As a contemplative therapist in training, like many other psychotherapists, my home base is a humanistic and strengths-based approach, which is a synthesis of many western and eastern approaches.
From western psychology and psychotherapy, it draws from humanistic psychology, Freud’s psychoanalytic theory, Jungian analytical theory, Rogerian person-centered therapy, and positive psychology. From the eastern traditions, contemplative psychotherapy draws from 2,400 years of contemplative practices, psychologies, and philosophies such as Buddhist psychology, meditation, and yoga.
While I find the empathic and person-centered contemplative approach incredibly helpful in creating a deep therapeutic bind between my clients and me, I believe it can go to greater lengths when coupled with much more active marriage and family therapy modalities.
Couples and family therapy is a huge umbrella for a myriad of theories and therapy modalities, some drawing from each other, and some improving upon each other. I am grateful to be able to use the many family therapy theories, assessments, and interventions I have been trained in, including but not limited to Bowenian family therapy, structural family therapy, strategic family therapy, emotionally focused couples and family therapy, narrative therapy, Gottman couples therapy and others (Sexton, Weeks, & Robbins, 2004). The theories I use complement each other by combining cognitive and emotional insight, taking action, and experiential relationship building. The contemplative approach allows the creation of a safe, supportive, and empathic environment. Clients learn to put their thoughts, emotions, and physical sensations into words, thus gaining deep insights and integrating their experience. In contemplative psychotherapy, the sharing and the clarity with a mindful and present therapist allow a sense of calm and relief for the clients and a renewed sense of trust in themselves and others. New ways of interactions and a deep emotional bond can occur with the contemplative therapist, which can be applied to any other relationship in the clients’ lives. Also, the strengths-based approach, together with the unconditional positive regard of contemplative psychotherapy, empowers the clients to view themselves more positively, believe in themselves, and feel encouraged to take more risks and step out of their comfort zone.
That being said, contemplative psychotherapy is a highly person-centered model, in which the client mostly leads the session, and the therapist is mainly providing empathic presence. The therapist is encouraged to let go of any agenda, not give any advice, and not be an obstacle between the client and healing. Even though research shows the therapeutic relationship plays an immense role in how helpful the clients feel the therapy was, this kind of unstructured model cannot help the client create change promptly. Also, the model is more suited to working with individuals than working with couples or families. Merely listening to a couple in distress or just replaying the same family quarrel in the therapy office will not cut it: There needs to be experiential work to experience and practice new ways of interaction to reduce conflict.
One might ask, how does the contemplative view, which encourages the therapist to let go of the agenda and take on a more passive role, work with the more active modalities of family therapy? The answer is that modalities from family therapy are by themselves strengths-based and very much humanistic, so that there is an overarching belief in human potential. The systemic view of focusing on the whole system, such as family and society, is very much in correlation with the Buddhist idea of interconnectedness from which the contemplative psychology theory draws. In both approaches, humans are connected much more than they think, and when one is affected, many more are affected. The systemic theory in family therapy and the Buddhist approach both seek the true meaning and life’s organizing force in our connection with others.
When I lean more towards the contemplative psychotherapy style, very much impacted by the Rogerian client-centered approach, I am not leading nor prompting. At the same time, many of the family therapy interventions I use are very much the opposite, very direct, and leading the clients towards the goals they identified at the beginning of our work together. However, I do not have to choose one approach or the other. Just like with jazz, since I know the rules very well, I can drop the rules entirely and just enjoy being in the moment, completely present, improvising, and letting the interventions choose themselves. There is tremendous freedom in not subscribing to a family therapist’s active role, or what looks to the outsider as the passive role of the contemplative psychotherapist; I can be both, depending on the client and the moment. Sometimes clients just want to vent and be heard. Sometimes they clearly want to create specific changes in their lives but do not know how. By combining contemplative psychotherapy with family therapy, I can be useful in doing both.
Combining these modalities, however, is both an art and a skill. I am always attentive to the clients’ needs, determining when I need to be merely warm and attentive, and when the clients are stuck in a loop, trapped in telling the same story repeatedly, or enacting the same, old unhelpful behaviors with their partners or family members in the office. Depending on the situation, I might step in and be more active-directive and probing, sometimes even challenging, deferring more towards family therapy’s active styles. For example, in emotionally focused couples therapy, after I gather all the information needed, many times I will be doing most of the talking, rephrasing, and integrating my client’s experiences, for the sake of both clients. In this way, they can both feel seen and heard by me, and start to feel safe, to go deeper into exploring their feelings. I will gradually begin incorporating more emotion related words to move from just sharing the content of the problems in the couple’s relationship towards exploring the emotional impact that the negative cycle has on them, and thereby, moving them towards a deep emotional bond. In doing so, I have a clear agenda: to facilitate the couple’s work towards a secure attachment.
This integrative theoretical model for conceptualization and treatment of individuals, couples, and families includes a cyclical flow between three components:
- assessment
- goal setting
- therapeutic work
The thread that binds these components together is the therapeutic relationship, which stems from the humanistic, person-centered, and holistic view, which is the center of contemplative psychotherapy. None of this work would be possible if the therapist were to fail to create a sense of safety, warmth, compassion, and unconditional positive regard. If the therapist does succeed in that, gradually, of course, there is then space for the therapeutic work to occur, and there is a buy-in on the client’s end to experiment with new interventions of family therapy modalities. In other words, contemplative psychotherapy provides the ground to indeed support clients in an empathic way, to experiment with new ways of being in the world, both in terms of more vulnerable sharing and taking further action in the world, in the office, and in everyday life. Thus, we use the therapeutic alliance for the sake of growth and healing. The paradox of change from Gestalt therapy (Yontef & Fuhr, 2005) comes into play: If the clients feel entirely accepted, there is a safe ground to experiment with change. The fear of failure is diminished, as well as the fear of success. If they know and feel that no matter what they do in the world they will be unconditionally accepted by me, they permit themselves to play. Just as the child who develops a secure attachment with a parent feels comfortable later in life as an adult to step outside the comfort zone because they did so successfully many times as a child. In the same way, supported by the accepting therapeutic relationship, clients can step out of their comfort zone and allow growth to manifest.
The contemplative practices and psychologies incorporated in the contemplative psychotherapy model are beneficial to support clients in intensive and lengthy therapeutic work. Mindfulness plays a big part in helping bring calm and presence even amid the most challenging moments; for example, when a client shares a trauma or when an argument between family members escalates. I remain grounded by practicing mindfulness, for example, focusing on my breath throughout the session and maintaining a daily meditation practice. In doing so, I am fully present for clients to support them without them worrying about needing to safeguard me from their problems. Additionally, almost all my clients start a meditation practice from the moment we begin work together. The benefits that a meditation practice brings are extensively supported by research (AsapSCIENCE, 2015; Kabat-Zinn, 2016). By helping my clients create a habit of meditating daily, we create another source of support available for free, every day. Self-care is then expanded from one weekly therapy session to a daily practice that promotes relaxation and prevents stress. In the longer term, meditation also brings powerful insights, and these can be further explored in therapy.
In contemplative psychotherapy, the Buddhist idea that everything is temporary, and one does not need to take things personally, is something I reflect on often during sessions. Doing so brings relief from the idea that things should always be perfect, or that when things are not going the way clients want, it is them against the world. The sense of constant struggle can be lifted, and acceptance, together with more courage to change things that clients want to change, can be accomplished.
Assessment includes getting as much information as possible about the people and family members in their lives, including their relationships. I refer to these people when appropriate as sources of support, especially when clients feel they have to do everything themselves, or are afraid to seek assistance from others. A therapy goal is to create a connection with clients and empower them to do likewise in their other relationships. I believe this is such an important goal, I spend most of the time in therapy doing experiential work, connecting in a more profound and vulnerable way.
I strive to ensure I fit the best model to the needs of my clients, from an ethical standpoint and while considering multicultural and diversity issues. For example, I am cautious with cultural appropriation. Even though Buddhist concepts are very close to my heart and are a central piece in contemplative psychotherapy, my office is not filled with statues of Buddha. Some clients might not feel comfortable with that, and I do not want to devalue cultural pieces of Buddhist countries where I did not grow up.
Finally, a critical point for me is to make sure I listen to the needs of my clients. If they need to create a specific change in their life, I will not indulge in a lengthy contemplative psychotherapy process of emotional exploration.
The benefits that a meditation practice brings are extensively supported by research.
Sasha Raskin, MA, is a Pre-Clinical Fellow of AAMFT, a psychotherapist and coach, working with individuals, couples and families in Boulder, CO. He’s a Doctor of Counseling Education and Supervision student at Argosy University, and an adjunct faculty at the Contemplative Counseling Master’s Program at Naropa University.
www.heartandmeaning.com
REFERENCES
AsapSCIENCE. (2015, January 18). The scientific power of meditation [Video File]. Retrieved from https://www.youtube.com/watch?v=Aw71zanwMnY
Kabat-Zinn, J. (2016). Coming to our senses: Healing ourselves and the world through mindfulness. New York: Hachette Books.
Sexton, T., Weeks, G. R., Robbins, M. S. (Eds.). (2004). Handbook of family therapy. Routledge.
Yontef, G. M., & Fuhr, R. (2005). Gestalt therapy theory of change. In A. L. Woldt & S. M. Toman (Eds.), Gestalt therapy: History, theory, and practice. Sage Publications.
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