Briefly, the paper gives an overview of Contemplative Psychotherapy (CP) as a discipline at the intersection of psychotherapy, Buddhism, and mindfulness, reviews its core theories and practices, and argues that CP may have special value in helping therapists become better at the common factors— the active ingredients of psychotherapy that are common to the different schools and styles of counseling.

The version of record is visible at https://doi.org/10.1037/int0000191. You can also download a self-archived version of the paper here. (It lacks the fancy typesetting of an APA journal, but reads just fine.

The abstract is ©2019 American Psychological Association.

Contemplative Psychotherapy: Clinician Mindfulness, Buddhist Psychology, and the Therapeutic Common Factors

Abstract:

Contemplative psychotherapy (CP) is a counseling discipline that integrates psychotherapy training, clinician mindfulness, and Buddhism. This review articulates CP as developed at Naropa University, contextualizes its core concepts and practices with regard to the common therapeutic factors, and briefly reviews the Buddhist frameworks, theories of pathology, and interventions that characterize CP.

The foundation of CP training is clinician mindfulness and compassion. Because of its integrative approach to developing these therapeutic traits in clinicians, aspects of CP have the potential to enhance the common factors and therapeutic outcomes across counseling disciplines. Future empirical research should investigate these claims, and if they are verified, explore best practices in clinician mindfulness and compassion training. Because CP thoroughly integrates clinician mindfulness and compassion into clinical training and practice, it is a notable field for research into psychotherapy practice, pedagogy, and outcomes.

Keywords: Contemplative psychotherapy, mindfulness, compassion, Buddhism, common factors

I figured it would be nice to share the summaries of those articles I prepared, in case other folks are interested in the dialogue between mindfulness, Buddhism, and psychology.

These four articles are just a tiny slice of the pie, so-to-speak. But that was enough to supply plenty of food for thought and conversation during our 2-hour seminar discussion.

Kinds and Dimensions of Mindfulness (Dorjee, 2010)
Writing in the journal Mindfulness, Dorjee reviews how mindfulness has been understood so far in psychology and cognitive science, articulates its speculative cognitive and neural functions, and argues that there isn’t just one kind of mindfulness.

Dorjee, D. (2010). Kinds and dimensions of mindfulness: Why it is important to distinguish them. Mindfulness, 1(3), 152–160. https://doi.org/10.1007/s12671-010-0016-3

Therapeutic Aims in Psychotherapy and Meditation (Engler, 1986)
In this classic article, Jack Engler articulates the value and dangers of mindfulness practice in the context of contemporary Western forms of psychopathology.

Engler, J. (1986). Therapeutic aims in psychotherapy and meditation: Developmental stages in the representation of the self. In K. Wilber, J. Engler, & D. P. Brown (Eds.), Transformations of consciousness: Conventional and contemplative perspectives on development (pp. 31–50). Boston, MA: New Science Library/Shambhala.

Mindfulness: A Dialogue between Buddhism and Clinical Psychology (Kang & Wittingham, 2010)
The authors provide an overview of major psychotherapies that incorporate mindfulness, articulate how mindfulness meditation practice shows up in the many Buddhist schools, and suggest new directions in the dialogue between Buddhism and psychology.

Kang, C., & Whittingham, K. (2010). Mindfulness: A dialogue between Buddhism and clinical psychology. Mindfulness, 1(3), 161–173. https://doi.org/10.1007/s12671-010-0018-1

A Meta-Critique of Mindfulness Critiques (Walsh, 2016)
In this book chapter, Zack Walsh summarizes and critiques the various critiques of mindfulness he has encountered, and argues that mindfulness has been subverted to the ends of those in power to serve as both a palliative and a commodity in neoliberal capitalism.

Walsh, Z. (2016). A meta-critique of mindfulness critiques: From McMindfulness to critical mindfulness. In R. E. Purser, D. Forbes, & A. Burke (Eds.), Handbook of mindfulness: Culture, context, and social engagement (pp. 153–166). New York, NY: Springer.

I lectured in three parts. For the first section, I presented on Contemplative Psychotherapy and the Common Factors, based largely on an article I have under review. Basically, I covered how mindfulness, brilliant sanity, maitri, and exchange are core concepts and practices of Contemplative Psychotherapy, and talked about how they can help enhance the common therapeutic factors.

Brilliant sanity is the notion that human beings are fundamentally wakeful, and sanity precedes all ignorance, suffering, and confusion. Maitri is an attitude of unconditional friendliness towards life, oneself, and others, including all situations, thoughts, and emotions. Exchange is the phenomenon of limbic resonance, or the fact that as human beings, we can subtly sense other peoples’ emotions in our own experience. Mindfulness ties them all together, because therapists who practice mindfulness guided by these principles are able to use mindfulness in the therapeutic relationship to develop unconditional confidence in clients’ brilliant sanity, express unconditional friendliness and openness towards clients and their experience, and work with the subtle information that comes through in the exchange without shutting down or blocking their emotional connection with clients. In this sense, they are all interrelated.

In the common factors model, the most important ingredients of therapy are common to all forms of therapy, rather than residing in specific ingredients that are unique to different models of therapy.

The most important common factors are:

• the therapeutic relationship
• client variables, including motivation for change, capacity to relate, and resources in their social environment
• therapist variables, such as presence, empathy, humor, compassion
• expectancy/placebo

The common factors model is supported by research, including large meta-analyses of psychotherapy outcome studies. Within the rest of the clinical picture, the common factors fit in like this:

I suggested to students that clinician mindfulness practice using the guiding principles of Contemplative Psychotherapy may be an effective means of enhancing the common factors and becoming better therapists, no matter what techniques or other schools of therapy one incorporates into one’s practice.

Then we took a nice break, and when we came back, I presented on bipolar disorder and some preliminary results from a qualitative study I’m doing as part of my dissertation. I went over the costs of bipolar disorder and some of the theories of how it comes to arise in people, and talked about the wide variance in functional outcomes among people who have this diagnosis. (Some people perform as exceptionally creative and functional human beings, some folks have a long downward spiral towards chronic disability, and some folks wind up between these two extremes.)

Because of my own experience recovering from bipolar disorder in my early twenties using mindfulness and Buddhist ideas, I set out to research how people recover using a similar approach. I’m currently coding and analyzing the interviews from a qualitative study, which asked the question “What is the lived experience of people who recover from bipolar disorder using mindfulness meditation and Buddhist psychology and philosophy?” the parameters of the study and a recruitment poster are displayed here.

To wrap it up, I discussed some preliminary results from my dissertation research. The key points of this included the fact that recovery from bipolar disorder is possible, some people found mindfulness meditation and Buddhist ideas extremely helpful, and folks usually included a number of other wellness practices in their recovery. These included:

• sleep hygiene
• steady routine
• exercise
• healthy diet
• community connections
• reducing use of drugs and alcohol
• a meaningful life role

For the third section, I presented on Hakomi tracking and contact methods, and we did a live demo with a student volunteer. I asked the students to track what they observed in the volunteer ‘client,’ and then we checked in with the client about the other students’ hunches and observations. It was fun to show the students some of these principles at work, and discuss how mindful therapists can help bring client present-moment experience into the therapy room in a non-violent, organic, and loving way.

References:

Norcross, J. C., & Lambert, M. J. (2011). Evidence-based therapy relationships. In J. C. Norcross (Ed.), Psychotherapy relationships that work: Evidence-based responsiveness (2nd
ed, pp. 3–21). New York, NY: Oxford University Press

Levy, B., & Manove, E. (2012). Functional outcome in bipolar disorder: The big picture. Depression Research and Treatment, 2012, 1–12. https://doi.org/
10.1155/2012/949248

My presentation covered the CP core commitments of brilliant sanity, maitri, exchange, and clinician mindfulness, and related them to Carl Rogers’s necessary and sufficient conditions for therapeutic change.

Here’s the audio file in case you’d like to listen in.