Thérèse: I was delighted that you wanted to talk about mindfulness and the work you are doing and so while I have many thoughts about mindfulness, it would be lovely to just hear your reflections and to trust the organicity of what may emerge.
Mary: Thanks Thérèse, me too, I am delighted to have this opportunity to talk about mindfulness which is something I feel very passionate about and which has been a very important part of my own life for nearly thirty years. It is only in the past few years that I have had the means and perhaps the insight to bring mindfulness more explicitly into my psychotherapy practice. We all know that Eastern thinking has had an important part to play in the evolution of Western psychotherapies. William James, one of the founding fathers of western psychoanalytic thinking, is reputed to have remarked when he saw a Buddhist monk at one of his talks: “you should be in this chair ….. you are much more equipped to talk about psychology than I. Yours is the psychology everybody will be studying twenty-five years from now”. That didn’t happen of course; it has taken a hundred years for James’s thought to manifest. I think that we needed that time to distill the essentials of Buddhism to fit into our own mainstream cultural and secular context. Since James many other significant psychological thinkers have been influenced by eastern thinking, for example Jung and Perls. So I suppose what I am saying is that if you look more deeply into the humanistic and integrative approaches to the psyche you will find a lot of Buddhist influences. Apart from the explicitly Buddhist trainings like Tara Rokpa and Karuna, the influences of Buddhism on psychotherapy, however, have remained implicit. What Jon Kabat-Zinn has done is to use explicit Buddhist techniques and to dissociate them from Buddhism. I think there is wisdom in that, in that it makes it more accessible to the general public, who are looking for ways to understand themselves and their struggles more deeply without feeling that they have to subscribe to a particular religion. Anyway, the reality is probably that the practice of mindfulness is more universal than Buddhism.
By freeing mindfulness from its Buddhist matrix, Kabat-Zinn has brought tens of thousands of Americans through his eight week programme and there is copious evidence that points to the efficacy of these practices for people who are suffering from chronic pain. He is based at the University of Massachusetts Medical School. There are now over two hundred and fifty mindfulness training centres around the world using Kabat-Zinn’s approach. During the 90s the eight week course was adopted by a group of three psychologists (Zindal, Segal and Williams) who found the practice of mindfulness to be very effective in helping people understand and cope with depression. These results led one of them, Mark Williams, to set up a mindfulness training at Bangor University in Wales. They are running a Masters in Mindfulness and I believe that there are some Irish people currently on that course.
Thérèse: Can you say a little more about the particular areas of mental health and well-being where the practice of mindfulness, as you teach it, might be most effective.
Mary: Firstly, I think that mindfulness has helped me a lot to come to terms with myself and it goes some way to keeping me connected. I think that if I don’t have a way of taking care of myself then I am of little use to anyone else. Because mindfulness has become so much a part of my work I have made the commitment to myself to take some time every day for some formal meditation practice which enhances my capacity to live my life more mindfully. This can either take the form of sitting or walking meditation. What I have noticed over the years is that I have slowed down, that I can be stiller that I would normally be. I can be quite speedy and live in my head, so I need to make a conscious effort every day to connect to my body and my breathing. As I have slowed down, I notice that I am less reactive and can look more deeply into things, things are always more complex that they initially appear, and there is always more to an event or story than meets the eye. When I am in a place where I recognise that there are many perspectives from which to view a situation and that any view that I am holding is only provisional, that kind of awareness, which is more like to happen when I am being mindful, has freed me a lot. One of the things that I have found is that when I slow down I have a greater capacity for curiosity. Where there is curiosity there is space and where there is space there is choice. All of these things are encouraged and to some extent cultivated as we train as psychotherapists, but for myself I have needed a more formal discipline to keep these qualities alive.
Secondly, there is a lot of research into the efficacy of mindfulness in mental health and the results are generally very positive, for such conditions as stress, chronic pain, anxiety, depression, bulimia, psoriasis and probably a lot more things that I am not aware of. I don’t naturally enquire into research studies as they generally don’t interest me.
I have had the opportunity to work with a number of clients both in the context of psychotherapy and on the mindfulness course. What I consistently see with clients who have done the course is a greater sense of ease, gentleness towards themselves and more curiosity about their internal processes; sleep is enhanced and dreams become more vivid. I have also noticed that people seem less censoring in what they share about their thoughts, feelings and fantasies. This may be to do with the practice of letting thoughts and feelings come and go without over-identifying with them. This, of course, gives rise to a more textured relationship in the consulting room.
One of the tasks on the course is to explore how we experience both pleasant and unpleasant events. Invariably people are more attracted to the unpleasant events and they tend to linger longer with them. This is always an interesting insight for people. I think that this raises interesting questions: Have we become conditioned to looking at what is wrong with life rather than what might be ok with life? Is it enough to just let the mind do its own thing or is it important to cultivate particular attitudinal dispositions? Might the cultivation of a habit that is predisposed to appreciating what life has to offer help us to create more balance and connection? As people become aware of their tendency to gravitate towards the unpleasant it tips the balance and people seem effortlessly able to appreciate the very ordinary things like the quality of light, the sunrise, a tree that they never noticed before. It seems to me that an active appreciation of our environment is a crucial element in experiencing health and well-being. All of this hinges on becoming curious about ourselves and what is going on around us, and curiosity is the life blood of mindfulness.
Thérèse: …stimulation of our own curiosity. When I consider two practices that are central to my well-being and development both personally and professionally; the 5 Rhythms and sensorimotor psychotherapy – mindfulness is at the heart of these and not as an abstract concept or a technique but as a way being in the practice, where there is an invitation to deepen into our process through the stimulation of our own curiosity of our physical, emotional and cognitive responses.
Mary: Yes, if mindfulness becomes an abstract concept or even a technique then it isn’t mindfulness. Mindfulness has to be lived moment by moment. I have a friend who lives in New York who says with exasperation “if I hear the word mindfulness one more time…..”. Mindfulness is becoming one of those very sexy words these days, and for this reason we have to be careful that we don’t lose touch with its essential meaning and experience. Mindfulness is not really about what we do but how we do it. We can dance the 5 Rhythms with mindfulness or with mindlessness – it’s up to us. If we dance with mindfulness then our experience will be all the richer. Mindfulness is really like a light we shine on what is going on within and around us. There are many disciplines that have mindfulness at their core. I think a psychotherapeutic encounter at its best is a mindful engagement. This is why they work so well together. Perhaps one of the reasons that the practice of mindfulness has become so important is because we are living in such speedy, mindless times and we are carried along by this energy. A lot of psychotherapists attend the courses that I run because they also recognise that they need to slow down and de-stress and learn to take care of themselves. Unfortunately training as a psychotherapist doesn’t necessarily equip us to take real care of ourselves. And, as I mentioned already, curiosity is more likely to emerge out of a context where we spend some time slowing down, relaxing and connecting up to our breathing. The breath is particularly important in mindfulness practice. As we become familiar with our own breathing patterns we will recognise how interconnected our breath and state of mind is. In eastern thought they say that the mind rides on the breath, which is also my own experience.
Thérèse: When you speak about the body and the mind, the interconnectedness – you speak of the moment to moment awareness in body and mind. It seems to me that the spiritual realm is implicit in the practice of mindfulness but perhaps for some clarity, it would be helpful to hear where in your practice and teaching of mindfulness the connection with the ever changing emotional responses that are part of the human condition emerge.
Mary: It is interesting that you use the word spiritual, its funny but I find myself using that word less and less. The word spiritual seems to be understood in so many different ways that I feel unclear as to what it really means. For many decades the word spiritual was important to me and I think it was in opposition to what I construed as mundane and ordinary. These days I find the so-called mundane and ordinary teeming with mystery. Things truly are not what they initially seem and when I am open to this I feel more connected both to myself and to what I tend to consider the ‘not me’. This is an important insight especially in the therapy relationship and I tend to agree with Jung that in the therapy relationship both people are changed by the meeting. At the very heart of mindfulness is the realization of the impermanent and transitory nature of all phenomena including ourselves. As soon as we make anything into a ‘thing’, including mindfulness, then it is lifeless. This is really why the sustained practice of mindfulness is so crucial. By staying connected to the moment to moment change of the breath we are alive to the every changing movement and flux of life. When we are out of touch with our breath and by extension the moment, then we are thrown back on our habitual responses and operate from what Kabat-Zinn has called our automatic pilot mode. We then go through life as if we are sleep-walking and everything seems familiar, predictable and lifeless. We are also out of touch with our body and sensations. In this way we deprive ourselves of a very valuable resource in maintaining our connection with our moment to moment experience.
We do not really have the time to go into the particular view of the mind that underpins the practice of mindfulness but suffice it to say that mindfulness, like western psychotherapy, also implies a ‘dynamic unconscious’. So at both a conscious and unconscious level things are constantly in flux. Any authentic engagement needs to takes account of this.
Thérèse: In the sensorimotor approach, one has tools which inform the work and assist the therapist in bringing awareness to the body and to the language of sensation. There is an educative aspect to the work, and so I’m curious to hear how you might engage in mindfulness with a client and how you might support them in bringing their awareness to sensation.
Mary We know that the importance of being present to the here-and-now is a crucial element of any genuine encounter and that this here-and-now quality of awareness has long been recognised as important in the psychotherapy relationship. We also know that a huge proportion of what we communicate is through our body. Because the practice of mindfulness pays a lot of attention to what is going on in the body in the here-and-now, I use body-awareness explicitly in my communication with a client. I might for example share with a client how I am experiencing what is happening right now in my body or enquire into how they are experiencing things in this moment. Sometimes the client might have no idea what is happening at a visceral or sensation level, or feel that they have no access to any particular sensation. Even if people do not make an immediate connection to the sensations that are happening in their body, very often they will come back after a while, even at a later session, with an awareness of how they experience sensations and with a certain curiosity about it. While this used to surprise me, I now realise that here is a lot of unconscious bodily communication going on in the consulting room and that clients do pick up my own curiosity, openness and a certain stillness that comes from the practice of mindfulness
As clients settle into their body and become more curious as to how they are experiencing their sensations, they become more aware of the interconnectedness of sensations, feelings and thoughts. Staying with the sensations can also bring awareness to previously unconscious memories. I think a lot of therapies that have given the body a central place are very aware of how the body and the unconscious are so deeply connected. To coin a phrase that Thich Nhat Hanh uses, they ’inter-are’, which is to say, they are not two separate things.
Of course this level of bodily awareness is more accessible to people that undergo a mindfulness training. But it is also true that the more the therapist has developed a mindful way of being, the more likely the client is to develop their own bodily awareness. Of course this is not always easy and requires effort and courage to face what the body holds.
Thérèse: And to live out of that place, in making these choices, there is a letting go of habitual ways of responding that is both challenging and incredibly rewarding.
Mary: It is challenging but yes, it is also very liberating. I think that Kabat-Zinn’s approach to developing mindfulness is very practical and skilful. When I first started meditating in India in 1978 I was pretty gung ho, I threw myself wholeheartedly into a twenty one day retreat. It was a gruelling schedule, up at five in the morning, sitting cross-legged for eight or nine hours per day. The whole retreat was conducted in silence, which meant that one did not talk about or share one’s experiences. A lot of things came up that I did not really know how to handle and at times it felt very bruising. I noticed that there was a split developing between my interior world and my ordinary engagement with life. For a number of years after that I felt that being ‘spiritual’ was something that one did on a meditation cushion. On the eight week course you learn right from the beginning to bring a routine activity into one’s mindfulness practice. It might be washing the dishes, changing a nappy or eating a piece of fruit. So already that distinction between inner/ outer, spiritual/mundane is broken down. I found that deeply liberating. One of the most important things I’ve learnt from the eight week course is that spirituality is an attitude, it’s not a thing, it’s a way we live our lives and not something we reserve for private moments of the day. The ordinary things we do in life are very important because that is life.
Thérèse: In your eight week training, the stimulation of the senses begins immediately with the exercise you do with tasting food which is immediately very provocative and evoking of the senses.
Mary: Yes, the first exercise we do on the course is to eat a raisin mindfully. It usually takes about ten minutes to complete the exercise, it always surprises me how readily people go into a very peaceful and concentrated place. Many people comment that even though they are very familiar with raisins it is the first time that they have really tasted one. The exercise is an invitation into a very sensual world. By bringing our senses back to life it is much easier to stay present and be alive to the moment. It is always easier to maintain the awareness in the group. One of the exercises during the course is to eat a meal mindfully once a week. For many people this is a very difficult exercise and the difficulties are always worthwhile to reflect upon in the group. People very quickly realize how difficult it is to remain mindful and that is a really important realisation. When they can manage to stay present to a whole meal they also realise how nourishing it is on so many different levels.
Thérèse: There seems to be a lot of interest in mindfulness, how would you like to see it develop in Ireland.
Mary:I think that mindfulness has a huge amount to offer to the field of mental health in general and I think that it is an invaluable practice for psychotherapists. I would like to see it develop gradually and slowly. I would hope that therapists would use it first and foremost for themselves, gain experience of the practice and then use it with clients. I invited mindfulness trainers from Bangor over to Oscailt to do a course recently. There were about 30 mental health workers, most of whom were psychotherapists and psychologists. It was interesting to see the weekend evolve. At the beginning the participants were inclined to see the course more as an aid to their professional development rather than as something they could use just for themselves. The facilitators did not buy into that initial pressure and consistently emphasised the importance of personal practice as a bed-rock for further professional development. It was wonderful to see the group gradually settle into their own process and really be there for themselves.
In the initial stages I think there would be a lot of value in developing stronger links with Bangor University and to develop training programmes in Ireland. There is a lot of experience here in the meditation area and I think it would be beneficial if we could pool our resources and have a forum where we could begin to share our experiences, particularly in the areas where we use mindfulness in the work context.
I have probably taken a couple of hundred people through the mindfulness courses that I run and am frequently having enquiries for follow-up sessions. I think it would be very helpful if there were mindfulness groups around the country that could provide support for themselves and each other. There is a lot to explore in the practice of mindfulness and I think in time it will find its own momentum. Mindfulness and meditation have until recently been held as very private practices and I thin that we are coming to a time when we are beginning to recognise the need to pracise in community. Certainly in my own case I have learned a huge amount through dialogue and sharing with others’ experiences in the practice.