Embracing Suffering and Joy: A Contemplative Approach in Therapy

1. Minding Our BusinessContemplative Practices for Meeting Suffering, Comfort and Joy in Our Most Wounded Christie Bates, MA Contemplative Therapist Spring 2016 EAP/MHP Conferences

2. “Mindfulness” of Trauma • This workshop is about learning to love and enjoy our work with our most complex clients while giving them some skills to love and enjoy themselves. You’ll see this means increasing our own mindfulness and self-compassion. • The root of the word mindfulness suggests “to guard, stay attentive, bear up in the face of change or chaos” • Our culture thinks therapy is about “getting past” trauma so that people can gain comfort and joy that is somewhere “out there” • People who survive chronic developmental trauma, especially, struggle be with/bear up under the suffering that comes with experiencing comfort and joy due to protective parts of personality that have learned good feelings aren’t safe • We, their helpers, often struggle to support them through their experiences of backdraft due to our self protective impatience with their self protectiveness. (as John Briere said, we often hold the unspoken attitude, “If you don’t have the common courtesy to improve in my presence you can get out!”) • It is this attitude - not clients - that burns out clinicians

3. Contemplative Practice • While reasonably connected with “mindfulness” in the parlance of most people, contemplative practice has more to do with this shift away from giving the message to clients (or ourselves) that “getting past” or “getting over” trauma is the goal. For us, “getting over” does not relieve suffering. • We are also not trying to make clients believe suffering is not suffering via spiritual bypass (the language of “lessons”). • Instead, we seek to open the blocked access to the power of the Authentic Self, Whose compassionate presence is spacious enough to hold the truth of pain & joy, while courageous enough to turn toward all of it with care. • Access to Authentic Self is cultivated thru regular practice of some sort – prayer, meditation, journaling, art – that allows us to face and befriend all parts of ourselves so that we recover unfettered access to Authentic Self • For the contemplative therapist, the transformative potential for healing in session (that goes beyond skills training for the client) is in the regular practice of the therapist whether or not you call yourself “contemplative.” • So let’s see what it looks like to view the world more “mindfully”

4. Meeting, Greeting, Letting Go (Activity) Response to stressful experience can be

5. Practicing Helpers • Singh, N., Lancioni, Winton, Singh, J., Singh, A., Adkins and Wahler (2010) performed additional analysis of a study in which training caregivers in mindfulness apparently improved the happiness ratings and compliance of their clients with profound disabilities. • Additional analysis indicated that similar benefits of helper meditation had also transferred to the children of the caregivers. There were fewer incidences of non-compliance, although the children were not themselves engaged in mindfulness training. • Singh et al theorized that mindfulness training led to a transformation in the caregivers that positively influenced their families/home lives, even though the training was offered in the context of work

6. Practicing Helpers • In Coatsworth, Duncan, Greenberg and Nix’s (2010) study, an experimental group of parents received training in a child management program that included intentional training in mindfulness. The control group of parents received training in child management skills alone. In this study, the mindful parenting program was shown to be equal to the control group in terms of producing more frequent use of positive parenting technique. • However, the mindful parenting program produced significantly higher scores in parent-youth relationship qualities. One factor in this appears to be that as mindfulness increases, parents may become less ego-centered in evaluating children’s displeasing behavior; so instead of viewing that behavior as an attempt to anger the parent, the parent becomes able to recognize when a child is trying to make a connection by any means possible (Coatsworth et al, 2010). • It maybe that a similar reduction in self-centeredness in helpers leads to improvement in patient/client care as helpers assess needs more accurately and respond more appropriately.

7. Contemplative Practice, a tall order • Contemplative theory says that problems grow from the refusal (or inability) to be present for the full range of life, including suffering. • Moreover, …“if the therapist is afraid to experience pain, there is no hope for progress” in the client or the therapist (Kaklauskas, Nimanheminda, Hoffman, & Jack, 2008). • Through the clear seeing made possible (via mindfulness of one’s own process) during sessions, and the modeling of attitude and behavior that the client can take with him/her out of sessions, the client enjoys (1) a reduction of the suffering caused by not facing reality and (2) an increase in tolerance for the necessary and temporary growing pains caused by facing reality (Kaklauskas, et. al., 2008). • Jack Kornfield: Honor System Parking • To meet this demanding work, we have to deal with our own self-protective parts that would have us avoid pain. Thus our own need for self-compassion

8. The Therapist as Experiencer “It’s an open secret, known to any halfway honest therapist, that our clients stir up in us as many unruly feelings, thoughts, prejudices, negative associations, and untoward impulses as we stir up in them. Not only are we as susceptible to the crosscurrents of contagious emotions typical of almost any human interaction as anybody else of our species, but we have certain vulnerabilities unique to our field. For one thing, we’re supposed to be perfect – in session at least – mature, selfless, perceptive, calm, lucid, kind, hopeful, and wise no matter how nasty, hostile, self-centered, unreasonable, childish, despairing, and uncooperative our clients are.” ~ Richard Schwartz, PhD selfleadership.org/the-larger-self.html

9. Mindfulness Training of Helpers documented in research has resulted in… • Lower stress level for helpers • Increased helper empathy and self-compassion • Increased satisfaction of helpees • Increased compliance of helpees • Increased job satisfaction for helpers • Decreased nonproductive counter-transference • Increased efficiency of exchange; defined as the therapist’s ability to sit with (experience) the client’s pain and allow the client to sit with (borrow) the therapist’s equanimity and hope as s/he develops his/her own tolerance for reality. (Kaklauskas, et. al., 2008)

10. Our Experience: Words from Ranch Staff Members • April C ~ I like to share with my group my first experience with meditation and what that looked like for me…Terrible!!! I was even more stressed out and angrier than when I went in…It was me being in my head and everywhere but in that room and what few minutes I did come back to present I was shaming myself because I can’t do this right. I have noticed since that day the more I did meditation the more present I became. It is a part of my life now. I love to be able to take 10-15 minutes to do something for me and have that be OK in my mind. • Priscilla S ~ Since we started meditation I can tell a BIG difference. I am calmer and more relaxed during work. I feel like I can solve issues easier and remain calm in stressful situations. • Karen M ~ I have noticed a difference in my anxiety since doing the meditation and am able to do breathing exercises throughout the day to help me if I start to feel anxiety. It helps me stay focused through the day. • April W ~ I enjoy and look forward to the meditations. It helps me begin my day with less stress and to be more focused on the clients and do the task I need done. I have recently been diagnosed with high blood pressure and can  feel a difference in my blood pressure after doing meditation.

11. Response to a stressed experience-er (i.e. stress response turned inward) can be… Beginner’s Self-Compassion (Activity)

12. The 4 Immeasurable “Heart Practices” • Kindness, Compassion, Gladness, Equanimity • Can be obscured but always there as a capacity • These traditional practices can be practiced daily for short periods of time as a gentle way to help increase tolerance for positive experience of connection and healthy attachment to authentic self and others • Concentration • Cultivation • Purification • Allow clients to access “authentic self” (Christ in you, Buddha Nature, Self Leadership, Brilliant Sanity)

13. Phrases for Lovingkindness Practice • May I be peaceful. • May I be happy. • May I be at ease with things as they are right now. • May I feel safe and healthy. • May I be free of internal or external harm. • May I know myself as loved and worthy of love. • May I be open to unconditional happiness • May I consider myself worthy of well-being because I exist. • May I be filled with lovingkindness.

14. Phrases for Compassion Practice • May I learn to care about this ________ (confusion, pain, irritability, etc) • May I meet this with tenderness and mercy • May I not abandon myself to avoid this • May I bring presence to this, that confusion may clear and leave wisdom, and that this pain may be transformed into compassion • May I be filled with compassion

15. Phrases for Gratitude Practice • May I notice and enjoy the good in my life • May my enjoyment of goodness continue & grow • May I notice & revel in moments of well-being • May I celebrate progress/victories, large & small • May I see the good in other beings • May I see the good that I bring to other beings • May I be happy with others and increase my joy • May I be happy for myself as I would for others • May I be filled with gratitude

16. Phrases for Equanimity Practice • May I remember that my happiness depends upon my actions, not my preferences • May I remember that your happiness depends upon your actions, not my preferences for you • May I care about your pain & respect it as yours to meet • May I wish you freedom from pain, but not rob you of its gifts. • May I allow you the dignity to choose freedom or suffering. • When I see you choose suffering over freedom, may I respond to my own pain with wisdom and compassion. • Knowing that the only things that belong to us in this world are our actions and their consequences, may I allow us both to experience the consequences of our actions.

17. Self-Compassion Training Neff and Germer found that Self-Compassion can be cultivated in stages for those who find it difficult to be gentle in self-care, including ourselves • May you safe and at ease • May you and I be safe… • May we be safe and … • May I be safe and at ease

18. Letting Go: The Ultimate in Self-Compassion This intervention can be carried out with groups of dyads or in holding space for an individual client. Each pair of people have a rope between them to represent the “burn” of suffering due to clinging. • I’m holding onto this because… • The price I pay for holding onto this is… • This price my loved ones pay because I hold on is… • For now, I’m willing to let go of this because…

19. Other Resources • Buddhist or Mindful Recovery talks theeasiersofterway.com/buddhist-recovery-speaker-tapes/ • Centering Prayer resources – contemplativeoutreach.org • Internal Family Systems selfleadership.org • Kristin Neff, PhD self-compassion.net • Meditation Meeting Network buddhistrecovery.org • Noah Levine’s Refuge Recovery refugerecovery.org • Penuel Ridge Retreat Center penuelridge.org • St. Mary’s (Centering prayer) stmaryssewanee.org • Tara Brach, PhD on Relational Mindfulness & Breaking the Trance of Unworthiness www.tarabrach.com • UCLA Mindful Awareness Research Center/Free Meditation Podcasts marc.ucla.edu

20. References • Chiesa, A. & Seretti, A., (2009). Mindfulness-based stress reduction for stress management in healthy people: a review and meta-analysis. Journal of Alternative and Complementary Medicine, 15(5) 593-600. DOI: 10.1089/acm.2008.9485 • Coatsworth, J. D., Duncan, L. G., Greenberg, M. T., & Nix, R. L. (2010). Changing parents’ mindfulness, child management skills and relationship quality with their youth: Results from a randomized pilot intervention trial. Journal of Child and Family Studies, 19(2), 203-203-217. doi:10.1007/s10826-009-9304-8. • Epstein, M. (1995). Thoughts without a thinker: psychotherapy from a Buddhist perspective. New York: Perseus Books. • Follette, V.M., Briere J. Rozelle, D., Hopper, J. W., & Rome, D. I., (2015) Mindfulness-Oriented Interventions for Trauma: Integrating Contemplative Practices. New York: The Guildford Press. • Kabat-Zinn, J. Wherever you go there you are: mindfulness meditation in everyday life. New York: Hyperion. • Kaklauskas, F. J., Nimanheminda, S., Hoffman, L., & Jack, M. S., (2008). Brilliant sanity: Buddhist approaches to psychotherapy. Colorado Springs: University of the Rockies Press. • Pruitt, I. T. & McCollum, E. E. (2010) Voices of experienced meditators: the impact of meditation practice on intimate relationships. Contemporary Family Therapy 32:135-154. doi:10.1007/s10591-009-9112-8. • Singh, N.N., Lancioni, G.E., Winton, A.S.W., Singh, J., Singh, A.N., Adkins, A.D., & Wahler, R.G. (2010). Training in mindful caregiving transfers to parent-child interactions. Journal of Child and Family Studies 19:167-174. doi: 10.1007/s10826-009-9267-9.