford in seiner

souffrance comme dit le Professeur Mark

Einleitung zu Great Course - Practicing

W. Muesse de lUniversit de Stanford

Mindfulness. Achtsamkeitstraining be-

dans son introduction Grand Cours

inhaltet geistige Wachsamkeit, Offenheit

la Pratique de la Pleine Conscience. La

und Aufnahmebereitschaft ohne Bewer-

formation la pleine conscience inclut

tung und Beurteilung: Es kann als eine Art

un tat dveil mental, de louverture, et

W. Muesse

sanftes und konkretes Bewusstsein be-

de la rceptivit, sans valuation et sans

schrieben werden, mit dem man Acht gibt,

jugement ; cela peut tre dcrit comme

was in einem selbst und um uns Moment

une sorte de prise de conscience bien-

fr Moment passiert. Als ein Bewusst-

veillante et prcise pour prter attention,

seinszustand, der erforscht und erfahren

moment par moment, ce que se passe

werden kann, ist es mehr als eine Einstel-

en nous-mmes et autour de nous. Plus

lung. Die wohltuende und transformative

quune attitude, cest un tat desprit qui

82 | Extra Special Issue: Mindfulness and Psychotherapy

/.

Mark

EAP | International Journal of Psychotherapy | 83

FRANCOISE GUILLOT -

How can mindfulness be relevant


or useful to the psychotherapist

First of all, what exactly


is mindfulness?

ness, there is no notion of past, present

can observe that psychic problems are

build new faculties in response to speci-

or future, just a flow of clear perception

increasing in number and complexity in a

fic mental training. Davidson used tech-

The meditation teacher James Baraz

and awareness, happening right now, in a

fast changing world, so that the challen-

niques, including functional Magnetic

(2012) says: Mindfulness is simply being

vast space (moment, after moment, after

ges are becoming more and more difficult

Resonance Imaging (MRI) and Positron

aware of what is happening right now wi-

moment, ).

to cope with. Psychotherapists often feel

Emission Tomography (PET) to analyse

overwhelmed in their interactions with

the processes occurring in the brain of

thout wishing it were different; enjoying


the pleasant, without holding on when

Actually it is impossible to give an exact

patient/clients and institutions: so, how

experienced meditators and mindfulness

it changes (which it will); being with the

and exhaustive definition of mindfulness:

can they work in demanding therapy ses-

practitioners. A strong emergence of syn-

unpleasant, without fear it will always

in attempting to do so one just circles

sions; doing a good job in supporting di-

chronized Gamma waves, which are well

be this way (which it wont). James also

around the deeper meanings, trying to

sturbed people; in the best way; and also

known to occur in connection with peak

writes: Mindfulness is commonly descri-

catch the essence of this phenomenon,

remain healthy and stable themselves?

experiences and an increment of grey

bed as non-judgemental awareness, and

without being really able to shape it per-

The cognitive solutions of the past dont

matter in the area of the hippocampus

refers to a specific practice of consciously

fectly. This is because the mindfulness

seem to be adequate or enough to

and of the amygdala, were observed. This

paying attention to what is happening in

experience is always more than just

face the present situation. Mindfulness

area of the brain is connected with our

the mind and in the body in the moment

descriptions; wider, beyond words, as

in the fields of therapy, care-giving, and

faculty of memory and affect-control. La-

without judging it, without getting tangled

Bhante Henepola Gunaratana (2002, p.

social work has been widely propagated

ter on, a measurable reduction of stress

up in a commentary, without wishing it

137) explains: Words are devised by the

during recent years, as it offers a new and

symptoms was demonstrated, which in-

were different. One could also add this

symbolic levels of the mind , mindfulness

helpful approach. To understand better

volves the observation of positive side-

complementary quotation from Jon Kabat

is pre-symbolic. It is not shackled to logic.

how mindfulness can support the hard-

effects in the function of the nervous and

Zinn (1990, p. 62), the developer of MBSR-

Nevertheless, mindfulness can be expe-

working therapist, as well as the patient/

hormonal systems, and on the immune

Mindfulness

Reduction:

rienced and it can be described, as long

client, it is helpful to look into the latest

response (Davidson, 2003). Therefore, it

Mindfulness is not merely a good idea or a

as you keep in mind that the words are only

results of scientific research on mindful-

is evident that a regular, daily practice of

nice philosophy. It is something we need to

fingers pointing at the moon. They are not

ness practice, especially from the view-

mindfulness-practice, or similar medita-

embody moment by moment for ourselves,

the moon itself.

point of neuro-science.

tive exercises, are able to create the re-

Based

Stress

generative space that practitioners need

if it is to have any value for us at all.


Psychiatrists,

and

Intense research about the neuro-bio-

to better confront burdening situations in

My own experience of mindfulness is

psychological consultants are greatly

logical effects of mindfulness-training

their work.

that it relates to an essential, innate qua-

motivated to help people overcome any

and meditation have been undertaken in

lity of the conscious mind that allows one

mental and emotional problems. Howe-

the USA and Europe, especially by Prof.

For these reasons, mindfulness can be a

to perceive thought processes, emotions

ver, this motivation, and the system in

Dr. Richard Davidson, University of Wis-

valuable therapeutic skill and an asset to

and physical states in a very direct, accu-

which practitioners have to navigate, can

consin Madison and Prof. Tania Singer, at

their training! The purpose of the work of

rate and differentiated way, without com-

be a source of exhaustion and burnout, if

the Max Planck Institut, in Leipzig, among

a therapist should be to assist, support

ments, judgement or appraisal. It seems

not balanced with proper self-care. Ad-

other scientists. All this research clearly

and accompany people in difficulties,

that, in this state of experienced mindful-

ditionally, to these causes of stress, we

shows that the brain can be trained to

who are not able to find their way back

84 | Extra Special Issue: Mindfulness and Psychotherapy

psychotherapists

EAP | International Journal of Psychotherapy | 85

FRANCOISE GUILLOT -

How can mindfulness be relevant


or useful to the psychotherapist

to a state of healthy balance on their own.

human beings are part of this mindful,

Mindfulness Practice

Actually, this description of mindfulness

Although some therapists believe they

fertile ground. Therefore, the practice of

During mindfulness training, one usually

training is a classical description of the

can heal people from diseases, mental

mindfulness can enhance that very same

focuses gently on body sensations, or on

Buddhist meditation, Shamatha and Vi-

distress or psychic disorders, the reality

humility and respect. In the process of

the breath, without commenting or jud-

pashyana. To practice mindfulness, this

is a little bit different: each patient/cli-

mindfulness, we try to accept everything

ging what is observed or felt. The attenti-

does not mean that the practitioner has

ent or client in the best instance heals

that is coming up physically, emotional-

on rests lightly and mindfully on the ob-

to become a Buddhist, in a religious sen-

himself; finding a way back to a natural

ly and mentally with a gentle curiosi-

ject of attention. Then, when one notices

se. Chgyam Trungpa, one of the most fa-

state of homeostasis and inner harmony.

ty. This radical acceptance comes as the

that the attention begins to wander, fol-

mous Buddhist teachers of the 20th cen-

The therapist is therefore just a facilitator

deepest humility a person can experience

lowing thoughts and emotions, one brings

tury always said: Meditation in Buddhism

of this process.

(Dr. Gary Pasternak, Mission Hospice San

it back again and again, for example to the

is not a religious practice, but rather a way

Mateo, California).

breath. This first step of training in mind-

of clarifying the actual nature of mind and

fulness stabilises the mind and prepares

experience.

To fulfil in the best possible way this


purpose of an optimal assistance the

The best way to listen attentively and

psychotherapist uses different skills and

carefully to another person is to aban-

cognitive knowledge: these are not total-

don an attitude of self-importance, and

After a fairly long period of this initial

the practice of meditation, and that me-

ly the result of long and deep theoreti-

also to try to be free from any dogma or

training, the next step is to observe what

ditation is not necessarily exclusively

cal studies, but also stem from their abili-

prefabricated solutions for problems. By

is coming up in the mind, the different

connected to Buddhism, although it has a

ties, gained through experience and trai-

practicing mindfulness, through regular

thoughts and the feelings, and it is im-

fundamental significance in this spiritual

ning. Mindfulness therefore seems to

training, one will lose this attitude step-

portant to observe these, without iden-

tradition. It seems natural to use a part

be the fertile ground in which practical

by-step and the cup of ones ego can

tifying with them or grasping them, while

of this method for therapeutic purposes

abilities and a deeply compassionate at-

become empty of concepts, expectations

still remaining free of any judgement or

because the profound and precise explo-

titude strike root. A direct experience of

and zeal, ready to be filled with the infor-

comment: one just stays with them. While

ration of the mind has always been the in-

the mind, through mindfulness, requires

mation coming from the other side. Mind-

this is happening, there is always a slight-

strument used by Buddhists to ascertain

regular training and practice, enables the

fulness-training begins with becoming

ly distanced but kind attitude with a

the origins of suffering, the very nature of

therapist to develop skills like awareness,

aware of the thoughts, emotions and phy-

precise, alert awareness of what is going

suffering, and its resolution.

insight, empathy and intuition.

sical sensations which occur inside of us,

on in the mind. Since the practitioner is

one for the next level of practice.


This suggests that Buddhism is not just

right now. It also enables one to enhance

not emotionally involved and entangled,

But what exactly happens when one

Another significant quality for the prac-

the ability to become more aware about

a space arises in which thoughts, sensa-

mindfully and kindly listens to the mind

titioner to develop, in his interactions

the thoughts, emotions and physical sen-

tions and emotions can appear and dis-

activity, the emotions and the body sen-

with patient/clients, could / should be

sations inside the client: Mindfulness is

appear, like a river flowing freely without

sations without comments and apprai-

humility. This attitude definitely opens

non-egotistic alertness. It takes place wi-

obstacles. Insights about function, co-

sals? To put it briefly, one can say that

doors, and enhances healing processes -

thout reference to self. (Bhante Henepola

herence, and the nature of the mind, ari-

space appears: thus a vast space comes

in both the therapist and client. It seems

Gunaratana, 2002, p. 140).

se, and genuine compassion increases as

into being when we allow mindfulness

a consequence of this practice.

to happen. Consequently, the observer

humility and a deep felt respect for other

86 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 87

FRANCOISE GUILLOT -

How can mindfulness be relevant


or useful to the psychotherapist

is no longer entangled with symptoms,

during hypnotherapy sessions. To induct

in the present moment and within the

thoughts, emotions and sensations. They

mindfulness into the experience of the

patient/client. Humility and mindfulness

still exist, but they have this comforta-

patient/client, it could be necessary to

boost the ability to induce a fruitful, em-

ble, available space in which to move, to

build a bridge between the thoughts and

pathic and compassionate rapport with

come, and to go. It is not about a feeling

emotions and the senses, to connect the

the patient/client. A natural patience

of estrangement, but rather compara-

mind with the experience of the body, and

and kindness follow automatically. If the

ble with a state of healthy distance to a

then to assist the patient/client by sta-

practitioner does not trust in his genuine

presently happening situation, and the

ying with these embodied emotions with

power of mindfulness and intuition, the

cessation, or end, of a state of identifica-

kindness and openness. The more this

risk to over-analyse and to lose the con-

tion. The perception is nevertheless very

succeeds in a relaxed and gentle way the

nection to the patient/client could occur.

clear, more open. Relaxation and a feeling

better the healing effect.

fects calm down. This is not to confound

In trauma therapy, the procedure is ac-

The principles of selforganisation and self-healing

with some form of anaesthesia. Naked,

cordingly careful and cautious, but simi-

Knowing about the principle of self-or-

and sensitivity, s/he can easily recognise

intense emotions of anger, sadness, me-

lar. The practitioner should be centred,

ganisation (Bateson, 1972; Varela, 1991)

the boundaries or limits that should not

lancholy, feelings of being wounded are

aware, listening attentively, and emana-

and the potential of self- healing helps

be crossed, thus staying with himself (or

all allowed to be there, but it is easier to

ting an appreciative presence that pro-

the clinician to go beyond normal cogni-

herself) and therefore allowing the pati-

accept them, to simply be with them be-

vides a feeling of comfort and security.

tive strategies, and to develop authentic

ent/client full responsibility. S/he can

cause they are not commented or apprai-

This kind of impartial but highly empathic

confidence in the skills of the patient/

feel very precisely the processes that

sed. Through this acceptance and with an

watchfulness, bare attention, will usually

client. This attitude supports the pati-

the patient/client is going through, and

attitude free from reaction, compassion

be felt as a soothing experience from the

ent/client in his capacity to let go of his

can therefore apply the necessary inter-

arises naturally and spontaneously.

side of the client.

own fears and doubts, and to develop

ventions with the same precision, accor-

his self-confidence. This self-confidence

ding to the needs of the partner. In fact,

Psychotherapists need a kind of flexible,

In mindfulness-based psychotherapy,

comes naturally as a fruit of compassio-

the patient/client is more a partner than

cognitive framework and deep know-

cognitive knowledge about psychic disor-

nate awareness by practicing Mindfulness

merely a customer. When the therapy

ledge, as well as a genuine ability to listen

ders should always stay in the background

meditation regularly, and this is probably

partner receives empathic, respectful,

to, and to feel, what patients/clients are

of the therapists mind, as a pool of refe-

related to the deeper and stronger con-

mindful and friendly attention from the

going through. Practicing mindfulness

rence. Of course, the psychotherapist will

nection with our own inner qualities and

psychotherapist, he will be able to relax

with unconditional, radical acceptance

use this information to intercede if the

potential.

more deeply and to open the doors to the

and compassion, the therapist stays pre-

right moment comes, but, placed in the

sent with his patient/client and every-

foreground as the main instrument of the

Mindfulness practice therefore helps

thing the patient/client is experiencing.

therapy, this theoretical knowledge could

the therapist in many ways to stay heal-

If the practitioner develops the capabi-

This is also valid in therapies in which

mask and adulterate the perception of

thy in his/her relationship with the pa-

lity to stay with any doubts and uncer-

regression into the past takes place or

what really is and what really happens

tient/client.

tainty without feeling unsettled, and, in

of letting go occur spontaneously. Af-

88 | Extra Special Issue: Mindfulness and Psychotherapy

inner space of healing.

Through

this

awareness

EAP | International Journal of Psychotherapy | 89

FRANCOISE GUILLOT -

How can mindfulness be relevant


or useful to the psychotherapist

the case of intense suffering or ostensibly

In Germany, practitioners often use a

liar experience for most people who come

emotional impasses, without feeling the

method called Dialogues, according to

for therapy sessions. As we know, a ma-

urge to react with strong intervention in

Moeller [Zwiegesprche nach Mller], in

jor amount of mental disorders has their

a more conceptual way, s/he can then li-

the relational psychotherapy of conflicts.

origin in chronic feelings of culpability,

sten, and be totally present, with his/her

This dialogue, between two people, lasts

shame, unwanted solitude, lack of affec-

therapy partner. This attitude allows both

for 90 minutes. Each person has three

tion, and feelings of rejection. The mo-

the practitioner and the patient/client

opportunities (of fifteen minutes each)

dalities, Compassion Focused Therapy

to become more relaxed, letting the pro-

to express any kind of thoughts, feelings,

CFT (from Paul Gilbert) and the Mindful

cesses of healing occur.

emotions, pain or sorrow, while his or

Self-Compassion Therapy (MSC) (from

her partner listens in a careful, mindful

Christopher Germer & Kristin Neff), es-

way, without interruption. After fifteen

pecially use this attitude of radical, mind-

minutes, the listener then becomes the

ful acceptance to support the client on

speaker and the speaker the listener. It

their path towards self-compassion:

What is truly therapeutic


and how is it related to
mindfulness?

is a wonderful training in mindfulness


Deep listening which involves listening

with many positive side effects: learning

The approach to self-compassion

from a deep, receptive and caring place

to listen patiently and attentively, without

involves three main components:

in oneself, to deeper and often subtler

reacting; learning to accept whatever the

levels of meaning and intention in the

partner says; learning to give the partner

other person has deep therapeutic effect

the space that she or he needs; learning to

on people who suffer mentally.

allow anything and everything, whatever

(Rome, spoken commentary, 2015)

needs to be expressed, but usually cannot be expressed. In the normal way of

Being mindful and open


to ones own suffering

Being kind, and non-self-condemning;

An awareness of sharing experiences

and

Some criteria have already been develo-

conversation and exchange, the precious

of suffering with others rather than

ped in this article, showing how mindful-

space that one needs in order to feel at

feeling ashamed and alone - an open-

ness can have truly therapeutic effects,

ease is restricted into a narrow corridor

but the criterion of deep listening deser-

because of the reactions, judgements and

ves to be further considered. Some peo-

comments of the partner.

ness to our common humanity.


(Paul Gilbert, 2010)
If we examine the evolution of psycho-

ple have been privileged to experience

90 | Extra Special Issue: Mindfulness and

deep listening in their relationships. A

The unconditional acceptance of the

therapy in general, and the upcoming

good friend, who is able to listen atten-

whole personality of the patient/client is

and further development of derivational

tively, with respect and compassion, is

an essential part of mindfulness-oriented

forms or concepts during the last fifty ye-

the best therapist ever. The mechanisms,

therapy. To feel rejected increases men-

ars, we can observe a shift attributable to

which are activated in such an interac-

tal suffering; to feel totally accepted is a

the intense exchange of information, ex-

tion, are almost magical.

very soothing, often strange and unfami-

periences and comprehensive networks

Psychotherapy

EAP | International Journal of Psychotherapy | 91

FRANCOISE GUILLOT -

between different scopes psychology,

Franoise Guillot

neurobiology, body-work and spirituality.

was born 1956 in the middle of France.

This has generated new concepts or/and

She is a book-author and therapist spe-

new therapies, such as: Acceptance and

cialised in eastern traditional methods,

Commitment Therapy ACT; Contem-

Shiatsu and ear-acupuncture. She also

plative Psychotherapy; Hakomi; Acceptance and Commitment Therapy for


the treatment of Post-Traumatic Stress
Disorder and Trauma-Related Problems;

trained in psychological consulting,


Mindful Self-Compassion (Christopher
Germer), and stress-reduction, and she
is presently developing stress-reduction

How can mindfulness be relevant


or useful to the psychotherapist

references
BARAZ, J. & ALEXANDER, S. (2012). Awakening Joy: 10 Steps To Happiness. California:
Parallax Press.
BATESON, G. (2000, originally publ. 1972). Steps to an Ecology of Mind. Chicago, IL: The
University of Chicago Press.
DAVIDSON, R.J., KABAT-ZINN, J., SCHUMACHER, J., ROSENKRANZ, M., MULLER, D.,
SANTORELLI, S., URBANOWSKI, F., HARRINGTON, A., BONUS, K., & SHERIDAN, J.

and burnout prevention programs for

(2003). Alterations in Brain and Immune Function produced by Mindfulness Meditati-

Mindfulness Cognitive Therapy MBCT-

German companies and civil services.

on. Psychosomatic Medicine, 65, pp. 564-570.

Based; Mindfulness Based Relapse Pre-

She lives in Mannheim, Germany and

vention MBRP; Compassion Focused

has worked in her own clinic since

Therapy CFT; Mindful Self-Compassi-

1993. Francoise has practiced Buddhist

on Therapy MSC; Mindfulness Based


Stress Reduction-MBSR, among many
others, all of which use mindfulness as an
essential practice in their work and en-

meditation for 40 years, and has guided


many seminars focused on mindfulness
training, body awareness and meditation in the last 30 years.
E-mail: francoise_guillot@hotmail.com

rich the landscape of psychotherapy in a


crucial way!
The beauty of this evolution lies in its
deeply human quality, and in the shift
from the head to the heart, with the wish
to alleviate the mental suffering in our
society and to realise it in a straight-

GERMER, C.K. (2009). The Mindful Path to Self-Compassion: Freeing Yourself from Destructive Thoughts and Emotions. New York: The Guilford Press.
GILBERT, P. (2010). Compassion Focused Therapy. New York: Routledge, Taylor & Francis
Group.
GUNARATANA, B.H. (2002). Mindfulness in Plain English. Somerville, MA: Wisdom Publications.
KABAT ZINN, J. (1990). Full Catastrophe Living. New York: Bantam Dell, Random House.
NEFF, K. (2011). Self-Compassion: Stop Beating Yourself Up and Leave Insecurity Behind.

International Journal of Psychotherapy:


2016, Vol. 20, Extra Special e-Issue,
pp. 81-93: ISSN: 1356-9082
Author and European Association of
Psychotherapy (IJP): Reprints and
permissions: www.ijp.org.uk
Submitted Sept. 2015; peer-reviewed twice
and reformatted, Nov. 2015; revised,
resubmitted and accepted, April 2016.

forward and feasible way. Mindfulness is


openheartedness, says Jon Kabat Zinn.

New York: HarperCollins Publishers.


FOLETTE, V.M., BRIERE, J., ROZELLE, D., HOPPER, J.W. & ROME, D.I. (Ed.) (2015). Mindfulness Oriented Interventions for Trauma: Integrating Contemplative Practices. New
York: The Guilford Press.
TRUNGPA, C. (2008). The Meeting of Buddhist and Western Psychology. In: Kaklauskas,
F.J., Nimanheminda, S., Hoffman, L. & MacAndrew S.J. (Ed.). Brilliant Sanity: Buddhist
Approaches to Psychotherapy, (Preface). Boulder, CO: University of the Rockies Press.
VARELA, F.J. (1993). The Embodied Mind-Cognitive Science and Human Experience.
Cambridge, MA: MIT Press.
WEIN, H., JOHANSON, G. & MONDA, L. (2015). Hakomi Mindfulness Centered Somatic
Psychotherapy: a Comprehensive Guide to Theory and Practice. New York:
W.W. Norton & Co.

92 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 93

EAP special JOURNAL : Mindfulness and Psychotherapy -

Developmental Trauma from a Buddhist


and Relational Inter-subjective Perspective

Developmental Trauma

from a Buddhist and Relational


Inter-subjective Perspective
Sebastin Medeiros & Simon Guendelman
Abstract
This article explores possible integrations
between contemporary psychotherapy
and Buddhist psychology in conceptualizing relational trauma and its treatment.
Interweaving ideas from developmental
psychoanalysis, clinical neuroscience and
insights from mindfulness meditation
practice, it focuses on understanding
trauma by neglect, i.e. the impact of chronic
mis-attunement and disconfirmation of

Sebastin Medeiros
is a medical-doctor from Universidad
Catlica de Chile, a psychiatrist
trained at Universit Paris-7 and
Centre Hospitalier Sainte-Anne.

self-experience during the childs bodymind development. We propose that developmental trauma might result from
the unmediated and premature exposure
to the three mark of existence (suffering,
impermanence

and

no-self)

during

infancy. Mindfulness may foster healing


and transformation of procedural memories

relational trauma
and its treatment

Mindfulness may foster healing


and transformation of procedural
memories through cultivation of
awareness and compassion towards
painful embodied history.

94 | Extra Special Issue: Mindfulness and Psychotherapy

through cultivation of awareness and compassion towards painful embodied history.


Healing would occur, in part, through

Simon Guendelman
is a medical-doctor, an adult
psychiatrist, a psychoanalytic
psychotherapist trained at the
University of Chile.

openness and acceptance of somatic present moment experience, in particular, the traumatic memory and its reactions that naturally emerge during
the therapeutic encounter, during meditative practice and ordinary life.
Key Words: mindfulness, psychoanalysis, development, trauma, basic-sanity

EAP | International Journal of Psychotherapy | 95

Sebastin Medeiros & Simon Guendelman -

Developmental Trauma from a Buddhist

and Relational Inter-subjective Perspective

Das Entwicklungstrauma
aus einer buddhistischen
und beziehungsbasierten,
intersubjektiven Sichtweise

und die Reaktionen darauf, die whrend

duraux en cultivant la pleine conscience

. ,

der therapeutischen Aufarbeitung, wh-

et de la compassion envers une histo-

rend der Meditationspraxis und im tg-

ire douloureuse intgre dans le corps.

lichen Leben auftauchen.

La gurison se passerait, en partie, par

()

Kurzfassung: Dieser Artikel beschreibt

Schlsselwrter: Achtsamkeit, Psycho-

louverture et lacceptation des expri-

Integrationsmglichkeiten von moderner

analyse, Entwicklung, Trauma, grundle-

ences somatiques du moment prsent,

Psychotherapie und buddhistischer Psy-

gende Vernunft

en particulier, le souvenir traumatique et

ses ractions qui mergent naturellement

self).

pendant la rencontre thrapeutique, pen-

dant la pratique mditative et la vie ordi-

naire.

analyse, den klinischen Neurowissen-

Trauma dveloppemental
vu dune perspective intersubjective relationnelle
et bouddhiste

Mots cls: pleine conscience, psychana-

schaften und Erkenntnissen aus der an-

Rsum: Cet article explore des int-

lyse, dveloppent, trauma, sant mentale

, ,

gewandten Achtsamkeitsmeditation fo-

grations possibles entre la psychoth-

basique

kussiert der Artikel auf das Verstndnis

rapie contemporaine et la psychologie

von Trauma durch Vernachlssigung, d.h.

bouddhiste dans la conceptualisation du

die Auswirkung von chronischer Dishar-

trauma relationnel et de son traitement.

monie und Verhinderung der Selbsterfah-

chologie durch die Konzeptionalisierung


des Beziehungstaumas und seiner Behandlung. Durch die Verknpfung von
Konzepten aus der Entwicklungspsycho-

(,

Tissant entre elles des ides tires de la

rung whrend der Krper-Geist Entwick-

psychanalyse dveloppementale, de la

lung des Kindes. Wir denken, dass ein

neuroscience clinique et de la pratique

Entwicklungstrauma daraus resultieren

de la mditation de pleine conscience,

knnte, in der frhen Kindheit unmit-

il traite surtout la comprhension de

telbar und zu frh den drei Markern der

trauma caus par ngligence, i.e. limpact

: ,

menschlichen Existenz (Leiden, Vergng-

dune non-concordance chronique et

, , ,

lichkeit und Ich-Losigkeit) ausgesetzt zu

dune dis-confirmation de lexprience

sein. Achtsamkeit kann Heilung frdern,

de soi pendant le dveloppement corps-

, ..

ebenso wie die Umwandlung von proze-

esprit de lenfant. Nous proposons que le

duralen Erinnerungen durch die Kultivie-

trauma dveloppemental peut rsulter

rung von Bewusstsein ber schmerzliche

de lexposition prmature, et sans m-

verkrperte Geschichte und deren Ak-

diation, aux trois marques de lexistence

zeptanz. Teilweise wrde Heilung durch

(souffrance, impermanence et non-soi)

Offenheit und die Akzeptanz krperlicher

pendant la petite enfance. La pleine con-

Erfahrung im Jetzt erfolgen, insbesondere

science pourrait gnrer une gurison et

in Bezug auf die traumatische Erinnerung

une transformation des souvenirs proc-

96 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 97

Sebastin Medeiros & Simon Guendelman -

Developmental Trauma from a Buddhist


and Relational Inter-subjective Perspective

Introduction

healthy psycho-biological development

mentation of their personality functions

Originating from Buddhism, and being

Buddhist psychology considers suffering

(Lyons-Ruth et al., 2012). In this paper, we

and structures, which underlie categories

re-contextualized into western scientific

as a common and inevitable characte-

explore how developmental trauma ari-

such as borderline and narcissistic disor-

and clinical settings during the last years

ristic of all sentient beings. Trauma is a

ses from parental difficulties to recognize

ders. It expresses dys-regulation of arou-

35 years, mindfulness-based treatments

pervasive form of existential, physical and

and regulate aspects of themselves and

sal, including a wide range of dissociative

are increasing in popularity and have

psychological suffering. Etymologically,

thus their childs affective life. Relational

phenomena and other autonomic reac-

been shown to be effective for a wide ran-

trauma means wound (Gk. traumat) and

wounds remain embodied, as procedural

tions resulting from difficulties in feeling

ge of conditions. Mindfulness has been

accounts for the impact of threatening

affective and relational memories, im-

and regulating painful experiences. Subtle

operationally defined as, the awareness

events on the body and the mind. Accor-

pacting the development of the implicit

and major psychosomatic symptoms, as

that emerges through paying attention, on

ding to Bromberg (2008), everyone is

self (Schore, 2005); they shape the way

well as different forms of anxiety and de-

purpose, in the present moment, and non-

vulnerable to the experience of having to

the child (or adult) relates to their in-

pression, are usually present in the con-

judgementally to the unfolding of expe-

face something that is more than his mind

ner and relational life. We examine how

sulting room and may also emerge during

rience moment by moment (Kabat-Zinn,

can deal with (p. 330). From an experien-

such memories can be accessed during

the psychotherapeutic processes.

2003, p. 145).

tial account, as observed during medita-

mindfulness meditation and psychothe-

tion, it is difficult to be in direct contact

rapy through body-awareness and self-

Regarding memory systems, trauma dis-

We suggest that mindfulness in the

with painful experiences. We conse-

compassion; and we propose how certain

orders are commonly characterized, in

form of both a practice and a relational

quently function in autopilot mode, dis-

qualities of the mind, such as openness,

part, by dysfunctions in the persons auto-

attitude is always an accessible form

sociating from present moment, lost in

curiosity and kindness towards felt trau-

biographical and episodic-explicit memo-

of affective disposition, which through

stories about ourselves, about the future

matic phenomena, at a very somatic level,

ry. For example, amnesia of biographical

acknowledgment and a holding of the

and with reference to the past.

may help in the healing process.

episodes, or re-experiencing traumatic

fragility of the present moment at a very

events (flashbacks), are core symptoms

intimate level may help integration and

In the context of child development, cer-

The concept of relational or develop-

of the traumatic spectrum. However, in

acceptance of felt experience. In this ar-

tain degrees of mis-attunement and pa-

mental trauma comes close to categories

this article, we will focus mainly in the

ticle, we will not focus on the effective-

rental unresponsiveness are normal, and

such as developmental trauma disorder

procedural-implicit affective processing

ness of mindfulness as an intervention for

sometimes even formative. Nevertheless,

(van der Kolk, 2005), or complex Post

(McNally, 1997), as a putative biological

the treatment of trauma, instead, we offer

when intense and chronic, they may lea-

Traumatic Stress Disorder (Herman, 1992),

basis of various psychosomatic and in-

an integrative perspective of how mind-

ve silent, embodied wounds. As develop-

signalling a degree of psychopatho-logy

terpersonal domain dysfunctions, resul-

fulness and Buddhist psychology prin-

mental theorists argue, the capacity to

extending far beyond any single-episode

ting from relational trauma (Shore, 2007).

ciples can be integrated within the psy-

face potentially traumatic experience de-

trauma and its clinical manifestations.

Such alterations usually originate from

chotherapeutic treatment of relationally

pends, in part, from acquired regulatory

The

trau-

early developmental experiences and

originated trauma.

capacities, critically shaped in early-life

ma is known to be both physiologically

emotional learning processes, shaping

attachment relationships. According to

and neurologically based. Clinically, rela-

automatic out of awareness proce-

research, interactive qualities of early

tional trauma affects a person in a per-

dural routines, or habits of affective and

relationship are decisive factors for later

vasive manner, leading to eventual frag-

motor reactions.

impact

98 | Extra Special Issue: Mindfulness and Psychotherapy

of

developmental

EAP | International Journal of Psychotherapy | 99

Sebastin Medeiros & Simon Guendelman -

A Relational and
Inter-Subjective Perspective

Developmental Trauma from a Buddhist


and Relational Inter-subjective Perspective

Experiential worlds are a co-creation

mena. Relational trauma originates when

tsunami (p. 5). According to Bromberg,

of mutual exchanges among individuals,

mis-attunement and non-validation of af-

even though the not-me self-states re-

The relational view recognizes a shift to-

whose personal dynamics express the to-

fects and self-states are chronic, probably

side out of conscious awareness, they can

ward a two-person psychology, emphasi-

tal of their implicit relational memories,

as a consequence of parental resistances

never be suppressed completely. Non-

zing on the centrality of mutuality in the

since their early life. In this view, suffe-

to engage in the natural unfolding of dya-

integrated affects risk a flooding of these

therapeutic process (Aron, 1996). In this

ring is not a consequence of a conflict

dic dynamics. The texture of these rela-

traumas into awareness, which becomes

sense, experiential phenomena are not

between drives and defences; rather, it

tional processes are at a base-line during

source of life-long emotional vulnera-

the products of isolated intra-psychic

originates from the difficulties in establi-

intergenerational transmission of trau-

bility. We argue that such inner chronic

mechanisms, but are rather, forming at

shing and sustaining relationships with

matic attachment (Jillberg, 2015). Paren-

threats have an somatic correlate, which

the interface of reciprocally interacting

others (Mitchell & Black, 1995) and as

tal relational memories are re-enacted as

can be noticed at a bodily level, specially

worlds of experience (Stolorow, 2002,

we argue also with ourselves.

implicit and usually unacknowledged dys-

during meditation practice, thus setting

regulated patterns, while sharing degrees

a starting-point from where they can be

of inter-affectively.

worked through.

p. 330). Individuals interact in an incredibly complex network, beyond classical

Affective regulatory processes are cen-

unconscious psychic determinisms, and

tral to the building up of ones health, and

driven by biologically-based instincts:

of an integrated degree of relatedness.

Children of traumatizing narcissist

according to inter-subjective authors,

The child needs other peoples body-mind

parents (Shaw, 2013), may (or almost cer-

A Buddhist
Integrative Approach

the therapists organization of experience

presence(s) to assist him/her in installing

tainly) have difficulties in acknowledging

Even though Buddhist psychology lacks a

interacts with that of the patient to form a

inner systems of integration and regula-

their inner emotional wounds, as they

theory of human psychological develop-

unique and indissoluble psychological sy-

tion, and establishing an embodied con-

have not received the kind of attention

ment across ontogeny, the Tibetan aut-

stem (Orange et al., 1997, p. 9).

tainer that is capable to hold such pheno-

that makes it possible for such a func-

hor, Trungpa (2007) holds that peoples

tion to be internalized. As these children

fundamental psychological problems es-

are often treated more as objects, their

sentially arise from neglect and from an

subjective experiences will remain un-

inappropriate environment during their

acknowledged and un-validated. More-

early years. Interestingly, he suggests

over, Bromberg (2011) argues that such

that care-givers have the capacity to offer

children suffer, when certain aspects of

psychological warmth and basic sanity.

their selves are not recognized as ha-

Such basic (or brilliant) sanity is already

ving a legitimate existence in the world

present in all human being and refers to

of others. A consistent disconfirmation

the expression of the precision and the

of self-experience leaves the child-adult

clarity of the awakened state of mind

lacking in creativity, spontaneity, stabi-

(Trungpa, 2003, p. 13).

lity and authenticity. The illegitimated

100 | Extra Special Issue: Mindfulness and Psychotherapy

not-me of self-states, haunt the corri-

Wegela (1996) characterizes this by three

dors of the mind as a dissociated affective

experiential qualities: openness; clarity;

EAP | International Journal of Psychotherapy | 101

Sebastin Medeiros & Simon Guendelman -

Developmental Trauma from a Buddhist


and Relational Inter-subjective Perspective

and compassion. The fundamental quality

relational trauma originates from the

is to be in contact with everyday expe-

Coming back to the theme of develop-

of basic sanity points to a primary aspect

incapacity of the growing child to face

rience, as it is; the addictive clinging for

ment, later in life, the wounded child will

of the mind, which is unconditional and

these Marks of Existence, all alone and

the next moment to be different, avoiding

set his self-locus in a mental domain that

unconstrained, and which underlies af-

unsupported. In other words, relational

or numbing the present moment, is a very

largely avoids affective experience (Ep-

flictive and non-afflictive mental states.

trauma could / would consist of a prema-

common expression of the human mind.

stein, 1998). Using the minds safe Ego,

This notion particularly emphasizes that,

ture exposure to existence, and its marks,

beyond psychopathological mental states

in the context of an absent, or a negli-

The difficulties in creating a relational

otherwise raw and unbearable somatic

(developmental trauma in this case), hu-

gent, caregivers contingent responses.

home, in which the childs (or patients)

feelings. The identification to a solid and

mans and human mind are fundamentally

Physical and emotional pain, early in-

experience can be held, appear as the

separate sense of self creates an illusory

sane. This quality of mind can be expe-

teractive losses and the experience of

parents (or therapists) own difficulties to

refuge, characterized by self-invalidation

rienced personally and inter-subjectively.

having an un-integrated self, represent

be in contact with and to regulate their

and non-authenticity.

a significant danger to the babys deve-

own self-experience. As we have menti-

Moreover, meditative insight recognizes

loping constructs of cohesion and em-

oned, early personal inter-affective me-

We suggest that during development,

what traditionally has been called the

bodied self-organization: and thus his/

mories usually model such present mo-

the childs body silently parallels such

Three Marks of Existence: 1) imperma-

her mind-body integration. As the childs

ment relational dynamics. In this sense, it

mental dispositional styles, learning to

nence (anicca), or the changing nature

experiences cannot be properly seen or

is possible to normalize both caregivers

reject most of the chronic inner signals of

of phenomena; 2) the pervasiveness of

held, as s/he does not encounter a safe

and therapists reactions to unpleasant

danger, and thus shaping a different way

suffering (dukkha) at a bodily, emotional,

space and a basic quality of acceptance in

dyadic experiences. Therapeutic mis-

of relating to his/her own relational ex-

mental and relational level; and 3) no-

the caregiver, an inner fear reaction be-

attunement (and parental unresponsive-

periences. Chronic muscular patterns of

self (annata) the absence of an inde-

comes a habit in his/her body and mind.

ness) manifest our natural resistance to

contraction, defensive second skin pheno-

pendent, unchanging and solid sense of I.

Traumatic scars develop and then reside,

the changing and painful quality of inter-

mena (Bick, 1968), as well as hyperactive

deeply embodied, as forms of chronic re-

affective phenomena. The felt menace of

behaviours are some of the usual expres-

actions to such a felt danger.

possible dys-arousal, of what Bromberg

sions of the learned avoidance to pain. In a

(2008) calls the shadow of the tsunami,

similar sense, Kostners (2014) views rela-

As an attempt to integrate these different views, we suggest that difficulties

the child learns to avoid contact with

in establishing a relationship to these

According to Buddhist Psychology, most

rests deeply inscribed and is constantly

tional suffering as constructed within an

Three Marks, from the pre-verbal stages,

afflictive mental states arise from: either

protected. Relational trauma leaves em-

on-going relational matrix, arguing, the

constitute a form of implicit relational

clinging to pleasant experiences; an aver-

bodied shadows that create difficulties

tendency toward re-creating early relatio-

knowledge, which lays at the root of de-

sion to negative stimuli; and/or indiffe-

in the possibility of any intimacy with

nal patterns is what gives rise to suffering

velopmental trauma and its consequent

rences towards neutrality. All three habits

self and others. Tensing the body, when

in contemporary life (p. 65). We suggest

suffering.

are characteristic features of the ordina-

in relationship and irritation, or while in

that through mindfulness practice it

ry ignorant mind (avidddya), which rests

meditation, can be seen as examples of

is possible to explore how the ways that

The new-born baby is totally dependent

blind to the impermanent and non- (or

the caregivers (therapists) inner defen-

we relate to ourselves is expressed in the

on the caregivers attuned mind and em-

un-)substantial nature of these pheno-

siveness.

forms that we relate to others, and visa

bodied responsiveness. We believe that

mena, including the self. The difficulty

102 | Extra Special Issue: Mindfulness and Psychotherapy

versa. Through mindfulness practice, it is

EAP | International Journal of Psychotherapy | 103

Sebastin Medeiros & Simon Guendelman -

Developmental Trauma from a Buddhist


and Relational Inter-subjective Perspective

possible to validate own experience, tru-

self-regulation (Schore, 2013). The paren-

sensorial input (touch, intero-ceptive

sting the felt sense of existence.

tal (or care-givers) negligence impacts on

perception, smell, audition and taste) with

the childs developing brain, manifesting

dys-regulation of the thalamus; and diffi-

Clinical and NeuroScientific Correlates

as poor cognitive-affective attitudes and

culties in regulating limbic hyperactivity,

dysfunctional relational styles. For exa-

with damage to the pre-frontal cortex.

Mis-attunements to painful affects

mple, early exposure to maternal stress

or a breakdown of the childs and/or

sensitizes (or de-sensitizes) the childs

caregivers system of mutual regulation

brain-body connections to later stress

leads to the childs loss of capacity to

and these become associated with beha-

Dissociation as a Possibility The legacy of non-validated


experience

integrate affect, and thereby this leads

vioural manifestations in children often

Nowadays, dissociation is viewed through

to overwhelmed and disorganized states

impulsivity and aggressivity (Essex, 2012).

an interdisciplinary lens that bridges both

(Storolow, 2011). Research reveals how

Burgy (2012) explores how early life stress

the psychological and biological realms

early dysfunctional interactive patterns

can alter functional emotional regulation

(Schore, 2007). It consists of a right-brain

affect ones dynamics of experiential in-

at adolescence, thus possibly observing

strategy, representing the ultimate defen-

tegration. Schore (2010), reviewing many

less amygdalaventromedial pre-frontal

ce for blocking emotional pain (Schore,

studies on attachment dysfunction and

cortex connectivity. The autonomic ner-

2010). Biologically, it is a condition of dis-

psycho-biological

vous system remains vulnerable, both to

engaging (hypo-arousal) from reality, in

intense hyper-arousal and hypo-arousal.

order to conserve energies and survive.

development,

states

that relational trauma has an enduring effect on the right brain structure and or-

The old un-mielinated dorsal vagus nerve

ganization, characterized by impairments

Frewen and Lanius (2015) describe vario-

discharges itself in order to reduce ener-

in emotional processing and pathologi-

us deficits in children with early chronic

gy consumption, sometimes even feigning

cal dissociations, among other forms of

trauma, which included problems with

death as a last strategy (Porges, 2001).

psycho-pathology. He considers the right

emotional awareness, emotional regulati-

hemisphere as the unconscious, emoti-

on, self-referential processing, and a sta-

Bromberg (2006) states, In the face of

onal and procedural brain, orchestra-

ble sense of self. The corresponding brain

psychological trauma, self-continuity is

ting reactions to danger and stress. With

areas show dysfunctions that correlate

threatened, and this threat, for most hu-

secure attachment bonds, the brains

towards a disconnection from emotional

man beings, is countered by the use of dis-

right hemisphere adaptively learns to re-

life, and difficulties in regulating inter-

sociation as an evolutionary response

gulate appropriate levels of arousal.

affective dynamics. In adults with history

(p. 113). Dissociation occurs in stressful

of trauma, van der Kolk (2014) describes

situations in which the individual strives

On the other hand, insecure attachment

brain dysfunctions at three different le-

to become unseen (Schore, 1994, 2001).

styles are correlated with anomalies in

vels: hyper-vigilance a sense of chro-

Lanius et al., (2005) showed predomi-

the childs development, resulting in im-

nic threat with increased reactivity in

nantly right-hemispherical activation in

plicit dysfunctional memories and poor

the amygdala; difficulties in integrating

traumatized patients while they are dis-

104 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 105

Sebastin Medeiros & Simon Guendelman -

Developmental Trauma from a Buddhist


and Relational Inter-subjective Perspective

sociating, as a method to escape from the

becomes an experiential possibility in

phenomena is not traumatizing in itself,

ment of the diaphragm while breathing. In

overwhelming emotions associated with

both meditation and psychotherapy. Mo-

and these are possible to be felt. Through

this way, intimacy with bodily sensations

traumatic memories.

reover, it is in the context of a relation-

mindfulness practice, the capacity to

is developed beyond theories, self-narra-

ship with the therapist and/or meditation

dwell in such quality of consciousness

tives and classical psychological insight.

Treatment: Cultivating
wisdom and compassion

teacher, and it is through a process of ap-

the awareness of the changing nature of

preciative inquiry and validation of sub-

phenomena is progressively cultivated.

According to Stolorow (2011), for the

jective experiences, that new relational

Embodied affective wounds are worked

Psychotherapy as a Re-creation
of a Relational Home

childs affective experience to be deve-

knowledge may emerge.

through, as pain and its aversion are re-

The therapeutic process is a co-creation

cognized, and then held in basic sanity.

that results from the coming together of

According to Epstein (2013), the Buddhas

the therapists and the clients embodied

most fundamental discovery was that the

memories and their inner worlds, which

adequate attunement to the childs painful

Personal Practice:
From the body to welcoming
non-validated experience

human mind is, in itself, the relational

are inter-subjectively shared. The affec-

emotional reactions that renders them un-

Epstein (2013) draws a parallel between

home that is needed to process trauma

tive quality of the encounter includes a

endurable and thus a source of traumatic

meditation and re-experiencing a good

(p. 202). Meditation offers an embodied

non-verbal level that can be experienced

lopmentally traumatic, it must lack of


a relational home where it can be sustained and integrated: It is the absence of

states and psychopathology (p. 27). Sto-

enough mothering attention early on in

training that seems to reinforce our own

and mutually explored. A contemplative

lorow also claims that if a painful expe-

life: a holding environment in which

psycho-corporal continent: an inner felt

relational psychotherapy would reco-

rience has a relational home, then it may

unknown and unexamined aspects of the

space of safety.

gnize basic sanity as a shared container

result in enhancement of real existence.

past can be experienced for the first time

In a similar direction, Buddhism teaches

in the here and now (p. 158). Moreover,

Pointing to the importance of the body

terns and reactions (of both therapist and

that beyond all forms of suffering we

Epstein (1995) sees, in meditation, the

in the healing process, Brach (1997) sug-

patient), which can then gently start to be

all may access brilliant sanity through

possibility to deconstruct self-identifi-

gests, the key to awakening from the

seen and untied. The therapist creates a

cultivation of non-judgmental awareness,

cations and narratives, returning to the

bonds of fear is to move from our mental

healthy environment where basic sanity

acting as a container in which affective

felt sense the bare experience in the

stories into immediate contact with the

can emerge and be inter-subjectively felt

pain may safely unfold.

body. The body is the first foundation of

sensations of fear-squeezing, pressing,

and re-evoked. Holding mutual vulnerabi-

mindfulness and during meditation

burning, trembling .... It is possible to

lity with a caring and non-judgmental at-

Reinforcing the importance of body awa-

the experiential sense of self is physically

cultivate a gentle curiosity to the direct

titude, can help model others acceptance

reness, van der Kolk (2014) states that,

explored and held. Mindfulness implies

contact with somatic experience, inclu-

of inner and inter-subjective experiences.

learning to observe and tolerate your phy-

courageously facing the Three Marks of

ding chronically unfelt and threatening

As the therapist takes care of his own

sical reactions is a prerequisite for safely

Existence with less resistance. Progres-

sensations. For example, while sitting in

experience, through pausing, breathing,

revisiting the past (p. 209). When the past

sively, a felt space is created between

meditation posture in an upright posi-

feeling and cultivating compassion, the

is trauma that was occurring during the

painful stimuli and habitual reactions.

tion with the belly and chest open, it is

client can begin to feel himself in a safe

possible to allow oneself to welcome the

space; one where a shift into a less de-

early years, the body keeps the score (van

able to hold learned inter-affective pat-

der Kolk, 2015). The acceptance of the

From a meditative perspective, we be-

sensations of the ventral part of the body,

fensive inner attitude can be experienced.

painful contact with ones experiences

lieve that the awareness of traumatic

including the occasionally painful move-

106 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 107

Sebastin Medeiros & Simon Guendelman -

Developmental Trauma from a Buddhist


and Relational Inter-subjective Perspective

sential element of the therapeutic action

stance to feel the reactivation of painful

going scientific and clinical data are in-

that makes reliving a part of a growth

and procedural memories at a bodily le-

creasingly being integrated, nourishing

process psychoanalytic blind instead of a

vel. We have discussed how mindfulness

a much better interdisciplinary under-

repetition of the past. Bromberg (2009)

practice and basic sanity in the psycho-

standing of human development and the

suggests a subtle and fragile domain is

therapeutic approach can help to create

treatment of the traumatized self.

needed in order to help shrink a patients

a safe somato-psychic space in which to

vulnerability to their shadow of affective

hold, regulate and integrate un-validated

Finally, exploring the impact of our own

destabilization. Fear and tension while in

subjectivity. The learnt implicit memory

relational (and trans-generational) histo-

relationship can also be occurring from

of rejecting ones previously experienced

rical embodiment of inter-affective life,

the therapists side, as signs of self-de-

(and as yet unmet) needs can be trans-

its somatic manifestation, and its possible

fensiveness signal the risk of emotional

formed into new forms of being with the

validation through mindfulness practice

flooding. Navigating in and around the

pain. By befriending such vulnerability

and psychotherapy, our understanding of

borders of the patients windows of tole-

and allowing the experiential marks of

relational trauma and its treatment may

rance and the felt resonance in the the-

existence to unfold, developmental trauma

deepen and thus open new clinical and


research questions.

The ability to explore the quality of di-

rapist, is the proper practice of a mind-

may begin its healing process. Both psy-

rect contact to present moment, parallels

fulness oriented psychotherapy, which

chotherapy and meditation help to create

the capacity to re-evoke good enough

includes an inter-subjective view of sha-

a relational home from which sponta-

introjected functions toward the Three

red affects and suffering.

neous feelings of dignity and connection


can arise. Both scenarios may allow one

Marks of Existence. There is always a


healthy trace of presence, the felt fee-

With regards to dissociation, it is impor-

to cultivate an acceptance of the present

ling of having received attuned attention,

tant to recognize it as a valid and instinc-

moments mind-body activity and embo-

which can now be redirected to the relief

tive strategy to survive. As and when this

died history. These are the moments in

of suffering. Such quality is in line with

occurs during the therapeutic encounter,

which basic sanity is experienced within

Oranges (1995) notion of witnessing as,

it can be normalized and explored with

the healing process, allowing clarity and

part of the validation that makes possible

less resistance, or just silently held, in

compassion to arise mutually.

the childs trust in her or his own expe-

order for it to integrate naturally as the

rience and sense of real (p. 140).

relationship grows.

During the therapeutic encounter, when

Conclusion

it is important to recognize common

emotional intensity arises, the natural

An early inter-subjective wound is often

dualisms (including separating the brain

fear (or anticipation) of re-traumatisation

carried through life and is usually ex-

from psychic and bodily experience), as

can also be acknowledged and held. Ac-

pressed in personal and interpersonal dy-

well as separating present moment en-

cording to Bromberg (2009), the coexis-

namics. Non-optimal relational patterns

counters from their context (the patients

tence of security and risk become the es-

can be understood as arising from resi-

and therapists relational histories). On-

For a conceptualization of relational


trauma from a mindfulness perspective,

108 | Extra Special Issue: Mindfulness and Psychotherapy

This paper was supported by the Fund for


Innovation and Competitiveness (FIC) of the
Chilean Ministry of Economy, Development
and Tourism, through the Millennium Scientific
Initiative, Grant N IS130005.
International Journal of Psychotherapy:
2016, Vol. 20, Extra Special e-Issue,
pp. 95-113: ISSN: 1356-9082
Author and European Association of
Psychotherapy (IJP): Reprints and
permissions: www.ijp.org.uk
Submitted Sept. 2015; peer-reviewed twice
and reformatted, Nov. 2015; resubmitted
and accepted, April 2016..

EAP | International Journal of Psychotherapy | 109

Sebastin Medeiros & Simon Guendelman -

Developmental Trauma from a Buddhist


and Relational Inter-subjective Perspective

Sebastin Medeiros

Simon Guendelman

is: a medical-doctor from Universidad

is: a medical-doctor; an adult

Catlica de Chile; a psychiatrist trained

psychiatrist; a psychoanalytic psycho-

ARON, L. (1996). A Meeting of Minds. Mutuality in Psychoanalysis. NJ: The Analytic Press.

at Universit Paris-7 and Centre Hos-

therapist trained at the University of

BICK, E. (1964). Notes on infant observation in psychoanalytic training. International

pitalier Sainte-Anne; and a relational

Chile; a mindfulness based interven-

psychotherapist, with influences from

tions teacher trained at the University

Zen and the contemplative psychothe-

California San Diego; and a meditation

rapy traditions. He trained as a mindful-

instructor from the Shambhala traditi-

ness-based interventions teacher at the

on. He is co-founder of the Center for

Center for Mindfulness University of

Mindfulness and Medicine, Chile. He is

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E-mail: sebastianmedeiros@gmail.com

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Achtsamkeit in verschiedenen Therapie-Anstzen


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112 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 113

www.schattauer.de

EAP special JOURNAL : Mindfulness and Psychotherapy -

Side Effects:

A case illustration from a


Mindfulness Based Existential
Therapy (MBET) perspective
Jyoti Nanda

Mindful
awareness
creates space
in which to
hear the client

Side Effects: A case illustration from a Mindfulness

Based Existential Therapy (MBET ) perspective

aside ones prior assumptions and pre-

Inhalte des Bewusstseins in der Gegen-

conceptions, in order to stay close to ex-

wart erkannt werden, und das Loslassen

perience. MBET values Thich Nhat Hanhs

schaffen nahtlos Raum fr das Hren des

(1998) focus on listening with presence

Klienten. Dies ist dem was Husserl (1931,

and compassion, and Kramers (2007) at-

2002) als Einklammerung bezeichnet,

tentive listening with heart. MBET also

nicht unhnlich, nmlich ein Versuch, sei-

values tuning in to respond to the unique

ne frheren Annahmen und Vorverstnd-

needs of each client. Interconnectedness

nisse beiseite zu legen, um nahe an der

of part and whole is one of its foundati-

Erfahrung zu bleiben. MBET hlt Thich

onal principles: it recognises that change

Nhat Hanhs (1998) Fokus auf das Hren

in any one area of persons life can bring

mit Prsenz und Mitgefhl hoch, und

unforeseen changes in other parts.

Kramers (2007) aufmerksames Zuhren

Key Words: MBET, interrelatedness,

mit dem Herzen. MBET beinhaltet auch

uniqueness, human-to-human, open-

das Einstimmen, um auf die einzigartigen

ness, worlding, world-view

Bedrfnisse jedes Klienten reagieren zu

knnen. Die Vernetztheit von Teilen und


Jyoti Nanda
CPsychol, AFBPsS, is a practising
Chartered Counselling Psychologist,
and an Existential Psychotherapist,
Coach, and Supervisor.

Nebenwirkungen: Falldarstellung einer Mindfulness Based


Existential Therapy (MBET)

des Ganzen ist eines der grundlegenden

Kurzfassung: Achtsamkeit und existen-

reich einer Person unvorhergesehene

tielle Therapie haben mehrere grund-

nderungen in anderen Teilen mit sich

legende Prinzipien gemeinsam. Diese

bringen kann.

Prinzipien: Es wird erkannt, dass Vernderung in einem beliebigen Lebensbe-

Abstract

Fallstudie zeigt eine Integration beider

Schlsselwrter: MBET, Vernetztheit,

Mindfulness and Existential Therapy share several foundational principles.

Praktiken innerhalb des Wesens des The-

Einzigartigkeit, Mensch-zu-Mensch,

This case study illustrates Mindfulness Based Existential Therapy (MBET)

rapeuten (Nanda, 2010) und eine freie

Offenheit, Weltkind, Weltsicht

as an embodied integration of both practices within the being of the the-

phenomenologische Erforschung der ge-

rapist (Nanda, 2010) and as a free flowing phenomenological enquiry into

lebten Erfahrung des Klienten. Sie schtzt

the lived experience of the client. It values a human-to-human, I Thou,

eine Mensch-zu-Mensch, Ich Du Bezie-

relationship, respecting client uniqueness, and difference between the-

hung mit Respekt der Einzigartigkeit des

rapist and client, in which there is mutuality, openness, presence, and

Klienten, und den Unterschied zwischen

directness (Buber, 1947, 1958; Friedman, 2003). Mindful awareness of no-

Therapeut und Klienten, der Wechselsei-

Les effets secondaires : Un


cas dtude illustrant la
perspective tire dune thrapie existentielle base sur la
pleine conscience (MBET)

ticing contents of consciousness in the present, and letting them go, se-

tigkeit, Offenheit, Prsenz und Direktheit

Rsum: La pleine conscience et la thra-

amlessly creates space in which to hear the client. This is not dissimilar to

beinhaltet (Buber, 1947, 1958; Friedman,

pie existentielle partagent plusieurs prin-

what Husserl (1931, 2002) refers to as bracketing, an attempt at putting

2003). Achtsames Bewusstsein, in dem die

cipes de base. Cette tude de cas illustre

114 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 115

Jyoti Nanda -

Side Effects: A case illustration from a Mindfulness

Based Existential Therapy (MBET ) perspective

de la vie dune personne peut entraner

ne conscience (MBET) comme intgration

des

concrte des deux pratiques dans ltre

dautres parties.

du thrapeute (Nanda, 2010) et comme

Mots cls: MBET, inter-connectivit,

une recherche phnomnologique qui

spcificit, humain--humain, ouverture,

coule de source dans lexprience du

mondialement, vision universelle

(1931, 2002) bracketing (

imprvisibles

dans

vcu du client. Ca place la valeur sur le

Friedman, 2003). La pleine conscience

:




()

et lattention porte aux contenus de la

conscience dans le moment prsent, et

leur lcher prise, crent sans efforts une

espace dans laquelle entendre le client.

(Kramer, 2007).

Ceci nest pas dissimilaire ce que Hus-

serl (1931, 2002) appelait bracketing [i.e.

la mise entre parenthses ], lorsquon

(),

essaie de mettre de cot ses prsomp-

tions et prsupposs pralables, afin

de rester proche de lexprience vcue.

MBET donne de la valeur la perspective

de Thich Nhat Hanh (1998) sur lcoute

avec prsence et compassion, et celle de

Kramer (2007) sur lcoute attentive avec

, -,

: MBE, ,

cur. MBET donne de la valeur galement

, -,

lide de se brancher pour tre lcoute

, ,

et rpondre aux besoins spcifiques de

chaque client. Un des principes de base

se situe dans lide que les parts et le tout

(Buber, 1947,

sont interconnects, reconnaissant quun

1958; Friedman, 2003).

changement dans nimporte quelle partie

humain--humain, Je-Tu, la relation, respectant lindividualit unique du client,


et la diffrence entre thrapeute et client,
dans laquelle il y a rciprocit, ouverture,
prsence, et franchise (Buber, 1947, 1958;

MBET

Nhat Hanh, 1998)

(Thich

2010),

116 | Extra Special Issue: Mindfulness and Psychotherapy

(Nanda,

), ..

la Thrapie existentielle base sur la plei-

changements

EAP

International Journal of Psychotherapy | 117

Jyoti Nanda -

Side Effects: A case illustration from a Mindfulness


Based Existential Therapy (MBET ) perspective

Introduction

supports moving away from analysing ex-

practice mindful breathing, deep listening,

transformation and healing become pos-

Within the scope of this paper, I will brief-

perience and staying with describing it, a

and deep looking (Ibid. p. 172). Drawing

sible (Thich, 1998, 2006). We can awaken

ly outline the philosophical underpin-

desirable stance in conducting a pheno-

from the Lotus Sutra, Thich Nhat Hanh

our minds and hearts to love, compassion,

nings of a Mindfulness Based Existential

menological enquiry (Nanda, 2005, 2009,

brings our attention to Avalokiteshvara,

joy and equanimity (Thich, 1991, 1998); to

Therapy (MBET) approach, and illustrate

2010, 2012, 2013). As a practice of pausing,

the bodhisattva of deep compassion that

loving-kindness and compassion (Brazier,

it through a case example. Note: To ensu-

noticing and choosing to respond, it also

practices looking with the eyes of com-

2013); a tender heart for self and others

re anonymity, all identifying details have

supports Existential Therapys emphasis

passion, and listening deeply to the cries

(Welwood, 1985); and to listening with

been changed.

on reflection, choice and responsibility

of the world (Ibid. p. 172). Compassion

heart (Kramer, 2007): valuable relational

to give meaning, purpose and direction to

is a deep concern for the other, in which

qualities for any therapist.

life (van Deurzen, 1997, 2002).

there is the intention and capacity to re-

Mindfulness
Jon Kabat-Zinns (1990, 2005) definition

lieve and transform suffering and lighten

Philosophical underpinnings

sorrows (Ibid. p. 172).

Mindfulness

of Mindfulness as Paying attention in a

Importantly, the quality of mindfulness

particular way: on purpose, in the present

as illuminating arising thoughts, fee-

moment, and nonjudgmentally is widely

lings, emotions and bodily sensations

Thich Nhat Hanh (2006, 1998) also points

les (Nanda, 2009, 2010; Claessens, 2009).

utilised by practitioners and researchers.

non-judgmentally in the present moment

out that mindfulness illuminates the

Each is firmly grounded within rela-

In elaborating on this definition, which I

facilitates acceptance of how things are

seeds in our store of consciousness

tedness, recognising the inseparability

also utilise in therapy, I see mindfulness

in any given moment: thus allowing an

those that cause greater affliction, and

of subject-object (Husserl, 1931/2002;

within an Existential Therapy context,

ease of being with what shows itself to us,

those that bring freedom from suffe-

Thich, 2006, 1998, 1991) and the insepa-

as a way of being in relation with myself,

helping us to step out of reactivity, and

ring. Thus, we can intentionally choose

rability of self-other-world (Heidegger,

with others and with the world (Nanda,

responding through choice. The practice

to water the seeds that take us towards

1962; Thich, Ibid.). Each practice values

2005, 2009, 2010, 2012, 2013).

of mindfulness also generates the energy

freedom from suffering, and let lie dor-

the stance of co-creation, rather than

of mindfulness in which powerful emo-

mant the seeds that increase suffering.

seeking a single causal explanation cau-

and

Existential

Therapy

also share several foundational princip-

Mindfulness practice illuminates the con-

tions can be embraced (Thich, 2001), and

With mindfulness, we can cultivate the

sing an effect. Each recognises the pre-

tents of consciousness in the present mo-

brings awareness of valuable insights of

four immeasurable minds of love (also

sence of suffering, change, imperma-

ment nonjudgmentally: i.e. noticing them,

impermanence, and the recognition of

referred to as loving-kindness (Thich,

nence, uncertainty and death as basic

letting go, and coming back to the present

inter-connectedness of self as being em-

1998, p. 171)), compassion, joy and equa-

givens (Ibid.). Each recognises the im-

moment, again and again. From an MBET

pty of a separate self (Thich, 1991, 1998,

nimity (Thich, 1998; Bien, 2008), which

portance of reflecting on our volition or

perspective, Mindfulness fulfils an impor-

2006). It makes meeting suffering with

help us move towards greater well-being.

choices, as they will have consequences

tant phenomenological stance of noticing

compassion possible.

Thich Nhat Hanh also points out that the

for self and others. Each emphasises ta-

four immeasurable minds are the four

king responsibility for our actions (Ibid.).

aspects of true love (Thich, 1998, p.170).

Each values openness to discovery, seeing

and acknowledging assumptions and presuppositions, and putting them aside, and

Listening with compassion to ourselves,

seamlessly bracketing them to stay close

and others, is an important aspect of

to clients first person lived experience

MBET. As Thich Nhat Hanh says, To de-

Thus, with mindfulness and our inten-

not knowing (Thera, 1996; Suzuki, 2006)

in the present. Mindfulness practice also

velop compassion in ourselves, we need to

tional practices of cultivating the mind,

and similarly the stance of unknowing

118 | Extra Special Issue: Mindfulness and Psychotherapy

with a beginners eye, and the stance of

EAP | International Journal of Psychotherapy | 119

Jyoti Nanda -

Side Effects: A case illustration from a Mindfulness

Based Existential Therapy (MBET ) perspective

(Spinelli, 1997). With so much common

table with uncertainty, unpredictability,

remaining open to the inter-relatedness

with every client. As Cohn (1997) points

ground, an embodied integration of both

and remains open to what emerges, while

of everything in the universe.

out, The client you meet, is the client who

practices arises seamlessly, as a way of

remaining

being in relation to oneself, others and

hearted, anchored and calm. In such a

The subtle, unseen and unspoken in-

client, it is not the same. Instead, the fo-

the world (Nanda, 2010). The practice of

human encounter, it is recognised that

ner atmosphere of the therapist, cannot

cus is on listening attentively with pre-

mindfulness also puts a special emphasis

both therapist and client are affected by

be objectified and measured; nor indeed

sence and heart (Kramer, 2007), tuning

on the practices of loving-kindness and

each other, and are both changed by the

can that of the client. What manifests is

in, and responding in the moment, being

compassion and both these qualities are

encounter.

what arises between therapist and client,

comfortable with unknowing (Spinelli,

unique to that moment, and also unique

1997) and the uncertainty of what will

to that particular relationship. MBET does

emerge next (Spinelli, 2015), while remaining anchored.

present,

receptive,

warm-

actively cultivated.

Therapeutic stance

meets you. If two therapists meet the same

MBET is a human-to-human encounter.

Listening

presence,

not subscribe to any forms of manualised

It adopts a non-pathologising stance to-

kindness, compassion and openness is

protocols to be used in the same way

wards the clients distress, seeing it as

a valued stance of MBET. It requires the

arising from the difficulties of life and

therapist to check in with herself and to

living. The stance in therapy is meeting

become mindful of his/her inner atmos-

suffering, not only with courage as in

phere. It requires pausing, even momen-

Existential therapy, but also with loving-

tarily; connecting with the anchor of ones

As we enter the therapy room, Mary says, Oh, I like this room. It feels so calm. I smile and

kindness and compassion. It actively en-

breath; and becoming aware of inner spa-

reply, Oh, Thank you! Im so glad you like it.

gages in a phenomenological enquiry, re-

ciousness in which thoughts, feelings,

spects the clients uniqueness, and stays

emotions and body sensations emerge in

I accept Marys compliment and let her know that her presence has affected me, thus ex-

with description as in Existential The-

the moment. This awareness brings reco-

pressing mutuality. Both therapist and client have exchanged gestures of small talk. Small

rapy. MBET also encourages spontaneity,

gnition of the body-mind connection in

talk, too, is part of therapy, and is an expression of lived experience between two human

responding in the moment, and multiple

the present moment in relation to a gi-

beings co-creating their therapeutic relationship (Mitchell, 2014).

ways of being within the uniqueness of

ven context, and allows noticing, both the

each therapeutic relationship. Important-

change and flux, as well as the quietness

Mary is a tall, slender, pretty woman. Dressed neatly in a skirt and sweater and wearing

ly, MBET also moves away from seeking

of spacious awareness that surrounds all

black tights, she has blonde hair with highlights and soulful grey-blue eyes, but it feels as

causal relationships, or making claims

change and movement, both within and

though she wants to hide and not be seen.

that it is the therapist who causes healing.

outside of the practitioner. A conscious

Rather, it recognises therapy as co-crea-

deliberate intention to evoke the heart of

Mary has not had therapy before. We have an initial discussion around how I offer the-

ted space between therapist and client,

loving kindness and compassion shifts the

rapy and our therapy agreement, including confidentiality and its limits, the structure of

and the interrelatedness of both with the

texture of inner atmosphere from neutral

sessions, their frequency, breaks, cancellations, fees, and ending.

universe. It recognises that it is not pos-

to warm-hearted. There is also a recogni-

sible to predict or control therapy outco-

tion of this self as being part of some-

I can do only six sessions, she says. She wants my agreement on this. On exploring this

mes: thus the therapist remains comfor-

thing far larger than just the body, and

further, she says, that she does not want her husband to pay for therapy, that she is not

120 | Extra Special Issue: Mindfulness and Psychotherapy

attentively

with

MBET: A human-to-human encounter

EAP | International Journal of Psychotherapy | 121

Jyoti Nanda -

Side Effects: A case illustration from a Mindfulness

Based Existential Therapy (MBET ) perspective

earning much in her job as a carer, and wants to live within her means. Even six sessions

Mary expresses great remorse at not having had the courage to take responsibility for

feels like a luxury for her. I agree to her request for six sessions and offer her a reduced

bringing her baby into the world and protecting it. By now, her child would have been 12

fee. She thanks me. I smile and say, OK, we have six sessions. If each one of us gives 100

years old. She blames herself for committing a crime, feels immense shame and guilt, and

percent of ourselves, lets see what happens. My manner conveys hopefulness, energy and

sees herself as a coward, and a baby-killer, who deserves punishment. Mary weeps and

openness to discovery. She expresses her gratitude and we both show a keenness to be

her tears flow like torrents down her cheeks: she apologises for her crying.

together.
As I hear her story, I feel immense compassion for Marys suffering. My eyes tear up
I feel a sense of warmth towards Mary, and also a sense of anticipation of what might

(get moist) as well. I say, Now theres two of us! Even though my eyes are moist, I feel

unfold in her story. The session described below is an unfolding of a phenomenological

a sense of calmness and of being anchored. My emotion is a spontaneous resonance in

enquiry (reconstructed from memory). After a silence, Mary sighs and starts to speak.

my body and I accept it. I am affected by her suffering and Mary sees this aspect of my
human-ness.

Her low mood is affecting everything, including her work and her relationship with her
husband, who she describes as a good and kind man. She practises meditation and yoga,

While I feel deeply for Mary, I do not wish to judge her strong beliefs that she has

but feels no peace. There are things that she has not been able to share with anyone for

committed a crime, or that she is a baby killer and thus deserves punishment

many years: they haunt her constantly. Despite meditation, she is unable to let go of them

and so I dont tell her that she shouldnt think in this negative way. Mary believes in

and doesnt know what to do. I then summarise what I have heard and ask her if I have

her religion, and she is adamant in her belief that she has committed a crime by kil-

understood her correctly; and I also ask her to feel free to correct me, if otherwise. Mary

ling her baby. As Spinelli (2015) points out, a fixed world-view bestows certainty.

validates my understanding.
Inwardly, I bring mindful awareness to my own arising thoughts: The abortion was not
My openness to be corrected by Mary gives us both the permission to do our best, frees

your responsibility alone ... The babys father refused to take any responsibility ... Your fa-

us from the fear of getting it wrong, and also gives recognition that we might both need

mily didnt support you How can you blame yourself in such a harsh way ... Cant you see

clarification from each other in our dialogue. Her verification is important to me. As exi-

how destructive this way of thinking is ... Be kind to yourself ... This harsh judgement is a

stential therapists, we recognise that we may not be able to understand the other exactly

sedimented belief ... In becoming aware of my own arising thoughts, feelings, emotions,

because we are unique and different from each other: our attempt is therefore to stay

bodily sensations (including my moist eyes), in our interactions, and acknowledging all

alongside, engage and enquire.

these, I just let them go. In recognising my assumptions and pre-suppositions of what she
should do and bracketing them (Husserl, 1931/2002), my thought clutter clears, allowing

Mary speaks with great sadness about an abortion that she had many years ago: it was an

spaciousness in which to stay alongside Mary and to explore and engage with her further.

out-of-wedlock conception. Her (then) boyfriend was not willing to take on the responsibility of being a father. She did not have any family support, as her actions had brought

I ask with navet, I am not sure I understand why you call yourself a baby-killer? My

shame on her family, and she was urged by those concerned to have the abortion. However,

difference in understanding gently challenges her deeply-held belief, while also being

she had wanted to keep her baby, and she speaks of her distress at having to go through the

respectful of the place she is in. Mary then says: I took the decision. I signed the form the

abortion. Later, she had confessed to a priest and he had told her that to abort a

doctor asked me to sign. I gave permission for the abortion. I am the guilty one. I could have

baby was to commit both a crime and a sin: and he reminded her of Judgment Day.

stopped it.

122 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 123

Jyoti Nanda -

Side Effects: A case illustration from a Mindfulness

Based Existential Therapy (MBET ) perspective

Therapist You say that you gave permission. But I am not quite sure that I understand

Mary is now beginning to acknowledge both sides of her narrative, allowing her world-

why you say, I am the guilty one. Because I also heard you say, The babys fa-

view to make space to include another perspective; and in so doing the certainty in

ther was not willing to take responsibility for being a father, and your parents

her worldview appears slightly less certain. (Long silence.)

were not willing to support you. You said your mother hid the news from your
father, so that you would not get into trouble with him and she didnt want it

Therapist Heres a thought and a question: Are you the only one responsible for the

known in the wider society. Is that so?

abortion, or are there many factors that came together for this abortion to
happen?

Thus, I bring to her awareness both sides of her narrative, instead of her focussing on
only one aspect of her story.

The insight that I offer Mary derives from the stance of co-creation of situations, and
from the Buddhist notion of dependent origination. Many factors come together and

Mary

Yes.

then something manifests. It is a gentle challenge to her deeply held view, that I gave

Therapist If, for a moment, you can imagine: that the babys father was willing to take res-

permission, therefore I am guilty. This particular intervention asks her to reflect further,

ponsibility for the baby, along with you; if you had had support from your

allowing greater uncertainty, and less rigidity to her worldview. There followed a long,

parents, and that their view of society was not critical; would you have given

silent pause in which Mary seemed very thoughtful. In these silences, I can see Mary

permission for the abortion?

actively processing what I have said, through her thoughtful pose and eye movements.

While staying with her narrative, I have flipped the scenario around, where she could

Mary

Umm! (and she nods slightly).

imagine a different set of conditions, and reflect on the outcome.


Therapist Is it possible to see it as, I am part of the whole situation. Others are also a
Mary

(forcefully) No, never! I really wanted the baby. I felt so bad. I felt forced to

part of this situation?

have the abortion.


Based on inter-relatedness between a part and whole, the assumption is that each
In speaking aloud like this, Mary is able to hear her own words powerfully, and another

persons actions will have consequences, not only for themselves, but also for others.

side to her story.


Mary
Therapist You wanted the baby so much, but without support from anyone, you felt

Hmm! (And now Mary repeats what I have said): I am part of this situation.
Others are also a part of this situation.

forced to have the abortion.


Our being together in this dialogue feels as though we are co-creating new meanings
I repeat her words, so she can hear me acknowledge what she says. Hopefully, she will be

together, the process and outcome of which is unpredictable and uncertain.

able to hear her dilemma, in her narrative.


Therapist Whats it like for you to say this and to hear yourself saying this?
Mary

It would have been very, very difficult to have the baby. No house, no food,

Mary

Mmm! Ive never thought of it like this.

no support. An outcast. Everyone was too critical. My father would have gone
ballistic: too much shame, being shunned by family, and society.

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Jyoti Nanda -

Side Effects: A case illustration from a Mindfulness

Based Existential Therapy (MBET ) perspective

Our session is coming to an end and its time to stop. In the next session when we meet,

As Mary stays with the clenched, tight sensations in the throat, without being in conflict

Mary looks very perturbed.

with them, I can see her throat muscles easing. Likewise, I guide Mary to notice the

tightness in her chest. My own calmness, anchor, and ease in being with Marys arising
Mary I am feeling a lot of different feelings. Its all mixed up relief, sadness, a lot of

experience, gives her the confidence to experience her own arising emotions and body

anger. I just want to cry. I want to scream. Why didnt anyone support me? So

sensations without panicking. Mindfulness has, thus, been seamlessly introduced into

unfair! (She speaks forcefully: her face is flushed with anger.)

the session.

The structure of Marys fixed, familiar, and certain world-view is dissolving into the cha-

Mindfulness may seem to be similar to Gendlins focussing in its being body-focussed,

os and uncertainty of worlding (Spinelli, 2015) and the fluidity of meaninglessness, not

yet we need to acknowledge its differences too. The unconditional presence in mindful-

to be confused with lack of meaning. Meaninglessness, here, is meant as this changing,

ness has a non-striving quality to it. It does not seek conceptual knowing and a resolu-

shifting, uncertain (and not yet formulated) new meaning, which is in the process of

tion through verbalising meaning, as in focussing, where one layer of meaning gives way

becoming (Spinelli, 2015). The process of moving from the certainty of the familiar world-

to another, and another in what Welwood (2002) calls a horizontal shift. In mindfulness,

view to the chaos of the fluid, unfamiliar, uncertainty of worlding can unleash feelings of

the shift is vertical where one moves from personality into a deeper quality of being, as

destabilisation and groundlessness. Unforeseen and unpredictable expressions of emo-

a fixed constellation of observer/observed dissolves, along with all reactivity, contraction,

tions can arise for the client in this upheaval.

or striving (Ibid., p. 120).

Therapist I can see how angry you feel! Its OK to feel anger. Its OK to feel whatever you feel.

Mary is already familiar with meditation and yoga. She finds great comfort in this practice
of illuminating her bodily sensations without being in conflict with them. She is happy

I am feeling calm, anchored and non-judgmental in being with Mary, holding and con-

for me to guide her in a short formal practice of mindfulness of the breath and body

taining her emerging strong emotions. Perhaps, it models for her a stance of mindfully

sensations, which helps her to reconnect with the breath as an anchor, and check in

being with her experience. I can see turmoil in her flushed face and tight body.

with the body. Its a ten-minute practice, which helps her and has helped many clients
over the years (Nanda, 2010, 2012, 2013). Despite her background in meditation and yoga,

Therapist May I ask you to notice how your body is feeling just now?

Mary says this is the first time that she is beginning to make sense of her experience, in
a meaningful way.

I guide Mary towards recognising the embodiment of her emotions (Merleau-Ponty, 1999;
Gendlin, 2003) and that they can all be noticed, acknowledged, experienced and embra-

Conclusion

ced, without one being in conflict with them (Thich, 2001).

Marys experience of MBET started the

process of worlding, giving rise to new

unfolding of a process in which she could

meanings and shifts in her worldview.

Mary

My throat is very tight. Its like I might choke.

speak and hear her story, through our

And there is a tightness in my chest.

being together, where both the clients

Recognition of the interconnectedness

uniqueness and our differences were pre-

of body and mind, and seeing herself as

Therapist Mary, can you bring awareness to the tightness in your throat? Dont push it

sent. In this human-to-human encounter,

a part of the whole situation, were new

away ... just shine awareness on the tightness ... staying with it ... making space

Marys fixed rigid worldview entered into

ways of looking for Mary. Her experience

for it ... being with it kindly ... allowing it to be there.

a more fluid, uncertain and unfamiliar

of mindfulness with me gave her the con-

126 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 127

Jyoti Nanda -

Side Effects: A case illustration from a Mindfulness


Based Existential Therapy (MBET ) perspective

fidence to turn towards her strong emo-

Jyoti Nanda

tions (like anger and sadness), embracing

CPsychol, AFBPsS, is a practising Char-

them in mindful awareness with kindness.

tered Counselling Psychologist, and an

BRAZIER, D. (2013). Not Everything is Impermanent. Kindle edition.

The seamless organic nature of MBET,

Existential Psychotherapist, Coach, and

BUBER, M. (1947). Between man and man. London: Kegan Paul.

grounded in inter-relatedness, concedes

Supervisor. She trained at Masters level

BUBER, M. (1958). I and Thou (R.G. Smith, Trans.). New York: Harper & Row.

that examining any one aspect of a clients


life can unpredictably affect other aspects
for all of them are interconnected.
In Marys case much to my surprise

in Child Development and Counselling


Psychology, and at an Advanced level in
Existential Counselling Psychology and
Existential Psychotherapy at Regents
University, London. A long-term practitioner of meditation in more than one

in the sixth and last session, just before

tradition, Jyoti has pioneered the intro-

we said goodbye, she said, Oh, I forgot to

duction of mindfulness into existential

mention, I found out only yesterday, I am

therapy. Her published work, in peer-

pregnant! I cant believe it! Imagine, after


all these years! She smiled shyly. I am so
happy for you, I smile. Inwardly I am thinking, you now know your baby will be safe

reviewed journals and book chapters,


focuses on an embodied integration of
the two approaches.
E-mail: jyoti@mindfultherapy.co.uk

with you... You now know you are not a


baby killer... You now know you can trust
and rely on another...
It was now time to say goodbye. I wished
her: the very best for herself; her unborn
baby; and the rest of her family. After
Mary leaves, I sit. Gratitude and peace
arise in feeling the interconnectedness

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2016, Vol. 20, Extra Special e-Issue,
pp. 114-130: ISSN: 1356-9082
Author and European Association of
Psychotherapy (IJP): Reprints and
permissions: www.ijp.org.uk
Submitted Sept. 2015; peer-reviewed
twice and reformatted, Nov. 2015;
resubmitted and accepted, April 2016.

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advertisement

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130 | Extra Special Issue: Mindfulness and Psychotherapy

Annes Healing Music

@AHealingMusic

EAP special JOURNAL : Mindfulness and Psychotherapy -

The Mindful Bridge


Back To Work
1

Frank Musten

Mindful
awareness
creates space
in which to
hear the client

The Mindful Bridge Back To Work -

to the practice community between the

wickeln einer gesnderen Beziehung zu

weekly group sessions. Stress and low

sich selbst unter dem Einfluss der Ar-

support are known to be major contri-

beit und anderer Stressfaktoren. Ebenso

butors to the severity and chronicity of

beinhaltet das Programm Praktiken, die

PTSD and other trauma related disorders.

darauf abzielen, eine Verbindung zur Pra-

The effectiveness of this approach is il-

xisgruppe zwischen den wchentlichen

lustrated in a case example.

Gruppensitzungen zu frdern. Stress und

Key Words: Military, First Responders,

niederschwellige Untersttzung sind be-

Mindfulness, Posttraumatic Stress Disor-

kannte Haupteinflussfaktoren fr den

der, Return to Work

Schweregrad und die Chronizitt von


PTSD und anderen mit Traumata verbun-

Die Achtsame Brcke


Zurck zur Arbeit

denen Strungen.

(Mindful Bridge Back to Work, MBBW)

Achtsamkeit, Posttraumatische Bela-

Kurzfassung: Diese Arbeit beschreibt ein

tungsstrung, Rckkehr zur Arbeit

acht-wchiges
Frank Musten
is a psychologist in private
practice and the Co-Director
of the Ottawa Mindfulness Clinic

Schlsselwrter: Militr, Ersthelfer,

Achtsamkeitsprogramm

ganz oder teilweise an posttraumatischer

Le Pont de la pleine conscience


vers un retour au travail

Belastungsstrung (Post Traumatic Stress

Rsum: Le prsent article dcrit un

Disorder PTSD) oder anderen mit Trau-

programme de huit semaines bas sur la

mata verbundenen Strungen leiden. Di-

pleine conscience cr pour les militaires

ese Personen leiden oft an chronischen

et les premiers secouristes qui souffrent

fr Militrangehrige und Ersthelfer, die

Abstract

Symptomen, die ihre Funktionsfhigkeit

pleinement ou partiellement du trouble

This paper describes an Eight Week Mindfulness Based Program for mili-

einschrnken und es unmglich machen in

de stress post-traumatique (TSPT) ou

tary members and first responders suffering from full or partial Post Trau-

ein produktives Leben zurck zu kehren.

dautres troubles lis un trauma. Ces in-

matic Stress Disorder (PTSD) or other trauma related disorders. These

Die Mindful Bridge Back to Work (MBBW)

dividus ont souvent des symptmes chro-

individuals often experience chronic symptoms that limit functioning and

ist eine Abnderung des Kernprogramms,

niques qui limitent leur fonctionnement,

are unable to return to productive life. The Mindful Bridge Back to Work

das an der Ottawa Mindfulness Clinic

et ils sont incapables de retourner une

(MBBW) is an adaptation of the core mindfulness program offered at the

(OMC) angeboten wird. Genauso wie die

vie productive. Le Pont de la pleine con-

Ottawa Mindfulness Clinic (OMC). Like the core programs at the OMC,

Kernprogramme am OMC ist MBBW eine

science vers un retour au travail (Mind-

MBBW is an ethics based approach to mindfulness. However, MBBW also

auf Ethik basierende Herangehenswei-

ful Bridge Back to Work, MBBW) est une

includes practices that relate mindfulness to developing a healthier rela-

se an Achtsamkeit. Dennoch inkludiert

adaptation du programme de base de la

tionship with oneself in the presence of work and other stresses. As well,

MBBW auch Praktiken, die Achtsamkeit

pleine conscience offert la Clinique de

the program includes practices that are intended to foster a connection

in Zusammenhang bringen mit dem Ent-

la Pleine Conscience Ottawa (OMC).

132 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 133

Frank Musten -

Comme les programmes de base OMC,

MBBW est une approche de la pleine con-

science base sur lthique. Cependant,

MBBW inclut galement des pratiques qui

mettent en relation la pleine conscience

et le dveloppement dune relation plus

(MBBW)

saine avec soi-mme eu gard du travail

et dautres sources de stress. Aussi, le

programme inclut des pratiques qui ont

pour objectif le renforcement dune con-

nexion la communaut de pratique entre

les sessions de groupe hebdomadaires. Le

stress et le peu de soutien sont connus

, MBBW

comme facteurs majeurs dans la svrit

et la chronicit du trouble du stress post

traumatique et dautres troubles lis aux

traumas. Lefficacit de cette approche

est dmontre dans un cas dtude.

Mots cls: Militaires, premiers secou-

Introduction to the Problem

responders and military personnel at risk

ristes, pleine conscience, trouble de

Civilian first responders2 and military

of developing burnout (Jackson, Schwab &

stress post-traumatique, retour au travail

personnel are at high risk of exposure

Schuler, 1986; Maslach, Jackson & Leiter,

PTSD ,

to trauma. In addition, their work set-

1997; Maslach, Schaufeli & Leiter, 2001).

, .

tings are also often in very demanding

environments where individuals have

It has been suggested that this combi-

only limited control over outcomes and

nation of exposure to trauma and job-

: ,

experience low organizational support

related burnout puts members of these

(Donnelly, Chonody & Campbell, 2014;

professions at increased risk for deve-

, -

Halpern & Maunder, 2011; Regehr & Le-

loping Post-traumatic Stress Disorder

Blanc, 2011; Regehr & Millar, 2007). These

(PTSD) (Boudoukha, et al., 2013; Halpern

job characteristics (Karasek & Theorell,

& Maunder, 2011; Perez, Jones, Englert &

1990) along with confused roles, and poor

Sachau, 2010; Shakespeare-Finch, Rees

(PTSD)

relationships (Cooper, Dewe & ODriscoll,

& Armstrong, 2014). Two meta-analyses

2001) are also major stressors in these

lend support to this suggestion (Brewin,

working environments and put these first

Andrews & Valentine, 2000; Ozer, Best,

134 | Extra Special Issue: Mindfulness and Psychotherapy

(OMC).

The Mindful Bridge Back To Work -

EAP | International Journal of Psychotherapy | 135

Frank Musten -

The Mindful Bridge Back To Work -

Lipsey & Weiss, 2008). Together these two

military and first responders suffering

finding an individual path without fear

M4 adaptations and the rationale under-

analyses found that the risk of developing

from PTSD, as well as from chronic work

of criticism or censure. The group bears

lying those adaptations are described in

PTSD depended on a number of factors.

stress (Christopher et al., 2015; Frewen,

witness to, and holds the suffering of,

recent publications (Monteiro & Musten,

All of the factors examined had low to

Rogers, Flodrowski & Lanius, 2015; King

each individual in the group.

2013; Monteiro, Nuttall & Musten, 2010;

moderate associations with risk of de-

et al., 2013; Vujanovic, Niles, Pietrefesa,

veloping PTSD. However, peri-traumatic

Schmertz & Potter, 2011). The results have

Furthermore, when mindfulness is vie-

tion in M4 programs is that they explicitly

factors (e.g., intensity of response to the

been promising, showing improvement

wed as more than a clinical intervention,

incorporate ethics in the form of beha-

incident, dissociation, and so on) along

in symptom-severity over the course of

based primarily on meditation, there is an

vioral practices, the Five Skillful Habits,

with post-traumatic factors (low social

treatment.

opportunity to draw some wisdom from

based on Thich Nhat Hanhs interpreta-

its different roots (Monteiro, Musten &

tion of the Buddhas five ethical precepts

However, mindfulness practice also has

Compson, 2015). From this perspective,

(Hanh, 2007). The Five Skillful Habits are

the potential to address the concurrent

mindfulness has the potential to be a po-

meant to provide a framework for culti-

Most individuals who experience trauma

stress and lack of social support that has

tent step on the path to living a fuller life,

vating ethical practices that both foster

do not develop PTSD, and most of those

also been related to symptom severity

in the presence of the reality of suffering

and emerge from living a valued life.

who do typically recover. However, a si-

and chronicity. Mindfulness, as a trans-

and loss.

gnificant proportion of those individuals

diagnostic intervention, fosters emo-

exposed to such risks develop chronic

tion regulation and promotes general

This is important to first responders

aptations. First, the didactic portions of

PTSD or chronic partial-PTSD. Their

well-being, independent of the disorder

and members of the military whose social

the program use work related examples

symptoms remain clinically significant

(Corcoran, Farb, Anderson & Segal, 2010;

identities are often strongly defined by

(Krger et al., 2014). The examples are

and result in enduring functional impair-

Mitchell & Heads, 2015). Thus it has the

their work organizations. Prolonged trau-

generic and are meant to illustrate how

ment (McLaughlin et al., 2015; Westphal et

potential to foster a more skillful ap-

ma (and PTSD) typically removes them

mindfulness practices can help an indi-

al., 2011). The limited evidence available

proach to managing stress, independent

from that social space: sometimes tem-

vidual manage the stress of productive

also suggests that lack of social support

of the specific stressors.

porarily; sometimes permanently.

life more skillfully. When appropriate, the

risk of developing PTSD and also increase

Mindfulness is also often taught in a

these class exercises is also related to the

the risk that PTSD or partial-PTSD will

group program, following the basic for-

The Structure of the Mindful


Bridge Back to Work Program

become chronic (Haugen, Evces & Weiss,

mat originally developed by Jon Kabat-

The Mindful Bridge Back to Work program

skillful ways of relating to their produc-

2012).

Zinn (1990). Group participants were as-

(MBBW) is an eight-week, mindfulness-

tive life.

ked to speak about their experience and

based, group intervention, which is one of

The Potential of
Mindfulness Interventions

from their experience, not to give advice,

the Mindfulness4 (M4) programs offered

Secondly, participants are encouraged to

and not to speak about anothers expe-

at the Ottawa Mindfulness Clinic. M4 pro-

adopt physically-focused practices, which

Mindfulness Based Interventions (MBIs)

rience. Then the group becomes a contai-

grams are adapted from the Mindfulness

they may experience as more grounding,

have begun to be introduced, often as

ner, where each person has the freedom

Based Stress Reduction (MBSR) program

and that can supplement (or be substitut-

adjunct treatments, for members of the

to explore her or his own suffering, and

developed by Jon Kabat-Zinn (1990). The

ed for) the standard mindfulness medita-

support, concurrent stress, etc.) had a


stronger association with risk of PTSD.

Monteiro et al., 2015). An important adap-

The MBBW program has additional ad-

awareness that participants develop from

and concurrent stressors increase the

136 | Extra Special Issue: Mindfulness and Psychotherapy

increased possibility of developing more

EAP | International Journal of Psychotherapy | 137

Frank Musten -

The Mindful Bridge Back To Work -

tions that are regularly associated with

tant for individuals suffering from PTSD

ments included the Beck Depression In-

sponses to the clinical questionnaire in-

eight-week mindfulness programs. It is

and who may have difficulty, in their in-

ventory (BDI), the Beck Anxiety Invento-

dicated that she experienced eighteen

emphasized that being able to sit in medi-

itial practices, with attention bias and

ry (BAI), the Outcome Questionnaire-45

out of thirty-two symptoms as either ha-

tation is not a gold standard. Participants

attention control (Olatunji, Armstrong,

(OQ-45) and a 32-item questionnaire,

ving quite a bit or an extreme impact

often feel that they are somehow failing if

McHugo & Zald, 2013; Schoorl, Putman,

developed in our clinic, that asks how

on how she managed her ordinary life.

they are unable to sit in meditation, even

Van Der Werff & Van Der Does, 2014).

severely a respondents symptoms have

Her responses to these instruments, af-

interfered with their ordinary life during

ter the course was completed, indicated

the past seven days.

that she was still moderately depressed

when it is clear that just sitting quietly


opens up a space for significant emotio-

An Illustrative Case

nal experiences.

Angela3 is a 35 year-old constable in a

and anxious, and she still experienced a

Canadian police service. She experienced

As well, as noted above, mid-way bet-

wide range of symptoms as severe. Ho-

Thirdly, course participants are some-

a series of traumatic incidents over the

ween

are

wever, the number of symptoms that she

times contacted between classes so as

course of several years. These incidents

contacted by email and asked about their

experienced as significantly interfering

to check in on their practice. Experience

included several significant threats to her

practice at home. They are encouraged to

with her daily life had decreased from

suggests that regular email contact (for

personal safety and prolonged exposure

give a summary of how their practice has

eighteen down to four. This finding was

example) is beneficial, as it both encou-

to traumatic visual material. She also in-

been going and also to ask questions if

consistent with what might be expected

rages their practice and allows them

itially experienced significant interperso-

they have concerns about practice.

from a mindfulness intervention. In es-

an opportunity to raise issues that they

nal stress and lack of organizational sup-

might not want to raise in class.

port, primarily associated with specific

The psychological assessment instru-

gnificant symptoms, but appeared better

individuals in one of her work settings.

ments and the regular email check-ins

able to live her ordinary life in the pre-

were not included explicitly as research

sence of those symptoms. She responded

Fourth, the Subjective Unit of Distress

each

session,

participants

sence, Angela continued to experience si-

Scale (SUDS) (Monson & Shnaider, 2014) is

She was referred to the Ottawa Mind-

tools. Rather the information available

four times over the eight weeks to the

used as an individual measure of distress.

fulness Clinic for an eight-week Mindful

from the tests and emails was gathered to

between-session emails, which was sup-

In the first class of the MBBW program,

Bridge Back to Work Program (MBBW).

support the clinical intervention. Howe-

ported by her responses.

participants are instructed in its use and

In Angelas case, her participation in the

ver, these inputs also provide information

then are asked to use SUDS as a regular

MBBW program was an adjunct to on-

that relates to the effectiveness of the in-

In the first week, she had reported that

check-in during the week and to track

going

tervention.

she was trying to establish the habit of

what differences they notice when SUDS

Therapy (McLean, Asnaani & Foa, 2015)

is in the mid-range, as opposed to very

with a therapist who was not associated

Angelas responses (to the BDI and the

climbing stairs at her workplace. She

high or very low scores. They are also as-

with the Ottawa Mindfulness Clinic.

BAI before the course) indicated that she

also noted that the power went out three

was experiencing severe symptoms of

times in her building, and there was one

individual

Prolonged

Exposure

ked to record their SUDS level before and

maintaining her attention on the act of

after a planned exercise: SUDS provides a

All participants in the MBBW program

depression and anxiety. Her responses

prolonged period when it was completely

concrete measure of change that allows

completed a short battery of psychologi-

to the OQ-45 also indicated that she was

dark. She reported being very anxious on

participants to track the benefits of their

cal assessment instruments both pre- and

experiencing a wide range of symptoms,

these occasions, but she was able to use

practice. This can be particularly impor-

post- course. Those assessment instru-

in the severe category. As well, her re-

the breathing exercises that she had been

138 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 139

Frank Musten -

The Mindful Bridge Back To Work -

taught in the course to lower her anxie-

now become a habit to bring her attenti-

change. Her choice might have been to be

Frank Musten

ty enough so that she was able to think

on back to climbing the stairs when she

in constant conflict with those realities. In-

is a psychologist in private practice

about what she needed and managed to

used them at her office.

stead, because of the MBBW program, she

and the Co-Director of the Ottawa

seemed to find a healthier way to be with

Mindfulness Clinic. He is interested in

herself in the presence of those realities.

developing mindfulness based group

find a spot near a window and began to


meditate. Once the lights came back on,

These results suggest that Angela was

she reports that she was able to return to

bringing mindfulness practices into her

work, even though she was still experien-

daily life and the outcome was that she

Case studies are limited in their gene-

cing some anxiety.

was better able to engage effectively in

rality and it is important to explore the

interventions for individuals who are

her daily life, even though her written as-

possibilities suggested here more rigo-

In the third week (when she was intro-

sessment results suggested that she was

rously. Angelas response to the emails

duced to the Pleasant Events Calendar

still experiencing significant symptoms.

contacts suggest that she found the skills

exercise (Monteiro & Musten, 2013)), she

Further, she also seemed able to use the

she was learning helpful, and that they

noted that she was not able to connect to

skills that she had acquired in the MBBW

were contributing to her sense of well-

the pleasant events as they were occur-

program to augment her individual Pro-

being. However, she was also in individual

ring, but at the end of the day she was

longed Exposure Therapy.

therapy at the same time and a case stu-

able to reflect back on the day and pick

dy does not allow for a separating out of

out a few occasions that had been plea-

Discussion

the contribution of each intervention to

sant, and the memories brought a smile

Many who are impacted by stress and

her reported improved functioning. Also,

to her face.

trauma at work develop chronic, debili-

space limitations did not allow for a full

tating symptoms. Concurrent stress and

description of the course. A full descrip-

In the fourth week, she reported being

lack of support appear to be major fac-

tion of a core M4 course is found in our

able to connect what was happening in her

tors that determine who develops chro-

book (Monteiro & Musten, 2013).

body with what she was experiencing

nic trauma-related symptoms. Angelas

emotionally and finding that she had new

case illustrated how mindfulness practi-

Finally, it is important to acknowledge

ways of regulating her emotional responses.

ces helped help her to engage more ef-

that, even after completing a program

fectively with some of the challenges that

like ours, many trauma sufferers do not

In the seventh week, she reported that

she faced in her work and personal life.

return to their work. Sometimes, this is by

she was beginning to use her ability to

The support of the group, that was impli-

choice, sometimes not. The intent of the

notice her sensations and able to use

cit in the case, also allowed her to develop

program is not to train skills that would

the Subjective Units of Discomfort Sca-

her practice in her own time and on her

allow individuals to return to emotionally

le that she had learned in the course to

own terms.

dangerous work environments, rather the

help with her exposure therapy and she

experiencing occupational stress.


Email: frank.musten@gmail.com

International Journal of Psychotherapy:


2016, Vol. 20, Extra Special e-Issue,
pp. 132-145: ISSN: 1356-9082
Author and European Association of
Psychotherapy (IJP): Reprints and
permissions: www.ijp.org.uk
Submitted Sept. 2015; peer-reviewed twice
and reformatted, Nov. 2015; revised,
resubmitted and accepted, April 2016.

intent is to foster an awareness that cre-

was finding that those mindfulness skills

Angelas symptoms were the result of a

ating a mindful bridge back to productive

were beneficial. She also noted that it had

number of factors that were unlikely to

life is about much more than work.

140 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 141

Frank Musten -

The Mindful Bridge Back To Work -

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Endnotes

6 (1), pp. 1-13. doi: 10.1007/s12671-014-0301-7


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144 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 145

EAP special JOURNAL : Mindfulness and Psychotherapy -

Mindfulness, Equanimity and Cognitive Flexibility -

Mindfulness,
Equanimity and

Cognitive Flexibility
Mirjam Hartkamp
Abstract
Mindfulness

meditation

is

becoming

more profoundly and widely implemented in Western clinical practices and Western daily life. However, clearly defining
and objectively measuring its mechanism
and outcomes, poses a challenge to research on mindfulness. A growing body
of literature affirms the positive effects,
but recent meta-analyses show that many
studies suffer from methodological limitations that undermine the reliability of

Mirjam Hartkamp
has a background in Art Therapy and
Integrative psychotherapy and has worked several years in an Anthroposophic
health institute (in Spain) and in her
private practice (The Netherlands)

this evidence. While most studies focus


on its effectiveness as an intervention, underpinning neural and cognitive
mechanisms of mindfulness are given relatively little attention. A fuller
understanding of mindfulness is therefore needed to support the prac-

mindfulness

tice of mindfulness in psychotherapy. The present paper argues for an


integrative approach that is informed by both its contemporary Buddhist

is seen as a method that strips the

soteriological1 context (Vipassana) and its Western psychological under-

conditionings of the mind, with

standing. Following this approach, cognitive flexibility is identified as a

effects such as well-being, balance


and insight. Engaging in mindfulness becomes a creative constitutive process that can have value both
in and of itself.

146 | Extra Special Issue: Mindfulness and Psychotherapy

feature of both Western and Buddhist understanding of the benefits of


mindfulness.
Keywords: mindfulness, meditation, cognitive flexibility, emptiness,
equanimity, Buddhism

EAP | International Journal of Psychotherapy | 147

Mirjam Hartkamp -

Mindfulness, Equanimity and Cognitive Flexibility -

Achtsamkeit, Gelassenheit
und Kognitive Flexibilitt

Verstehen des Nutzens von Achtsamkeit

sa comprhension psychologique occi-

. ,

erkannt.

dentale. Selon cette approche, la flexi-

Kurzfassung:

Schlsselwrter: Achtsamkeit, Meditati-

bilit cognitive est identifie comme une

wird in westlichen klinischen Anwen-

on, kognitive Flexibilitt, Leere, Gelas-

facette des deux comprhensions, occi-

dungen

senheit, Buddhismus

dentale et bouddhiste, des bnfices de la

pleine conscience.

Pleine conscience, quanimit


et flexibilit cognitive

Mots cls: pleine conscience, mditation,

flexibilit cognitive, vide, quanimit,

()

Mechanismen und Ergebnisse eine He-

Rsum: La mditation de la pleine con-

Bouddhisme

rausforderung fr die Erforschung von

science est en train de devenir plus large-

Achtsamkeit dar. Ein wachsender Fundus

ment et plus profondment implmente

an Literatur besttigt die positiven Wir-

dans des pratiques cliniques lOuest et

kungen, aber neueste Meta-Analysen zeigen, dass viele Studien unter methodolo-

und

Achtsamkeitsmeditation
westlichem

Alltagsleben

sukzessive tiefgreifender und hufiger


implementiert. Jedoch stellen die klare
Definition und objektive Messung ihrer

dans la vie quotidienne occidentale. Ce-

pendant, le besoin de dfinir clairement

, ,

gischen Einschrnkungen leiden, welche

et de mesurer objectivement son mca-

, ,

die Verlsslichkeit der Beweise untergra-

nisme et ses rsultats pose un dfi aux

ben. Whrend sich die meisten Studien

recherches menes sur la pleine consci-

auf ihre Wirksamkeit als eine Intervention

ence. Un corpus littraire grandissant

konzentrieren, wird den untermauernden

affirme les effets positifs, mais de rcen-

neuronalen und kognitiven Mechanis-

tes mta-analyses dmontrent que bien

men der Achtsamkeit relativ wenig Auf-

dtudes souffrent de limitations mtho-

merksamkeit geschenkt. Es ist daher ein

dologiques qui rduisent la fiabilit de ces

breiteres Verstndnis von Achtsamkeit

preuves. Alors que la plupart des tudes

notwendig, um die Anwendung von Acht-

se concentre sur son efficacit comme

samkeit in der Psychotherapie zu unter-

intervention, les mcanismes neuraux et

sttzen. Die vorliegende Arbeit tritt fr

cognitifs sous-jacents de la pleine con-

eine integrative Herangehensweise ein,

science sont peu traits. Une plus grande

die von ihrem zeitgenssischen buddhi-

comprhension de la pleine conscience

stischen soteriologischen Kontext (Vi-

est donc ncessaire pour soutenir la pra-

passana) und auch von ihrem westlichen

tique de la pleine conscience en psycho-

psychologischen

Verstndnis

: ,

geprgt

thrapie. Le prsent article argumente en

ist. Wenn man diesem Denkansatz folgt,

faveur dune approche intgrative avise,

wird kognitive Flexibilitt als ein Bestand-

ET par le contexte sotriologique boud-

teil von westlichem und buddhistischem

dhiste contemporain (Vipassana), ET par

148 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 149

Mirjam Hartkamp -

Mindfulness, Equanimity and Cognitive Flexibility -

Introduction

have helped to build my perspective as

cognitive therapies. While these mindful-

reached 549 and has been growing ever

In this paper, no formal unequivocal de-

well. Please note that the scope of this

ness based programmes seem to do well,

since (Black, 2014). This seems rather pro-

finition of mindfulness will be given; this

paper does not allow for a comprehen-

an unequivocal definition of mindfulness

mising for propagators of mindfulness-

is because the absence of such gives rise

sive coverage of all the rich material on

has yet to be established.

based interventions, and yet there is a

to the call for a deeper understanding of

the topic. Rather, I aim to invite a deeper

mindfulness, which is the topic of this pa-

understanding of mindfulness and point

In the afore-mentioned programmes,

out some structural methodological limi-

per. However it should be noted that in

to directions where one can obtain such

the cultivation of mindfulness is proposed

tations that call into question the reliabi-

general mindfulness can refer to a for-

a deeper understanding.

to help alleviate all sorts of problems; men-

lity of the results of some of these stu-

tal, physical, physiological and behaviou-

dies (Sedlmeier et al., 2012; Chiesa, 2012;

Mindfulness research and


application; state of affairs

ral. Accordingly, many healthcare policies

Grossman, 2008; Goyal et al., 2014). These

are including mindfulness-based inter-

limitations include (but are not limited

Generally, mindfulness refers to a mental

ventions (MBI). Mindfulness-meditation

to): difficulties in defining, conceptuali-

The present paper consists of three sec-

training of Buddhist origin and typically

is also increasingly being practiced out-

sing and operationalizing mindfulness;

tions. The first section gives a brief criti-

includes the practice of mentally atten-

side the clinical context, in everyday life.

dependency on self-report scales; and the

cal assessment of the state of the art of

ding to whatever arises from moment to

We now see educational institutions, cor-

absence of randomised controls. A recent,

mindfulness research: what claims about

moment in a non-judgemental way (e.g.

porate businesses and prisons offering

fairly comprehensive, meta-analysis as-

the working and effects of mindfulness

Kabat-Zinn, 1990; Linehan, 1993). Duri-

mindfulness-training

to

sessed the effect of MBIs on psychologi-

meditation and mindfulness-based inter-

ng the last two and a half decades, this

their staff, clients, students and inmates.

cal stress and well-being. It initially found

ventions in psychotherapy can be backed

training has been increasingly used an

These recent developments show that the

over a 15,000 studies on the effects mind-

up with empirical evidence? The second

intervention in clinical psychotherapy

training of mindfulness is believed to bring

fulness and MBIs, but only considered 47

section will highlight the working and

settings. This increase started with the

about wholesome qualities. These qualities

(!) studies as being scientifically rigorous

aims of mindfulness from the perspec-

introduction of the Mindfulness Based

include: enhanced cognitive performance,

enough to be included. Moreover, this

tive of the Buddhist Vipassana tradition.

Stress

(MBSR)

focus, efficiency, stress coping, emotion

meta-analysis found little or no effect

The third and last section will elaborate

(Kabat-Zinn, 1982, 1990). MBSR propo-

regulation, relaxation and compassion. In

of MBIs on stress and well-being and no

on the notion of cognitive flexibility - that

ses mindfulness-meditation as a tool to

short, mindfulness-meditation training

significant difference between MBIs and

seems to bring together the Buddhist and

cope with anxiety, stress, pain and illness.

programmes start to raise quite high ex-

any other active treatment (Goyal et al.,

Western psychological perspective, as far

MBSR was followed by other mindfulness-

pectations in a great variety of domains.

as the various understandings of mindful-

based interventions, such as Mindfulness

ness are concerned. In my writing, I am

Based Cognitive Therapy (MBCT; Segal et

Accordingly, a growing body of litera-

vention, found that MBCT, medicine and

mostly informed by recent empirical fin-

al., 2002), Dialectial Behaviorial Therapy

ture on mindfulness-based interventions

treatment as usual, were equally effective

dings and Buddhist philosophy, however,

(DBT; Linehan, 1993) and Acceptance and

is supporting the claim of the wholesome

(Kuyken et al., 2015), while another lar-

my experience as a psychotherapist, me-

Commitment Therapy (ACT; Hayes et al.,

effects of mindfulness on mind, body and

ge sample sized randomised controlled

ditation teacher and (since recently) re-

1999). These therapy-programmes form

behaviour. In 2013, the number of pu-

study, conducted by Williams, who co-

searcher in the field of cognitive sciences

part of the third wave of behavioural and

blished research articles on mindfulness,

founded MBCT, found no significant dif-

mal meditation practice, a mental stance,


a mental state, a concept, and sometimes
a psychological intervention.

Reduction

150 | Extra Special Issue: Mindfulness and Psychotherapy

programme

caveat. Meta-analyses and reviews point

programmes

2014). Likewise, a recent longitudinal study on MBCT as depression relapse pre-

EAP | International Journal of Psychotherapy | 151

Mirjam Hartkamp -

Mindfulness, Equanimity and Cognitive Flexibility -

ference between MBCT with and MBCT

In the light of these questions, the call

The following section will therefore look

Truths is therefore said to encapsulate all

without including the actual mindfulness-

for a deeper understanding of mindful-

into the Buddhist roots of mindfulness

of Buddhist philosophy. It is contained in

meditation training (Williams et al., 2014).

ness becomes more evident and urgent.

according to the contemporary Vipassana

the early Buddhist text, Setting the Wheel

Chiesa et al. argue (2011) that we havent

(insight meditation) tradition. It will shed

in Motion (Pali canon; Dhammacakkapa-

It follows that, although MBIs are gene-

succeeded in defining mindfulness in a

light on its underlying worldview, and

vattana Sutta) and it reads as follows:

rally held to be effective to some extent,

satisfactory way, because it doesnt re-

assumptions about the human condition

the evidence supporting this claim is at

spond to Western scientific postulates.

that the practice of mindfulness-medi-

some times not too compelling. In addi-

Mindfulness implicitly adheres to a Bud-

tation responses to. Please note that this

tion, most studies look at the effects of

dhist worldview that clashes with our im-

is not intended to be comprehensive, but

mindfulness-based interventions, while

plicit view on the nature of reality (Chie-

rather hints at the Buddhist worldview

1. The Truth of dukkha


(suffering, anxiety, dissatisfaction); in
life, there is suffering.

2. The Truth of the origin of dukkha:

the cognitive and neural mechanisms un-

sa et al., 2011, Grossman, 2011). Indeed,

that might be implicated when embracing

the origin of suffering is attachment,

derpinning mindfulness practice are given

mindfulness is a pre-scientific Buddhist

mindfulness as a salutary practice.

or thirst to whatever is not the case,

relatively little attention. This is, however,

practice and it is embedded in a belief sy-

not so surprising since it is difficult to

stem that is foreign to Western modern

look for underpinnings of something that

science (Kudesia & Nyima, 2015). Promi-

Mindfulness:
Cultivating right view

is lacking a clear demarcation and precise

nent researchers and practitioners inclu-

Soteriological Framework: 4 Noble

unequivocal operationalization.

ding Grossman and Kabat-Zinn, h like ave

Truths and the Eightfold Path

now called out for a deeper conceptual

Mindfulness stems from a Buddhist prac-

Thus, given the state of the art, there is

understanding of mindfulness. They pro-

tice and is a translation of the word sati.

cessation of dukkha:

reason for some pause for thought. The

pose a fuller appreciation of its Buddhist

There is not just one Buddhist tradition,

the eightfold path.

empirical findings are less compelling

roots and its originating soteriological

there are many. Buddhism developed

than we might have been led to believe

framework, so that the current Western

over the course of several centuries and

The fourth noble truth offers a path, or a

following the enthusiasm of researchers,

perception of mindfulness may be clari-

has travelled from India, down to Sri Lan-

remedy that should lead to the cessation

psychologists, clients or practitioners

fied, refined and enriched.

This would

ka, and up to Nepal, Tibet, Mongolia, and

of suffering. This medicine, the Eightfold

in the field. However, it has been gene-

allow for a better evaluation and appre-

then to China, Japan and elsewhere, es-

Path, is divided in three main categories,

rally accepted that MBIs are proven to

ciation of MBIs, a clearer conceptualisa-

pecially in southeast Asia. More recently,

namely:

be beneficial for stress, depression and

tion, less ambiguous empirical findings,

since the beginning of the 20th century,

substance abuse relapse. Moreover, the

and greater scientific rigor. In short, such

Buddhist meditation practices have come

general interest and enthusiasm, plus the

would help the field of mindfulness re-

to the West. Clearly, from different parts

(1. right view; 2. right intention),

amount of research, make it is hard to

search and its clinical applications in psy-

of the world, different perspectives and

ii) Ethical conduct (3. right speech;

deny that something is at work. Its just

chotherapy a great deal (e.g. Chiesa, 2012;

traditions have evolved. Nevertheless, all

that the questions What is it? What ex-

Grossman, 2011; Kudesia & Nyima, 2015).

traditions and interpretations are based

iii) Concentration (6. right effort;

actly does it do? and How does it do it?

on the Four Noble Truths and the Eight-

7. right mindfulness; and

are still subject to debate.

fold Path. The doctrine of the Four Noble

8. right concentration).

152 | Extra Special Issue: Mindfulness and Psychotherapy

or will cease to be the case (aversion


and desire).

3. The Truth of the cessation of dukkha:


the cessation of suffering is attainable.

4. The Truth of the path leading to the

i) Wisdom

4. right action; 5. right livelihood) and

EAP | International Journal of Psychotherapy | 153

Mirjam Hartkamp -

Mindfulness, Equanimity and Cognitive Flexibility -

The third category includes (right) mind-

from this perspective, taking up the prac-

plying the right view would cut through

Buddhagosa, 1975). Insight would bring

fulness and involves the cultivation of this

tice of mindfulness for whatever reason,

the illusionary view of the world and show

about relief from suffering, equanimity,

mental quality that takes four foundations

can have implications that largely extend

all phenomena to be empty of essence,

and a dispositional flexibility towards the

as its object: (1) mindfulness of the body;

the formal training. Mindfulness practice

empty of self. It follows that emptiness

ever-changing nature of our experience.

(2) mindfulness of feelings (liking /not

along with the other components of the

(Pali: sunyata) is the groundless ground

However, the first encounters with empti-

liking /neutral); (3) mindfulness of mind

eightfold path was designed to establish

that characterises all the phenomena that

ness provoke an existential fear that one

(consciousness and mental states); and (4)

the right view. Right view means seeing

we experience. In fact, following the Bud-

can only overcome by further training of

mindfulness of mental phenomena (mental

through the illusory and ephemeral na-

dhist scriptures, the right view would dis-

the mind. This (latent) existential fear is

objects / thoughts) (Satipattana sutta).

ture of the phenomena that are blinding

close a fluctuating stream of the on-going

believed to give rise to all sorts of beha-

our sight and causing misery. Applying

arising and passing away of all phenome-

viour, both functional and dysfunctional,

These four foundations of mindfulness

the right view and seeing reality in its

na, including the self. The self is, then,

while steering away from the looming

are usually included in the programs that

true nature would lead to liberation from

regarded as a process subjected to conti-

void (Buddhagosa, 1975). Thus, the un-

are currently being offered in the West.

suffering (Buddhagosa, 1975).

nuous change, rather than as a fixed thing

trained mind is conditioned and prone to

that one should identify with, or hold

suffering; it grasps and attaches itself to a

However, the ethical connotations, contained in the word right, are typically left

Mindfulness and the Buddhist soterio-

onto. This continuous flux of phenomena

cover-up reality that is illusory and ephe-

out. According to David Brazier, this is

logical frame of reference are therefore

is mostly beyond our control. According

meral and thus ultimately unsatisfactory.

questionable, because mindful and acute

deeply intertwined. As was said above,

to this view, impermanence and empti-

Therefore, the Eightfold Path includes a

attention are essential also to a sniper

this has provoked several researchers and

ness are the root and outcome of any

solid mental training that effectively de-

(Brazier, forthcoming). All componen-

scholars to claim that mindfulness, alt-

experience. Our fear of this looming void,

conditions the untrained mind. Mindful-

ts of the eightfold path make reference

hough practiced in a secular setting, still

the selfless emptiness of existence, the

ness, in this view, cultivates an unprejudi-

to right, which shows the firm ethical

strongly adheres to its implied worldview:

confrontation with impermanence, with

ced, flexible open view, while attentively

base of this framework. It follows that the

the right view (Grossman, 2011; Kabat-

the reality that everything one holds on

monitoring moment-to-moment expe-

practice of mindfulness doesnt stand by

Zinn, 2003). We will now take a closer

to will cease to exist and moreover will do

rience. Phenomena are monitored as they

itself, but is practiced in coherence with

look at the right view in relation to mind-

so on its own accord, beyond our control,

come and go, without grasping or rejec-

ethics for which one needs wisdom as

fulness and the ending of (mental) suffe-

form the very roots of suffering. Imper-

ting them. These phenomena include

well. Thus all aspects of the three catego-

ring according to Buddhist philosophy.

manence, non-self and suffering are thus

our own emotions, (existential) fears and

seen in Buddhism, as the three characte-

thoughts, as are encapsulated in the four

Implications of the Right View:


Emptiness & Impermanence

ristics of existence that one firs has to re-

foundations of mindfulness. Taken from

cognise in order to become free of suffe-

this perspective, mindfulness meditation

According to the Buddhist scriptures,

ring (Barendregt, 2011; Buddhagosa, 1975).

is seen as a central part of the process of

ries of the eightfold path (wisdom, ethics


and concentration) are intertwined and
proposed to enhance each other.
In addition, mindfulness as a cultivated

suffering is constituted, cultivated and

mental stance can accompany activities

enhanced by failing to see reality in its

The Eightfold Path is believed to cultivate

table (illusory) dynamics that underlie our

in daily life and is therefore not tied just

true nature. In other words, by applying

both a gradual and a sudden insight in to

behaviour and ultimately our existence.

to the formal meditation practice. Seen

a wrong view one suffers. In contrast, ap-

the empty nature of reality (Bohdi, 2000;

These include becoming intimate with

154 | Extra Special Issue: Mindfulness and Psychotherapy

becoming acquainted with the uncomfor-

EAP | International Journal of Psychotherapy | 155

Mirjam Hartkamp -

Mindfulness, Equanimity and Cognitive Flexibility -

existential fear and discomforts that are

Equanimity was recently proposed as a

indeed suggest a correlation between

flexibility, self-referential processing and

intrinsic to life, while cultivating an equa-

new outcome measure of meditation and

mindfulness-meditation training and co-

mental balance (Brewer et al., 2011). The-

nimous, balanced and flexible stance

contemplative practices (Debordes et al.,

gnitive flexibility (Moore & Malinowski,

se findings indicate that cognitive flexi-

towards it (Wallace & Shapiro, 2006; Ba-

2015). Debordes et al. specify equanimity

2008). However, more data is needed to

bility can be related to the cultivation of

rendregt, 2011).

as the most prominent factor for mental

verify this suggested relation. Recent-

mindfulness. This is not too surprising

well-being. In their proposal, they draw

ly, this relationship has been addressed

if one considers that attending to new

The foregoing gives a perspective on

upon Buddhist philosophy, Western (co-

by Barendregt & Raffone (forthcoming).

and unexpected situations in an adequa-

mindfulness as a practice that helps co-

gnitive) psychology and neuro-imaging

They provide for an integrative outlook

te manner, requires an open and atten-

ming to terms with any phenomenon as it

methods. Equanimity is thus defined as,

that includes neuroscience, psychology,

tive stance towards the present moment.

arises and ultimately with the three cha-

an even-minded mental state or disposi-

psychotherapy and Buddhist philosophy.

A stance that is typically cultivated with

racteristics of existence. Equanimity and

tional tendency toward all experiences or

Besides its relation to mindfulness prac-

mindfulness.

a balanced flexible stance towards life,

objects, regardless of their origin or their

tice, they propose cognitive flexibility as

that are said to be cultivated with mind-

affective valence (pleasant, unpleasant,

negatively related to self-referential pro-

While the cultivation of mindfulness is

fulness, are seen as important notions for

neutral) (Deborders et al., 2015, p. 3).

cessing (Raffone et al., 2010; Berkovich-

aimed at de-conditioning, cognitive fle-

the constitution of well-being from both

This definition is not only faithful to both

Ohana, 2011; Brewer et al., 2011).

xibility is usually contrasted with condi-

a Buddhist and a Western perspective.

Buddhist and Western psychology, but it

The next section will therefore focus on

also shows an intimate relation to ones

Interestingly, self-referential proces-

less automatic the behaviour, the more

(cognitive) flexibility as a crucial aspect to

mental balance. The relation of mental

sing in the form of self-focussed attenti-

mentally flexible one becomes. Cognitive

the cultivation of mindfulness. Also, new

balance and well-being was previously

on, can be found in the vast majority of

flexibility is classically studied in relation

research perspectives that move beyond

addressed by Wallace and Shapiro (2006).

mental disorders as described in DSM-V

to learning capacities and the cognitive

effectiveness research will be suggested.

They proposed an integrative theoretical

(Goldin et al., 2009; Ingram, 1990). This

development of children. Its relation to

framework for mindfulness meditation

suggests that cognitive flexibility is nega-

mental balance and well-being might be

Cognitive Flexibility, Equanimity and Mental Balance

research that includes both Western and

tively related to a central feature of men-

an aspect of cognitive flexibility that is re-

Buddhist psychology. Their framework

tal disorders, namely that of self-focused

levant for mindfulness research, however

The former section proposed equanimity

consists of a four-component model that

attention. Moreover, the counterpart of

it has been given little attention thus far.

and mental flexibility as fruits of mind-

describes the cultivation of well-being

cognitive flexibility, mental rigidity, plays

fulness from a Buddhist understanding.

through mindfulness meditation. Herein,

a central role in most mental disorders, as

These proposed hypotheses and findings

The present section focuses on studies

mental balance forms a major part of

well.

give rise to exciting and promising lines

and theories that point to a relatively new

well-being and is constituted by cognitive

line of research that seems to be in ali-

flexibility (Ibid, 2006). Cognitive flexibility

In addition, recent findings in cogni-

flexibility and mental balance in the light

gnment with the above. This new line of

is defined as the ability to react adequat-

tive neuroscience, concerning the def-

of mindfulness practice is particularly

mindfulness research focuses on cogni-

ely to new and unexpected situations, and

ault mode network (e.g. mind wandering)

interesting because it seems to bridge

tive flexibility and equanimity in relation

as intrinsically linked to attentional pro-

seem to lend support for the linkage

the gap between the Western modern

to well-being.

cesses (Caas et al., 2003). Empirical data

of attentional processes with cognitive

conception of mindfulness and the pre-

156 | Extra Special Issue: Mindfulness and Psychotherapy

tioned (automatic) behaviour. Thus, the

of inquiry and research. Seeing cognitive

EAP | International Journal of Psychotherapy | 157

Mirjam Hartkamp -

scientific ancient religious construct that

Mirjam Hartkamp

mindfulness is rooted in. The intimate re-

has a background in Art Therapy and

lation between equanimity and cognitive

Integrative psychotherapy and has

flexibility seems crucial in bridging this

worked several years in an Anthropo-

gap. Equanimity has a long history in Bud-

sophic health institute (in Spain) and

dhist contemplative traditions, whereas


cognitive flexibility is a well-studied notion in the field of cognitive psychology.
This line of research differs from the

in her private practice (The Netherlands). She has acquired an academic


grounding in Eastern and Western
Philosophy and has taught meditation

primarily on effectiveness as opposed

researchers and practitioners (see: Consciousness, Mindfulness & Compassion,


International Association). In addition,
she provides Buddhist informed therapeutic consults on a donation base.
With all her activities, she aims to dee-

that counter-acts a certain condition or

pen our knowledge of overcoming and

a disorder, like a pill. Rather, it is seen as

going beyond our selves towards inner

a method that strips the conditionings

freedom, while cultivating sustained

of the mind, with effects such as wellbeing, balance and insight. Considering
the fact that well-being is generally defined as the absence of mental disorders
or disturbances, this seems a fruitful ap-

compassionate happiness, for the sake


of ourselves, our loved ones and the
world we live in.
E-mail: mhartkamp@gmail.com
Websites: www.cmc-ia.org;
www.matterofmind.org

proach to assess the possible benefits of


the cultivation of mindfulness to Western
psychotherapy. Engaging in mindfulness
then becomes a creative constitutive process that can have value both in and of
itself.

In: H. Walach, S. Schmidt & W.J. Jonas (Ed.), Neuroscience, Consiousness and
Spirituality, (pp. 195-206). New York: Springer.
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global neuronal workspace and flexible mental programs in meditation and hypnosis.
BERKOVICH-OHANA, A., GLICKSOHN, J. & GOLDSTEIN, A. (2012). Mindfulness-induced

She is currently dedicated to further


works with an international team of

mindfulness is not employed as a method

BARENDREGT, H.P. (2011). Mindfulness Meditation: deconditioning and changing view.

changes in gamma band activity - Implications for the default mode network,

tion, in the sense that it does not focus

give rise to of and on itself. In this way,

references

self-reference and attention. Clinical Neurophysiology, 123, pp. 700-710.

scientific knowledge of meditation and

at the mechanism itself and what it can

Mindfulness, Equanimity and Cognitive Flexibility -

in the Vipassana tradition since 2013.

studies we have discussed in the first sec-

to another treatment, but rather looks

BLACK, D.S. (2014). Mindfulness-based interventions: An antidote to suffering in the


context of substance use, misuse, and addiction. Substance Use & Misuse, 49 (5),
pp. 487.
BOHDI, B. (2005). In the Buddhas words: An anthology of discourses from the Pali canon.
Boston: Wisdom.
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London: Routledge Taylor & Francis.
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the National Academy of Sciences, 108, pp. 20254-20259.
BUDDHAGHOSA. (1975). The path of purification (B. anamoli, Trans.). Kandy, Sri Lanka:
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International Journal of Psychotherapy:


2016, Vol. 20, Extra Special e-Issue,
pp. 147-161: ISSN: 1356-9082
Author and European Association
of Psychotherapy (IJP):
Reprints and permissions: www.ijp.org.uk
Submitted Sept. 2015; peer-reviewed twice
and reformatted, Nov. 2015;
resubmitted and accepted, April, 2016

158 | Extra Special Issue: Mindfulness and Psychotherapy

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Future. American Psychological Association, D12. Doi: 10.1093/clipsy/bpg016.
KUDESIA R. & VEN. NYIMA, T. (2014). Mindfulness Contextualized: An Integration of
Buddhist and Neuropsychological Approaches to Cognition. Mindfulness, 6 (4).
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BYFORD, S. (2015). Effectiveness and cost-effectiveness of mindfulness-based
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EAP special JOURNAL : Mindfulness and Psychotherapy -

Beyond kusala and akusala?


Mindfulness and Buddhist Ethics

Beyond kusala
and akusala?

Mindfulness and Buddhist Ethics


ANDR VAN DER BRAAK

the practice of
mindfulness
could remain
beyond good and
evil in a systematic
ethical sense.

ANDR VAN DER BRAAK


is a professor of Buddhist Philosophy
in Dialogue with other World Views
at the Faculty of Theology of Vrije
Universiteit, Amsterdam

Abstract
This article investigates to what extent a Buddhist ethical framework can
contribute to the way that mindfulness is being practiced in a contemporary psycho-therapeutical context. It highlights some philosophical
obstacles to the endeavour of building a bridge between mindfulness and
Buddhist ethics, and eliminates some preconceived ideas about Buddhist
ethics. It argues that the Buddhist notions of kusala and akusala (wholesome and unwholesome) could be a promising enrichment to an extended
secular discourse on mindfulness-based interventions that takes into account ethical considerations, without descending into a full-blown Buddhist single set of ethics. The Dalai Lama has attempted to develop such
a secular discourse in his books, Ethics of a New Millenium and Beyond
Religion: Ethics for a Whole World.
Key Words: Mindfulness, Ethics, Dalai Lama

162 | Extra
EAP | Special
Mindfulness
Issue:and
Mindfulness
Psychotherapy
and Psychotherapy

EAP | International Journal of Psychotherapy | 163

ANDR VAN DER BRAAK -

Beyond kusala and akusala?

Mindfulness and Buddhist Ethics

ber kusala und akusala


hinaus? Achtsamkeit und
Buddhistische Ethik

Au del de kusala et
akusala? La Pleine conscience
et les thiques bouddhistes

KUSA-

Kurzfassung: Dieser Artikel berprft

Rsum: Cet article explore dans quelle

: ,

in welchem Ausma ein buddhistisches

mesure un cadre thique bouddhiste peut

ethisches Rahmenwerk die Art, wie Acht-

contribuer la faon que la pleine consci-

samkeit in einem modernen psychothe-

ence est en train dtre pratique dans un

rapeutischen Kontext angewendet wird,

contexte psychothrapeutique contem-

beeinflussen kann. Es werden einige

porain. Il pointe quelques obstacles phi-

philosophische Hindernisse im Bem-

losophiques aux efforts pour construire

hen, eine Brcke zwischen Achtsamkeit

un pont entre la pleine conscience et les

und buddhistischer Ethik zu bauen, her-

thiques bouddhistes, et limine quel-

vorgehoben und einige vorgefasste Mei-

ques ides prconues concernant les

nungen ber buddhistische Ethik aus

thiques bouddhistes . Il argumente

dem Weg geschafft. Angefhrt wird, dass

que les notions bouddhistes de kusala

. ,

die buddhistischen Konzepte von kusala

et akusala (sain et malsain) pourraient

kusala aku-

und akusala (heilsam und unheilsam) eine

tre un enrichissement prometteur vers

sala (, ,

vielversprechende Bereicherung fr ei-

un discours sculier tendu relatif aux

nen erweiterten weltlichen Diskurs ber

interventions bases sur la pleine con-

achtsamkeitsbasierte

Interventionen

science qui prennent en compte les con-

sein knnten, der ethische berlegungen

sidrations thiques, sans descendre vers

bercksichtigt ohne in eine gnzlich

un cadre unique et exhaustif dthiques

buddhistische,

einheitliche

Ethik

LA AND AKUSALA?

ab-

bouddhistes. Le Dala-Lama a tent de

zutauchen. Der Dalai Lama hat in seinen

dvelopper un tel discours sculier dans

Bchern, Das Buch der Menschlichkeit:

ses livres, Ethiques dun nouveau mille-

Eine neue Ethik fr unsere Zeit und Jen-

nium (Ethics for a New Millenium) et Au-

seits von Religion - Ethik und menschliche

del de la religion : des thiques pour un

: .

Werte einen derartigen skularen Diskurs

monde entier (Beyond Religion: Ethics for

: ,

entwickelt.

a Whole World).

Schlsselwrter: Achtsamkeit, Ethik,

Mots cls: Pleine conscience, thiques,

Dalai Lama

Dala-Lama

164 | Extra Special Issue: Mindfulness and Psychotherapy

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ANDR VAN DER BRAAK -

Beyond kusala and akusala?


Mindfulness and Buddhist Ethics

Discussing mindfulness without including

dom 2.0 conference on February 15, 2014.

ethical injunctions. Therefore, there is an

other integral aspects of Buddhist prac-

Activists from Heart of the City (a coll-

ethical dimension to mindfulness, accor-

tice, the noble Eightfold Path and Four

ective campaigning against the adverse

ding to the Buddhist tradition: but, how

Immeasurables (that is brahmavihara;

impacts of rapid expansion by technolo-

does one combine mindfulness with Bud-

ntroduction

compassion, loving kindness, sympathetic

gy corporations in the San Francisco Bay

dhist ethics? To what extent can a Bud-

Generally speaking, there is a lack of

joy and equanimity), may lead to signifi-

Area1) jumped onto the stage to chant,

dhist ethical framework contribute to the

agreement about different definitions

cant denaturing of mindfulness. Although

Wisdom means stop displacement! Wis-

way that mindfulness is being practiced

of mindfulness (Grossman, 2013). The-

a denatured approach may, nevertheless,

dom means stop surveillance! (Ng, 2014,

in a contemporary psychotherapeuti-

re is a wide range of interpretations and

yield some health benefits, such a tact is

p. 360) He comments that:

cal context? Or, in the words of a recent

descriptions: some accentuate aspects

more in line with implementing limited

of attention (e.g. Bishop et al., 2004),

components of a broad, not easily dis-

the protest against corporate mind-

ethical space of mindfulness-based inter-

whereas others also stress cognitive and

sected, process, rather than exploring the

fulness is guided by a belief that mind-

ventions (MBIs) in clinical practice?

emotional factors (e.g. Gethin, 2013). Ka-

process as a whole. (Grossman, 2013, p.

fulness training ought to be oriented

bat-Zinn defined mindfulness as, paying

223; see also Monteiro et al., 2014)

by Buddhist ideals about wisdom and

This article aims to highlight some phi-

study of McCown (2013), What about the

compassionor at least by a generaliza-

losophical obstacles to the endeavour

in the present moment, and non-judgmen-

Many contemporary definitions of mind-

ble, non-Buddhist specific set of ethical

of building a bridge between contem-

tally (1994, p. 4), and as the intentional

fulness turn it into something that has no

guidelines such as those that can be ex-

porary mindfulness-practice and Bud-

cultivation of non-judgmental moment-

obvious ethical implications. According to

tracted from the Five Precepts.

dhist ethics, and also tries to eliminate

(Ng, 2014, p. 362).

some preconceived ideas about Buddhist

attention in a particular way: on purpose,

Those

such definitions of mindfulness, it would

three elements of intentionality, present-

be perfectly possible to kill somebody

centredness, and absence of judgment

mindfully, and mindfulness practice could

In the Buddhist tradition, mindfulness

were very influential. Shapiro et al. (2006)

in principle even be used to train army

is often described as right mindfulness

posit three axioms: Intention, Attenti-

snipers and help them to develop their

(samma sati). The term implies that there

Mindfulness and
Buddhist Ethics

on, and Attitude (IAA) as simultaneously

skills in here-and-now awareness.

also exists such a thing as wrong mind-

As

fulness, which, presumably, would inclu-

(MBIs) have developed over the past thir-

Apart from such well-known textbook

de our sniper example (see also: Maex,

ty years, researchers and clinicians seem

examples, the ethical implications of

2013, p. 169).

to have shown very little interest in the

to-moment

awareness

(1996).

manifesting the elements of the formal or


informal practice of mindfulness.

ethics.

mindfulness-based

interventions

Most of these discourses tend to valori-

mindfulness also come to the fore in what

se the individual inner experiences of

Purser and Loy (2013) have described as

In Buddhist texts, right mindfulness is

searched for significant repositories of

mindfulness meditation (McCown, 2013,

the commodifying trend of MacMind-

connected to following the first five fac-

the academic research literature on the

p. 33). However, some authors suggest

fulness. Ng (2014), for example, discusses

tors of the Eightfold Path: right view,

MBIs, the MEDLINE and psychINFO data-

that such an approach reduces mindful-

the protest that interrupted Googles

right resolve, right speech, right ac-

bases, using the very broad search string:

ness, and removes it from its Buddhist

presentation, 3 Steps to Build Corporate

tion and right livelihood (see Majjhima

of mindfulness and ethics: and was

roots:

Mindfulness the Google Way at the Wis-

Nikaya3). These can all be considered as

rewarded with 8 and 31 articles, respec-

166 | Extra Special Issue: Mindfulness and Psychotherapy

ethical aspects of mindfulness. McCown

EAP | International Journal of Psychotherapy | 167

ANDR VAN DER BRAAK -

Beyond kusala and akusala?


Mindfulness and Buddhist Ethics

tively. Again respectively, 0 and 3 of those

Nirvana, the ultimate liberation of suffe-

Many therefore agree with Kabat-Zinn,

articles specifically actually referred to

ring. Nirvana is seen as the highest good,

who is reluctant to articulate an ethic for

ethics within the MBIs (Cullen, 2011; Kang

not as a mundane goal. How can practiti-

MBSR or for MBIs explicitly. He feels it is

One of the earliest and most important

& Whittingham, 2010; Sauer et al., 2011),

oners of mindfulness be expected to sub-

the personal responsibility of individual

contributions to the budding field of

and none was wholly devoted to the sub-

scribe to such a religious notion?

clinicians and teachers implicitly to ex-

Buddhist ethics has been Keowns book,

press such an ethic in their day-to-day in-

The Nature of Buddhist Ethics (Keown,

ject (McCown, 2013, p. 17).

begin with regard to Buddhist ethics.

The second objection is related to the

teractions with others (Kabat-Zinn, 2013,

1992/2001). In it, he claims that Buddhist

The Journal of Buddhist Ethics has carried

first. Buddhism relies upon a world-view

p. 294). The fear of bringing a single set

ethics is best interpreted as a form of

(since its inception in 1994) only one arti-

that includes cosmological notions, such

of ethics (into an inappropriate setting) is

virtue ethics, with Nirvana (the ultimate

cle on the ethical-political significance of

as karma and rebirth that do not fit well

understandable. The question is, howe-

liberation from rebirth) as the highest

mindfulness (Ng, 2014). The recent exten-

with the empirical, naturalized Western

ver, is it contended that there are more

good (summum bonum), and the ultimate

sive collection of articles on mindfulness

worldview. How is it possible to speak

appropriate discourses to be found with

criterion of goodness. From this point of

by Williams and Kabat-Zinn, subtitled Di-

about Buddhist ethics, without immedi-

regards to the field of Buddhist ethics?

view, good would be whatever contri-

verse perspectives on its meaning, origins

ately having to accept such foreign no-

and applications, lack any contributions

tions, such as karma and rebirth?

The Many Faces of


Buddhist Ethics

of goodness with the ultimate Buddhist

From the side of the MBIs, to be able

Interestingly enough, there is no clear

table for building a bridge between Bud-

to articulate an ethic-based philosophy

agreement on the nature of Buddhist

dhist ethics and MBIs. Firstly, it seems to

Although engaging the Buddhist ethical

on distinctly Buddhist concepts, or one

ethics: Keown (1992/2001) sees it as a

marginalize all kinds of proximate goals,

tradition would seem to be a sensible

that uses specifically Buddhist language,

form of virtue ethics (a form of norma-

and in the clinical application of mindful-

move (especially as Buddhism is the tra-

would run counter to the concepts and

tive ethics that emphasizes the role of

ness, such proximate goals are especial-

dition where the practice of mindfulness

practices that have fuelled their growth

ones character and the virtues that ones

ly important. Secondly, since Nirvana is

is presented most clearly and distinctly),

(McCown, 2013, p. 58). Cullen, in speaking

character embodies for evaluating ethical

generally achieved only after many life-

there is a widespread hesitation to do so

of an ethic for MBIs, is very clear on this:

behaviour); Goodman (2009) views it as a

times, the notion of rebirth looms large in

type of consequentialism, which derives

ethical evaluation. Therefore, such a form

from an ethical perspective (Williams &


Kabat-Zinn, 2013).

now. There are objections related: both

butes to Nirvana. Such an identification


goal, however, does not seem very sui-

to Buddhism, and to MBIs themselves

It is of critical importance in most main-

rightness or wrongness of an action from

of Buddhist ethics would indeed not

(McCown, 2013, p. 37). I will describe two

stream settings that a single set of ethics

its consequences; others conclude that

translate well to a secular clinical setting.

objections that are specifically aimed at

is not imposed, as this can both create

the Buddhist tradition advises us to look

Buddhist ethics within itself, and a third

conflict with different faith traditions

at ethical problems from a variety of dif-

However, Velez de Cea argues that early

more general objection aimed at ethics in

and bring an association of religion into

ferent points of view, without assigning

Buddhist criteria of goodness do not ex-

general.

a setting where this is inappropriate and

any form of theoretical or practical pri-

clusively focus on Nirvana, and that pro-

threatening ``

ority to any one of them (Velez de Cea,

ximate goals also have a legitimate place

(Cullen, 2011, p. 189).

2004). Such a confusing array of interpre-

(inter alia the Buddhist tradition men-

tations makes it hard to know where to

tions a large fortune, a good reputation,

The first objection sees Buddhism as


a religion that aims at the realization of

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ANDR VAN DER BRAAK -

Beyond kusala and akusala?


Mindfulness and Buddhist Ethics

entering confidently into any assembly, or

gether strict moral requirements, general

humanity, rather than on specific Bud-

Ceas modifications, it becomes possible

an unconfused death). Also, the goodness

and not very urgent guidelines, and mat-

dhist notions of Nirvana.

to discuss proximate goals such as happi-

of actions is determined not only by the

ters that are of no moral concern at all

mental states underlying actions (as Ke-

(Goodman, 2009, p. 63).

own claims), but also by their objective


status as intrinsically kusala or akusala

ness, relaxation, and stress management

Conclusions

on their own merits, without reference to

If Buddhist ethics is to be of any relevance

an ultimate Nirvanic goal.

Olendski (2013) describes how kusala and

for the ethical space of mindfulness-ba-

akusala play an important role in the psy-

sed interventions, it is important to find

Also, the psychological model of the Bud-

chological model that is to be found in the

an appropriate discourse within which

dhist Abhidhamma writings, with their

The oppositional pair of concepts kusala

various Abhidhamma writings.6 However,

to discuss it. Keowns claim that Nirvana

language of kusala and akusala, could be

/ akusala has several meanings.4 It can-

he prefers their translation as healthy

serves as the ultimate good in Buddhist

a promising enrichment to an extended

not be simply translated as good/bad or

or unhealthy, insofar as it delineates not

ethics, and is the sole criterion for good-

discourse on mindfulness-based inter-

right/wrong, but more as wholesome/

a moral standard, nor a normative defi-

ness, retains too much of an otherworldly

ventions that takes into account ethical

unwholesome, skilful/unskilful, heal-

nition of right and wrong, as much as a

flavour in Buddhist ethics, marginalizes

considerations, without descending into

thy/unhealthy, or even intelligent/unin-

description of what factors contribute to

proximate goals, and strongly connects

a full-blown Buddhist single set of ethics.

telligent According to the Buddhist psy-

(or detract from) the result of well-being,

ethics to the notion of rebirth, thus ren-

chological system known as Abhidhamma

the reduction of suffering, and the capa-

dering it unsuited for application in a

The Dalai Lama has attempted to deve-

(a detailed scholastic rewriting of materi-

city for understanding. The word has also

clinical context. However, with Velez de

lop such a secular discourse in his books,

al appearing in the early Buddhist suttas),

the sense of skilful and unskilful, which

mindfulness (sati) is only ever present as

means that the Buddhist practice of inte-

(Velez de Cea, 2004, p. 134).

.5

a mental factor (cetasika) in kusala states

grity (sila) is regarded as a skill that can

of mind (kusala-citta): however, if there

be learned, while even the most atrocious

is mindfulness, there is a kusala type of

misbehaviour is evidence not of an evil

consciousness; and since mindfulness is

nature, but of a lack of understanding.

in fact always present in kusala states

The centrality of this ethical evaluation

of mind; if there is a kusala type of con-

reveals the extent to which this entire

sciousness, there is then mindfulness

system, both in its Nikaya origins, and

(Gethin, 2001, p. 57).

in its Abhidhamma extension, is meant


as a tool for effecting personal psycho-

The term kusala does not always have an

logical transformation, rather than as an

ethical meaning. Pali texts group toge-

intellectual exercise of building doctrine

ther, and treat in a parallel fashion, ac-

(Olendzki, 2013, p. 60). This pair of con-

tions that are akusala, because they harm

cepts, kusala and akusala, can possibly

others and actions that are regarded as

contribute to a secular discourse on Bud-

akusala for other reasons. They mix to-

dhist ethics that is based on our common

170 | Extra Special Issue: Mindfulness and Psychotherapy

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ANDR VAN DER BRAAK -

Beyond kusala and akusala?


Mindfulness and Buddhist Ethics

Ethics of a New Millenium (Dalai Lama,

Andr van der Braak

1999) and Beyond Religion: Ethics for a

is a professor of Buddhist Philosophy in

Whole World (Dalai Lama, 2011). For ex-

Dialogue with other World Views at the

ample, if an individuals overall state of

Faculty of Theology of Vrije Universiteit,

SEGAL, Z.V., ABBEY, S., SPECA, M., VELTING, D. & DEVINS. G. (2004). Mindfulness: A

heart and mind is kusala, their resul-

Amsterdam. He graduated with a thesis

proposed operational definition. Clinical Psychology: Science and Practice,

ting actions will be ethically wholesome.


Therefore, it pays off to cultivate such a
wholesome state of heart and mind (Dalai
Lama, 1999, 30, p. 33).

on Nietzsche and Buddhism. He wrote


somewhat disillusioned in 2003
about the American guru, Andrew Cohen
in, Enlightenment Blues, in which he

of mindfulness, the Dalai Lama considers

2009, he was director of the Philosophy Foundation East-West (FOW), and,


in 2012, he became the Zen teacher at
the Zen Center, Amsterdam. In 2012,
he was appointed as an extraordinary professor at the Free University of
Amsterdam. He continues in his work in

An ethic of restraint deliberately re-

philosophy, writing and education.

fraining from doing actual or potential

E-mail: a.vander.braak@vu.nl

harm to others; an ethic of virtue actively cultivating and enhancing our positive behavior and inner values; and an
ethic of altruism dedicating our lives,
genuinely and selflessly, to the welfare
of others. (Dalai Lama, 2011, p. 103)
At all three levels, the practice of mind-

Wisdom 2.0 Conference, Tricycle, 17 February 2014. http://www.tricycle.com/blog/

sistic, power-hungry teacher. And then


Buddhist meditation, and, from 2007 to

for its success upon the former:

CARING-LOBEL, A. (2014). Protesters Crash Google talk in Corporate Mindfulness at


protesters-crash-googletalk-corporate-mindfulness-wisdom-20-conference.

dhist set of ethical rules for the practice

gressively more advanced and dependent

11: pp. 23041.

COUSINS, L.S. (1996). Good or skilful? Kusala in Canon and Commentary. Journal of

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ryday life as having three levels, each pro-

BISHOP, S.R., LAU, M., SHAPIRO, S., CARLSON, L., ANDERSON, N.D., CARMODY, J.,

describes Cohen as a deranged, narcis-

Rather than developing a single Bud-

the process of ethical mindfulness in eve-

references

International Journal of Psychotherapy:


2016, Vol. 20, Extra Special e-Issue,
pp. 162-174: ISSN: 1356-9082
Author and European Association of
Psychotherapy (IJP):
Reprints and permissions: www.ijp.org.uk
Submitted Sept. 2015; peer-reviewed twice
and reformatted, Nov. 2015;
resubmitted and accepted, April 2016.

fulness has much to offer. In such a way,


the practice of mindfulness could remain
beyond good and evil in a systematic

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Perspectives on Its Meaning, Origins and Applications, (pp. 281-306). London/New

Googles handling of the protest could be seen as a further illustration of this need.

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After the activists were removed from the stage (the live feed was cut and the inter-

McCOWN, D. (2013). The ethical space in mindfulness in clinical practice. Tilburg:

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Tilburg University [Ph.D. thesis]

Google spokesperson directed the audience to check in with your body to feel what

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In: M.G. WILLIAMS & J. KABAT-ZINN (Eds.) Mindfulness: Diverse Perspectives on Its

its like to be in conflict with people with heartfelt ideas (Caring-Lobel, 2014).
3

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Meaning, Origins and Applications, (pp. 165-175). London/New York: Routledge.


MONTEIRO, L. M., MUSTEN, R.F. & COMPSON, J. (2014). Traditional and contemporary

accesstoinsight.org/tipitaka/mn/mn.117.than.html
4

Harvey describes a kusala action as a blameless one which is wise or skilful in pro-

mindfulness: Finding the middle path in the tangle of concerns. Mindfulness.

ducing an uplifting mental state and spiritual progress in the doer (unless he or she

doi: 10.1007/s12671-014-0301-7

has already attained the goal), or wholesome, in that it involves a healthy state of mind

NG, E. (2014). Towards a dialogue between Buddhist social theory and affect studies
on the ethico-political significance of mindfulness. Journal of Buddhist Ethics,

stable, pure, unencumbered, ready-to-act, calm and contented (Harvey 2000: 42).
5

L.S. Cousins traces the meaning of kusala/kusala in pre-Buddhist and Buddhist sources and summarizes thus: (1) An original meaning of intelligent wise; (2) An expertise

21 (pp. 353384).
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in magical and sacrificial ritual; (3a) Skilled in meditational/mystic (/ascetic?) practi-

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ces; (3b) Skilled in performing dana [giving] and yanna [sacrifice], now interpreted in

(pp. 55-70). London/New York: Routledge.

terms of central Buddhist ethical concerns; and associated with keeping the precepts

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and so on; (4) Kusala in later Buddhist and Jain sources becomes generalized to refer

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Buddhist Ethics. Journal of Buddhist Ethics, 11, pp. 12342.

Endnotes
1

Heart of the City claims that Google should not be speaking as experts on mindfulness, when theyre playing a role in displacement, privatization of public assets, forprofit surveillance, profiling, policing, and targeting of activist communities. It also
criticizes the way in which Google and other tech corporations market themselves

174 | Extra Special Issue: Mindfulness and Psychotherapy

to something like wholesome or good states (Cousins 1996: p. 156).


6

Abhidhamma: https://en.wikipedia.org/wiki/Abhidhamma_Pitaka

EAP special JOURNAL : Mindfulness and Psychotherapy -

Buddhist Heartfulness: Beyond Western Mindfulness -

Buddhist
Heartfulness

Beyond Western Mindfulness


G.T. Maurits Kwee & Peter T. Van Den Berg
Abstract
In this article, we propose that mindfulness meditation (as it is widely practised
in the Western way) is only a limited version of mindfulness, as it has been developed in Buddhism down the ages in the
East. By combining the best of Theravada,
Mahayana, and Relational Buddhism (or
Buddhism 4.0), we differentiate four stages
and eight states that culminate to full

G.T. Maurits Kwee


Clinical Psychologist and Psychotherapist,
is the founder of the Institute for Relational Buddhism & Karma Transformation

pristine mindfulness practice. These


stages and corresponding states are described and linked to their Buddhist origins. In order to discern this pristine
mindfulness, from the mindfulness that is
currently being popularized in the West,
it is here called heartfulness. The diffe-

Peter T. van den Berg


Faculty of Social and Behavioral Sciences,
Tilburg University, Netherlands

mindfulness meditation

rences between stress-reducing mind-

as it is widely practised in the

discussed with ramifications for in-depth training in heartfulness, partic-

western way is only a limited


version of mindfulness, as it has
been developed in Buddhism down
the ages in the East.

176 | Extra Special Issue: Mindfulness and Psychotherapy

fulness and Buddhist heartfulness are

ularly for those psychotherapists who are interested in its Buddhist roots.
Keywords: pristine mindfulness, heartfulness, Buddhism 4.0, Relational
Buddhism, social constructionism

EAP | International Journal of Psychotherapy | 177

G.T. Maurits Kwee & Peter T. Van Den Berg -

Buddhist Heartfulness: Beyond Western Mindfulness -

Buddhistische Herzerflltheit: ber die Westliche Achtsamkeit hinaus

La plnitude de cur
bouddhiste: au-del de la
pleine conscience occidentale

Kurzfassung: In diesem Artikel legen wir

Rsum: Dans cet article, nous proposons

dar, dass die Achtsamkeitsmeditation (wie

que la mditation de la pleine conscience

, (

mind-empty but full-of-heart, while

sie auf die westliche Art weit verbreitet ist)

(tel que largement pratique la faon oc-

remembering to be constantly watchful in

nur eine eingeschrnkte Version der Acht-

cidentale) nest quune version limite de

open attention to whatever appears in the

samkeit ist, wie sie im Buddhismus im Os-

la pleine conscience, telle que dveloppe

stream of body/speech/mind conscious-

ten ber Jahrhunderte hinweg entwickelt

dans le bouddhisme travers les ges

ness to secure wholesome karma (defined

worden ist. Durch das Verbinden des Be-

lEst. En combinant le meilleur de la The-

as intentional action aiming health and

sten aus Theravada, Mahayana und bezie-

ravada, de la Mahayana, et du bouddhis-

well-being). Mindfulness, as it is widely

hungsbasiertem Buddhismus (Relational

me relationnel (ou Bouddhisme 4.0), nous

practised in the Western way, is a limited

Buddhismus oder Buddhismus 4.0) un-

diffrentions quatre tapes et huit tats

( ), (

version of the mindfulness meditation,

terscheiden wir zwischen vier Stufen und

qui culminent la pratique pleinement

) (

as it has been developed within Buddhism

acht Zustnden, die ihren Hhepunkt

impeccable de la pleine conscience. Ces

Buddhism 4.0),

and Buddhist psychology. Our hypothe-

in

Achtsamkeitspraxis

tapes et tats correspondants y sont d-

sis is that, by restoring and embracing its

erreichen. Diese Stufen und entspre-

crits, et lis leurs origines bouddhistes.

Buddhist roots, Western mindfulness can

chenden Zustnde werden beschrieben

Pour distinguer entre cette pleine consci-

be enriched. This article, written from

und mit ihren buddhistischen Ursprn-

ence impeccable et la pleine consci-

the perspective of Relational Buddhism

gen verbunden. Um diese vollkommene

ence qui est actuellement en train dtre

(or Buddhism 4.0 which is Buddhism as

Achtsamkeit von der Achtsamkeit, die

popularise lOuest, cest appele ici

a psychology and psychotherapy), de-

derzeit im Westen populr gemacht

plnitude de cur . Les diffrences en-

scribes the practice and theory of pri-

wird, zu unterscheiden, wird sie hier

tre la pleine conscience rductrice de

stine mindfulness, developed to awaken

Herzerflltheit genannt. Die Unter-

stress et la plnitude de cur boud-

oneself, like the Buddha. To distinguish

schiede zwischen Stress-reduzierender

dhiste sont discutes avec des ramifica-

pristine mindfulness from the mind-

Achtsamkeit und der buddhistischen

tions pour une formation approfondie

fulness that is popular in the West, it is

Herzerflltheit werden mit ihren Aus-

en plnitude de cur, particulirement

here called heartfulness. Pristine mind-

wirkungen auf fundierte Ausbildung in

pour les psychothrapeutes qui sont in-

fulness may also be called heartfulness

Herzerflltheit diskutiert, insbesondere

tresss par ses racines bouddhistes.

because the experience is in essence a

fr jene Psychotherapeuten, die an den

Mots cls: pleine conscience impecca-

love affair between a lover (I/me) and the

buddhistischen Wurzeln interessiert sind.

ble, plnitude de cur, Bouddhisme 4.0,

beloved (myself), i.e. a Buddha within, or

Schlsselwrter: vollkommene Achtsamkeit,

Bouddhisme relationnel, construction-

: ,

Buddha-nature, resulting in the vanishing

Herzerflltheit, Buddhismus 4.0, Beziehungs-

nisme social

, 4.0,

of the two into leaving only being, which

is a state of reset or reboot of the mind

vollkommener

basierter Buddhismus, Sozialkonstruktivismus

178 | Extra Special Issue: Mindfulness and Psychotherapy

he term mindfulness, as a
translation of sati (in Pali) or smriti (Sanskrit) feels like a misnomer,

as the strife-less striving is toward being

EAP | International Journal of Psychotherapy | 179

G.T. Maurits Kwee & Peter T. Van Den Berg -

Buddhist Heartfulness: Beyond Western Mindfulness -

Relati-

Relational Buddhism is a psychology that

onal Buddhism is about being mindful to

is based on Ancient Greek Buddhism1 and

be heart-full, when relating to self and

may differ from traditional accounts as

Nowadays, Western mindfulness-ba-

seemingly excluded the Buddhist wisdom

others. The objective of this article is the-

it radically discards all other-worldly or

sed mindfulness is mushrooming es-

inherent in the practice and the more so

refore to delineate heartfulness medita-

metaphysical views. In keeping with The-

pecially after its introduction into the

by framing mindfulness within the Hip-

tion, and its constituent four stages and

ravada, it eschews ideas on the Buddhas

medical setting in 1979, through the work

pocratic Oath (Kabat-Zinn, 2009). Some

eight states, and to show what heart-

divinity, deification, omniscience, tran-

of J. Kabat-Zinn (1990) in the USA. Since

psychologists, familiar with a Buddhist

fulness provides in addition to Western

scendentalism, mysticism, authoritaria-

his introduction of an 8-week outpati-

background, have harshly criticized this

mindfulness.

nism, worship, dogma, creed, belief, ma-

ent program, called mindfulness-based

rendition as it obfuscates and even denies

gic, miracles and views any such sacer-

stress reduction, other mindfulness-ba-

the undeniable Buddhist roots of the prac-

called not-self or emptiness.

He further emphasized that mindfulness

without considering metaphysics.

is just a human capacity, and therefore

Relational Buddhism

dotal allusions as merely metaphoric

sed interventions have followed suit. Ha-

tice (e.g., Kwee, 2010; 2012a&b; 2013ab&c;

The heart as a location of mind is not

(Kwee, 2010; 2015; McWilliams, 2014). It is

ving entered the field of health care, it has

Kwee, Gergen & Koshikawa, 2006). Most

an outlandish idea if one considers how

not our intent to eliminate or disrespect

become a hot topic among psychologists

importantly, the mindfulness-based We-

love and infatuation are experienced

the long-standing religion-like Mahayana

and psychotherapists, as well as among

stern therapies (e.g. Segal, Williams &

and depicted in Western culture. Hence,

tradition, but to bring into focus a more

the public at large. Kabat-Zinn (1994, p. 4)

Teasdale, 2002; Shapiro & Carlson, 2009)

heartfulness appeals as an alternative

promising demystified alternative, which

defined mindfulness as, paying attenti-

isolate their mindfulness trainings from

term and the more so because it associ-

suits 21st century rational beings and

on in a particular way: on purpose, in the

the 12 basic Buddhist meditations.

ates with the heart, resonating to other

secular societies. From this perspective,

present moment, and non-judgmentally.

hearts rather than with the solitary con-

we do not consider Buddhism as a sky-

ceiving mind (Vimalakirtinirdesa Sutra).

god religion but take it as a religion-

The main proposition of Relational Bud-

less religiosity, whose priority is to save

dhism is that the mind is not locked-up

people from this-worldly unwholesome

between the ears but operates as interde-

karma (intentional action leading to un-

pendent mind-in-between-people. This

healthfulness and ill-being). Focussing on

is called the inter-mind or inter-being

wholesomeness, it views Buddhist deities,

(Gandhavyuha Sutra). Heartfulness is

Buddha-nature, eternity, reincarnation,

also in accordance with a broader Asian

past and other lives as narrative tools for

perspective, which views mind as located

educative purposes. Rebirth is thus infer-

in the heart. Thus, the Chinese view on

red as the revival of a previous emotional

mindfulness is demonstrated in the calli-

episode, not as a resurrection of the self

graphic representation (nian), which li-

or soul. To be sure, Buddhist heartful-

terally means presence (upper character)

ness is about regulating karma by judging

of heart (lower character).

the wholesomeness of present intentional ideas for future premeditated conduct

180 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 181

G.T. Maurits Kwee & Peter T. Van Den Berg -

Buddhist Heartfulness: Beyond Western Mindfulness -

Heartfulness is integrated within a

and hatred, (c) and which can be sol-

as an anchor, which aims at sharpening

nal stimuli such like feeling and thinking

pan-Buddhist context, i.e. it is part of

ved by countering ignorance, by (d)

concentration leading to immersion-ab-

(sanna: Kuan, 2012). The sixth perceptual

the awareness meditations that include

traversing an eightfold path/practice;

sorption ( jhana). This one-pointed con-

organ discerned by the Buddha is infer-

contemplation, visualization and attenti-

(12) this 8-Fold Balancing Practice aims

centration is a run-up to fully developed

red here as the heart as an organ which

on-concentration. In short, heartfulness

at attaining nirvana (extinction of

sati and to awakening in emptiness which

is able to perceive internally sensed sti-

consists of a series of meditations that are

self-sabotaging emotional arousal)

is a rebooting experience that is always

muli that are subsequently integrated by

characterized by a focus on:

and includes awareness and attenti-

available and prompted by the insight and

the brain in combination with the input

on training.

understanding of the ever-changing na-

of all other sensory stimuli. Nonetheless

ture of impermanence regarding things,

puzzling, this sixth sense, usually transla-

As an overarching process, heartfulness

persons and self at the ultimate level of

ted as mind, is not something metaphysi-

constitutes both the general and central

reality. This emptiness is a pervasive, ubi-

cal as it functions within the sensory mo-

factor for clearing the mind to practice

quitous and omnipresent experience of a

dality. Still, mind sounds airy and does

(3) Repulsiveness: the body as a skin-

these meditations, which the historical

vacuous mind.

not parallel the other fleshy organs: eyes,

bag enveloping organs, liquids and

Buddha offered humanity as a gift of com-

digested food;

passion about 2600 years ago.

(1) Breathing: air passing the nostrils as


an anchor for concentration;
(2) Behaviours: sitting, standing, walking and lying;

ears, nose, tongue and skin. Nowhere can


Heartfulness fine-tunes attention, to

a bodily account for this sixth sense as

discipline the wandering mind, and awa-

being the brainy heart be found in the

reness-introspection, to understand both

literature (e.g. Austin, 2010).

rots, stinks and turns into bones and

The Foundations
of Heartfulness

dust);

The first step in the Buddhist meditati-

of self means that phenomena, including

In order to fully understand heartful-

on training is the taming of the restless

persons, have no permanent or fixed

ness and the minds eye, it is imperative

mind toward tranquillity, by first relaxing

identity; karma refers to the hypothesis

to comprehend the heart as the internal

(7) Hindrances: human pleasures, ill-

the body while sitting. This can be done

that present psychological states are a

eye organ and the brain as the integrating

(4) Elements: water, fire, earth and wind;


(5) Decomposing: the body eventually

(6) Feelings: positive, negative or neutral; skin-deep or heart-felt;

emptiness of self and karma. Emptiness

will, sloth, torpor, agitation and worry;

in any position, as long as the back is held

function of past behaviours; Intellectually,

processor. The brain is able to apperceive

(8) Modalities (or skandhas of clinging):

in an upright posture, not slouched for-

these conceptscan be easily understood,

the perception of each sense organ in a

behaviour, affect, sensation, imagery,

ward. Psycho-physiological research fin-

but heartfulness opens the doors to

split second: post-perceptual, but pre-

cognition and interactions;

dings suggest that holding the back and

know them from experience. It operates

conceptual. This apperception is a pre-

head straight strengthens confidence in

through the minds eye in sensorium and

conceptual perception that excludes pre-

the emitted thoughts, whether negative

is a function that enables seeing empti-

conceived ideation. Indeed, the brains

(10) Awakening: being analytical, forbe-

or positive (Brinol, Petty & Wagner, 2009),

ness as an ultimate reality. What is this

grey matter is able to integrate heartfelt

aring, serene, enthusiastic, focused,

and that this posture boosts positive

minds eye which the Buddha had under-

perceptions of internal as well as external

even-minded and aware;

(9) Senses: eyes, ears, nose, tongue, skin


and the minds eye;

mood, while a doubtful posture invites

stood as the sixth sense? Could it be the

stimuli by all senses. It enables engaging

(11) The 4-Ennobling Realities: (a) there

(or worsens) a dejected mood (Haruki et

heart-as-an-organ that is able to notice

in neutral observational processes of full

is emotional suffering, (b) which is de-

al., 2001). In the Buddhist discipline, this

what is experienced by its perception of

attention and pure perception, and com-

pendently originated through greed

sitting is called jhana. It uses breathing

external (nimitta: Kuan, 2012) and inter-

pleting by a heedful conscientious judg-

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G.T. Maurits Kwee & Peter T. Van Den Berg -

Buddhist Heartfulness: Beyond Western Mindfulness -

mental assessment of what is perceived

and relational equanimity. Forasmuch as

dividual mind is full of voices in a continu-

as being either wholesome or unwhole-

the Buddhist teachings are a modus vi-

ing dialogue with significant others, even

some. It also enables the concentration of

vendi, life is to be spent in heartfulness.

though these persons are not physically

attention upon introspective awareness,

Informal meditation is advisably always at

present. Viewed this way, one is never

which illuminates consciousness and fa-

hand and, if appropriate (without being

alone and constantly together with self

cilitates the alert monitoring and com-

hyperconscious all the time), applied to

on the provisional level of social identi-

prehending of the arising, peaking, sub-

daily experiencing, such when looking,

ty. On the ultimate level of reality there

siding and ceasing of emotion, cognition

listening, watching, laughing, smiling,

is not-self beyond thinking and feeling,

and action in dependent origination (pra-

singing, drinking, eating, chewing, sa-

which is known as empty. The dual or

titycasamutpada), via body/speech/mind.

vouring, or being silent (Brazier, 2015). In

fully functioning person (as self and not-

The Buddha ascribed heartfulness as a

essence, heartfulness aims at differen-

self) is a Buddha in conversation with

central place in his training toward awa-

tiating, evaluating and judging unwhole-

others within and without. Wisdom de-

kening, giving it four frames of reference

some vs. wholesome experiences in the

toxifies by the awareness of inter-mind

karma. The exercise starts with a love

(Mahasatipatthana Sutta). These are:

pursuit of ending emotional suffering and

and through sane self-talk and healing

affair with the self by tolerating and ac-

advancing karmic happiness.

speech.

cepting whatever happens to appear

As touched upon earlier, the Buddha had

Heartfulness in Eight States

thoughts in the mind. Thus, it does not

(2) the bodys behaviours (i.e., move-

a tripartite view of human life as body,

While sati has traditionally been viewed as

pursue any grand aim in the beginning:

ments of external and internal phy-

speech and mind. The human predica-

individually bound, the present view tran-

what one does in the moment is both

sique; this includes speech);

ment of suffering is basically relational

scends this understanding by adopting a

means and goal at the same time. During

and rooted in the three poisons of greed,

relational perspective to this seemingly

heartfulness, one perceives sensory ex-

hatred and ignorance, as obstacles to

solipsistic exercise. Many practitioners

perience by an effortless effort of an in-

heartfelt speech or communication (Se-

first encounter with meditation is to do it

nocent beginners mind, with no aim and

daka Sutta). Relational Buddhism conveys

the Bodhidharma way, by sitting alone fa-

no gain. Thus, there is no way to heart-

that inter-mind is constructed through

cing a wall. Grappling with the meaning of

fulness, heartfulness is the way, which

The first six meditations of the twelve

speech, which exists prior to the indivi-

sitting alone, one might wonder about the

is realizing that we are not going any-

(summarized previously) refer to heart-

dual mind and is located beyond the brain

rationale of artificially cutting oneself off

where, for we are already there; therefore

fulness of the body and its behaviours,

in-between-people. Inter-mind denotes

from the world in this sort of retreat. Is

nothing needs to be done: the grass will

and the second six to heartfulness of the

the psychological inter-connectedness

solitary confinement and isolation feasible

grow by itself. The relational practice of

mind and its behaviours. However, there

of inter-being, or relational being, which

and desirable on the road to awakening?

heartfulness refers to an initially neu-

are many more meditations. Well-known

is at bottom empty of individual mind

are the Brahmaviharas: contemplations

(Gergen, 2009a&b). Inter-minds activity

Heartfulness is a general factor sustai-

moments experience in heartfelt accep-

toward godly feelings: loving-kindness,

involves speech, especially when emitting

ning meditation, including concentration

tance and mindful tolerance. Subsequent-

empathic compassion, sympathetic joy

self-talk and talking with others. The in-

and contemplation toward a wholesome

ly, one inquires and curiously introspects

(1) the body (i.e., action and feelings:


sensations and emotions);

(3) the mind (i.e., visualizing imagery and


conceiving cognition); and
(4) the minds behaviours (i.e., changing
images and cognition).

in the spaces of bodily sensations and

184 | Extra Special Issue: Mindfulness and Psychotherapy

tral focus, just to observe and note every

EAP | International Journal of Psychotherapy | 185

G.T. Maurits Kwee & Peter T. Van Den Berg -

Buddhist Heartfulness: Beyond Western Mindfulness -

in order to naturally guard against un-

(2) Samadhi: Concentrated awareness

(7) Brahmaviharas: Social meditations

Heartfulness in Four Stages

wholesomeness and intelligently to form

quenches flames of emotional arousal

boosting/revering the four highest Bud-

The eight states can be grouped into four sta-

a wholesome karma (Kuan, 2008; Kwee,

toward extinction (nirvana) while ex-

dhist values leading to a this-worldly

ges as summarized in the following Table 1.

2013). This comprehension of heartful-

periencing firm receptive absorption,

heartfelt heaven (loving-kindness, em-

ness is constructed on the four pillars

called flow in psychology; e.g. when in a

pathic compassion, shared joy and rela-

Stage I: Watching and witnessing body/

of Buddhism. These were erected by the

creative activity (Csikszentmihalyi, 1990).

tional equanimity).

speech/mind, one develops the compo-

1.0), Nagarjuna as a philosophy (Buddhism

(3) Vipasanna: Insight into the dependent

(8) The dharmas (with small case d): a

stress-free serenity amid adversity (Sa-

2.0), Asanga/Vasubandhu as a religion

origination of emotional experience as

scholastic term for the smallest units

matha), leading to absorption, flow and

(Buddhism 3.0) and by the interpreters of

an antidote to ignorance on how the

of experience, is conceivable as neither

nirvana (the extinction of emotional arou-

Buddhism as a psychology/psychothera-

mind works. Emotion is a function of

empty nor not-empty (the Buddha) or: as

sal) (Samadhi). At this stage, the medita-

py, which includes Relational Buddhism

feeling-thinking-doing which arise and

empty of social constructions (Relatio-

tion training requires focus on one-point

or Buddhism 4.0: the psychology and art

subside in conjunction with greed and

nal Buddhism).

concentration with profound diligence,

of living Buddha (Kwee, 2016).

hatred.
These temporary states might transform

da). By only covering these two states,

Based on these integrating views, and

(4) Sunyata: A reset/reboot-point of

over time into relatively stable persona-

Western mindfulness-based approaches

grounded in almost a half century of

emptiness appearing after having clean-

lity traits. The pinnacle of these states (7

preserve the illusion of self, which heart-

meditation, I (MK) came to differentia-

sed unwholesomeness due to greed and

and 8) emphasises the relational dimen-

fulness aims to dispel. Heartfulness con-

te cyclical spans that are based on psy-

hatred. This is opposed to believing in

sion.

tinues to the Stages II-III-IV.

chological understanding and (relational)

metaphysics and results in the wisdom

insights regarding heartfulness. They

of not-self and inter-mind (the matrix of

can be summarised in eight experiential

inter-being).

Buddha as a liberation quest (Buddhism

sure of self-control by tranquillity and

heedfulness, zeal and vigilance (appama-

Table1: Heartfulness in Four Stages and Eight States

states, which can consecutively be at-

Stages (mental investment)

State

tained. These dynamic states precede the

(5) Advaya or mahamudra: Non-duality

previous 12-Buddhist meditations as they

(non2ness) is a state requiring freedom

I 1-Point concentration

1. Samatha

2. Samadhi

activate attention-concentration, aware-

of speech and self-talk, which is alert to

Calmness

Absorption

ness, and immersion. As fluid processes

duality of concepts as a trap. The practice

of discernible but inseparable stretches,

transcends cyclical suffering (samsara).

II Wise reflection

3. Vipassana

4. Sunyata

Emotional insight

Emptiness

(6) If you meet The Buddha on the road, kill

III Direct comprehension

5. Non-duality

6. Kill-the-Buddha

(1) Samatha: Stress-free serenity amid ad-

him is a Chan/Zen expression. As the

Silence of speech

Autonomy

versity. The consecutive and desensitiz-

Buddha is already dead, killing alludes

ing calming is a basis for serenity during

to a hampering dependency on a guru.

they are not static and overlap slightly:

sensing, perceiving and meta-cognizing.

186 | Extra Special Issue: Mindfulness and Psychotherapy

(gradual)

(gradual)

(sudden)

IV Matrix of inter-mind

(sudden)

7. Brahmaviharas

8. dharmas

Social meditations

Empty of social constructions

EAP | International Journal of Psychotherapy | 187

G.T. Maurits Kwee & Peter T. Van Den Berg -

Buddhist Heartfulness: Beyond Western Mindfulness -

Contrasting Mindfulness
and Heartfulness

Stage II: Having thus tamed emotional af-

tiful = ugly, good = bad, yes = no, and

are

fliction, the practice advances into clean-

so on, which usually culminate in some

empty-of-Transcendental-Truths

sing the doors of perception enabling

mind-blowing humour. In this non-du-

gen, 2009a&b). Thus, telescoping and

Aiming no less than accomplishing bud-

seeing things as they are and become.

al/non2ness spirit, Kill the Buddha is a

encountering dharmas in inner galaxies,

dhahood, heartfulness is presented here

This introspective insight comes about

Chan-anarchistic instruction of the ninth

insight dawns that things and thoughts

in contrast to the Western mindfulness-

by remembering to be heedful, regarding

century genius Lin-chi, who eradicated

are empty on the ultimate level of reality

based approaches, which have invaded

the wholesomeness or unwholesomeness

awakening-hindering concepts (like the

and socially constructed on the provisio-

the literature. Reviewing this literature

of karma. Speech, thought and self-talk

Buddha), and other progress-impeding

nal level of reality. The whole process is

leads to the conclusion that the salubri-

arise toward insight in the dependent

dependencies. This stage is based on in-

a track of social de-constructing. Finally,

ous outcome of these approaches refers

origination (pratityasamutpada) of body,

sight experiences during States 5 and 6:

one accomplishes sudden experiences of

to the first two states of stress-free se-

speech and mind and karma (Vipassana)

an alert and clear comprehension (sam-

insight by understanding inter-mind, the

renity (Shamatha) and to concentrative

leading to the highest wisdom of Sunyata

pajanna), while understanding the non-

mind-in-between-selves

(antaratman),

absorption (Samadhi) leading to nirvanic

(not-self or emptiness), a state of lumi-

dual nature of all things, and working

inter-being or relational being (Gergen,

extinction of emotional arousal. Heart-

nous such-ness or vast zero-ness. This is

toward autonomy by not clinging to the

2009b). The student applies kindness,

fulness, while being neutrally mindful of

a re-setting or re-booting of the mind in

last hindrance: gurus, masters, or even

compassion, joy and equanimity, based

all perceptual inputs during apperception

the total absence of emotionality and is a

Buddhas.

on a deep insight in the empty nature of

the first milliseconds of perception

dharmas reality as a social construction

offers a practice that inherently includes

(Kwee, 2013 ab&c).

a judgmental aspect (vikappa), which aims

peak of self-inquiry. Both watcher and

inferred

as

social-constructions(Ger-

witness disappear in oblivion. This stage

With respect to Stage IV, the Buddha of-

requires wise reflection on the functional

ten used Brahmanistic terms like Brahma-

relationship between karma and depen-

viharas to which he would give a different

The Point Zero of emptiness is not a

cial karma. It offers a loving-compassio-

dent origination (pathanas) toward skil-

meaning. Thus, for Buddhists, the term is

goal in itself. A blank mind is the result of

nate practice that includes judgment as

fully experiencing the highest wisdom by

a metaphor for sublime places of benevo-

a regular reset point or an in-depth re-

an inherent part of the exercise, which

appropriate attention (yoniso manasika-

lent dwelling in ones heart that embodies

boot point and a scaffold for jump-star-

discerns wholesome and unwholesome

ra): the emptiness of self.

kindness, compassion, joy and equani-

ting the collaborative practice of social

karma as an inseparable part of the trai-

mity (Brahmavihara Sutta). Many more

re-constructing via mirthful experiencing

ning (Milindapanha,).

Stage III: Emptiness is then deepened by

exercises boosting positive affect can be

while fully functioning in the marketplace

practicing and experiencing the silenci-

practiced, e.g., mirth-laughing, joy-smi-

in the pivotal tenor of what we already

Heartfulness is as a chord holding awa-

ng state of non-duality (advaya), which

ling, delight-singing, savouring-eating,

are: inter-mind. As Dogen (1200-1253)

reness and attention in place. It corrects

transcends and eradicates the Yin-Yang

and so on. These meditations-in-action

said: To study Buddhism is to study the

distraction and guards against the in-

dualities of subject and object created by

are applied most solidly post-emptiness.

self, to study the self is to forget the self, to

trusion of unwholesome thoughts and

speech, language and inherent concepts;

Lastly, there is the experiencing of dhar-

forget the self is to be one with others and

feelings. This involves a distinctive ca-

examples of these are: cause = effect,

mas as neither empty nor not empty,

be able to help others.

pacity of recognising wholesomeness

emptiness = form, beginning = end, left

empty of emptiness, and empty of non-

and unwholesomeness, and the retenti-

= right, up = down, heaven = hell, beau-

duality. In Relational Buddhism, dharmas

on of what is beneficial in the pursuit of

188 | Extra Special Issue: Mindfulness and Psychotherapy

at differentiating and cultivating benefi-

EAP | International Journal of Psychotherapy | 189

G.T. Maurits Kwee & Peter T. Van Den Berg -

Buddhist Heartfulness: Beyond Western Mindfulness -

salubrious karma. By excluding karma,

it does not, therefore, omit the element

girl climbs via his shoulder. While she

inter-mind rejects the illusion of a boun-

Kabat-Zinns (2003a, p. 145) phrase, the

of judgment. The issue what is meant

climbs the man says: You watch me, whi-

ded self cut-off from others and propo-

awareness that emerges through paying

by non-judgmental in the mindfulness-

le I watch you, and thus we will both be

ses the balanced interconnectedness of

attention on purpose, in the present mo-

based interventions was also noted by

safe. Her response: No, master it is better

hearts glued by kindness, compassion

ment, and non-judgmentally to the unfol-

Gethin (2011, p. 273): Yet an unqualified

if I watch myself and you watch yourself,

and joy.

ding of experience, moment to moment, is

emphasis on mindfulness as non-judg-

and by watching ourselves we protect

an incomplete rendering of sati. Although

mental might be seen as implying that

each other; thats the safest way to show

As a Buddhist practice, heartfulness

the process starts in bare attention

being nonjudgmental is an end in itself

our act. The point of this story is that we

also deals with greed, hatred and igno-

(Gunaratana, 1992) and choiceless awa-

and that all states of mind are somehow of

practice sati, heartfulness, in order to

rance on how the mind works which ari-

reness (Krishnamurti, 1895-1986), heart-

equal value, that greed is as good as non-

protect each other. This reciprocal rela-

se in interpersonal context. The human

fulness is clearly not non-judgmental.

attachment, or anger as friendliness. It

tional process is beneficial for humanity

predicament and unwholesome karma

Choiceless awareness implies that there

seems that in Western mindfulness, many

and society.

are rooted in these three poisons. Wis-

is no prejudice, sympathy or antipathy

aspects of Buddhist heartfulness have

for what appears in body/speech/mind.

been neglected (or purposefully exclu-

Much different from mindfulness that

cures the delusion of metaphysics,

Being non-judgmental is confined to the

ded) in order to get the training accepted

is confined to an individual view, heart-

which is quintessential in the historical

very initial part of the process when the

in the non-receptive world of physicians

fulness relational perspective encom-

Buddhas message (Avyakata Sammyuta;

trainee learns to respond rather than to

where it was initially introduced.

passes social construction-ing. Bud-

Kwee, 2010). Furthermore, the psycho-

dhism not only deals with processes of

logy of greed inheres in fear of losing

react automatically by distancing. Ha-

dom corrects the illusion of self and

ving learned to see a thought or feeling

Heartfulness inheres in insight into de-

how people perceive, imagine, conceive,

a loved object and sadness for having

as a thought or feeling, distancing de-

pendent origination and karma, and en-

feel, emote and behave, but equally with

lost a loved object. Hatred includes anger

automatises and might end believing in

compasses an understanding of not-self,

how to relate and live with each other.

toward oneself and others, which might

self-sabotaging cognitions (e.g., Segal,

emptiness and inter-mind. Ever since the

Unlike psychologies that consider the

result in depression and aggression. By

Williams & Teasdale, 2002). Heartfulness

Buddhas time, there have been several

mind located and confined in the brain,

lifting the karmic causes of self-sabota-

also transforms self by removing unhel-

conceptualisations of and approaches to

heartfulness endorses a psychology of

ging emotions, one is liberated and ready

pful thoughts, feelings and actions and by

the practice of sati. The Buddha (Sedaka

Relational Buddhism which views mind as

for the social meditations. In conclusion,

retaining the helpful ones.

Sutt,) also expounded a relational per-

originated in-between people, i.e. as lo-

the psychological inference of karma as

spective on sati that evolved onto a Ma-

cated outside and inside the skull. Thus,

intentional action reflects a secular view

To be sure, Buddhist heartfulness does

hayana variant of realizing inter-mind

it deals with karma as intentional inter-

which dismisses the cosmic retribution

not forget to be judgmental as it regards

(Gandhavyuha Sutra). He addressed the

activity and with inter-mind rather than

of good and evil deeds. Rather than using

the formation of wholesome karma to be

relational aspect of heartfulness by nar-

only with mind. The basic idea of Rela-

ethical terms, like good and evil, which

the aim of the training. Body, speech and

rating a simile on two balancing acro-

tional Buddhism is that human beings

moulds the user in a religious blueprint,

mind are judged vis--vis virtuousness

bats: a master acrobat and his young

live in an ocean of relationships from

the terms wholesome and unwholesome

in present and future intentions and ac-

female apprentice. Their act is that the

the cradle to the grave. Born into a space

are preferred to judge the type of karma

tions. In contrast to Western mindfulness,

man holds a bamboo pole on which the

of linguistic meanings in-between-selves,

pursued in heartfulness.

190 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 191

G.T. Maurits Kwee & Peter T. Van Den Berg -

Buddhist Heartfulness: Beyond Western Mindfulness -

G.T. Maurits Kwee

Discussion

awareness, self-knowledge, equanimity,

The question still arises: Can Western

and self-compassion... practiced across

mindfulness be invoked without sub-

all activities of daily living aimed at the

In the end, all seems well that ends well.

therapist, is the founder of the Institute

scribing to Buddhism? Traditionally, sati

cultivation of insight and understanding

In the special issue Williams and Kabat-

for Relational Buddhism & Karma

though it is one of the factors of en-

of self and self-in-relationship ... the

Zinn (2011) stated that the introduction

Transformation. He originated Buddhism

lightenment that appears to be a goal

cultivation of openhearted presence [has]

of mindfulness into mainstream medi-

is not a goal in itself, but a tool with an

nothing particularly Buddhist.

cine and psychotherapy was a matter of

gy, by acknowledging its provenance.

Clinical Psychologist and Psycho-

expediency and politics, because in or-

inextricable function in the Buddhas

4.0, which he teaches worldwide. This is


a Buddhist psychology / psychotherapy,
thus a secular teaching, which transcends
Buddhism as a liberation quest, a

grand project to liberate humanity from

Sati is indeed just a human quality

der to get the Trojan horse inside the

unwholesome karma and emotional suf-

(Shapiro & Carlson, 2009). For example,

medical fortress, they conjectured that

other innovative contributions are

fering, and towards leading a fulfilling

if one does something extremely thrilling,

employing Buddhist traditional language

Ancient Greek Buddhism, Borobudur

life. Hence, Buddhist heartfulness is an

like stealing, robbing, sniping or raping

would have led to its rejection by those

Javanese Buddhism and Heartfulness

effortless effort for a goalless goal with a

and one does not want to be caught, sati

mainstream professionals. Whether that

(Pristine Mindfulness), which is covered

larger aim than just a psychotherapeutic

will arise naturally. By appealing to the

would have actually been the case, re-

technique for alleviating stress.

Hippocratic Oath and to universalism,

mains unknown. Few mindfulness-based

Kabat-Zinns (2009; 2015) personal judg-

professionals seem to be unappreciative

The tactical intention behind separating

ments somewhat disparage Buddhism2,

towards Buddhism. In closing, one cannot

Western mindfulness from its Buddhist

where the meditation comes from. Yet,

but be appeased by the openness, breadth

roots is not to burden patients/clients

most

practitioners

and scope that the issue radiates in brin-

with Buddhism, and not to repel main-

are not physicians and besides the prin-

ging back mindfulness into the bosom

stream psychology and psychotherapy

ciple of non-harming (ahimsa), the oath

of Buddhism. That particular anthology

professionals (Grepmair, Mitterlehner &

is already part and parcel of Buddhism. Is

reinstalls the Buddhist factor in Western

children. He gained his Ph.D. in 1992 and

Nickel, 2008). This leaves Western mind-

there possibly more behind the move of

mindfulness and leaves no doubt about its

was an Assistant Professor at Tilburg

fulness-based practitioners with a proce-

hiding Buddhism than the political expe-

Buddhist roots. The plea made in this ar-

University, Netherlands, until his

dure de-contextualized from Buddhist te-

diency of getting mindfulness accepted

ticle is to take a further step and re-name

retirement. He has practiced Zen

achings. Then, there is this baffling notion

by the medical and psychological pro-

current Western mindfulness by calling it

that Buddhism is diluted to some univer-

fessions? Is it appropriation, or exploi-

heartfulness with all ramifications for its

sal lawfulness, exacerbated by Davidson

tation leading to fragmentation and de-

understanding and training. Now Western

and Kabat-Zinn (2004, pp. 150-152), who

contextualization? One might be inclined

mindfulness has become popular, resto-

dismissed Buddhist psychology by stating

to think so, but fortunately, in a laudable

ring the full meaning of sati as the prac-

psychology and Christianity.

that mindfulness, defined as a moment-

special issue of Contemporary Buddhism

tice of heartfulness implies a tremen-

Email: p.t.vandenberg@uvt.nl

to-moment, non-judgmental awareness,

(2011), most of its authors re-installed the

dous move in transcending Eastern and

does not include Buddhist psychology; it

Buddhist context of Western mindful-

Western mentalities onto the wholeness

is an isomorphic translation for greater

ness, which includes Buddhist psycholo-

of humanitys heart, the Buddhist way.

mindfulness-based

192 | Extra Special Issue: Mindfulness and Psychotherapy

philosophy. and a religion. Among his

in this article.
Website: www.relationalbuddhism.org
E-mail: mauritskwee@gmail.com

Peter T. van den Berg


Faculty of Social and Behavioral
Sciences, Tilburg University,
Netherlands. Born in 1950, Peter now
has three children and nine grand-

Buddhism since his youth and led a


Nichiren Buddhism group for several
years. Now, he teaches secular
Buddhism in his own group of students,
relating Buddhism to modern

EAP | International Journal of Psychotherapy | 193

G.T. Maurits Kwee & Peter T. Van Den Berg -

International Journal of Psychotherapy: 2016, Vol. 20,


Extra Special e-Issue, pp. 176-196: ISSN: 1356-9082
Author and European Association of Psychotherapy (IJP):
Reprints and permissions: www.ijp.org.uk
Submitted Sept. 2015; peer-reviewed twice and reformatted, Nov. 2015;
resubmitted and accepted, April, 2016

Buddhist Heartfulness: Beyond Western Mindfulness -

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advertisement
*

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Endnotes
1

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you can find on www.integraltranspersonal.com or www.itiedizioni.com

Ancient Greek Buddhism is a term coined by Kwee (2015) to refer to the Pali paracanonical text Milindapanha (or The Questions of King Menandros c.100 BCE). Menandros was the Indo-Greek king of Bactria who reigned in 155-130 BCE who was converted to Buddhism through his dialogues with the mendicant Nagasena. (After him 27

biotransenergetics.
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beyond the mind.


theory and practice of
transpersonal psychology.
a book written by p.l.lattuada

other Indo-Greek kings were also Buddhist until the year 0.)
2

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196 | Extra Special Issue: Mindfulness and Psychotherapy

follow biotransenergetica on facebook or contact biotransenergetica@gmail.com

EAP special JOURNAL : Mindfulness and Psychotherapy -

The Winner of the Race: The Dharma in the Digital Age -

The Winner of the Race:

The Dharma in
the Digital Age
Manu Bazzano

slowing down

If we move too fast,


we wont be able to
feel or adequately
process experience ...
with all its riches
and tribulations

Manu Bazzano
is an author, psychotherapist and
supervisor in private practice.

Abstract
Variously drawing on the Buddhist notion

Le Gagnant de la course :
Le Dharma de lge digital

of skandhas, with the connection to Eu-

Rsum: Tirant parfois sur la notion boud-

ropean philosophy between bad faith and

dhiste de skandhas, avec une connexion

speed, and on the notion of hysteresis in

la philosophie europenne entre mau-

physics, this paper will discuss some of

vaise foi et vitesse, et parfois sur la notion

the challenges and rewards of attempting

de hysteresis en physiques, cet article va

to implement the Buddhas teachings in

traiter quelques uns des dfis et rcom-

the contemporary world.

penses lorsquon tente dimplmenter

Key words: Dharma, digital age, speed,

les enseignements bouddhistes dans le

bad faith

monde contemporain.
Mots cls: Dharma, ge digital, vitesse,

Der Gewinner des Wettlaufs:


Das Dharma im Digitalen
Zeitalter

mauvaise foi

das buddhistische Konzept von skandhas,

mit seiner Verbindung zur europischen

Philosophie zwischen schlechtem Glauben

und Geschwindigkeit, und an das Konzept

Kurzfassung: Durch das Anknpfen an

198 | Extra Special Issue: Mindfulness and Psychotherapy

der Hysterese in der Physik errtert die-

(),

ser Artikel einige der Herausforderungen

und Nutzen aus dem Versuch Buddhas

Lehren in der zeitgenssischen Welt zu

implementieren.

Schlsselwrter: Dharma, digitales

: ,

Zeitalter, Geschwindigkeit, schlechter

, ,

Glaube

EAP | International Journal of Psychotherapy | 199

Manu Bazzano -

The Winner of the Race: The Dharma in the Digital Age -

hat time is it?

The pace of life accelerated dramatically.

Within a society ensnared by the cult

not aligned to positivism, is routinely de-

A couple of years ago I heard

Industrialization is already a faint memo-

of work, slowing down (assisted by ex-

graded and downgraded. Positivism is but

one of my favourite novelists,

ry in the developed countries: we now

ercises, techniques and iTunes apps) is

the creed of neo-liberalism, an insidious

James Salter, telling an audience cram-

live in the digital age. Every shift has ine-

instrumental in regaining the energy ne-

ideology declaring the end of all ideolo-

med into a Bloomsbury bookshop how

vitably carried its own range of problems:

cessary to maintain a compulsory fast-

gies. Colleagues working in academia may

one of his friends got to meet Nabokov in

including widespread alcoholism among

pace. The market place expertly co-opts

recognize this, as they are routinely asked

their publishers office. Salter, an admi-

workers in the case of industrialization,

far-reaching ideas and practices (whether

to come up with adequate measurements

rer of Nabokov, was mightily impressed:

and regular consumption of speed, am-

ancient or new, antagonistic or compli-

for empathy, or they engage in peculiar

What did you talk about? he asked. Oh,

phetamine salts, and cocaine among the

ant) and makes them instrumental to its

research to quantify the level of mea-

we discussed time his friend replied,

adherents to the contemporary cult of

purposes. This is what I believe has hap-

ning in (say) the life of terminally-ill pa-

adding: He would say, Its five to three

work ushered in by the digital age.

pened with the Mindfulness movement

tients, and so forth. Likewise, meditators,

and its various manifestations, including

who through sincere practice, have had a

Social acceleration (Rosa, 2013) brought

the Mindfulness-Based Stress Reduction

glimpse of the magnitude and ineffability

exhilaration, but also the conflation of

(MBSR) programs (Kabat-Zinn, 1991).

of the Dharma, may shudder a little when

according to my watch. What time do you


make it?
No literary wisecracks on time, imperma-

home and workplace, work-time and lei-

nence and the human condition, as I had

sure time. Networking opportunities be-

The Dharma a multi-faceted, multi-

expected. Instead, the two men talked eve-

gan to proliferate, replacing more direct

layered millenarian tradition, aimed at

ryday stuff. Yet there are profound impli-

human interactions.

the cessation of all suffering by sentient

The CBT-based mindfulness movement

confronted with its MRI-scan triggerhappy version.

beings has been expediently adapted

has effectively adapted the Dharma to our

it? This question was not uttered in Eu-

Mindfulness and Productivity

to the ever-growing wants of consumers.

time and age. Adaptation here means

rope until the beginning of the thirteenth

After a recent philosophy class, a young

The skill with which this has been achie-

that, instead of learning from a corpus of

century, its emergence coinciding with

student told me that she had just began

ved inspires awe: it is quite a feat, encap-

knowledge and wisdom, instead of being

the expansion of commerce. It was around

to practice mindfulness and how benefi-

sulating the zeitgeist and distilling from

impacted by its revolutionary potential,

this time that people in European cities

cial she was finding it. Thats wonderful!

its shiny, consumer-friendly entrails, an

the Dharma has been bent to the (false)

began to feel a peculiar urge they wanted

I said encouragingly. I asked her if she

enticing remedy. The reification of hu-

needs of productivity. Slowing down, pa-

to know the time. Gods time gradually

meditated on her own, or with a group of

man and non-human life forms in our

ying attention, and becoming mindful, all

gave way to the time of the traders. Work

friends, and, in what way was it benefi-

neo-liberal world has made consumers

inherent to meditative practice, can easily

and business began to quantify human

cial. It had nothing to do with meditati-

of us all. In the bustling Universal Shop-

become practices, subservient to the tu-

existence. Primordial human anxiety about

on or anything like that, was her reply.

ping Mall that we inhabit, various appeals

nes of productivity.

time, ordinarily linked to our feeling of

Mindfulness was an app that she had

to the wisdom of old, to the dignity of

uncertainty about the future and the cer-

uploaded from iTunes. She listened to it

the human spirit, and to the potential of

What is productivity? It is the amount

tainty of our death, was now accompanied

in bed, after a long stressful day (working

spiritual awakening, always sound pic-

produced per worker per hour (Lanchester,

by a new awareness, which can be sum-

full time, studying and travelling), and it

turesque and even archaic. Similarly, any

2015, p. 7), that, because of the increased

marized in the dictum: time is money.

sent her straight to sleep.

philosophical or psychological practice,

automation brought about by computer

cations in that simple query: What time is

200 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 201

Manu Bazzano -

The Winner of the Race: The Dharma in the Digital Age -

technology, greatly contributes to capital,

The Slow Food movement began in Italy

in wanting to slow down that knee-jerk

meaning nimble fingers, an activity re-

but not the labour (Brynjolfsson & McA-

in the mid-nineteen-eighties as a form of

aversion to speed and technology. The-

lying on speed and sharing with digital

fee, 2014). The amount of work that each

ethical, aesthetic and health-conscious

re may be something more than simply

more than a linguistic source. In order

worker actually does goes up but their

opposition to junk food. Since then, it

buying into a digital dualism that rigidly

to maintain our notion of self, a certain

pay doesnt. Within this scenario, mind-

has expanded in over a hundred countries

perceives the physical as authentic and

speed is needed. Fredric Jameson writes:

fulness becomes another way of increa-

across the globe, fostering in its wake

the virtual as inauthentic.

sing productivity, rather than questioning

parallel initiatives such as: Slow Cities

its rationale. It coats its practices with the

which encourages walking instead of

Even so, slowing down for its own sake

involve a peculiar kind of inner pre-

auratic idiom of an ancient religious prac-

driving; small shops with local products

can at times appear precious, other-

stidigitation, in which I manage to

tice, which only adds insult to injury.

instead of shopping malls; and even Slow

worldly, and removed from ordinary life.

talk myself into being something: the

So mauvaise foi in this respect will

Education, which conceives of schooling

When going into a Zen retreat, the ex-

process seems to involve speed I

The Winner of the Race

beyond instrumentality (or the pressures

pectation for some is of a quiet, tranquil

must work very fast indeed in or-

Perhaps, because I have been a musician,

of governmental targets) and more as a

time away from work and daily chores. It

der to prevent the whole construc-

I couldnt help noticing changes in pop

process with a necessary societal context.

will be peaceful and relaxing, colleagues

tion from falling apart ... in order

(unacquainted with sitting) invariably tell

to confuse myself into momentarily

in the name of productivity: the rhythms

I want to think of the popularity of the

me before I set off for a sesshin. In reality,

believing the things I want to affirm

of techno and rave metamorphosing into

Slow Movement as an indication of an

it is well-documented that, alongside joy

about myself. (Jameson, 2014, p. 131)

the beats of motivational work music, is a

unspoken longing for the philosophical

and serenity, we will often experience bo-

sort of chamber music to an aggressive work

life; the innate province of slowness:

redom, anger, frustration, and a creeping

The above quote is even more true in

sense of not having as firm a hold on our

the age of social networks, where our

music reflecting universal acceleration

culture. A song by David Guetta declared:


Work hard, play hard its the only thing

In philosophy, the winner of the race is

own identity as we thought we did. This is

various virtual avatars are continually

we know how to do (Guetta, 2013): this is a

the one who can run most slowly.

because meditative practice can help us

being propped up by a constant stream of

rather dismal interpretation of Homo sa-

Or: the one who gets there last

see the arbitrary nature of our identity.

data, images and opinions on just about

piens after five (or fifty) thousand years.

(Wittgenstein, 1998, p. 40).

We may get a glimpse of the fluidity and

anything, from the Middle East, to liking

permeability of the Self, and come to rea-

or un-liking the sneezing cat posted on

What happens if speed becomes a way

In spite of its superficial, even consume-

lise that the notion of Self that we cherish

YouTube. Having eschewed the Freudian

of life? Slowing down becomes a luxu-

rist, appeal, the yearning to slow down

is but a construct, an experience that is in

unconscious, Sartre connected his noti-

ry, an exotic pastime, a respite from the

may indicate, at least symbolically, that

turn unsettling and liberating.

on of mauvaise foi, already formulated in

dread of the Universal Traffic Jam or

we value: the journey more than reaching

even an aberration. At the same time, I

the destination; compassion, more than

For the Sartre of Saint Genet (Sartre,

the very construction of the Self, an ob-

want to believe that, implicit in the wish

indifference; process, more than out-

2012), the maintenance of self-justifica-

ject as Jameson puts it for ... impersonal

to slow down; there lies a yearning for

come; critical reflection, more than ac-

tion (what he calls mauvaise foi, or bad

consciousness (Jameson, 2013, p. 129).

a deepening of experience and a greater

quiescence. There may be something im-

faith) involves a peculiar kind of inner

insight into our condition.

plicitly, more subtle and more profound,

prestidigitation, a word of French origin

202 | Extra Special Issue: Mindfulness and Psychotherapy

Being and Nothingness (Sartre, 2003), to

EAP | International Journal of Psychotherapy | 203

Manu Bazzano -

The Winner of the Race: The Dharma in the Digital Age -

Digital Solipsism

our existential dilemmas. This argument

Appropriate Speed

The digital era has also brought about a

has been taken up by Richard Sennett in

The natural slowing down that takes place

new condition: digital solipsism, a state

his recent writings (Sennett, 2012), where

through dedicated meditative practice

of splendid isolation, inhabited by many

he introduces a new character type, the

brings about invaluable clarification of

of us today, and for the safeguarding of

uncooperative self: a person whose que-

our actual experiences. As we accept the

which highly intricate, large-scale ma-

st is entirely inner, forever engaged in a

Buddhas invitation to come and see for

chinery has to be maintained. Digital and

struggle to prove oneself and where other

ourselves, the Dharma becomes embo-

physical dimensions are increasingly and

people either have no place or become

died, alive and breathing in our personal

inevitably meshed together in a form of

merely instrumental to his goals. This sort

experience beyond the mere acquisition

augmented reality. Perhaps resistance

of person, Sennett writes, is bent on re-

of a set of doctrines.

is futile, even undesirable especially if

ducing the anxieties which differences can

done in the name of nostalgia for an al-

inspire, whether these be political, racial,

This is where we began to realize first-

legedly purer, less adulterated physical

religious, ethnic or erotic in character. The

hand the Buddhas teachings on skandhas

dimension. Equally pointless may be the

persons goal is to avoid arousal, to feel as

(heaps, or aggregates). We discover that

need to complain about the hectic pace of

little stimulated by deep difference as pos-

we are made of combinations: physicali-

post-modern life in the name of a sanc-

sible (Sennett, 2012, p. 8).

timonious return to the good old days.

ty (rupa), feeling-tone (vedana), perception, (samjna), impulse, (samskara), and

I have occasionally met people who ap-

Digital solipsism may be cured by so-

consciousness (vijnana). The Buddhas

proach the Dharma in that spirit. Yet an-

cial cooperation and communal feeling,

description of experience does not give

yone who has practiced for a while will

so it would be a poor choice indeed if we

primacy to mind or to the conventio-

agree that there is more to Dharma prac-

were to use meditation as an exercise for

nal mind-body split, but depicts instead

tice than a narcissistic quest for authen-

insulating ourselves from the very real

a dynamic process of experience which

ticity and an ever-elusive nirvanic state

challenges of the world and from life with

dissolves the conventional sense of being

of mind. Digital solipsism cannot be cured

others. Evidence suggests that programs

a mind inside a body inside a world. Simi-

by spiritual solipsism.

such as Mindfulness-Based Stress Red-

larly, one should regard the skandhas as

uction are entirely based on a particular

swept-up leaves which have been thrown

For Lionel Trilling (1974), the search to

form of social amnesia and on a reductive

on the bonfire (Brazier, 1995, p. 85) and

discover what we really feel, or who we

view of the self that understands anxiety

learn to dis-identify with them.

really are, contains patently narcissistic

as the persons inability to self-regulate

traits. Implicit in the search is also the

(Purser, 2015).

Contemporary phenomenological psy-

assumption that hidden within us there

chotherapy presents us with the idea of

is a solid, self-existing inner core that,

sedimentations. Spinelli (2007) describes

once uncovered, will guide us through

these as fixed patterns of dispositional

lifes vicissitudes and provide answers to

stances (p. 35), embedded in our body/

204 | Extra Special Issue: Mindfulness and Psychotherapy

EAP

International Journal of Psychotherapy | 205

Manu Bazzano -

The Winner of the Race: The Dharma in the Digital Age -

mind a notion that in different ways

Hysteresis

stantly strives for without ever achieving

technologies known as high-frequency

also points to the non-substantiality of

A compelling argument in favour of ap-

it. What can be said with certainty, accor-

trading or flash trading, which emerged

the self and emphasizes the necessarily

propriate speed is found in complexity

ding Cilliers, is that going fast will oblite-

around the 2008 financial crisis. This new

embodied nature of our experience.

theory. Paul Cilliers (2007), an expert in

rate the system.

kind of market activity expanded to the


point that most share markets were now

the field, writes about hysteresis (from


In order to even realize that we are made

the Greek husteros = late), a word mea-

Computer technologies have distorted

made up of computers trading, with no

of skandhas (as well as sedimentations),

ning the lagging of effect when cause vari-

our understanding of time, to such a

human participation apart from the de-

appropriate speed is required. Sitting on

es. Complex systems, such as the human

degree that we have given up our em-

sign of their algorithms. You would sit at

a cushion will help, and so will therapy.

organism, are naturally slower than the

bodied, phenomenological experience of

your computer trying to buy a stock and

Both are ways to develop curiosity about

environment: they need to be so in or-

time in favour of a worldwide temporal

its price would shift the moment that you

our everyday existence, which may bring

der to process experience. For Cilliers, a

framework in which we can work faster.

clicked to complete the trade: in 2008,

about a gradual de-sedimentation, and an

complex system simply cannot reflect, or

Our actions need to be co-ordinated, gi-

this constituted 65% of US public mar-

increased flexibility against a previously

act upon, everything that is happening in

ving us the illusion of simultaneity and

ket stock trading. Predictably, there are

rigidly-held worldview.

the environment at a given moment. If it

the false confidence that we can control

ethical implications: Lewiss argument is

were so, the system would at all time be

the future. One of the myths of our time

that the stock market is essentially being

There is nothing inherently sacred

a mere reflection of its environment. The

is that speed means efficiency, when in-

engineered in support of front-running

about slowness, but, if we move too fast,

system must differentiate between infor-

stead a slower pace will grant greater ef-

traders. Predictably, his thesis created

we wont be able to feel or adequately

mation and noise. It cannot be pushed

ficacy. The cult of speed is potentially de-

outrage in Wall Street.

process experience. We wont be able to

around by every fluctuation and it must

structive; a slower approach is necessary,

appreciate our embodied, situated con-

be flexible enough to adapt. The state of

not only for survival, but also because it

Conclusion

dition with all its riches and tribulations.

optimal balance is what the system con-

allows us to cope with a complex world

There is a more reflective way of being

better. A slower approach is also poten-

in the world, as opposed to an existence

tially subversive, especially when allied

spent moving between making money and

to intelligent meditative practice: it un-

acquiring metaphysical candy floss in our

dermines the compulsion of the self, the

spare time. Reflection may, in turn, bring

need for acquisition, the very root of our

greater appreciation of life if by reflec-

neo-liberal world.

tion we mean not just logical reasoning


and intellectualism but the ability to fo-

206 | Extra Special Issue: Mindfulness and Psychotherapy

Greater speed augmented by technology

reswear reason in the name of reason,

would certainly allow us to make more

giving greater scope and range to human

money than our competitors. In his book,

reasoning beyond the narrowly-confined

Flash Boys, an expos of the stock market,

domain of logic. But reflection of this kind

Michael Lewis (2014) writes about a little-

involves delay, and in a cult of speed

known range of financial techniques and

delay is simply unacceptable.

EAP | International Journal of Psychotherapy | 207

Manu Bazzano -

The Winner of the Race: The Dharma in the Digital Age -

The argument in favour of slowness is

Manu Bazzano

really an argument for appropriate speed.

is an author, psychotherapist and

There is no objective or immediate rule

supervisor in private practice. He has

BRAZIER, D. (1995). Zen Therapy. London: Constable.

for what that speed might be. If anything,

studied and practice meditation since

BRYNJOLFSSON E. & MCAFEE, A. (2014). The Second Machine Age: Work, Progress and

it is a matter of experience, and expe-

1980, and in 2004 was ordained as a Zen

rience, as Aristotle teaches us, cannot


be taken for granted but has to be gained
(Taylor, 1955). The meditative life, the philosophical life a life inspired by wisdom

Buddhist monk in the Soto and Rinzai


traditions. He lectures and facilitates
workshops on Zen and post-phenomenology worldwide. Among his books are:
Buddha is Dead (2006); Spectre of the

references

Prosperity in a Time of Brilliant Technologies. New York & London: W.W. Norton & Co.
CILLIERS, P. (2007). On the Importance of a Certain Slowness In: C. Gershenson,
D. Aerts & B. Edmonds (Eds.) Worldviews, Science and Us: Philosophy and
Complexity Singapore: World Scientific, pp 53-64.
GUETTA, D. (2013). Play Hard. https://www.youtube.com/watch?v=5dbEhBKGOtY

and compassion may well be a way to gain

Stranger (2012); After Mindfulness (2013);

that experience.

Therapy and the Counter-tradition

JAMESON, F. (2013) The Antinomies of Realism London, New York: Verso.

(co-edited with Julie Webb); and the

KABAT-ZINN, J. (1991). Full catastrophe living: using the wisdom of your body and mind to

International Journal of Psychotherapy:


2016, Vol. 20, Extra Special e-Issue,
pp. 198-209: ISSN: 1356-9082
Author and European Association of
Psychotherapy (IJP): Reprints and
permissions: www.ijp.org.uk
Submitted Sept. 2015; peer-reviewed twice and
reformatted, Nov. 2015; revised,
resubmitted and accepted, April 2016.

forthcoming Zen and Therapy: a Contemporary Perspective. He is a co-editor


of PCEP (Person-Centered and Experiential Psychotherapy Journal) and a book
review editor for Self & Society.
E-mail: manubazzano@onetel.com
Website: www.manubazzano.com

Internet File, retrieved 14 February 2015.

face stress, pain, and illness. New York: Delta.


LANCHESTER, J. (2015). The Robots are coming London Review of Books. 5 March,
(37) 5, pp. 3-8.
LEWIS, M. (2014). Flash Boys: A Wall Street Revolt. London: Allen Lane.
PURSER, R. (2015) Confessions of a Mind-Wandering MBSR Student: Remembering
Social Amnesia. Self & Society, Vol. 43, No. 1, Spring.
ROSA, H. (2013) Social Acceleration: a New Theory of Modernity. New York: Columbia
University Press.
SARTRE, J.P. (2003). Being and Nothingness: An Essay of Phenomenological Ontology.
Abingdon, Oxfordshire: Routledge.
SARTRE, J.P. (2012). Saint Genet: Actor and Martyr. Minneapolis, MN: University of
Minnesota Press.
SENNETT, R. (2012). Together: the Rituals, Pleasures and Politics of Cooperation.
London: Penguin.
SPINELLI, E. (2007). Practising Existential Psychotherapy: The Relational World.
London: Sage.
TAYLOR, A.E. (1955). Aristotle. Mineola: Dover Publications.
TRILLING, L. (1974). Sincerity and Authenticity. Cambridge, MA:
Harvard University Press.
WITTGENSTEIN, L. (1998). Culture and Value. London: Wiley & Son.

208 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 209

EAP special JOURNAL : Mindfulness and Psychotherapy -

Implicit Ethics
and Mindfulness

Implicit Ethics and Mindfulness: Subtle


assumptions that MBIs are values-neutral

Implizite Ethik und Achtsamkeit: Subtile Annahmen


dass MBIs wertneutral sind

neutral, implizite Ethik, spirituell,


Psychotherapie, Psychotherapeuten,
Buddhismus

Kurzfassung: Buddhistische Lehren se-

annahme, dass die gelehrte Ethik impli-

Lthique implicite et la pleine


conscience: des prsomptions
subtiles que les interventions
bases sur la pleine conscience (Mindfulness-Based Interventions, MBIs) sont des
valeurs-neutres

zit vermittelt wird. Laut Grundgedanken

Rsum: Les enseignements bouddhistes

wird vermieden, dass den Teilnehmenden

place lthique au cur de la pleine con-

Abstract

externe Werte und Handlungsleitfden

science : lintention est la cultivation de

Buddhist teachings place ethics at the

auferlegt werden; des Weiteren stehen

la Personne Noble qui transcende lintrt

core of mindfulness: the intent is the cul-

die Werte des Individuums an erster

personnel et qui vit pour le bien-tre des

tivation of the Noble Person who tran-

Stelle. Jedoch macht dieser Standpunkt

autres. Les interventions cliniques, con-

scends self-interest and lives for the

einige Annahmen ber die unvermeid-

temporaines bases sur la pleine consci-

wellbeing of others. Clinical, contem-

liche Ethik, die durch den Lehrer, den

ence suivent linjonction de base que les

porary mindfulness-based interventions

Programminhalt und die Teilnehmenden

thiques enseignes sont transmises im-

follow the root injunction that the ethics

eingebracht werden. Die Annahme, dass

plicitement. Le raisonnement est dviter

taught are implicitly imparted. The ratio-

eine implizite Ethik den Teilnehmenden

dimposer des valeurs externes et des

nale is to avoid imposing external values

vor externem Einfluss schtzt, unter-

guides daction sur les participants et de

and action-guides upon participants and

sttzt auf subtile Weise das schon lange

tenir au plus haut les valeurs des individus.

to hold the individuals values foremost. However, this stance makes seve-

verworfene Konzept, dass Interventionen

Cependant, cette position fait plusieurs

ral assumptions about the unavoidable ethics brought into contact by the

wertneutral sein knnen. Diese Arbeit

hypothses concernant les thiques in-

teacher, program content, and participants. The assumption that implicit

erforscht diesen Fehlschluss der Wert-

vitables mis en contacte par lenseignant,

ethics shields the participant from external influence subtly upholds the

neutralitt und bekrftigt aufs Neue, dass

le contenu du programme, et les partici-

long-discarded concept that interventions can be values-neutral. This pa-

explizit erforschte Ethik in achtsamkeits-

pants. La prsomption que les thiques

per explores this fallacy of values-neutrality and re-affirms that explicitly

basierten Interventionen essentiell fr

implicites protgent le participant des

explored ethics in mindfulness-based interventions are crucial to the cul-

die Kultivierung der Noblen Person ist.

influences externes soutien subtilement

Subtle assumptions that


MBIs are values-neutral
Lynette Monteiro

Lynette Monteiro, Ph.D.


is a registered psychologist
and Director of Training at the
Ottawa Mindfulness Clinic,
Ottawa Canada

hen Ethik im Kern der Achtsamkeit: Es


besteht die Absicht, die Noble Person zu
kultivieren, die Eigeninteresse berwindet und fr das Wohlergehen der Anderen
lebt. Klinische, moderne achtsamkeitsbasierte Interventionen folgen der Grund-

tivation of the Noble Person.

le concept depuis longtemps rejet que

Keywords: mindfulness-based interventions, explicit ethics, values-neu-

Schlsselwrter: achtsamkeitsbasierte

les

tral, implicit ethics, spiritual, psychotherapy, psychotherapists, Buddhism

Interventionen, explizite Ethik, wert-

tres de valeurs. Ce papier explore cette

210 | Extra Special Issue: Mindfulness and Psychotherapy

interventions

peuvent

tre

neu-

EAP | International Journal of Psychotherapy | 211

Lynette Monteiro -

notion fallacieuse dune neutralit des

valeurs et raffirme que the thiques ex-

plores explicitement dans les interven-

tions bases sur la pleine conscience sont

cruciales la cultivation de la Personne

Implicit Ethics and Mindfulness: Subtle


assumptions that MBIs are values-neutral

s the field of mindfulness-based

the lines of secular and spiritually ori-

psychotherapy

sup-

ented interventions, MBIs have integra-

grows

ported by the exponential in-

ted a spiritually oriented approach into

crease in research, a number of issues

a therapeutic model with a considerable

are emerging in its conceptualization

level of success in clinical efficacy (Baer,

Noble.

. ,

and clinical delivery. Including ethics in

2003; Eberth & Sedlmeier, 2012; Khoury

Mots cls: interventions bases sur la

pleine conscience, thiques explicites,

the content of mindfulness-based in-

et al., 2013). Furthermore they meet the

terventions (MBIs) remains a central to-

criteria for Hodges (2011) five principles

valeurs-neutres, thiques implicites,

pic and this is typically discussed in the

for determining the advisability of using

spirituel, psychothrapie, psychothra-

context of reluctance to include overtly

a spiritually oriented practice in a clinical

peutes, Bouddhisme

the Buddhist model of ethics in a secu-

setting. Therefore the ethical issues for

lar program. In this article, I examine (1)

the clinician both of values and the im-


:

MBI

the reluctance about including explicit

plications of the spiritual base in MBIs are

ethics in mindfulness programs because

important to clarify.

it may impose external values, (2) the rea-

lity that MBIs are spiritually oriented and

Recent responses to Monteiro, Musten

therefore imbued with values, and (3) how

& Compsons (2015) examination of tra-

those values are intended as a cultivation

ditional Buddhism and its contemporary

of character which has significant impli-

vicissitudes explore the complexities of

cations for MBIs as agents of intra- and

integrating Buddhist and contemporary

interpersonal as well as societal change.

mindfulness including the issue of expli-

The perspective of value-neutrality may

refer to the overt and specific inclusion

represent an historical delimitation of

of an ethics or values-based framework in

psychology into an objective, actuarial

the MBI curriculum. Implicit ethics refer

, , ,

science with a focus on measures of per-

the assumptions that awareness in and of

cit versus implicit ethics. Explicit ethics

sonality as there is sufficient evidence

itself suffices for ethical thought, speech,

currently that no therapeutic approach

and action to emerge as well as be con-

is value-neutral (Hathaway, 2011). Being

gruent with the individuals self and world

based in Buddhist teachings on dealing

view. Rationales for implicit ethics sug-

with suffering through self-transforma-

gest that to be explicit would result in an

tion, MBIs can be considered a class of

imposition of values and principles that

spiritually oriented therapies. Where the-

may not be resonant with MBI partici-

rapies traditionally have diverged along

pants; that explicit teaching of ethics may

212 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 213

Lynette Monteiro -

Implicit Ethics and Mindfulness: Subtle


assumptions that MBIs are values-neutral

violate higher order ethics that proscribe

(2015) noted that it is equally important to

rapy as values-neutral and a way of not

professional and experiential status that

against it, especially in clinical settings.

investigate the subtle influences that are

interfering with or negating the partici-

tip the valuing of opinion towards the

Cullen (2011) explained that the impli-

already with us, in the Judeo-Christian

pants own values.

therapist. While in and of itself this is not

cit form is consistent with the Buddhas

conditioning of the West, particularly in

pedagogy of discovering for oneself how

relation to such issues as the concepts

The assumption that psychological in-

if the therapist is unaware of the power

unethical actions lead to suffering; also,

of right and wrong as well as the broader

terventions, including MBIs, can be

differential.

implicit ethics may run contrary to in-

topic of ethics (p. 64). These points are

value-neutral continues to hold sway,

dividual values and faith traditions. Ho-

consistent with the explorations of the

despite evidence that the clinician and

wever, this view fails to acknowledge

fallacy of values-neutrality in therapy and

client bring their unique patterns of va-

ation (CPA, 2015) and American Psycho-

that the Buddha specifically taught pre-

the implicit ethics and values embodied

lues into the therapeutic space (Jackson

logical Association (APA, 2010) address

cepts and rules for both lay and monastic

by the therapist and therapeutic models

et al., 2013; Patterson, 1959). Ali, Allmon,

the need to be vigilant about the ways

communities, respectively (Bodhi, 2013;

(Burns, Goodman & Orman, 2013; Hamil-

and Cornick (2011) explored the impor-

in which both clinicians and clients va-

Harvey, 2000). Critics of implicit ethics

ton, 2013), which are discussed next.

tance of value clarification so that intra-

lues can have impact upon the therapeu-

personal value conflicts are not confoun-

tic process. Recent editions to the CPA

suggest that the exclusion of ethics un-

unethical, it can lead to unethical actions

Both the Canadian Psychological Associ-

Value-neutrality in
Psychological interventions

ded by client-clinician value conflicts. For

Ethical Guidelines include specific men-

from its roots. Amaro (2015) noted that

example, a value conflict may arise for a

tion of personal values of psychologists.

Kabat-Zinns (2011) rationale for such an

Much of the debate about explicit or im-

client between needing divine guidance

While the Code of Ethics states there is

approach is vague and lends itself to a

plicit ethics in MBIs is rooted in the hi-

and engaging in autonomous decision-

no expectation that psychologists can be

dubious principle upon which to structure

storic aim of psychology to be objective

making. If a clinicians values lie in the

value-free, the onus is upon the psycho-

a pedagogical approach (p. 67). Monteiro

and scientific. If therapies are viewed as

development of autonomy as a process

logist to ensure a level of self-awareness

et al. (2015) indicated that regardless of

moral encounters (Burns et al., 2013) the

of self-determination, this gives rise to

and monitoring. This includes transpar-

the intention to not impose extraneous

process of treatment lies in the clients

an interpersonal value conflict. Emilius-

ency about the influences of their value

hinges the core elements of mindfulness

values, the very act of teaching a philo-

examination of disconnection between

sen and Wagoner (2013) pointed out that

system on the integrity of their relation-

sophy derived from an Eastern spiritually

ideal and actual values, a state that leads

therapists carry privileges of education,

ship with clients.

oriented practice has crossed into that

to distress (Fisher, 2011; Leiter, et al.,

arena. Furthermore, to do so without

2009). Influenced by the assumption of

transparency raises other higher-order

value-neutrality as a form of respect for

ethical issues of informed consent and

the clients own values, therapies have

patient care.

adopted a stance of objectivity and neutrality to avoid unduly influencing or

However, such implications of implicit/

detracting from these values. It is under-

explicit values conveyed in therapy are

standable, therefore, that the desire to

not solely the bte noir of mindfulness-

avoid an overt ethical framework in MBIs

based interventions (MBIs). Ajahn Amaro

arises from this historic paradigm of the-

214 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 215

Lynette Monteiro -

Implicit Ethics and Mindfulness: Subtle


assumptions that MBIs are values-neutral

In so far as MBIs are classified as mind-

in therapy. Hathaways exploration of how

are many such training programs. They

their own system of desires and inten-

fulness-based or mindfulness-informed,

to integrate the APA Ethics Code with

typically require pre-existing meditation

tions that can lead to misappropriation.

and mindfulness has it roots in Buddhism,

religion-derived practices is detailed and

practice, attendance at (usually Buddhist)

they can also be considered a class of

important but outside the scope of this

retreats, and an ongoing personal con-

Each of these dimensions content, te-

spiritually oriented approaches. In this

paper. In his conclusion, he called for ac-

templative practice (Crane et al., 2010).

acher, and clientele is fertile ground for

context, the clinicians valuing of secula-

countable practice that requires clarity in

The primary aim in teacher training is

the cultivation of what Amaro (2015) called

rized or religious frameworks carries risks

any use of spiritually oriented approaches

to cultivate an embodiment of the prin-

a holistic mindfulness. While all the need

for the client. The clinicians approach

as a clinical intervention. To achieve this

ciples, including ethics (Grossman, 2015)

for caution discussed earlier may be ap-

may strip the spirituality away and mis-

in MBIs the dimensions of ethics in mind-

that support the embodiment of the dee-

propriate in how one constructs, models,

characterise the concepts or the clinician

fulness-based interventions need to be

per principles of a skilful and healthy per-

and instructs mindfulness, what is missed

may advocate for a spiritual perspective

examined.

son (see the concept of Noble Person in

in these concerns of imposing extraneous

Harvey, 2000, 2013a, 2013b). Healthcare

values is that neither the participant nor

professionals such as physicians, psycho-

teacher arrives tabula rasa; their ethics

to explore the application of APA guide-

The dynamic interplay


of ethics in MBIs

logists, social workers, nurses, etc., who

and values are already present. The in-

lines to a spiritually oriented intervention.

The role of ethics in a mindfulness-based

train as MBI teachers would carry an ad-

fluences of Eastern spiritually oriented

He found a lower level of acknowledgment

program presents itself in three dimen-

ditional, though not contradictory, set of

practices are present in the content of

of religiousness among psychologists and

sions (Monteiro et al., 2015). First, ethics

ethical guidelines of their specific profes-

an MBI. The personal preferences, per-

a bias against conventional religion that

is contained, explicitly or implicitly, in

sional practice.

spectives of well-being and perhaps even

was likely to affect questions asked on

the content of a mindfulness program.

intake and generate a tendency to inter-

While Buddhists precepts may not be for-

The third dimension is related to the

mores are entwined in the world-views

pret spiritual experiences as pathology.

mally referenced in an MBI, the theme of

clientele who seek out a mindfulness

of the teacher. And, a rarely considered

Alternatively, difficulties can arise from

restraint by not doing harm to self and

program. One of the major concerns of

reality but crucial nevertheless, each par-

the clinicians own religious beliefs that

others is implicit in the process of cul-

Buddhist practitioners and scholars of

ticipant comes to mindfulness with their

may result in discarding evidence-based

tivating awareness of ones actions and

contemporary mindfulness applications

own set of ethics, values and perspectives

approaches for stand-alone explicitly

their consequences (Mikulas, 2015). Re-

is that mindfulness practices may be mis-

of well-being.

religious interventions (p. 68). Defining

cent debates have focussed on the con-

appropriated by agencies whose prima-

spiritual interventions also is challenging.

sequences of implicitly conveying ethics

ry ethic is questionable (police, military,

While the deconstruction of secularized

There is considerable overlap among the

in MBIs and the appropriateness of assu-

corporations) (Titmuss, 2013). In this re-

mindfulness has focused on the content

techniques. Is meditation a secular, trans-

ming Buddhist ethics are universal (Ama-

gard, the issue of ethics is a crucial one,

of MBIs, i.e., the debate around implicit

theistic or spiritual intervention? Fur-

ro, 2015; Monteiro et al., 2015).

not only as it relates to the teachers own

and explicit ethics, a far more complica-

that the client may not desire, respectively. Hathaway (2011) used the APA Code

the subtle influences of Judeo-Christian

ethics, but the intention of the program

ted picture emerges when content, te-

such as finding meaning in life, relaxati-

Second, ethics is modelled or embodied

and oversight of its eventual use. Howe-

acher, and client are taken as a three-fold

on, social justice, and acceptance of self

in the person of the MBI teacher (Evans et

ver, it is important to remember that the

interaction of already existing values and

and others also overlap with secular goals

al., 2014; van Aalderen et al., 2014). There

individual client always does present with

ethics. Thus, perhaps the allure of implicit

thermore, many value-laden approaches

216 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 217

Lynette Monteiro -

Implicit Ethics and Mindfulness: Subtle


assumptions that MBIs are values-neutral

ethics is simply an historic artefact of the

Seligman, 2004), as well as positive psy-

of moral neutrality and argued that the-

Moving closer to the reclamation of

fallacy of values-neutral therapy; it may

chology, is reclaiming the cultivation of

rapy is at its heart a moral endeavour in

virtue and ethics, Grossman (2015) de-

even be an effort to maintain respect for

character and virtues.

which the intent is to cultivate an excel-

scribed ethics in MBIs as an embodied

lence of character (p. 485), and Tjeltveit

process and mindfulness as melding

the client by inadvertently shifting from


client to protocol. In fact, actual respect

Fowers (2012) noted that the measure-

(1999) analysed the confusion around the

cognitive dimensions (e.g., of attention,

for the clients values and ethics lies not in

ment of personality overtook the exa-

issues of value-laden therapy through the

memory and consciousness together with

the red herring of maintaining some form

mination and cultivation of character

lens of the various dimensions of ethics

ethical qualities (e.g., of compassion, kind-

of values-neutrality, but rather in the

in psychology in the mid-20th centu-

in psychotherapy, one of which is vir-

ness, courage, and equanimity) (p. 21).

more challenging process of cultivating

ry. He pegged the onset of this shift on

tue ethics, concluding that the therapist

This integration, according to Goodman,

well-being as an aspect of character.

Gordon Allports critique of the study of

functions as an ethicist when therapy

is a shift away from Western psychologys

character, the desire to place its under-

goals and life choices are being explored

convention of separating cognition from

The facts of personality


and cultivating virtue in
the Noble Person

standing on scientific grounds, and later

in sessions.

ethical values; in the context of this

situational rather than moral factors. Fo-

Looking again at Buddhist ethics we

perspectives that question the ascendan-

Drawing

paper, Goodmans view echoes clinical

studies that inferred a greater impact of

psychology,

wers also observed that despite the drive

see that the practice is embedded in vir-

cy of personality over character and

mindfulness is one part development of

to an actuarial science of personality, it is

tue ethics (Harvey, 2000; Keown, 2001,

virtues. Greenberg and Mitra (2015) ex-

attention and two parts the cultivation of

almost impossible to discuss its factors

2005) and the cultivation of character:

plored in-depth the foundations and

intention and a quality of mind that is, in

without appealing to virtues as descrip-

the Noble Person is its raison dtre.

principles that constitute secular ethics;

Ajahn Amaros terms informed and ho-

tors (openness, courage, resilience, etc.).

Bhikkhu Bodhi (2013) described the spiri-

they pointed out clearly that contem-

listic (Amaro, 2015). Viewed through the

Kristjnsson (2012) pointed out that the

tual training of the Buddha as a two-fold

porary mindfulness must distinguish bet-

lens of character, mindfulness can be seen

convergence of work in emotional intel-

process of self-transformation and self-

ween practice for individual release from

as the cultivation of the Noble Person

ligence and positive psychologys work

transcendence. The former requires the

suffering and practice that results in a

(Harvey, 2013a), someone who embodies

in virtue development calls for a coope-

uprooting of unwholesome seeds or ten-

larger scale transformation at the inter-

the concepts and precepts of Buddhist

ration among moral educators, psycho-

dencies and the cultivation of wholesome

personal and collective level of engaged

teachings and who is able to act from

logists and moral philosophers. However

ones; selfishness gives way to generosity;

teaching, learning, and ethical action

those with compassion, non-attachment

psychology fails to cooperate because the

anger to compassion; ignorance to wis-

(p. 75). Their conclusion that the cur-

and wisdom. In Western psychology, for

facts (of personality) have precedence

dom. The latter requires rising above the

rent debate (about ethics) is an opportuni-

researchers and clinicians the dominant

and respectability in the field of research.

grasping ego; the sense of I, me, and

ty to connect our shared sense of urgency

mine give way to inclusiveness and in-

for unlocking human capacity with the

from

Buddhist

paradigm of best practice is supported


by scientific psychology and an actua-

Nevertheless, this different perspective

terconnectedness. Sila, or virtue ethics, is

temperate and systematic articulation

rial measure of personality, which has

in fields outside the direct influence of

the root of the practice that nourishes the

of ethical principles (p. 76) supports the

eclipsed the development of character

empirically driven psychology is impor-

spiritual effort. These two processes also

view of the cultivation of an excellence of

as a goal in therapy. However, the work

tant to MBIs. Hamilton (2013) addressed

appear to parallel the concepts of perso-

character. It resonates well with others

of Seligman and colleagues (Peterson &

the myth and risks of assuming a stance

nality and character.

who see interventions, especially the

218 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 219

Lynette Monteiro -

Implicit Ethics and Mindfulness: Subtle


assumptions that MBIs are values-neutral

MBIs, as a process that can do more than

2013). The paradigm shift of mindfulness

While there is concern that introducing

Lynette Monteiro, Ph.D.

relieve symptomatic discomfort.

in viewing the individual as a whole gre-

character invites old concepts of moral

is a registered psychologist and Director

ater than the sum of symptoms positions

weakness, the holistic view of the indi-

of Training at the Ottawa Mindfulness

MBIs to challenge many unexamined as-

vidual and relationships mitigates that

Clinic, Ottawa Canada. She is trained

sumptions that have accreted onto men-

fear by creating an environment where

in Cognitive Therapy for veterans and

tal health perspectives over the decades.

strengths and weaknesses become the

Mindfulness as agent of
conceptual change
Mindfulness-based

interventions

have

source materials to develop insight. In-

contributed in several important ways

active military personnel, mindfulnessbased treatments, and Buddhist chaplaincy. Dr. Monteiro co-developed the

to the field of psychotherapy and stand

If we trust in the capacity of participants

terpersonally, the practice of mindfulness

to do more as they challenge assump-

in MBIs to take cognitive and experiential

must offer a larger vision than changing

tions of personality, character, and well-

responsibility for their well-being, then

individual symptoms of suffering. By de-

mindfulness intervention for psycholo-

being that remain unexamined since the

we also trust in their capacity for insight

veloping the character of the Noble Per-

gical distress, pain management, and

mid-20th century. Kabat-Zinn (2003) has

in how their ethics and values guide them.

son, one with an excellence of character,

burnout resilience. She developed the

described contemporary mindfulness as

The practice of ethics is inseparable from

MBIs become a moral psychology. Mind-

M4 Teacher Training Path for healthcare

a paradigm shift in how to view suffe-

mindfulness practice and is its flavour.

fulness-informed psychotherapy then is

ring, to see human beings as inherently

However, it cannot be left to chance

responsible for being attuned to issues of

well rather than ill. This perspective has

through an implicit process. In fact, if we

ethics and values in the relationship. Its

a significant positive impact on their ca-

are to embrace the first paradigm shift

concerns cannot be limited to symptoma-

pacity to take charge of their well-being

towards the wholeness of the person, it is

tic relief. They must encompass the wel-

interventions.

and on the therapeutic relationship (Bri-

imperative that it is expressed relational-

fare of society by healing the conceptual

E-mail: lynette.monteiro@gmail.com

to, 2014). Mindfulness is also an oppor-

ly. That is, the roots of the intervention,

and structural divisions within it. That

tunity to heal deeper rifts in our clinical

its spiritual framework, and the clinicians

begins with an honest examination of its

perception of mental health. Historically,

values, as informed by those roots, must

own life.

the conceptualization of mental illness

be transparent. To do less is to circle

has progressed from being seen as de-

back, negate the non-hierarchical rela-

monic possession, to moral degradation

tionship in healing, sustain the fallacy

or weakness, to organic damage, and now

of a value-neutral system, and maintain

to a lack as determined by the measure

the split between personality factors and

of the person (Foerschner, 2010). Despi-

character.

te the proliferation of objective measures


of attributes and symptoms, the idea that

Mindfulness practice is ultimately the

mental health disorders arise from mo-

cultivation of healthy intra- and inter-

ral weakness remains a subtle influence

personal relationships. For the former,

and the stigma it imparts is still a major

the cultivation of well-being is intricately

contributor to suffering (Pescosolido,

bound with the cultivation of character.

220 | Extra Special Issue: Mindfulness and Psychotherapy

Mindfulness-based Symptom Management (M4) program, an ethics-based

professionals, is a Clinical Professor at


the University of Ottawa, and co-author
of Mindfulness Starts Here, and articles
on integrating Buddhist teachings,
specifically ethics, into mindfulness

International Journal of Psychotherapy:


2016, Vol. 20, Extra Special e-Issue,
pp. 210-224: ISSN: 1356-9082
Author and European Association of
Psychotherapy (IJP): Reprints and
permissions: www.ijp.org.uk
Submitted Sept. 2015; peer-reviewed twice and
reformatted, Nov. 2015; revised,
resubmitted and accepted, April 2016.

EAP | International Journal of Psychotherapy | 221

Lynette Monteiro -

Implicit Ethics and Mindfulness: Subtle


assumptions that MBIs are values-neutral

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Mindful Moral
Compass:

Embodying ethics for mindfulness


trained practitioners
Craig Mackie, Michele Chaban, Sarah Serbinski,
Dekyi-Lee Oldershaw & Robert J. MacFadden

Developing a Mindful Moral Compass: Embodying


ethics for mindfulness trained practitioners

Robert J.
MacFadden

is a faculty member of

is a Professor

the Applied Mind-

Emeritus and former

fulness Meditation

Director of Continuing

Certificate Program

Education at the Fac-

at the University of

tor-Inwentash Faculty

Toronto

of Social Work.

Michele Chaban,
MSW, PhD
(religious studies/thanatology) has worked

A secular ethical
system that emphasizes
contemplative practices
that cultivate compassion and wisdom

or bio-psycho-social-

Abstract
Psychotherapists,

and

other

change

agents, embody ethics through the adoption of theoretical frameworks, professional practices and personal values. There
is a growing need for ethics training to
be included in mindfulness certificate
programs, as has been recognized and
embraced by the University of Torontos

Craig Mackie,
MA, MSW

from a whole person

16 guidelines
for life

Entwicklung eines
achtsamen Moralkompass:
Ethik fr Therapeuten mit
Achtsamkeitsausbildung
Kurzfassung:

spiritual model of

Psychotherapeuten

und

andere Change Agents verkrpern Ethik

care for two decades.

durch die Annahme von theoretischen


Rahmenbedingungen,

Sarah Serbinski

professionellen

Praktiken und persnlichen Werten. Es

is a mindfulness

herrscht erhhter Bedarf an der Einbe-

practitioner who

ziehung von Ethiktraining in Achtsam-

teaches neuroscience

keits-Zertifikats-Programmen, so wie es

and mindfulness
within the Applied

im Applied Mindfulness Meditation Cer-

Applied Mindfulness Meditation Certifi-

Mindfulness Medita-

tificate Program der Universitt von

cate Program. Training in mindfulness-

tion Certificate at the

Toronto erkannt und umgesetzt wur-

based interventions for professionals should make explicit the motivati-

University of Toronto.

de. Die Ausbildung fr achtsamkeits-

on, intention, values, and practices that are sometimes assumed aspects
of mindfulness. The 16 Guidelines for Life (Murdoch & Oldershaw, 2009)
provides a secular system that emphasizes contemplative practices that
cultivate compassion and wisdom. Through examination of this system
and in combination with the latest research on neuroscience, mindfulness
practitioners can build mindful moral compasses that will guide their application of mindfulness in psychotherapy and beyond.

basierte Interventionen fr Fachleute


Dekyi-Lee
Oldershaw

sollte die Motivation, Absicht, Werte und


Praktiken explizit machen, die manch-

is faculty in the AMM-

mal als Aspekte der Achtsamkeit gel-

Mind and has previ-

ten. Die 16 Guidelines for Life (Murdoch

ously taught at the


University of Florence,

& Oldershaw, 2009) stellt ein skulares

Neurology, Psychiatry

System zur Verfgung, das kontempla-

Keywords: Mindfulness, ethics, morality, education, professionals,

and Pharmacology

tive Praktiken betont, die Barmherzig-

contemplative

Departments in Italy

keit und Weisheit kultivieren. Durch

226 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 227

Craig Mackie, Michele Chaban, Sarah Serbinski,

Dekyi-Lee Oldershaw & Robert J. MacFadden

Developing a Mindful Moral Compass: Embodying

ethics for mindfulness trained practitioners

die berprfung dieses Systems und in

2009) fournit un systme sculier qui

the University of Torontos Applied Mind-

Verbindung mit der neuesten Forschung

met lemphase sur les pratiques con-

fulness Meditation Certificate Program

im

16

Neurowissenschaften

templatives qui cultivent la compassion

(Murdoch & Oldershaw, 2009)

(AMM-MIND), housed in the Factor-In-

knnen Therapeuten achtsame Moral-

et la sagesse. En examinant ce systme,

wentash Faculty of Social Work. If directly

kompasse erstellen, welche die Acht-

combin aux dernires recherches en

addressed, training in mindfulness-based

samkeitsanwendung in der Psychothera-

neuroscience, les praticiens de la pleine

interventions can make explicit the mo-

Bereich

der

pie und darber hinaus leiten knnen.

conscience peuvent construire des com-

tivation, intention, values, and practi-

Schlsselwrter: Achtsamkeit, Ethik, Mo-

pas moraux de la pleine conscience pour

ces that are often assumed or implicit in

ral, Erziehung, Fachleute, kontemplativ

guider leur application de la pleine con-

science en psychothrapie, et au-del.

Mots cls: Pleine conscience, thique,

moralit, ducation, professionnels,

contemplative

Le Dveloppement dun compas


moral pour la pleine conscience: une thique pour les
praticiens forms la pleine
conscience

les thiques en adoptant des cadres th-


:
,

oriques, des pratiques professionnelles et

des valeurs personnelles Il y a un besoin

grandissant pour une formation lthique

inclure dans les programmes de certifi-

cation la pleine conscience, comme la

t reconnu et accueilli par lUniversit

de Toronto dans leur Programme de cer-

search in the field increases. Notions of

tification en Pleine conscience applique.

mindfulness range from religious appli-

La formation aux interventions bases

cation to therapeutic techniques. While

sur la pleine conscience pour des pro-

the impacts of mindfulness are becoming

fessionnels devrait rendre explicite la

evident, questions around motivations

motivation, lintention, les valeurs, et les

and intentions behind mindfulness are in-

pratiques qui sont parfois des aspects

prsums de la pleine conscience. Les

16 Lignes directrices pour la Vie (16 Gui-

delines for Life, Murdoch & Oldershaw,

Rsum: Les psychothrapeutes, et autres


agents de transformation, reprsentent

.
: , ,
, , ,

he field of mindfulness is expanding rapidly: as institutions


train employees; universities cer-

tify practitioners and therapists; and re-

creasingly pressing. Specifically, there is

a need for ethics training to be included

in mindfulness certification programs,

as has been recognized and embraced by

228 | Extra Special Issue: Mindfulness and Psychotherapy

When bombs begin to


fall on people, you
cannot stay in the
meditation hall all of
the time. Meditation is
about the awareness of
what is going on not
only in your body and in
your feelings, but all
around you.
Thich Nhat Hanh (2003)

Ethics is not simply a


matter of knowing.
More importantly, it
is about doing.
His Holiness the Dalai Lama
(2011, p.103)

EAP | International Journal of Psychotherapy | 229

Craig Mackie, Michele Chaban, Sarah Serbinski,


Dekyi-Lee Oldershaw & Robert J. MacFadden

Developing a Mindful Moral Compass: Embodying


ethics for mindfulness trained practitioners

mindfulness. This possibility has led to

ly. Mindfulness provides tools to become

and the evidence-based science of mind-

changes in the AMM-MIND program that

aware, present, intentional, and non-

fulness. These courses compose three of

presents participants with the tools to

judgmental such that one may uncover

the five A-Level core courses today: Hi-

build mindful moral compasses for their

human nature and act accordingly. Un-

stories of Mindfulness Practices; Mindful-

personal and professional practices.

derstanding interconnectedness is not a

ness Meditation and its Applications; and

spiritual luxury; its a societal imperative

Psychology, East and West. As the neuro-

The 16 Guidelines for Life is a secular

(Kabat-Zinn, 2011, p. 59). Mindfulness cre-

biological effects of mindfulness began to

ethical system that emphasizes contem-

ates the opportunity for the brain & body

come to light, a fourth course was added

plative practices that cultivate compas-

to have a controlled response (Luder et

to the core curriculum: Neuroscience,

sion and wisdom (Murdoch & Oldershaw,

al., 2009) through self-regulation (van den

Mindfulness and Mindfulness Meditation.

2009). Secular ethics can include both

Kurk et al., 2010) and awareness of bodily

In addition to A-Level courses, now there

religious and non-religious beliefs and

sensations, thoughts, and emotions in or-

are over 65 workshops in Levels B and C,

values (Gyatso, 2011). Making mindful

der to suppress and alter reactionary re-

taught by 45 faculty members, with more

ethics explicit does not have to be a pro-

sponses (Holzel et al., 2007). In the AMM-

than 800 learners, who have participated

cess of imposing a code or ethical agree-

MIND program, it has been referred to as

in the program.

ment (though many have gone this route).

the quarter second pause that allows for

Rather, strengthening embodied ethical

thought before reaction. Clearly, when

The program teaches the foundations of

practice can be achieved experiential-

training a range of professionals, it is

mindfulness practice and its applications

ly by raising ethical questions, providing

important to establish the mechanisms,

in psychotherapy, health, wellness, men-

conceptual framework to understand the

history, and techniques of mindfulness.

tal health, education, the arts, the corpo-

ethics within mindfulness and practicing

An essential addition to this is training is

rate world, leadership and governance.

transformative experiences that link va-

to build the capacity to understand how

The programs goal is to integrate what is

lues and practices to their moral expres-

mindfulness leads to paying attention to

often viewed as the separate domains of

sion. When ethics is brought to the fore

societal imperatives that arise through

mind, body, relationships, and society as a

in mindfulness trainings, the full range of

practice and then establish ones stance

whole. After the A-Level core courses are

what mindfulness can offer begins to be-

and from which to act.

taken, learners can take courses in diverse

methods for intervention or preventi-

come apparent (Monteiro et al., 2010).

on such as: Mindfulness Based Cognitive

Definition of Mindfulness

Overview of AMM-MIND Program


The inter-professional Applied Mindful-

Therapy; Learn to Breathe; Mindfulness

Taken together, the two opening quotes

ness Meditation program (AMM-MIND),

Without Borders; Mindful Leadership and

might read: Mindfulness is not simply a

hosted by the Factor-Inwentash Faculty

Governance; Conscious Care and Sup-

matter of knowing, it is a matter of pa-

of Social Work at the University of To-

port; Mindful Contemplative End of Life

ying attention to the fullness of ones

ronto, began over 10 years ago, with three

Care; Transformative Mindfulness Medi-

experience that leads one to act moral-

basic workshops that taught the practice

tation, as well as numerous other mind-

230 | Extra Special Issue: Mindfulness and Psychotherapy

EAP International Journal of Psychotherapy | 231

Craig Mackie, Michele Chaban, Sarah Serbinski,


Dekyi-Lee Oldershaw & Robert J. MacFadden

Developing a Mindful Moral Compass: Embodying


ethics for mindfulness trained practitioners

fulness-based interventions. This is sup-

practitioners, who apply mindfulness in

referenced later in this article, neurosci-

ported by an active relationship with the

therapeutic, educational, corporate, and

ence affirms the importance of empathy

The Process of Building a


Mindful Moral Compass

Centre for Mindfulness Studies (Toronto)

personal settings. Thus, the ethics course

and compassion as our social impera-

The 16 Guidelines for Life is a model

to build a community of practice.

(code: MINDA-5, SCS 3133) directs at-

tives, connecting us with each other (Ka-

that presents mindful wisdom, virtues,

tention to the possible outcomes sought

bat-Zinn, 2011; Siegel, 2012, 2013).

and practices in order to build an ethi-

After five years of teaching mindful-

through mindfulness practices that may

ness, the co-directors noticed that some

contribute to happiness, liberation from

Murdoch & Oldershaw (2009) offer 16

of self-reflective activities, experiential

people claimed they had a mindfulness

suffering and ultimately asks, What

Guidelines For Life based around four

visualizations, writing, and discussion,

practice, but they did not manifest the

would it take to create a civil society ba-

insights, or wisdom themes, about the

the MINDA-5 course uncovers motivati-

behaviours that had come to be associa-

sed on mindful qualities? (Klein et al.,

nature of Thinking, Acting, Relating and

on, intention, values/virtues, practices

ted with a regular consistent meditative

2015).

Finding Meaning. Each of the four wis-

and supports for individuals to practice

dom themes has four corresponding gui-

mindfulness ethically. The 16 Guidelines

practice. Although consistent practice

cal, mindful society. Through a series

has numerous positive effects (see neu-

Ethics and Mindfulness

delines that make up a total of sixteen vir-

for Life are taught as a descriptive rather

rological discussion later), the question

In the Western context, ethics typically

tues that can help to mindfully cultivate

than prescriptive system; it is up to par-

of how much practice, and how often,

falls into a few categories such as: conse-

compassion. The 16 Guidelines For Life

ticipants to decide how they define each

is still up for debate. In the interim, an

quentialism (which determines right and

is a secular, modern re-iteration of the

guideline and experience each wisdom

emphasis on becoming aware of ones

wrong by the outcome of actions); deon-

7th century code of conduct, compiled

theme. Furthermore, when the ethical

intentions, values, and actions through

tological ethics (which focuses on duty to

by King Songsten Gampo of Tibet, which

implications of each theme are consi-

mindfulness still needed to be addressed.

determine right, wrong, and intention);

began the process of transforming a war-

dered, participants begin to construct

Namely, AMM-MIND identified the need

and virtue ethics (which answers ethical

like nation into one noted for its peace and

their mindful moral compasses.

for an experiential course that addressed

questions as a matter of good character

serenity (Murdoch & Oldershaw, 2009, p.

the fact that mindfulness is a process that

and habit); all of which seek to answer the

2). These guidelines are part of what ma-

yields wisdom (of the nature of mind and

question of how to live a good life. Mind-

kes up the full training in becoming a wise

The Four Wisdom Themes and


Their Corresponding Guidelines

world) and can result in greater intenti-

ful ethics seeks to uncover the nature of

and compassionate human being (accor-

The theme of the First Wisdom of the

on towards ourselves, and others, which

our world and minds through the use of

ding to Tibetan Buddhist understanding),

16 Guidelines for Life examines how we

is often presented as self-compassion

attention, focus, visualization, contem-

incorporating

(ethics),

Think, providing the insight that our

and compassion (Davidson & Harrington,

plation, and then act accordingly with the

good heart (compassion) and good mind

world is shaped by thoughts or mind pro-

2001).

right motivation (Kabat-Zinn, 2011). The

(wisdom or understanding the nature of

jections and, as such, we must ethically

Dalai Lama (2011) argues that because we

the mind and how it perceives and expe-

consider how we are responsible for sha-

A fifth core course, Secular Ethics

are social beings that rely on each other

riences). This system has been adopted by

ping our world. There are four qualities or

Through

Mindfulness

good

conduct

Ethics

to thrive, empathy and compassion are

the AMM-MIND program, in order to te-

virtues that help to deepen the wisdom

Through Mindfulness), was introduced to

innate qualities, which can also be deve-

ach embodiment of mindful ethics.

of this insight and can lead to happiness

specifically explore the ethical questions

loped over a life-time and are not depen-

while deepening compassion: Humility,

behind the intention and motivation of

dent on religious beliefs or practices. As

Patience, Contentment and Delight.

(now

232 | Extra Special Issue: Mindfulness and Psychotherapy

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Craig Mackie, Michele Chaban, Sarah Serbinski,


Dekyi-Lee Oldershaw & Robert J. MacFadden

Developing a Mindful Moral Compass: Embodying


ethics for mindfulness trained practitioners

The theme of the Second Wisdom looks at

aning is always possible, and that it is up

program? Who are you studying and prac-

tant supplements to their professional and

how we Act: every action has an impact, both

to us to do so. Paying attention to ones

ticing for? What changes to your life and

personal codes of ethics, especially when

immediate and far-reaching, and thus

Aspiration alongside ones Principles

your world do you hope to achieve through

individuals connect with how they sup-

skilful action can lead to a better world.

and intentionally practicing Service and

your mindfulness studies? Answers ran-

port decision-making and inform actions.

This

demonstrated

Courage can create meaning in ones life.

ge from personal motivations that relate

through Kindness, Honesty, Generosity,

These four guidelines can also heighten a

to family and day-to-day life, to bringing

Practice and Support

and Right Speech (or Thoughtful Speech).

sense of agency around ones life purpose.

mindfulness into the workplace, or broad

The final task put to participants is to

intentions for social justice and equali-

identify the practices that will continue to

is

practiced

and

The Third Wisdom theme explores how we

One of the primary teaching tools used

ty. Having participants reflect and sha-

ground ethically their mindfulness: Who

Relate: we are all interdependent and if we

in this course is to reflect cognitively and

re these perspectives in the class helps

supports your mindful ethics and how do

cherish others, we cherish ourselves. Prac-

to use the feelings in the body as a me-

to heighten, and broaden, the collective

you support others? Some participants

ticing the four qualities of Respect, Forgi-

chanism to observe the ethical nature of

purpose of a moral mindful practice. The-

simply aspire to practice mindfulness

veness, Gratitude, and Loyalty helps nur-

one of their virtues in any situation: for

se questions start to identify, or affirm,

more consistently, while others identify

ture relationships. One can consider the

example, Go to an experience of Patience.

their moral compasses.

specific strengths, virtues or aspects of

ethical implications of this wisdom theme

What effect did it have on your situation?

as well as examine the impact of introdu-

How did it change you? What did it feel like

Values

cultivate more awareness and intention.

cing these four qualities into relationships.

in the body? And finally, Based on obser-

Participants are asked: What values do

Many participants identify a weekly or

ving this experience, what is the wisdom of

you hold and where did they come from?

daily practice with the 16 Guidelines for

The fourth aspect of Wisdom (that can

Patience? By observing a memory of a di-

What

to

Life as a crucial next step to bring intenti-

inform ethics) considers how we create

rect (embodied) experience, participants

ground your values and your morality? In

on to the moral aspects of their mindful-

or Find Meaning throughout our life, re-

can take note of the deep understanding

fact, connecting with values and identi-

ness practices. Finally, participants iden-

cognizing that if everything is constantly

that they have of their values and beliefs

fying where they come from inherently

tify supports in their lives, both literal

changing, then creating purpose and me-

(Kabat-Zinn, 2011). They begin to use their

strengthens the neural circuitry around

and figurative, to help them to continue

body as a tool to observe their emotions

them. The practice of uncovering and af-

to cultivate mindful ethics.

and feelings that guide their morality (e.g.

firming values, in itself, is a key positive

see Transformative Mindfulness: Older-

habit that is essential to an ethical ap-

shaw, 2015). When these virtues are con-

proach to mindfulness (Monteiro & Mu-

Ethical Challenges
in Mindfulness

sidered in light of a Wisdom Theme, they

sten, 2013, p. 49). It helps us to live closer to

Given the breadth of the mindfulness

can lead to a balanced ethical practice.

our intentions to build a better world (e.g.,

field, participants in MINDA-5 spend some

see: The Five Remembrances, Thich Nhat

time examining and debating questions

character towards which they hope to

mindfulness

practices

help

Motivation and Intention

Hanh, 2015; Monteiro, Nuttall & Musten,

such as: Is mindfulness a religion?; How

The MINDA-5 course starts by asking

2010). Often participants identify their

do I introduce mindfulness to a challenging

participants, What has drawn you to

values within the 16 Guidelines for Life

workplace?; How do I maintain integrity

mindfulness and an applied mindfulness

framework. These values become impor-

as a certified instructor?; and How could

234 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 235

Craig Mackie, Michele Chaban, Sarah Serbinski,


Dekyi-Lee Oldershaw & Robert J. MacFadden

Developing a Mindful Moral Compass: Embodying


ethics for mindfulness trained practitioners

I make mindfulness accessible to margina-

Social relatedness can be understood

tention behind any actions, including the

to pay attention on purpose (Kabat-Zinn,

lized populations? Also addressed is the

from the study of mirror neurons (Iaco-

active cultivation of mindfulness and its

2003). Within the context of AMM-MIND,

topic of the potential pitfalls of the mar-

boni, 2009), which are proposed to be the

applications, one can actually strengthen

deliberately paying attention to the ethi-

keting or commercialization of mindful-

roots of a system of empathy that allows

and awaken this motivation and intention.

cal implications of mindfulness has the

ness. These discussions are often just a

individuals to map the minds of others.

In so doing, one deepens moral agency.

potential to strengthen moral neuro-cir-

starting place for further consideration.

This forms the basis of what Daniel Siegel

Participants have often been grateful for

(2010) calls mind-sight maps:

cuitry. We are hard-wiring ourselves to be


Mindfulness puts individuals in touch

more ethical mindfulness practitioners.

with intuition and morality (Siegel,

the opportunity to share these questions


in a critical dialogue with their colleagues

The brain makes what I call a me-

2010). Modern research on moral aware-

Impact

because this prepares them for addres-

map that gives us insight into our-

ness, through functional magnetic reso-

Participants find MINDA-5 challenging

sing these potentially controversial topics

selves, and a you-map for insight

nance imaging scanners, indicates that

and transformative. As with any good

in their own applications of mindfulness.

into others. We also seem to create

the pre-frontal cortex (PFC) region of the

ethics course, participants leave with

we-maps, representations of our

brain is activated when one thinks about

many more questions to ponder, but also

The Neuro-Ethics
of Mindfulness

relationships. Without such maps,

the social good. When there is damage

with more connections to others in their

we are unable to perceive the mind

to this PFC region of the brain, individu-

community of practice, as well as new

Mindfulness impacts neurology; mindful

within ourselves or others. (p. 8)

als may struggle with thinking about the

ideas and tools by which to deepen their

social good. The PFC uses intuition to be

understanding of mindfulness practices.

practices increase empathy, compassion


and morality via brain changes, as well

These mind-sight maps allow one to re-

aware of bodily sensations and develop

as changes that increase neurotransmis-

sonate with the emotional states of others,

a gut response about what is the right

We have refined this course over the

sion around emotional awareness and

based upon their behavioural inten-

decision or choice (Marks-Tarlow, 2014;

past two years, having found that parti-

decision-making (Hlzel et al., 2011). Sie-

tions and observable emotions. When one

Siegel, 2010). Again, raising this for mind-

cipants are far more willing to dive into

gel (2012) notes that there are no single

senses ones own internal states, the pa-

fulness practitioners increases agency

ethical questions with more structure and

brains: we are hard-wired to connect

thways for resonating with others become

around, and intention, towards the rich

clarity around Western ethical concepts

socially. Social relatedness is structured

open as well. The application of this prin-

ethical implications of the integration of

at the outset. We have also developed a

within neural networks of: bonding and

ciple is profound and it helps mindful-

mind, body, and relationships.

one-page handout that participants re-

attachment, play, curiosity, acceptance,

ness practitioners to understand the in-

predicting others behaviours, and sen-

herently social nature of the human brain.

sing what others feel. These are all skills

turn to after every section of the course


Cozolino and Santo (2014) stated that

to note their personal insights and build

behavioural changes are expressions of

their mindful moral compasses (see Ap-

that develop throughout a lifetime (Siegel,

Paying attention to bodily states, as a mind-

neuroplasticity, or the ability of the brain

pendix). This handout allows participants

2013). Understanding the neurology of

fulness practitioner, is a crucial step in under-

to change in response to experience (pp.

to record their Motivation, Intention, Va-

mindfulness, and these impacts on mora-

standing the nature of interpersonal attu-

167-188). In other words, the experience

lues/Virtues, Practices and Supports for

lity via changes in the brain and nervous

nement that is at the heart of interpersonal

of practicing mindfulness is an act of cir-

ethical mindfulness, alongside reflections

system, are essential aspects to educating

integration (Siegel, 2010). Attuning to ones

cuitry building. The secret to deliberate

on the four wisdom themes of the 16 Gui-

applied-mindfulness practitioners.

motivation, and asking to be shown ones in-

circuit building is having the intention

delines for Life.

236 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 237

Craig Mackie, Michele Chaban, Sarah Serbinski,


Dekyi-Lee Oldershaw & Robert J. MacFadden

Developing a Mindful Moral Compass: Embodying


ethics for mindfulness trained practitioners

The instructors stance is incredibly im-

Many other mindfulness training and

Craig Mackie, MA, MSW

work for the Oxford University Press,

portant, combining therapeutic group

regulating organizations have codes of

is a faculty member of the Applied Mindful-

Oxford Bibliography Online. She is also

ethics (e.g. see: UK, Network for Mindful-

ness Meditation Certificate Program at the

a member of the Global Association of

del. One phrase that is often used in the

ness-Based Teacher Training Organiza-

University of Toronto. In private psychotherapy

Interpersonal Neurobiology community.

AMM-MIND program is to connect rat-

tions, 2015; Kabat-Zinn et al., 2015). These

practice, he specializes in youth, adult and

E-mail: sarah@serbinski.com

her than correct. In such a course (and

are essential contributions to the field of

program) that requires participants to be

applied mindfulness practices and repre-

vulnerable and self-reflective, holding a

sent one useful approach to make explicit

gentle, receptive but discerning guiding

moral practices. Paramount is the con-

stance has proven to be essential for in-

work with an experiential learning mo-

structors.

indigenous peoples trauma and addictions

in Ottawa, Ontario. He is also an internatio-

Dekyi-Lee Oldershaw

nal trainer for The Foundation for Develo-

is faculty in the AMM-Mind and has previ-

ping Compassion and Wisdom (UK) for the

ously taught at the University of Florence,

16 Guidelines. He practices and trains others

Neurology, Psychiatry and Pharmacology

sideration of ethics that are drawn from

in Transformative Mindfulness Methods (TMM).

Departments in Italy training medical and

personal experience and self-application

E-mail: craig@essentialchange.net

mental health professionals. She is co-author

of contemplative practices. Incorporating


Although feedback has been positive,

training focused on building an embodied

affirming the intention of course to rai-

ethical framework is an essential compo-

se ethical questions about mindfulness, a

nent to teach to those who are learning

comprehensive impact analysis on effects

to apply the vast range of mindfulness-

outside of the class on learners actual

based interventions into psychotherapy.

mindful moral practice is still needed.

and international trainer of 16 Guidelines

Michele Chaban, MSW, PhD

for Life. She is a board member of the inter-

(religious studies/thanatology) has worked

national Foundation for Developing Com-

from a whole person or bio-psycho-social-

passion and Wisdom in UK. Dekyi-Lee devel-

spiritual model of care for two decades.

oped the Transformative Mindfulness Me-

Traversing the comparative literatures and

thods protocol. She is a former Tibetan

practices of social work and religious stu-

Buddhist nun and founding director of

Bringing deep intention to mindfulness

dies, Micheles practice is deeply situated in

the Centre for Compassion and Wisdom,

Further study that uncovers the impact of

practice in combination with discernment

inter-professionalism, diversity and spiritu-

Burlington, Ontario. E-mail: dekyilee@

ethics training through mindfulness will

towards that which arises from practice

ality. She has had a 30 year career in end-

transformativemindfulness.com

be an essential contribution to the field of

can certainly result in a more compassio-

contemplative studies and psychotherapy.

nate and wise world.

of-life care, using mindfulness meditation


at the bedside of her clients, their families,

Robert J. MacFadden

and team members to enhance health, resi-

is a Professor Emeritus and former Director

liency, and attend to suffering. Her work has

of Continuing Education at the Factor-

been both family and community based.

Inwentash Faculty of Social Work. He has

The AMM-MIND program endeavours to

She is an adjunct professor, co-founder and

written on neuroscience for the Oxford

honour traditional contemplative practices

past Director of the Applied Mindfulness

University Press, Oxford Bibliography

while integrating current contemplative

Meditation Certificate Program.

Online and for Frank Turners 5th Edition

E-mail: chabanmichele@gmail.com

of Social Work Treatment (2011). He

Final Thoughts

practices, human history, literature, and


evidence-based

therapeutic

practices.

The 16 Guidelines for Life have been introduced as a model for an intentional exploration of the ethics of mindfulness. With
this framework in mind, psychotherapists
can heighten their mindful moral practices.

International Journal of Psychotherapy: 2016,


Vol. 20, Extra Special e-Issue,
pp. 226-242: ISSN: 1356-9082
Author and European Association of
Psychotherapy (IJP): Reprints and
permissions: www.ijp.org.uk
Submitted Sept. 2015; peer-reviewed
twice and reformatted, Nov. 2015;
resubmitted and accepted, April 2016.

238 | Extra Special Issue: Mindfulness and Psychotherapy

Sarah Serbinski

teaches two levels of neuroscience and


mindfulness courses in Continuing

is a mindfulness practitioner who teaches

Studies at University of Toronto, along

neuroscience and mindfulness within the

with a webinar version. He regularly

Applied Mindfulness Meditation Certificate

presents within the community on topics

at the University of Toronto. Sarah is the

related to neuroscience and mindfulness.

co-author of Neuroscience and social

E-mail: robert.macfadden@utoronto.ca

EAP | International Journal of Psychotherapy | 239

Craig Mackie, Michele Chaban, Sarah Serbinski,


Dekyi-Lee Oldershaw & Robert J. MacFadden

Developing a Mindful Moral Compass: Embodying


ethics for mindfulness trained practitioners

references
COZOLINO, L.J. & SANTOS, E.N. (2014). Why we need therapy and why it works:
A neuroscientific perspective. Smith College Studies in Social Work, 84, pp. 157-177.
doi: 10.1080/00377317.2014.923630
DAVIDSON, R. & HARRINGTON, A. (2001). Visions of compassion: Western scientists and
Tibetan Buddhists examine human nature. New York: Oxford University Press.
GYATSO, T., His Holiness the Dalai Lama. (2011). Beyond religion: Ethics for a whole world.
New York: Mariner Books.
HANH, T.N. (2003). In Engaged Buddhism, Peace Begins with You, John Malkin.
Retrieved 2016, April 16, from:
http://www.lionsroar.com/in-engaged-buddhism-peace-begins-with-you/#
HANH, T. N. (2015). Five Remembrances. Retrieved 2016, April 16, from:
http://mountainsangha.org/the-five-remembrances/
HLZEL, B.K., LAZAR, S.W., GARD, T., SCHUMAN-OLIVIER, Z., VAGO, D.R. & OTT, U.
(2011). How does mindfulness meditation work? Proposing mechanisms of action from
a conceptual and nueroal perspective. Perspectives on Psychological Science, 6 (6),
pp. 537-559. doi: 10.1177/1745691611419671
KABAT-ZINN, J. (2003). Mindfulness-Based interventions in context: Past, present,
and future. Clinical Psychology: Science and Practice, 10 (3), pp. 144-156.
doi: 10.1093/clipsy.bpg016
KABAT-ZINN, J. (2011). Why Mindfulness Matters. In: B. Boyce (Ed.), The Mindfulness
Revolution, (pp. 57-62). Boston: Shambala.
KABAT-ZINN , J., SANTORELLI S.F., BLACKER, M., BRANTLEY, J., MELEO-MEYER,
F., GROSSMAN, P., KESPER-GROSSMAN, U., RIEBEL, D. & STAHL, R. (2015).

correlates of long-term meditation: Larger hippocampal and frontal volumes of gray


matter. Neuroimage, 45 (3), pp. 673-678. doi: 10.1016/j.neuroimage.2008.12.061
MARKS-TARLOW, T. (2014). The interpersonal neurobiology of clinical intuition. Smith
College Studies in Social Work, 84, pp. 219-236. doi: 10.1080/00377317.2014.923712
MONTEIRO, L. & MUSTEN, F. (2013). Mindfulness starts here: An eight-week guide
to skilful living. Victoria, BC: Friesen Press.
MONTEIRO, L., NUTTALL, S. & MUSTEN, F. (2010). Five Skilful Habit: An ethics-based
mindfulness intervention. Counselling and Spirituality, 29 (1), pp. 91-104.
MURDOCH, A. & OLDERSHAW, D.L. (2009). The 16 Guidelines for Life: The basics.
London, UK: Universal Education for Compassion and Wisdom.
OLDERSHAW, D.L. (2015). Transformative Mindfulness Methods. Retrieved 2016,
April 16, from: lamponthepath.org
SIEGEL, D.J. (2010). Mindsight: The new science of personal transformation.
New York: Bantam Books.
SIEGEL, D.J. (2012). The Developing Mind: How relationships and the brain interact
to shape who we are (2nd edition). New York: The Guildford Press.
SIEGEL, D.J. (2013). Brainstorm: The power and purpose of the teenage brain.
New York: Jeremy P. Tarcher/Penguin.
UK, Network for Mindfulness-Based Teacher Training Organizations. (2015)
Retrieved from: http://www.mindfulnessteachersuk.org.uk/
VAN DEN KURK, P.A., GIOMMI, F., GIELEN, S.C., SPECKENS, A.E. & BARENDREGT, H.P.
(2010). Greater efficiency in attentional processing related to mindfulness meditation.
Quarterly Journal of Experimental Psychology, 63 (6), pp. 1168-1180.

Principles and Standards. Retrieved from:


http://www.umassmed.edu/cfm/training/principles--standards/

Endnotes

KLEIN, S., CHABAN, M., MASCARIN, M. & OLDERSHAW, D.L. (2015). Inter-professional
certificate in applied mindfulness meditation: A resource book for inter-professional
practitioners (Level A: Workshops 1-3). Factor-Inwentash Faculty of Social Work,
University of Toronto.
IACOBONI, M. (2009). Mirroring people: The science of empathy and how we
connect with others. New York: Picador.

Inquiries about the Applied Mindfulness Meditation Certificate Program at the University
of Toronto visit: http://socialwork.utoronto.ca/conted/programs-and-workshops/
certificates/mind/
Inquiries about the 16 Guidelines for Life, including the origins and translations visit:
www.16guidelines.org, or http://www.compassionandwisdom.org/

LUDER, E., TOGA, A.W., LEPORE, N. & GASER, C. (2009). The underlying anatomical

240 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 241

Craig Mackie, Michele Chaban, Sarah Serbinski,


Dekyi-Lee Oldershaw & Robert J. MacFadden

Appendix Mindful Moral Compass

Hellenic Institute for Psychotherapy

Building a Mindful Moral Compass

Wisdom Theme how does this

wisdom theme inform your ethics?

Intention

Think

Motivation

Inner Values

Practices

advertisement

Act

Relate

THE MINDFULNESS
WORKSHOP
The next Mindfulness*1 Workshop (ten sessions) will be starting on
26th September, 2016. This workshop is focused on Stress, Anxiety
and Attention problems. It is facilitated by Person-Centred
Therapists and includes meditations, exercises, discussion sessions,
videos, theory and research data.
Members with chronic diseases are most welcome.

THE ANGER PSYCHO-EDUCATION


WORKSHOP
A new group for the Anger psycho-education programme (two
phases, twenty sessions) will be starting on 30th May 2016. This
programme is scientifically and bibliographically documented
regarding the constant changes on personality traits.
(Callifronas & Kontou, 2016*2)

Supports

Create Meaning

For information and applications +30210 3817023, +306936 890313


Mrs X. Leonidhopoulos (xenialeoni@gmail.com, m@ediabetes.org)

University of Toronto, AMM-MIND, Applied Mindfulness Meditation Certification Program

242 | Extra Special Issue: Mindfulness and Psychotherapy

*1 Kabat-Zinn et al., Am J Psychiatry, 1992; 149, 936-943.


*2 Callifronas & Kontou, J Psychol Psychother 2016, 6:1

EAP special JOURNAL : Mindfulness and Psychotherapy -

Issues in the Training of Teachers


in Mindfulness-based Interventions

Slow and Fast Cooking of Rumis Chickpea:

Issues in the Training of


Teachers in Mindfulnessbased Interventions
Jessie Bosse, Brittany Glynn & Lynette Monteiro

Abstract There is fast growing interest in and demands for mindfulness-based


interventions and trained professionals.
The process of training competent mindfulness therapists is known to be a lengthy and extensive one. The combination of
high demands with the need for thorough
training raises many questions about the
training process itself; should it be revised or changed in ways that would allow
for greater number of trained therapists?

Jessie Bosse
is a PsyD Candidate at the Universit du Qubec en
Outaouais (UQO)
and an Intern at
the Cyber-psychology Lab of UQO
Brittany Glynn
MA, is a Ph.D.
Candidate at the
University of Ottawa in the School
of Human Kinetics.

Or is it essential to keep it as it is, considering that different training periods are


needed in order to allow full development
of the vast skill-set required to teach
mindfulness? In other words, should we

training

mindfulness teachers

The process of training mindfulness


teachers operates at a different
level from traditional training in
psychotherapeutic skills;

244 | Extra Special Issue: Mindfulness and Psychotherapy

sacrifice quality and length of training to


produce more qualified therapists? In order to shed light on those questions, cur-

Lynette
Monteiro, Ph.D.A
is a registered
psychologist and
Director of Training at the Ottawa
Mindfulness Clinic,
Ottawa Canada

rent training models are exposed, as well


as a brief review of the literature on training competent mindfulness therapists.
Keywords: Mindfulness-based Interventions; Teacher training, psychotherapy, therapists

EAP | International Journal of Psychotherapy | 245

Jessie Bosse, Brittany Glynn & Lynette Monteiro -

Issues in the Training of Teachers


in Mindfulness-based Interventions

y sont forms. Le processus de former

des thrapeutes comptents en la pleine

conscience est connu pour tre longue

et onreux. La combinaison de demandes

fortes avec le besoin de formation appro-

fondie et complte soulve beaucoup de

questions sur le processus de formation

lui-mme ; doit-il tre rvis ou chang

- .

de faon permettre la formation dun

plus grand nombre de thrapeutes ? Ou

est-ce essentiel de tout garder tel quel,

Langsames und schnelles Kochen von Rumis Kichererbse:


Fragestellungen bei der Lehrerausbildung fr achtsamkeitsbasierte Interventionen

ermglichen um Achtsamkeit zu lehren?

compte tenu les diffrentes priodes de

Anders gesagt, sollen wir Qualitt und

formation ncessaires afin de permettre

Ausbildungsdauer opfern um mehr quali-

le plein dveloppement des vastes com-

fizierte Therapeuten hervor zu bringen?

ptences requises pour pouvoir enseigner

Um Aufschluss ber jene Fragen zu ge-

la pleine conscience ? Autrement dit, de-

Kurzfassung: Das Interesse und die Nach-

ben, werden aktuelle Ausbildungsmodelle

vrions-nous sacrifier la qualit et la dure

frage an achtsamkeitsbasierten Interven-

und auch ein kurzer berblick ber die

des formations pour produire davantage

tionen und ausgebildeten Fachleuten

Literatur zum Thema: Ausbildung kompe-

de thrapeutes qualifies ? Afin de pou-

wchst schnell. Man wei, dass der Aus-

tenter Achtsamkeitstherapeuten gezeigt.

voir traiter ces questions, des modles

bildungsprozess fr kompetente Acht-

Schlsselwrter: Achtsamkeitsbasierte

de formation actuels y sont dcrits ainsi

samkeitstherapeuten lange und umfas-

Interventionen; Lehrerausbildung,

quun bref survol de la littrature relative

send ist. Die Kombination von groer

Psychotherapie, Therapeuten

la formation de thrapeutes la pleine

conscience.

Mots cls: Interventions bases sur la

pleine conscience; formation denseignants,

psychothrapie, thrapeutes

Nachfrage und Bedarf an umfassender

ist es wichtig, alles so zu belassen, wie

Cuisson lente et rapide


du pois chiche de Rumi:
Questions sur la formation
denseignants en interventions bases sur la pleine
conscience

es ist, mit Rcksicht darauf, dass unter-

Rsum: Il y a un intrt rapidement gran-

schiedliche Ausbildungszeiten notwendig

dissant avec des demandes pour des in-

sind, um die vollstndige Entwicklung der

terventions bases sur la pleine con-

enormen erforderlichen Kompetenzen zu

science et pour des professionnels qui

Ausbildung wirft viele Fragen ber den


Ausbildungsprozess selbst auf; soll er
berarbeitet oder dermaen gendert
werden, damit eine hhere Anzahl an ausgebildeten Therapeuten mglich ist? Oder

246 | Extra Special Issue: Mindfulness and Psychotherapy



:

,

.
:
,
, ,

EAP | International Journal of Psychotherapy | 247

Jessie Bosse, Brittany Glynn & Lynette Monteiro -

Issues in the Training of Teachers


in Mindfulness-based Interventions

he increasing evidence of the ef-

del of training and the assessment of its

many ways, very similar to the experien-

separates mindfulness from other ap-

ficacy of mindfulness-based inter-

effectiveness is for class-based training

tial process of training psychotherapists.

proaches stems from the fact that it is

ventions in psychotherapy has re-

(Crane et al., 2012b); while individual the-

Aspiring mindfulness teachers are trained

not a technique or a set of therapeutic

sulted in a growing demand for qualified

rapists may engage in this level of trai-

didactically in both the theoretical back-

tools that can be learned and performed

professionals (Crane et al., 2012a). Consi-

ning, theirs is usually obtained through

ground and science of mindfulness, and

(McCown et al., 2010). It is not to be used

dering the vast skill-set that is needed to

shorter-term processes such as work-

experientially through personal practice

when it just feels right and then put to

become competent, the process of trai-

shops. Thus, for the sake of clarity, we

and meta-cognitive processes. They cul-

rest in the toolbox when done. Instead,

ning mindfulness teachers proves to be

have referred to teachers on the trai-

tivate skills such as authenticity, authori-

mindfulness is more a way of being and

a complex and extensive one (McCown,

ning path and include individual as well as

ty through deep knowing, and friendship

the training process therefore differs si-

2013; McCown, Reibel & Micozzi, 2010;

those focused on group treatments.

through the form of caring and creative

gnificantly in length and content from

self-disclosure (McCown et al., 2010). Ad-

traditional teaching approaches.

Understanding the teacher training of

ditionally, through their personal practi-

Rumi (2004) described the necessary

mindfulness requires a clear compre-

ce, they learn to embody the methods and

Most traditional training models operate

slow-cooking process of the chickpeai

hension of mindfulness, whose intricate

teachings of mindfulness, which is known

as a top-down learning process, building

and, as a metaphor of teacher cultivati-

nature is multi-dimensional (Shapiro &

as a vital skill in both teachers and the-

on theoretical knowledge that eventu-

on, it raises an important question for

Carlson, 2009) and can be experienced as

rapists (Kabat-Zinn, 1990; Van Aalderen

ally transfers into practice. A review of

our community. Mindfulness, as a con-

a concept, as a psychological processes,

et al., 2012). Other specific skills that are

the literature on mindfulness training

templative, spiritually-rooted approach

and as a set of practices or skills (Ger-

necessary are the ability to guide group

by Baer (2003) highlighted the impor-

to relieving distress, requires a training

mer, 2013). This complexity of elaborating

processes (stewardship of the group), de-

tant differences between training from a

model that provides the time and space

a concise conceptual definition with the

liver didactic material, conduct formal

mindfulness perspective versus training

for growth, but with the claims on effi-

potential for multiple operational defi-

and informal practice, and perform direct

from more contemporary approaches,

cacy comes a desire to implement effici-

nitions, in turn, carries implications for

inquiry into the participants experience

such

ent training in order to meet the call for

the teacher training process because the

(McCown et al., 2010). A complex skill to

(CBT). The differences include: adopting

more mindfulness treatments. Does this

definition will shape what is being deve-

acquire, the inquiry process holds most of

a non-striving or non-goal-oriented atti-

place the slow-cooking style of therapist

loped in the training of mindfulness te-

the transformative power for participants

tude in therapy; this diverges from con-

development at risk or, in the face of de-

achers.

(McCown et al., 2010, p. 127). Finally, ano-

temporary approaches, which are based

Pollack, Pedulla & Siegel, 2014).

as

cognitive-behavioral

therapy

ther mode of learning in the development

on goals-clarification and goal-setting.

model? This article describes what is ex-

At the same time, the mindfulness

of essential skills is by teaching, often re-

Teaching mindfulness also demands that

pected of aspiring mindfulness teachers,

teachers skills must reflect mindfulness

ferred to as the co-creation of mindful-

one adopts, and models, an accepting

contemporary training models, and the

in its wholeness: from the conceptual

ness.

and non-judging attitude towards clients

implications for the mindfulness training

understanding, to the art of teaching it.

community given the increasing demand

This skill-set is acquired through diffe-

Consequently, the sought-after skills in

nal CBT method of labeling thoughts and

for psychotherapeutic mindfulness. It is

rent modes of learning and through an

mindfulness teachers differ significant-

deliberately changing them. Additionally,

important to note that the dominant mo-

extensive process (Crane et al., 2012a): in

ly from other therapeutic models. What

one of the most prominent differences

mand, will pressure-cooking become our

248 | Extra Special Issue: Mindfulness and Psychotherapy

thoughts, which differ from the traditio-

EAP | International Journal of Psychotherapy | 249

Jessie Bosse, Brittany Glynn & Lynette Monteiro -

Issues in the Training of Teachers


in Mindfulness-based Interventions

between mindfulness and contempora-

2014; CMRP, 2015; IMP, 2014). Attending

facilitate didactic learning, like weekly

ry CBT therapists is the necessity for

silent meditation retreats is also integral

classes, designated readings, discussions,

professionals teaching mindfulness to

to experiential learning, with a gradual

presentations, and residential retreats

engage in personal, regular practice. In

progression from two to three-day retre-

(IMP, 2014). Practitioners may also faci-

other words, mindfulness teachers are

ats to longer ones (i.e., five days or more)

litate didactic skill acquisition on their

expected to practice what they preach.

during and after the training process

own time, outside of the intensive trai-

(CFM San Diego, 2015; CFM UMass, 2014;

ning courses, such as attending relevant

Training Models

CMRP, 2015). Training programs also re-

skills workshops best suited to their clini-

Current models in teacher training pro-

quire participants to regularly implement

cal work and healthcare practices (CMRP,

grams offer various training pathways to

body-centered practices, such as yoga or

2015; Pollack et al., 2014).

develop the skills and competencies for

Tai Chi. From this base of a strong personal

delivering mindfulness-based programs.

practice, practitioners participate either

Group processes and mentor supervi-

In addition to establishing strong clini-

in a mindfulness-based intervention (MBI)

sion are also essential to the intensive

cal skills prior to mindfulness training,

program as a participant-observer, or an

teacher training programs (Evans et al.,

health care professionals enrolled in trai-

intensive week-long program. The Insti-

2014). Learning to attend to the group dy-

ning programs are expected to engage

tute of Meditation and Psychotherapy in-

namics and working with a variety of cli-

in intensive training in order to cultivate

tegrates meditation practices and on-line

nical experiences within a group setting

their personal practices. A summation

group learning and discussions over the

may be developed through experiential

of these components, via international-

course of nine months (IMP, 2014).

practices during residential retreats (CFM

San Diego, 2015; CFM UMass, 2014; CMRP,

ly recognized training models from the


Center for Mindfulness, Worcester, MA

Didactic learning develops concurrently

2015; IMP, 2014), as well as group practi-

- UMass; the Center for Mindfulness in

with experiential learning in such mind-

cums (CFM UMass, 2014) and small group

San Diego; the Institute of Meditation

fulness teacher training programs. In the

consultations

and Psychotherapy in Boston; and Ban-

CFM UMass program, comprehension of

among teacher trainers and leading ex-

gor Universitys Centre for Mindfulness

the didactic material occurs during an

perts (IMP, 2014). As mindfulness practiti-

Research and Practice is outlined below.

eight-week

Stress

oners progress through the training pro-

Mindfulness-based

and

group

discussions

Reduction (MBSR) practicum, or nine-day

tocols and reach a basic level of training,

Experiential learning is fundamental in

intensive practicum, where participants

so as to be able to teach MBI courses

teacher training for mindfulness-based

develop an understanding of the theory

(CFM San Diego, 2015), guidance and su-

programs. Practitioners are expected to

and practice of MBSR and deliver semi-

pervision from a mentor (i.e., lead senior

have an on-going daily practice, including

nars on topics relevant to the curriculum

teacher and expert) follows. Length of su-

formal and informal meditation, prior to

(CFM UMass, 2014). The Institute of Me-

pervision depends on the specific training

applying for teacher training and certifi-

ditation and Psychotherapy (IMP) incor-

models, such as a minimum of eight to 10

cation (CFM San Diego. 2015; CFM UMass,

porates numerous modes of training to

supervisor meetings (CFM UMass, 2014);

250 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 251

Jessie Bosse, Brittany Glynn & Lynette Monteiro -

Issues in the Training of Teachers


in Mindfulness-based Interventions

10 hours of mentorship (CFM San Diego,

ring the training programs calls for tho-

ding: 1. Coverage, pacing, and organiza-

outside of therapy, and then in their cli-

2015); 120 hours of faculty contact (IMP,

rough training procedures. For example,

tion of curriculum; 2. Relational skills; 3.

nical work with clients. After the 8-week

2014); and assessing teacher competency

practitioners enrolled in the Center for

Embodiment of mindfulness; 4. Guiding

intensive training program, therapists

via video/audio recordings during eight-

Mindfulness UMass program all partici-

mindfulness practices; 5. Conveying course

reported: feeling increased present mo-

week MBSR programs (CFM San Diego,

pate in an eight-day residential Teacher

themes through interactive inquiry and di-

ment awareness in session; a greater abi-

2015; CMRP, 2015). Furthermore, supervi-

Development Intensive (TDI) training,

dactic teaching; and 6. Holding group lear-

lity to meet clients where they are; and an

sion from a mentor during their training

focusing on sustained inner work in the

ning environment, (Crane et al., 2012b, p.

increased capacity to let go of expected

process facilitates their on-going learning

context of a rigorous teaching laboratory

3). Participating in such aforementioned

treatment outcome and treatment suc-

and skill development. For example, prac-

(CFM UMass, 2014). Expectations rise to

training protocols that include experi-

cess. Clinicians also reported being able

titioners may engage in a Post Super-

attend multiple meditation retreats for

ential and didactic learning, group pro-

to recognize their own limits in helping

vision Reflection and Assessment with

longer durations (CFM San Diego, 2015;

cesses, mentor supervision, and an inten-

others, and observed a shift, from fee-

a senior MBSR teacher for feedback and

CFM UMass, 2014; CMRP, 2015; IMP, 2014),

sive immersion process sets the intention

ling rushed to fix clients, to letting go

guidance in order to continue with on-

in addition to facilitating more MBSR

to develop necessary skills and knowledge

and bearing witness to suffering. Hence,

going training, retreats or teaching clas-

courses (i.e., five additional courses post-

for healthcare professionals to effectively

therapists showed a greater acceptance

ses (CFM UMass, 2014), or to develop te-

qualification status) to achieve full certifi-

deliver

programs.

of clients difficulties and were less judg-

aching portfolios throughout the duration

cation (CFM San Diego, 2015).

These intense protocols demand a degree

mental. Clinicians in their work also em-

of long-term dedication from aspiring te-

bodied essential relational qualities, such

Furthermore, deep self-reflection may

achers and the clinicians growth, and the

as listening skills, openness, tolerance for

Engaging in an intensive immersion

occur through ones reflective writings

quality of therapy is expected to reflect

silence, and patience. They also reported

processes so as to understand, concep-

and personal self-assessment. For in-

the impact of such training.

feeling more empathy and compassion,

tualize, and facilitate mindfulness-based

stance, participants in Bangor Universitys

courses is essential to the efficacy of

Centre for Mindfulness Research and

such teacher training intensive programs.


Achieving competencies, beyond the ba-

of their training program (CMRP, 2015).

mindfulness-based

both for themselves and their clients.


Therapists also reported an enhanced

Practice training program immerse them-

Research on training
mindfulness

selves in rigorous self-assessment in rela-

Current research on the process of trai-

clients stories, accompanied by a non-

sic levels of training, consists of embody-

tion to good teaching practices within an

ning competent mindfulness teachers

striving stance and attitudes reflecting

ing the practice of mindfulness through

ethical framework, (CMRP, 2015; UK Mind-

indicated significant changes in the cli-

their mindfulness practice. These changes

intensive training protocols, while also

fulness-Based Teacher Training Network,

nicians personal state of mind, and some

suggest that the training to be a mindful-

integrating the practices into the prac-

2011). The CMRPs Teaching Training Pa-

changes in the facets of mindfulness

ness teacher shifts the therapists way of

titioners everyday lives. Delving deeper

thway (TTP) encourages self-assessment

skills. A recent study showed an 8-week

being that transfers from their perso-

into skill acquisition and knowledge com-

via the Mindfulness-Based Interventions

intensive mindfulness training program

nal lives to their clinical practice. It also

prehension requires profound practice,

Teaching Assessment Criteria (MBI-TAC)

for therapists contributed to foundatio-

reveals that deeper attitudinal changes

self-reflection, and attuning to the needs

(Crane et al., 2012b). Practitioners use the

nal mindfulness skills, attitudes and rela-

can start to take place within a relatively

of clinical populations with great care and

MBI-TAC as a reflective tool assessing six

tional qualities (Lee, 2013) that were first

short time, although sustaining the mind-

transparency. Fostering these skills du-

different domains of competency, inclu-

observed in therapists personal lives,

fulness skills may be a different issue.

252 | Extra Special Issue: Mindfulness and Psychotherapy

curiosity and openness towards their

EAP | International Journal of Psychotherapy | 253

Jessie Bosse, Brittany Glynn & Lynette Monteiro -

Issues in the Training of Teachers


in Mindfulness-based Interventions

A team of Australian researchers deve-

Davis and Hayes (2011) reviewed the li-

specialists on the subject of mindfulness

thod that they wish to teach, or use with

loped a brief, standardized mindfulness-

terature on the benefits of mindfulness

are of interest. Researchers recruited

clients, prior to doing so. The consulted

training program to teach mindfulness

practice in both therapists and trainees;

experts in the field of mindfulness and

panel likewise firmly supported the ne-

knowledge, skills and attitudes to mental-

they support the idea that mindfulness

surveyed their opinions as to what spe-

cessity of engaging in mindfulness-rela-

health professionals (Aggs & Bambling,

training improves ones clinical practi-

cific competencies should be developed

ted processes in order to further develop

2010). The brief sessions (90 minutes)

ce in many respects. Reported benefits

in psychotherapists who wish to teach

teaching skills (Stauffer & Pehrsson, 2012).

occurred over an 8-week period. Partici-

include: greater empathy and self-com-

mindfulness as part of their clinical practi-

pants reported: feeling less stressed and

passion; decreased stress and anxiety;

ce (Stauffer & Pehrsson, 2012). Results in-

Engaging in a meta-cognitive examina-

less tense after undergoing the training

greater counseling skills; greater percei-

dicated that personal practice of mindful-

tion through the practice of mindfulness,

program; a greater ability to invoke mind-

ved self-efficacy in clinical work; greater

ness, prior to training others, is essential:

and being willing to do the internal work,

ful-states of consciousness both on de-

ability to distinguish clinicians internal

suggestions ranging from six months to a

are said to play an important role in the

mand and during therapy; higher levels

processes from the clients; and increased

year of prior practice. Keeping an active

development of the mindfulness teachers

of acceptance; and less judgment towards

patience and gratitude, as well as increa-

daily practice was also labeled as cru-

skills. In other words, one needs to be

their own private experience, as well as

sed body awareness. In developing more

cial. Moreover, they agreed that specific

willing to engage in an internal explora-

that of their clients. They also reported

capacity for empathy, one of the revie-

skills should be developed if one wishes

tion process, before doing any explorati-

less reactivity in session, when compared

wed studies showed increased empathy

to actively teach mindfulness. These are:

on with clients. Although not exclusive to

to pre-training, which translated into an

in counselors after participating only in a

the ability to integrate or incorporate

the teaching of mindfulness in a clinical

increased ability to let go of difficult emo-

four-week Zen meditation training (Lesh,

mindfulness methods and practices in

setting, mindfulness experts are adamant

tions, or thoughts as they surfaced during

1970; as cited in Davis & Hayes, 2011), sug-

everyday life; and the ability to distin-

about the importance of seeking continu-

therapy sessions. Results however did not

gesting that some skills can be acquired

guish mindfulness-related psychological

ing education opportunities, and keeping

yield significant improvement in other

rather quickly. Reviewed studies also

processes from other clinically relevant

up-to-date with the topic and practi-

core mindfulness skills: such as atten-

suggested the presence of a relationship

psychological processes (i.e. psychotic

ces of mindfulness (Stauffer & Pehrsson,

tion regulation; focused attention on cli-

between greater mindfulness and greater

features, dissociation, etc.). Specialists

2012). While the surveyed opinions do

ents; or maintaining awareness of their

perspective-taking (a dimension of empa-

also endorse that it is essential that the-

not necessarily aim for a different or a

own internal states during therapy. These

thy) (Davis & Hayes, 2011). Interestingly,

rapists: know about the diverse types of

new set of competencies, they comprise

results suggest that the development of

the relationship between these two has

mindfulness practices available; know

a continuation of what is typically asked

mindfulness-related attitudes and skills,

been shown to be fully mediated by self-

how to apply or carry-out such mindful-

of any mental health practitioner with an

such as attention regulation, may be inde-

compassion. Such results show the inter-

ness practices; and recognize when to use

added dimension of a personal commit-

pendent constructs, requiring different

connectedness and multi-layered process

them. More precisely, it is critical that the-

ment to embody the skills.

training periods in order to properly de-

of training in mindfulness skills.

rapists know how to apply various mindfulness practices, to specific clientele,

Taken altogether, the positive and broad

be needed in order to develop the latter

Significant to cultivating strong te-

and specific disorders, without harming

impact of incorporating intensive mind-

and may suggest different training trajec-

achers, the commonly-held ideas and

them. Finally, therapists should have per-

fulness training into therapists educa-

tories for clinical versus mindfulness skills.

thoughts on the training process amongst

sonally practiced every mindfulness me-

tion, whether for personal outcomes, for

velop. More precisely, a longer period may

254 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 255

Jessie Bosse, Brittany Glynn & Lynette Monteiro -

Issues in the Training of Teachers


in Mindfulness-based Interventions

(as a spiritually-oriented modality) calls

must remain major considerations. Final-

Brittany Glynn, MA

for clinical oversight in how therapist and

ly, mindfulness teacher training institutes

is a Ph.D. Candidate at the University of

client articulate common or conflicting

are also faced with the necessity for so-

Ottawa in the School of Human Kinetics.

values. An adjunct to this last point is the

lid mentoring and supervision (Evans et

She is a Certified M4 Teacher at the

reality that contemplative processes re-

al., 2014), which in turn means a need for

Ottawa Mindfulness Clinic where she

quire a lifetime to cultivate and develop,

highly experienced teachers to retain on-

a non-negotiable aspect of training with

going roles of supervisors and mentors.

significant implications for short, inten-

This perhaps points to the most impor-

therapeutic and client-related benefits,

sive training models. These issues form a

tant agenda for the community, culti-

or for assuring competence, are com-

considerable challenge in designing ap-

vating the next generation of wise te-

plex to administer. Although results from

propriate training protocols and holding

achers (or cooks) to take on the mantel of

many studies suggest that the develop-

that space with integrity.

nurturing new aspiring teachers.

Balancing

the

growing

demand

for

programs, and longer periods of training,

skilled teachers with the time required to

combined with sustained practice, are es-

cultivate mindfulness in teachers will re-

sential for teachers to fully bloom.

quire careful oversight. First, mindfulness


training will have to be careful to not be-

Conclusion

come trapped in a version of Rosenzweigs

The process of training mindfulness te-

(1936) Dodo-Bird verdict; in this case,

achers operates at a different level from

that all aspiring teachers given equal

traditional training in psychotherapeutic

cooking time can cultivate the necessa-

skills; it is a bottom-up approach to lear-

ry skills. The process of screening in and

ning, rather than the top-down approach

out is necessary, though it may seem anti-

of other modalities, such as traditional

thetical to the inclusive spirit of mindful-

CBT. Experience and personal practice


of mindfulness are the building blocks

sed stress and symptom management


courses. She is also a Trained Teacher
in Mindful Self-Compassion (MSC) and
teaches eight-week MSC courses.
E-mail: bglyn066@uottawa.ca

Lynette Monteiro, Ph.D.

ment of acceptable mindfulness skills can


be accomplished within most intensive

co-teaches eight-week Mindfulness-Ba-

is a registered psychologist and Director

International Journal of Psychotherapy:


2016, Vol. 20, Extra Special e-Issue,
pp. 245-259: ISSN: 1356-9082
Author and European Association of
Psychotherapy (IJP): Reprints and
permissions: www.ijp.org.uk
Submitted Sept. 2015; peer-reviewed
twice and reformatted, Nov. 2015;
resubmitted and accepted, April 2016.

of Training at the Ottawa Mindfulness


Clinic, Ottawa Canada. She completed
an MA on neuro-behavioural correlates
of human communication disorders and
a PhD investigating medical treatment
of ADHD in pre-school-aged children.
She is trained in Cognitive Therapy for
veterans and active military personnel,
mindfulness-based treatments and

Jessie Bosse

Buddhist chaplaincy. Dr. Monteiro co-

is a PsyD Candidate at the Universit

developed the Mindfulness-based

du Qubec en Outaouais (UQO) and an

Symptom Management (M4) program,

Intern at the Cyber-psychology Lab of

an ethics-based mindfulness interven-

ness practice. Secondly, training facilities

UQO. She uses mindfulness in her cli-

tion for psychological distress, pain

commit attention to the personal growth

nical work with clients battling anxiety

management, and burnout resilience.

of knowledge; comprehension, wisdom

of aspiring teachers, balanced by a resi-

and mood disorders. She teaches mind-

She developed the M4 Teacher Training

and insight emerge from the aspiring

stance to increasing demands. Despite

fulness in an academic context at the

Path for healthcare professionals, is a

teachers practice. Although some of the

the temptation to opt for a fast-cooking

UQO as a Sessional Lecturer. She also

Clinical Professor at the University of

knowledge is acquired through didactic

process, concerns for the integrity of

received her M4 Teacher Certification

Ottawa, and co-author of Mindfulness

methods, more substantial learning hap-

mindfulness, as a valuable treatment and

from the Ottawa Mindfulness Clinic and

Starts Here, articles, and chapters on in-

co-facilitates Mindfulness-Based stress

pens through personal encounters with

a sense of ethical responsibility for the

tegrating Buddhist teachings, specifically

and symptom management courses.

ethics, into mindfulness interventions.

mindfulness. Moreover, the mindfulness

often-vulnerable populations it serves,

E-mail: bossje01@uqo.ca

E-mail: lynette.monteiro@gmail.com

256 | Extra Special Issue: Mindfulness and Psychotherapy

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Jessie Bosse, Brittany Glynn & Lynette Monteiro -

Issues in the Training of Teachers


in Mindfulness-based Interventions

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258 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 259

PROFESSIONAL ISSUES & ADVERTS


-

Jessie Bosse, Brittany Glynn & Lynette Monteiro -

endnotes
1

A Chickpea to the Cook: A chickpea leaps almost over the rim of the pot where its
being boiled. Why are you doing this to me? The cook knocks him down with the
ladle. Dont you try to jump out. You think Im torturing you. Im giving you flavor, so
you can mix with spices and rice and be the lovely vitality of a human being. Remember when you drank rain in the garden. That was for this.

Grace first. Sexual pleasure, then a boiling new life begins, and the Friend has something good to eat. Eventually the chickpea will say to the cook, Boil me some more.
Hit me with the skimming spoon. I cant do this by myself. Im like an elephant that
dreams of gardens back in Hindustan and doesnt pay attention to his driver. Youre
my cook, my driver, my way into existence. I love your cooking.
The cook says, I was once like you, fresh from the ground. Then I boiled in time, and
boiled in the body, two fierce boilings. My animal soul grew powerful. I controlled it
with practices, and boiled some more, and boiled once beyond that, and became your
teacher. Rumi.

260 | Extra Special Issue: Mindfulness and Psychotherapy

advertisement

International Journal of PSYCHOTHERAPY -

addenda -

Other Internet Articles


all of these are available as PDF downloads

Daphne M. Davis & Jeffrey A. Hayes (2001). What Are the Benefits of

Susan Pollak, Tom Pedulla & Ronald Siegel (2014). Bringing Mindfulness into

Mindfulness? A Practice Review of Psychotherapy-Related Research.

Psychotherapy. In: S. Pollak, T. Pedulla & R. Siegel, Sitting Together: Essential

Psychotherapy, Vol. 48, No. 2, pp. 198-208. Accessed 26-Mar 2016:

Skills for Mindfulness-Based Psychotherapy, (Cpt 1: pp. 1-23). New York: Guilford.

www.apa.org/pubs/journals/features/pst-48-2-198.pdf

Accessed 26-Mar, 2016: www.mindfulness-solution.com/Handouts/Chapter%201%20-%20Bringing%20Mindfulness%20into%20Psychotherapy%20

Ronald D. Siegel, Christopher K. Germer & Andrew Olendzki (2008).

-%20Please%20Do%20Not%20Copy%20Without%20Permission.pdf

Mindfulness: What is it? Where does it come from? In: F. Didonna (Ed.),
Clinical Handbook of Mindfulness. New York: Springer. Accessed 26-Mar 2016:

www.mindfulselfcompassion.org/articles/nicamb_mindfulness.pdf

Willem Kuyken, Rebecca Crane & Mark Williams (2012).


Mindfulness-Based Cognitive Therapy (MBCT) Implementation Resources.
Exeter, Bangor & Oxford Universities. Accessed 26-Mar 2016:

Gregory J. Johanson (2006). The Use of Mindfulness in Psychotherapy.

mindfulnessteachersuk.org.uk/pdf/MBCTImplementationResources.pdf

Hakomi Institute Forum, No 16-17, pp. 23-34.Accessed 26-Mar 2016:


www.hakomiinstitute.com/Forum/Issue16-17/3_SurveyMindfulness.pdf

John C. Williams & Lidia Zylowska (2009). Mindfulness Bibliography. Mindful


Awareness Research Center, UCLA Semel Institute. Accessed 26-Mar, 2016:

Noah G. Bruce, Rachel Manber, Shauna L. Shapiro & Michael J. Constantino

marc.ucla.edu/workfiles/pdfs/marc_mindfulness_biblio_0609.pdf

(2010). Psychotherapist Mindfulness and the Psychotherapy Process.


Psychotherapy Theory, research Practice, Training, Vol. 47, No. 1, pp. 83-97.

Halko Weiss (2009). The Use of Mindfulness in Psychodynamic &

Accessed 26-Mar 2016: www.psicoterapiabilbao.es/wp-content/up-

Body Oriented Psychotherapy. Body, Movement and Dance in Psychotherapy,

loads/2015/12/mindfullness_and_psychotherapy.pdf

Vol. 4, No. 1, pp. 5-16. Accessed 26-Mar 2016:


www.hakomiinstitute.com/Forum/Issue22/04ArtMindfulness.pdf

Christopher K. Germer (2013). Mindfulness: What is it? What does it matter.


In: C.K. Germer, R.D. Siegel & P.R. Fulton (Eds.), Mindfulness and Psychotherapy
(2nd Ed.), (Cpt 1: pp. 3-35). New York: Guilford Press. Accessed 26-Mar, 2016:
www.guilford.com/excerpts/germer.pdf

Flavia Cigolla & Dora Brown (2011). A Way of Being: Bringing Mindfulness into
Individual Therapy. Accessed 26-Mar 2016:

Linked-In

Scoop.it!

There is also a Linked-In

another website also has a

discussion group entitled:

section on Mindfulness and

Mindfulness and Psychotherapy,

Psychotherapy with lots of

with nearly 39,000 members.

different posts by various people,

www.mais-psi.com/sites/default/files/publications/A%20way%20of%20

taking one further and further into

being%20Bringing%20mindfulness%20into%20individual%20therapy.pdf

this particular topic.

262 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 263

EAP special JOURNAL : Mindfulness and Psychotherapy -

books on Mindfulness and Psychotherapy -

BOOKS of
FURTHER INTEREST
about MINDFULNESS & PSYCHOTHERAPY

This is just a collection of various books on


Mindfulness and Psychotherapy, collated from
a quick search by the Editor from amazon.co.uk

Self-Compassion in Psychotherapy:
Mindfulness-Based Practices for
Healing & Transformation

Tim Desmond: with a forward by Richard J. Davidson

Mindfulness and Psychotherapy

W.W. Norton & Co. (2015)

Christopher K. Germer, Ronald D. Siegal & Paul R. Fulton (Eds.)

Hardcover: 256 pages, ISBN: 978-0393711004

Guilford Press; 2nd Ed. (2013)


Hardcover: 382 pages, ISBN: 978-1462511372

This lucidly written guide integrates cutting-edge


neuroscience with mindfulness and traditional Bud-

This practical book has given tens of thousands of clini-

dhist practices to show mental health professionals

cians and students a comprehensive introduction

how they can help clients develop a more loving, kind

to mindfulness and its clinical applications. The book

and forgiving attitude toward themselves. Researchers

describes the philosophical underpinnings of mind-

now understand that self-compassion is a skill that can

fulness and reviews the growing body of treatment

be strengthened through deliberate practice, and that

studies and neuroscientific research. Leading practiti-

it is one of the strongest predictors of mental health and wellness. The

oners in the field present clear-cut procedures for im-

brains compassion center, which neuroscientists call the Care Circuit,

plementing mindfulness techniques and teaching them

can be targeted and fortified using specific techniques. Filled with illumi-

to patients experiencing depression, anxiety, chronic

nating case examples, Self-Compassion in Psychotherapy shows readers

pain, and other problems. Also addressed are ways that mindfulness prac-

how to apply self-compassion practices to treat depression, anxiety, trau-

tices can increase acceptance and empathy in the therapeutic relation-

ma, addiction, relationship problems, self-sabotage, and more. Readers do

ship. User-friendly features include illustrative case examples and practice

not need to have any background in mindfulness in order to benefit from

exercises. New to This Edition: * Incorporates significant empirical

this book. However, those that do will find that self-compassion practices

advances - mindfulness has become one of the most-researched areas in

have the capacity to add new layers of depth to mindfulness-based the-

psychotherapy; * Most chapters extensively revised or rewritten; * Chap-

rapies such as Dialectical Behavior Therapy (DBT), Acceptance and Com-

ters on practical ethics, trauma, and addictions; * Greater emphasis on

mitment Therapy (ACT), Mindfulness-Based Stress Reduction (MBSR), and

the role of acceptance and compassion in mindfulness.

Mindfulness-Based Cognitive Therapy (MBCT).

264 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 265

EAP special JOURNAL : Mindfulness and Psychotherapy -

Sitting Together: Essential Skills

books on Mindfulness and Psychotherapy -

trauma, substance abuse, suicidal behavior, couple conflict, and parenting

for Mindfulness-Based Psychotherapy

stress. Seamlessly edited, the book features numerous practical exercises

Susan M. Pollak, Thomas Pedulla & Donald D. Siegel

and rich clinical examples. It examines whether wisdom and compassion

Guilford Press (2014)

can be measured objectively, what they look like in the therapy relation-

Hardcover: 240 pages, ISBN: 978-1462513987

ship, their role in therapeutic change, and how to integrate them into
treatment planning and goal setting. The book includes a foreword by His

This practical guide helps therapists from virtually any

Holiness the Dalai Lama.

specialty or theoretical orientation choose and adapt


mindfulness practices most likely to be effective with

Mindfulness Meditation in Psychotherapy:

particular patients, while avoiding those that are contra-

An integrated model for clinicians

indicated. The authors provide a wide range of medi-

Steven A. Alper

tations that build the core skills of focused attention,

New Harbinger (2016)

mindfulness, and compassionate acceptance. Vivid clini-

Paperback: 224 pages, ISBN: 978-1626252752

cal examples show how to weave the practices into therapy, tailor them to
each patients needs, and overcome obstacles. Therapists also learn how

If youre a psychotherapist interested in implementing

developing their own mindfulness practice can enhance therapeutic rela-

mindfulness practices into your therapy sessions, The

tionships and personal well-being. The Appendix offers recommendations

Essential Guide to Mindfulness Meditation in Psycho-

for working with specific clinical problems. Free audio downloads (nar-

therapy is a comprehensive manual to get you started.

rated by the authors) and accompanying patient handouts for selected

In this book, psychotherapist Steven Alper presents

meditations from the book are available at: www.sittingtogether.com.

the mindfulness pyramid model: a multi-dimensional


and graphic model for implementing mindfulness in

Wisdom and Compassion in Psychotherapy:

psychotherapy. This practical guide will help demystify mindfulness

Deepening Mindfulness in Clinical Practice

meditation; elaborate on the psychotherapeutic benefits of practices such

Christopher K. Germer & Ronald D. Siegal (Eds.), with a

as body scan, breath awareness, sitting meditation, and loving kindness;

forward by His Holiness the Dalai Lama

and offer helpful strategies for teaching formal and informal mindfulness

Guilford Press; 1st Edition (2014)

skills to clients. This book conceptualizes and explores the applicability of

Paperback: 407 pages, ISBN: 978-1462518869

his mindfulness pyramid model, and delves into the many ways in which
mindfulness can manifest and be incorporated in psychotherapy. This is a

Bringing together leading scholars, scientists, and clini-

must-have resource for any therapist.

cians, this compelling volume explores how therapists


can cultivate wisdom and compassion in themselves and
their clients. Chapters describe how combining insights
from ancient contemplative practices and modern research can enhance the treatment of anxiety, depression,

266 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 267

EAP special JOURNAL : Mindfulness and Psychotherapy -

books on Mindfulness and Psychotherapy -

Hakomi Mindfulness-Centered Somatic

Mindfulness Skills Workbook:

Psychotherapy: A comprehensive guide to

for Clinicians and Clients

theory & practice.

Debra Burdick

Halko Weiss, Greg Johanson & Lorena Monda (Eds.)

PESI Publishing & Media (2013)

W.W. Norton & Company (2015)

Paperback: 230 pages, ISBN: 978-1936128457

Paperback: 432 pages, ISBN: 978-0393710724

Like no other resource, Mindfulness Skills Workbook


Hakomi is an integrative method that combines Western

combines the latest research and best practices -- all in

psychology and body-centered techniques with mind-

a simple guide to successfully teach mindfulness to your

fulness principles from Eastern psychology. This book,

clients.This comprehensive workbook provides the the-

written and edited by members of the Hakomi Institute

ory behind each tool, a step-by-step process to imple-

- the worlds leading training programme for Hakomi

ment, and expert guidance on processing client results.

practitioners - provides all the processes and practices that therapists

It features: * Experiential exercises you can integrate into practice; *

need in order to use this method with clients.

Highly effective collection of mindfulness tools; * Special section to guide


understanding of neurobiology behind mindfulness; * Dozens of repro-

Mindfulness and Psychotherapy:

Working with anger and nourishing


inner peace each and every day

especially for psychotherapists

ducible activities, exercises, techniques and tools; * New meditations; *


Steps for increasing client use at home; * Basic through advanced mindfulness skills; * Skills for specific disorders; * Journal prompts; * Unique
templates to monitor progress

Thich Nhat Hahn


Sounds True (1999)

Yoga and Psychotherapy:

Audiobook: 2 hours and 59 minutes

The Evolution of Consciousness

ASIN: B002SPZZKK

by Swami Rama, Rudolph Ballentine, Swami Ajaya

Before you can help others, Zen Master Thich Nhat Hanh

1st Edition edition (9 Nov. 1999)

teaches that you must first bring peace and a deep love

Paperback: 327 pages, ISBN: 978-0893890360

Himalayan Institute Press;

of life into your own consciousness. Mindfulness and


Psychotherapy was originally created for those in the helping professions,

For thousands of years yoga has offered what Western

but has proven profoundly helpful to anyone who wants to understand

therapists are seeking: a way to achieve the total

why we are at war with ourselves - and with one another - and how to

health of body, mind, emotions, and spirit. YOGA AND

mend our conflicts. In a special section on anger, Thich Nhat Hanh sets

PSYCHOTHERAPY provides a unique comparison of mo-

aside the classic debate about suppression versus expression to offer

dern therapy and traditional methods. Drawing upon a

a radically different way of working with anger that uses techniques of

rich diversity of experience, the authors give detailed

breathing and walking meditation.

examples of how the ancient findings of yoga can be

268 | Extra Special Issue: Mindfulness and Psychotherapy

EAP | International Journal of Psychotherapy | 269

EAP special JOURNAL : Mindfulness and Psychotherapy -

used to supplement or replace some of the less complete Western theories and techniques. YOGA AND PSYCHOTHERAPY is accessible to the
layperson, yet detailed enough to be of value to the professional.

Practical Yoga Psychology


Vivekananda Rishi
Yoga publication trust (1 Nov. 2005)
Paperback: 307 pages
ISBN: 978-8186336397

The great mysteries in our lives are the understanding of


our personality,how we relate with other people and the
world around us,and our place,if any,in the vast scheme
of things.The other question we face is how we can improve our personal experience and our interactions with
society,so that we live a happy harmonious and helpful
life.For thousands of years yoga has been addressing
these questions and supplying the answers to them.
Practical Yoga Psychology is an attempt to simply blend the teachings of
yoga with those of pschology,psychiatry and other branches of western
science to give us an overview of the human personality,an idea of where
we are going and guidelines to proceed on our journey. A worthy companion to the many other classics brought out by Bihar School of Yoga and
Yoga Publications trust,Bihar.

270 | Extra Special Issue: Mindfulness and Psychotherapy

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Information and Guidelines for Authors -

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Guidelines for Authors

he International Journal of Psychotherapy welcomes original

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FAIRBAIRN, W.R.D. (1941). A revised psychopathology of the psychoses and


neuro-psychoses. International Journal of Psychoanalysis, Vol. 22, pp. 250-279.

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GROSTEIN, J. (1981). Splitting and projective identification.


New Jersey: Jason Aronson.

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RYLE, A. & COWMEADOW, P. (1992). Cognitive-analytic Therapy (CAT).

Long articles, which should not exceed 5000 words; or

In: W. DRYDEN (Ed.) Integrative and Eclectic Therapy: a Handbook,

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Copyright 2016, European Association of Psychotherapy

ISSN 1356-9082

internationa l J o u rna l o f

Psychotherapy

Volume 20, Extra Special Issue, July 2016

Editorial | Courtenay Young


Guest Editorial | David Brazier
The Phenomenology of Mindfulness | Emmy van Deurzen & Digby Tantam
Mindfulness Training for Psychotherapists and its Benefits in
Improving the Effectiveness of Psychotherapy | Elas Capriles
The development of a relational and dialogical ethics
in therapeutic mindfulness | Mats Hilte
How can mindfulness be relevant or useful to the psychotherapist
and how should a practitioner use mindfulness
to their best advantage? | Francoise Guillot
Developmental Trauma from a Buddhist and Relational Inter-subjective
Perspective | Sebastian Medeiros & Simon Guendelman
Side Effects: A case illustration from a Mindfulness Based
Existential Therapy (MBET) perspective | Jyoti Nanda
The Mindful Bridge Back To Work | Frank Musten
Mindfulness, Equanimity and Cognitive Flexibility | Mirjam Hartkamp
Beyond kusala and akusala? Mindfulness and Buddhist Ethics | Andr Van Der Braak
Buddhist Heartfulness: Beyond Western
Mindfulness | G.T. Maurits Kwee & Peter T. Van Den Berg
The Winner of the Race: The Dharma in the Digital Age | Manu Bazzano
Implicit Ethics and Mindfulness: Subtle assumptions
that MBIs are values-neutral | Lynette Monteiro
Developing a Mindful Moral Compass: Ethics for mindfulness trained practitioners |
Craig Mackie, Michele Chaban, Sarah Serbinski, Dekyi-Lee Oldershaw & Robert J. MacFadden

Slow and Fast Cooking of Rumis Chickpea: Issues in the Training of Teachers in
Mindfulness-based Interventions | Jessie Bosse, Brittany Glynn & Lynette Monteiro