How mindfulness meditation helps me be a better therapist to my clients
In the coming months I am delivering mindfulness workshops to practitioners within the counselling and psychotherapy profession. It is incredible to witness the growing interest to mindful living generally; I am especially pleased to see my profession placing value in the practice of meditation. There are benefits in teaching our clients how to use mindfulness: certainly there is a lot of research emerging as to how meditation may combine with therapy to produce more effective and long lasting change and / or symptom management. I am sure I will return to this topic in a future blog post. For today however I offer a personal perspective as to how I think my meditation practice (as therapist) benefits my clients.
I’ve been giving a lot of thought towards what (up until now) have been my two paths – those of my meditation and my therapeutic paths. I say ‘up until now’ because I am witnessing a merging: personally and professionally. I remember sharing with my own therapist about 5 months ago that I aspired to “truly being a Buddhist” and to have that cradle everything else in my world. That vision is coming to fruition: I see how my meditation practice underpins my values and way of being in the world; and that provides the support of my work as therapist (as well as other roles such as partner, daughter, friend).
My home retreat a few weeks back gave me the opportunity to reflect on living one, common path. I used the time and space to formulate my intentions, specifically as to how I can help others. What really came through to me is how important the actual practice of meditation is (aside from the ethics and compassion practices that are central to life as a Buddhist).
Stabilising the mind
The essential practice in my meditation ‘diet’ is that of breath-awareness, or ‘shamatha’ (sanskritfor ‘calm-abiding’). Using the breath as my object for my mindfulness, I sit and bring single-pointed attention. The phrase ‘calm-abiding’ doesn’t mean a goal of peace and tranquility (or that would mean I ‘fail’ 8 or 9 times out of 10!). Nor is the measure of the practice how well I hold on to the breath. Rather, I direct my attention to the breath as an anchor to the here and now, and if when I get distracted I label it with ‘thinking’ and I come back to the breath. Some days it is relatively straightforward and my experience is quite peaceful and easeful; on other days my mind is distracted and it feels a struggle – I lose the breath, I bring my mind back to it. The ‘calm-abiding’ is the attitude to the oft the tug-of-war. I practice ‘equanimity’ or non-judgement of my experience. Whether easeful of requiring constant effort ‘to come back’, through sitting (over time) my mind slows, gaps between each successive thought appear and lengthen. A period of mediation is often likened to having a jar full of muddy water which settles as we leave it to rest. Letting my mind settle, having my thoughts slow down allows clarity (the mud rests at the bottom with clear water on top). In this space I find that insights relating to my own process emerge. I start to make links between my state of mind, feelings, emotions and events in my life.
Developing the watcher
Another critical practice for me has been that of the Four Foundations of Mindfulness. In shamatha, the object is thebreath: in the Four Foundations 1) I begin with the object of the body noticing any physical sensations; 2) I move my attention to the feelings that come up and labelling them simply pleasant, unpleasant or neutral; 3) next my mindfulness is directed to the mind itself, watching the thoughts that arise; 4) finally mindfulness of the contents of the mind asks for a linking of the arising thoughts within aspects of Buddhist teachings. It provides a methodical way to practice applying my mindfulness across different processes that ordinarily I’m not aware of (because they are going on all the time underneath daily concerns). When I teach this practice to others, I describe how its a bit like watching our experience unfold on a screen from a seat in a cinema. It is a beautiful analogy because it implies an ability to stand-back: to be fully contacted with our experience yet not enveloped by it. Developing the movie-goer or ‘watcher’ (without entering the drama being played out on the screen / in the mind) helps build the quality of equanimity (upeksha in sanskrit). This is probably close to what Freud referred to as “evenly suspended attention”.
How often do we really take time out? My 30 minutes each morning is a very personal space, real ‘me-time’. Simplysitting still without an outcome is one thing that helps me keep my batteries charged. OK, each meditation is not all peace, calm and tranquility – it is not an easy practice: yet with time, the effects are become clear. Since I have been meditating (five years now) I sleep better, I understand more what is going on behind my feelings and emotions, and I am less reactive in relationships. Life takes less out of me when I make the time to meditate.
Rest and self-care are so important. When you take time to replenish your spirit, it allows you to serve others from the overflow. You cannot serve from an empty vessel.
― Eleanor Brownn
putting-on-your-own-oxygen-mask-firstThese first three aspects are really about ‘me’ – how meditation aids Helen as a person. In a modern day interpretation of the Buddhist teachings is the example of the oxygen mask – we can only help others once we have seen that our own needs are met. This is not some narcissistic statement – we have to be in sound health (physically and emotionally) to serve others. This is especially true in the helping professions. When seeing a number of clients per week and helping them with difficulty emotional struggles, my meditation keeps me grounded and ‘fit to practice’. Counselling and psychotherapy is known to be a profession with a high rate of burnout.
Adding value to the therapeutic relationship
Having stabilised my own mind and taken care of my self, I am ready to enter the room with a client undistracted and ready to be there for them, totally. Much of the therapeutic literature (especially the research of the Humanistic approach) speaks of the importance of ‘presence’. Therapeutic presence involves being fully in the moment with a client on a multitude of levels – physically, emotionally, cognitively, and spiritually. It is presence that helps me be fully open to the client’s world yet remain in touch with my own experience. Therapists rely a lot on their congruence – the ability to detect what is going on internally and to then be able to express this in real time to the client. Much feedback about a client’s way of being can be generated if a therapist is able to tune in as to how that client is impacting on them. The key for me is how mindfulness meditation (alongside my personally therapy) helps bring clarity to my own process and enables me to separate out my stuff* from the client’s.
Daniel Siegel writes beautifully on the topic of how mindfulness can enhance the therapeutic process, and I have found what he offers with the acronym of PART speaks to my experience with clients:
- My presence is a way I remain grounded in myself. I am able to locate my own needs and be undistracted with a client
- Settled, I am able to attune with the client’s internal experience and their world
- There is alignment, two people in a room opening to each other brings resonance – we recognise our shared humanity and begin to influence each other’s state of being**
- My client feels fully heard, fully felt – trust between us is nurtured which as Siegel explains is the starting point for true interpersonal integration
Neuroscience is establishing the changes in brain structure and function that come with regular mindfulness training – and this scientific basis is one reason why the health professions (including therapists) are keen to use meditation for themselves and reassured in recommending it to patients and clients. I certainly find it invaluable for my therapeutic counselling work. However, I would urge some caution: I believe we (the practitioner) need a strong personal mindfulness practice before we attempt to use it in our work, or indeed teach our clients to use it. As I mentioned earlier, whilst it is a straightforward practice, it is not an easy one. Having our own experience of the pitfalls and challenges is vital if we can attune to the client’s attempts. I have also found that meditation can bring up ‘stuff’, which while useful material for therapy it is again advisable to have experienced a version of this ‘stirring up’ ourselves so we can truly get alongside our clients.
*Stuff – technical term in the trade meaning baggage, personal history, unresolved issues. For example, if I am sitting opposite a client and notice sensations of anger, I need to be clear whether it is my own anger or that anger is in the room possibly coming from a client’s process.
**Maybe to the degree where the therapist-client experience Martin Buber’s “I-Thou” or what is called “relational depth” in some psychotherapeutic literature
There is no doubt about it, sport is lucrative business. For a country like the UK it also plays a huge part in our Nation’s identity. One only has to look at sporting participation data since the 2012 Olympics, the recent media coverage of the Commonwealth Games, and (much to my own delight) the crowds lining the roads for the 2014 Tour de France when it visited Yorkshire this July.
A lot of investment is made in improving athletic performance – time and money. British Cycling have coined the phrase ‘marginal gains’ to describe a process by which they leave no stone unturned to eek out the final percentages in an athlete’s capability. One example is how British cyclists have the same mattress transported to competition and training camps: the same bed = improved sleep quality. Every little effort made to enhance recovery time. And now these efforts aren’t being limited to the physiological or the nutritional – the two traditional inputs from sport science. Top class sport is turning more and more to an understanding of the mind. Most sporting governing bodies in the UK work with a team of sport psychologists now, and many individual athletes have a ‘head coach’ of some description or another. One of the most famous is Dr Steve Peters, brought in to work with British Cycling athletes over 10 years ago. What was headline grabbing about his appointment at the time was his being (not a sport psychologist but rather) a psychiatrist. Given the success of British Cycling (Vicky Pendleton, Sir Bradley Wiggins and Sir Chris Hoy are but a few who have worked with the man behind ‘managing the inner chimp‘) Maybe it IS ‘good to talk’?
Certainly this has been my own experience – both as an athlete and then as a coach of athletes. During my six year career as a cyclist I worked with a professional who helped me to balance the various demands placed upon me. OK, I was not in the same realm as Pendleton, Wiggins and Hoy, but I would call myself a ‘semi-pro’ (as I moved to part-time work to pursue my cycling for 2 years). Balancing my training whilst still working was one pressure; wanting to be successful on the bike and in my academic career another; maintaining a relationship with a partner, friends and family but also fulfilling a training plan sometimes 25h+ per week – having someone who I could share how hard it got sometimes helped… a lot.
And it was this period that inspired me to take up coaching. Knowing the benefits of receiving help, I wanted to become the helper. Within a few months of shifting in to the role of cycling coach, it began to dawn on me that what really helped my athletes wasn’t the prescriptions of training power output or the calculations of optimal race pace from laboratory testing, rather it was my time, my presence, my listening to them – as Carl Rogers might describe it, it was simply ‘being a person’. I was doing quite naturally what I was to learn later in my therapeutic training – and this forged incredibly trusting 1-2-1 relationships with my athletes.
I’ve worked with a wide range of abilities: from novice ‘weekend warriors’ hoping to complete their first race, to full-time professionals aiming for selection at International level. What these athletes share is an immense motivation to succeed. In my experience, we can categorise this motivation in two camps:
- those that love the sport they compete in and simply want to express their athletic potential;
- those who need to achieve their targets by way of proving themselves (to themselves, to others)
This was reinforced when I watched the recent BBC documentary “How to win gold”. Sir Chris Hoy described his own path to Gold as well as interviewing several other top-step Olympians. I was struck by the extremes between rower Sir Steve Redgrave and cyclist Graham Obree. Redgrave apparently in the ‘want’ camp explained “you have to love what you do, or you won’t have the desire to do everything for the win”; Obree (notably a survivor of two suicide attempts) on the other hand described his motivation as a “fear of regret”. He went on to explain one of his World Championship wins as being down to his “willingness to die for it” – and there was not a sense of drama there, he deeply believed he was pushing his body to the extremes. Obree was describing a phenomenon I have seen many times not only in athletes but also in many high achievers: the need to accomplish to fill a void, to simply to feel they have a right to exist.
There will always be times when even the most passionate athlete gets jaded and the training life can feel like a chore. But for those athletes who are needing success, sporting accomplishment is a way to make up for something they feel they don’t have. Celebrated psychiatrist C.G. Jung would call this part of a shadow-side: certainly there is an inner struggle. Sir Bradley Wiggins and Lance Armstrong – two athletes with estranged paternal relationships) are but two examples of success underpinned by a ‘fight with inner demons’ often cited in the media and sport psychology literature. Athletes with this inner struggle are those that will only be satiated by a win – they are fixated on the outcome. Those athletes with a healthier sense of self tend to be more engaged in the process – they are just as happy with a personal best performance even if that still means defeat.
Happy person but limited athlete?
This became a conundrum for me as a coach. When working with cyclists I was very aware of the inner struggles: and it would make me so sad to witness it. Yet I also knew it was the fuel keeping the desire to excel burning. So the question is – do athletes need an inner demon in order to reach the highest echelons of performance? Is a fight for survival critical? Whilst I would never advocate stirring up someone’s inner battle (the use of pre-race talk along the lines of “come on, prove them wrong”akin to kicking someone in the shins to make them angry) it begs the question as to whether performance is prioritised over psychological health. Or to put it another way, would the ‘fully actualised” human have the need to enter sport and seek every competitive gain?
I don’t claim to have a definitive answer, only one based on my experience. Where I have witnessed the inner demon as fuel, there was also a high incidence of self-sabotage. In other words, yes the need to perform well was a potent driver; but it was very often the cause of performance collapse at just the wrong moment. As if the ‘shadow-side’ was invested in staying intact. Our histories may be ones we fight against, but on some level there is comfort in the familiarity they offer. To give an example, we may have an athlete who keeps getting injured. Whether we consider Wilhelm Reich’s ideas on ‘body armour’, or Merleau-Ponty’s on ‘the lived body’ there is little doubt in Western psychotherapeutic theory that we carry emotional memory in the body. We probably all have some awareness of where we carry stress in our bodies – for me its in the upper back just under my shoulder blades: if I do too much cycling when stressed and anxious, I get referred pain in my lower back. An athlete with chronic psychological ‘blocks’ which are held in the body may well experience recurrent episodes of injury – and they will often appear at periods in the training cycle where physical form is looking good…surprise surprise, JUST when the expectations to succeed are mounting!
Can counselling and psychotherapy help athletes?
I believe yes, it can: if the word ‘help’ is placed in context of more harmonious relationships, decreased stress and depression, overall improved mental well-being resulting in longevity in sport. I have seen how mental issues restrict and constrict the performing athlete. It is wonderful to watch an athlete perform without the heavy burden of psychological ‘chains’.Psychological chains are a heavy burden, and that weight can slow us down – quite literally if “the lived body” makes us rigid (speaking as a physiologist now, we have to consider the oxygen cost that has and how it affects an athlete’s economy of movement?)
I often cite some of my most profound successes as a cycling coach were when I helped an athlete break free of the chains – even if this meant them leaving the sport. I love sport; it has been in my life ALL my life. I have made long-lasting friendships and learned a lot about my self through it. It has many amazing benefits socially and psychologically. However, I don’t believe in the pursuit of excellence we should encourage any kind of emotional imbalance – sport is JUST sport after all.
Ever since I started meditating 5 years ago, I have made the time and space to go away on a retreat at least once per year. Last year I was fortunate to go away twice: once to Vermont in the Spring, the second trip to Limoges in Central France. This year I've not been able to commit to an organised retreat, leaving me consider other ways to get a period of intensive meditation practice and study. I've always thought that a physical removal from one's normal environment was a necessary factor for a retreat, but when I read this account from Susan Piver, one of my trusted spiritual teachers, I thought "why not dedicate some time to doing this at home?".
To be honest, I struggle with retreats. Normally the first few days are spent wondering "why am I doing this to myself?", the next few calculating "when do I get to go home?", and then in the final days "I don't want to leave!" Ok, so that last one isn't entirely true, but I do find myself surrendering - not 'like it or lump it' but rather the resistance seems to drop away. I have reflected on these struggles and realise that its less about being unable to escape my mind (I have discovered my mind to be quite crazy company when I am sitting alone with it for 6 to 8 hours a day!), and more the projection of being away from home and missing my life there. Was this intensive practice at home going to help me understand this a little more? What would I blame my struggle on now?
Reading Susan's account of her home retreat experience opened my eyes to the need of planning and preparation - I was under no illusion that I could just plonk myself on the cushion at 8am Monday morning, sit all day and go to bed at 10pm; repeat for 5 days. In Buddhist parlance, I was aware I needed to pay attention to 'the Middle Way': not too tight, not too loose. I needed a schedule - this would help me keep a container (which is normally provided by the teachers and assistants on retreats), and with that taken care of I could relax in to it. It was important that I was disciplined, as 'right effort' is a very important component of the meditative path. I also pinned a copy on to my office door (where I was to be camped for the week) so that my partner also knew my plans. We were careful to discuss the implications of this retreat on our home and our movements. Whilst I was to eat breakfast and lunch alone (that was important for me to keep my flow of practice during the day), I was happy to share our evening meal together. On organised retreats, participants cook and eat together but are encouraged to consider their speech: Sometimes the instruction is to abide by 'Golden Silence' (no talking at all), sometimes by 'Functional Silence' ("Can you pass me the salt please?"), but at all times to be mindful of how much we break the silence. During this home retreat experience, my partner and I used our shared meal times to be mindful of the communication between us.
I also gave a lot of thought to what I wanted from the retreat. One of the reasons I chose not to go away this summer was to ensure I took a break. My on-going therapeutic training takes a lot out of me (quite rightly, it is a very involved and introspective process necessitated by the depth of stability we need to offer our clients). About to embark on the next stage of that training in the autumn (a two year Masters in psychotherapy), staying at home to recharge of my batteries became a priority. Staying here also allowed more control over the study component of the retreat - looking ahead to the next phase of my therapeutic training I was keen to dedicate time to 'relationship issues'. In the Humanistic psychotherapy tradition, the vehicle for healing is the relationship between therapist and client; furthermore, the school of Buddhism I practice within is committed to the relationship with other. In my personal life too, I have experienced how critical the relational field is for growth. The gardening metaphor is taken up by Dr Jeffrey Rubin, a Buddhist psychotherapist in his book "The Art of Flourishing". Dr Rubin recently taught a course based on his book at The Interdependence Project (where I studied to be a meditation teacher) so this became my study material for the week. Being able to bring together my two paths - the therapeutic and the meditative - is an area I continue to explore on a personal and professional basis.
Other logistics included setting my email to auto-respond, setting up a voicemail on my work and home phones and telling close family and friends I was 'offline' until Saturday.
My daily routine included around 4 to 5 hours of sitting practice - this was mainly breath awareness or 'shamatha', but I also included some work across 'the Four Foundations of Mindfulness', which invites the meditator to shift from the breath as 'object' towards the body, the feeling tone, the mind and then a more open awareness of the now. There were also meditations included within the IDP online classes. The classes gave a taught element totalling up to about 4 hours a day and I dedicated about another two hours a day for the class reading and journalling exercises. Add on 30 minutes of pre-breakfast yoga and a one hour walk after lunch each day and its no wonder I slept like a log: don't let anyone tell you that retreats are laid back! These activities easily filled my 7am to 10pm day. I made one adjustment to the routine mid-week, taking the opportunity of the beautiful weather to meditate and do my yoga on the beach at 6am - I think that was the highlight of my week.
Of course it is not all about what is done on retreat, it is more about the attitude we bring to those activities. I kept to a simple mantra 'one thing at a time'. For example, I normally walk listening to a podcast or some music - for this week I walked with nothing, instead allowing myself to experience the world 'as it is'. When I ate, I simply ate. When I had a tea, I sat just with my tea. No multi-tasking. Just this alone noticeably slowed my pace and opened up space. I noticed things more - both in my external world and in my internal space.
The outcome? I feel very rested, but also emotionally 'raw'...as if I have come closer to my core of being. I was keen to try this as an experiment as very often I come home from an organised retreat and wonder how I can keep the deep rested feeling and the enhanced clarity with which I see my world (and my reactive patterns) - is it the longer sittings, the opportunity to study the Buddhist teachings more consistently, being with like-minded people who are committed to a similar path, or is it simply the unplugging from the 'real world'? Doing this at home has enabled me to rule out that a geographical re-location is needed 'to get away from it all'. In fact I think one of the biggest influences on my state has been getting away from email, the internet and self-imposed expectations regarding 'to-do lists'. I strongly advocate the turning down of external chatter.
The account so far might lead you to the conclusion that it was rosier than the reality. This has been an incredibly hard experience. I cannot compare the difficulty with an organised retreat as there are too many variables. I certainly benefitted from being at home on one level: not having to travel, and the knowledge that during a tough sitting I was in a safe space are two that come to mind. Being at home however also contributed to some of challenges, namely:
- Switching on and switching off. When I am away, each and every 24h feels contained. Removing myself from home allows me to cross over a line for the entire period of the retreat. This home retreat has meant repeated crossings of a self-policed boundary. Getting up from my bed to cross in to the retreat arena, likewise at evening meal times it felt like I came out momentarily before heading back in for my evening practice, and out again for bedtime. That movement to and fro took energy.
- Freedom and separation. I noticed several times during my retreat how alone I was feeling (some people may read that as 'lonely', but I don't mean it that way). On one level, which the existentialist view would follow, is that the retreat helped me appreciate how ultimately we are alone in this world (by that I mean we self-responsible). I noticed that as I went deeper inward, I was drawn to total separation from the world. Indeed, the temptation of 'cave-dwelling' has cropped up in conversation with Buddhist friends of mine!! To call again upon 'the Middle Way' teaching, I think it is a fine line someone on this path has to tread - spending energy connecting to self but not at the expense of being-in-the-world wholeheartedly.
- Interdependence. This continues in the same vain as above. The irony didn't escape me: my chosen topic of study (around relationships) and the withdrawal from the world by doing this retreat on my own. Remaining in the space I share with my partner, walking around my home town and risking bumping in to a friend that I would have to (politely) walk on by are examples of what seemed to amplify some of the emotional obstacles that came up during the week. The study material held up a mirror to some of my relational shortcomings, and this was hard to digest at times*. What made it so hard was being isolated from loved ones when they were so still tantalisingly close, close enough to reach out to - all I had to do was break the retreat container and share all. Each evening meal time became a challenge - I knew to share some of my experience would tempt me to blurt out everything**. So on one hand I was aware of my aloneness, yet inspired by what was being thrown up by my study and practice: to create what Rubin refers to as 'evolutionary relationships'. I had to exercise patience, to rest with the material and know the time would come to put things in to action. As a human being, I cannot (and don't want to) live in isolation - I need relationships to thrive.
Would I do it again? In all honesty, probably not! And that is a conclusion based not simply on how tough I found it. Maybe the biggest shortfall of my week was doing this alone rather than within a community of others - especially with the relationship teachings I was studying. However, I'm very glad I have had this experience, and I have learned an awful lot to feed in to my personal and professional psycho-spiritual paths. Looking ahead, what this week has set up for me is a profound desire to take my understanding of Buddhist psychotherapy deeper - for future retreats my priority is to study with the world's experts in the growing area of contemplative psychotherapy.
I hope this post has been useful. I'd love to hear about any home retreat experiences readers may have had. I'd also be happy to answer any questions if you are thinking of doing something similar yourself.
*I use the word digest deliberately, for two days I was affected my severe stomach cramping - I am not dismissing it being emotionally rooted.
**Sage advice is always given on the final day of an organised retreat - remember that your loved ones haven't been through the same thing as you, be kind to them and don't flood all over them!
Page 36 of 38