Mindfulness-Informed Relational Psychotherapy and Psychoanalysis

Inquiring Deeply

Marjorie Schuman

• Publisher: Routledge
• Year: 2016
• ISBN:
  9781315517032
• Edition: 1
• Topic: Philosophy
• Subtopic: Eastern Philosophy

Mindfulness-Informed Relational Psychotherapy and Psychoanalysis: Inquiring Deeply provides a refreshing new look at the emerging field of Buddhist-informed psychotherapy. Marjorie Schuman presents a cogent framework which engages the patient at the levels of narrative, affective regulation, and psychodynamic understanding. Blending knowledge of contemporary psychoanalysis with the wisdom of Buddhist view, she examines how mindfulness can be integrated into psychodynamic treatment as an aspect of self-reflection rather than as a cognitive behavioral technique or intervention.

This book explores how mindfulness as a "self-reflective awareness practice" can be used to amplify and unpack psychological experience in psychodynamic treatment. Schuman presents a penetrating analysis of conceptual issues, richly illustrated throughout with clinical material. In so doing, she both clarifies important dimensions of psychotherapy and illuminates the role of "storyteller mind" in the psychological world of lived experience. The set of reflections comprises an unfolding deep inquiry in its own right, delving into the similarities and differences between mindfulness-informed psychotherapy, on the one hand, and mindfulness as a meditation practice, on the other.

Filling in an outline familiar from psychoanalytic theory, the book explores basic concepts of Self, Other, and "object relations" from an integrative perspective which includes both Buddhist and psychoanalytic ideas. Particular emphasis is placed on how relationship is held in mind, including the dynamics of relating to one's own mind. The psychotherapeutic approach described also delineates a method for practicing with problems in the Buddhist sense of the word practice. It investigates how problems are constructed and elucidates a strategy for finding the wisdom and opportunities for growth which are contained within them.

Mindfulness-Informed Relational Psychotherapy and Psychoanalysis demonstrates in clear language how the experience of Self and Other is involved in emotional pain and relational suffering. In the relational milieu of psychotherapy, "Inquiring Deeply" fosters emotional insight and catalyzes psychological growth and healing. This book will be of great interest to psychoanalytically-oriented clinicians as well as Buddhist scholars and psychologically-minded Buddhist practitioners interested in the clinical application of mindfulness.

Chapter 1

Prologue

Hokusai says Look carefully.

He says pay attention, notice.

He says to keep looking, stay curious.

He says there is no end to seeing.¹

Introduction

Inquiring Deeply grew out of my compelling personal desire to understand how to blend Buddhist mindfulness and relational psychotherapy into an integrative approach to working with psychological problems. I knew intuitively that there was wisdom in problems and opportunities for growth contained within them. I loved the Buddhist metaphor of the lotus flower with its roots in the mud growing toward the sunlight, and I could see for myself that problems always seemed to point exactly where I needed to look and reveal what I most needed to see. Early on in my meditation practice, I recognized the profound truth that this very moment is the perfect teacher, as Buddhist teacher Pema Chodron famously said (Chodron, 1997).

I also knew from my work as a relational psychoanalyst that problems have many layers, and that the meaning we assign to them is a very powerful catalyst in how they resolve (or don’t). At the core of problems, there is often some rejecting attitude toward the problem itself and/or toward some aspect of one’s experience. Indeed, the essential meaning of “problem” is that there is a circumstance or situation which one regards as unwelcome and needing to be dealt with or overcome. Sometimes we hold the view that problems are a punishment for something we have done, or failed to do; something in ourselves we deem blameworthy or shameworthy. Beyond the particular circumstances, there often seems to be an embedded view that having problems is itself a problem; as if life could be without problems, or that having problems were an indication of deficiency or failure.

I could see that finding an effective frame in which to hold problems, a “right view” in Buddhist terms, plays an important role in someone’s ability to find a path through their suffering. (And, it was clear that most often there is no way out of the swamp except through the alligators!)

So, my first set of questions became: What is a wise relationship to problems? What is a skillful way to “be with” problems? And/or: How can someone best “practice with” problems, in the dharmic sense of practice ?²

It was apparent to me that this skillful means could not be looking for something; it needed to be looking deeply into something. Whatever answers I arrived at would have to honor both of the interpenetrating strands of my own life experience: psychoanalysis and Buddhism.

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I searched for answers to these questions in many ways and in many different places, including of course the burgeoning literature on Buddhism and psychotherapy. Many of the available approaches were, by and large, not a good fit. For starters, most of the popular clinical applications of mindfulness—mindfulness-based cognitive therapies (MBCT), dialectical behavioral therapy (DBT), and acceptance and commitment therapy (ACT), for example—were cognitive-behavioral and problem-centered, whereas my own clinical work was psychodynamic/relational and depth-oriented. I was not drawn to mindfulness as a clinical technique but rather as an aspect of self-reflection. I sought to understand how to incorporate mindfulness into psychotherapy as an aspect of intimate relationship, not as a technique for modifying behavior. I also found that my own mindful awareness seemed to invite a resonating depth and immediacy in patients, enhancing the depth of our connection. My primary interest was relational psychotherapy, not applied mindfulness.³

In my own work, the focus tends to be on communication, both conscious and unconscious. Mindfulness is only one facet of a multifaceted effort to uncover previously unseen surfaces of experience. As the reader will see in the many clinical illustrations I have included in this book, I do sometimes incorporate mindfulness practice into the clinical protocol where appropriate, but the primary emphasis is not mindfulness practice.

I gradually crafted a “signature” clinical style which I call “inquiring deeply.” This approach interweaves psychodynamic principles and Buddhist thinking; it is both Buddhist-informed and what one of my patients calls “Buddhist-affirmative,” in that it blends Buddhist view into its interpretive framework. The best way to convey inquiring deeply is through clinical example; many of the clinical illustrations in this book come from my work with patients who are Buddhist practitioners, which may provide an added dimension of interest to readers.⁴

One preliminary caveat is that “Buddhist view” is not homogeneous, but rather varies across different schools of Buddhism. (A similar point can be made in regard to the various schools of psychoanalytic thought.) The principle Buddhist ideas in inquiring deeply are insights available in the practice of mindfulness meditation; that said, however, it should be noted that mindfulness is only one of many different Buddhist practices, one which is not included in every form of Buddhism. The primary focus of Inquiring Deeply is how Buddhist view is relevant to the practice of relational psychoanalysis and psychotherapy. While the basic ideas on which Inquiring Deeply is based are outlined later in this chapter and the next, the intended emphasis is how Buddhist view and psychoanalytic treatment can be blended into an integrative whole.

Inquiry

As I pursued these questions over a period of many years, it gradually dawned on me that the process I was engaged in is the one called “inquiry”—“living in the question of something.” This recognition further stimulated my curiosity about the process of inquiry itself. I looked into dharma teachings on this topic and I reflected on it a great deal. Some of what was generated by that process is written in this book.

Inquiry feels to me like an extended conversation that takes place within me and in the “external world” simultaneously. The typical sequence is generally something like this: first, a question arises in my mind. Sometimes this begins with a word or a phrase that starts to echo in my thoughts. Then, generally within a day or two, I find that something—just the “right” something—emerges: an insight; a comment someone makes as we are speaking together; or something that comes up in a therapy session with a patient. In the mystery of unconscious process, it feels as though life itself is alive and responsive to my inquiry; that answers are generated from (called forth by?) my intention to “answer” a particular question.

I have found inquiry to be a wonderful frame for relating to emotional problems. Exploring its value has remained the center of my interest and my attentional focus as I have practiced Vipassana meditation⁵ and worked with patients in psychotherapy over a period of many years. Over this time, my questions have broadened in scope and taken on different forms, but these have been the main ones:

• What are the essential similarities and differences between Buddhism and psychotherapy?

• Is Buddhist practice itself a form of psychotherapy? Or conversely, is psychotherapy a subcategory of dharma practice?

• Can mindfulness practice help bring psychodynamic efforts to fruition? And, if so, how?

• Can dharma practice be broadened to include the “relational field”: i.e. the implicit representation of our relationship to others that exists both in our minds and in the interplay between self and other?

And pragmatically:

• What is a skillful way to explore problems; to look deeply into them in a way that breathes space into them, decodes their hidden meanings, and allows them to resolve?

• Could awareness practice in everyday life be used as an effective adjunct to working with psychological problems in psychotherapy? Could this be done in the spirit of self-reflection rather than using mindfulness meditation as a cognitive behavioral technique?

This book, Inquiring Deeply (designated in italics to distinguish it from the framework/method I call “inquiring deeply”), describes some of what I have learned from my own process of inquiry about these questions.

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I have spent more than three decades concurrently involved in the practices of Buddhist mindfulness meditation and psychoanalysis.⁶ At some earlier points in my life journey, these practices not only felt disparate, they lived in my experience as disjunctive aspects of my identity: For many years I felt that I had to keep my involvement in Buddhism “in the closet” in order to be accepted as a psychoanalyst. The reflections on theory and clinical practice that comprise this book have developed in the context of my efforts to integrate these two different narrative strands in my own life experience. So the inquiry that gave rise to this book was not only a matter of intellectual or theoretical interest. As is obvious in hindsight, it was also a way of working through a personal issue.

My identity issues also lived in me at deeper levels which at times took the form of problematic situations in my personal life. Beyond professional identity, I could see that I was at core seeking to become somebody (and to discover who I am). Over time, the drive toward self-expression and self-actualization began to predominate over my concerns with validation. I began to feel that Inquiring Deeply was the outer form of a new level of integration within myself. And so, the writing of this book is for me the completion of something: the “working through” of a multilayered psychological issue. It is also a living example of how sustained inquiry can lead to and unfold into the solution for personal problems.

In any event, the two narrative strands—Buddhist and relational/psychodynamic approaches to working with emotional problems—have over time become woven together in my mind into a fabric of understanding that feels both seamless and rich. Inquiry is a process I often liken to clarification of butter; the essence gets increasingly more refined (and defined) as the questions “cook.” The framework of my inquiry became gradually clarified, fleshed out, and filled in as inquiry progressed. What I have learned is expressed in this book.

Inspirations

There are many insights from psychoanalysis embedded in the discussions in Inquiring D...

Table of contents

• Cover-Page
• Halftitle
• Title
• Copyright
• Contents
• Acknowledgements
• 1 Prologue
• 2 Preliminary Reflections: Definition and Fundamental Premises of “Inquiring Deeply”
• 3 Inquiring Deeply: Mindful Self-Reflection in Psychotherapy
• 4 Questions for Clinical Inquiry and Self-Reflection
• 5 Present Moments, Moments of Presence
• 6 Reflections on Connection
• 7 Reflections on Thinking
• 8 Reflections on Subjectivity and the Experience of Self
• 9 Mind as Object
• 10 How We Change: Inquiring Deeply and Psychological Growth
• Glossary
• Index