Contemplation and Counseling

An Integrative Model for Practitioners

P. Gregg Blanton

• Editore: IVP Academic
• Anno: 2019
• ISBN:
  9780830865192
• Argomento: Psychology
• Categoria: Psychotherapy Counselling

Interest in mindfulness and contemplative thought is growing among Christians, and it's time to consider the place of contemplative prayer within the field of counseling. Can contemplative prayer be integrated into therapeutic work? Can it in fact serve as a foundation on which to build a new approach to counseling? In Contemplation and Counseling Gregg Blanton presents a new paradigm for integrating contemplative prayer with counseling practice. He contends that contemplative prayer can illuminate the purposes of counseling and suggest interventions that help us accomplish these goals. This paradigm builds an alliance between science, theology, and Christian contemplative thought to create a dynamic approach to counseling and balance various dimensions of the human person: emotion, cognition, and action. And by recognizing the power of both words and silence, it harmonizes their functions. Based on this integrative foundation, Blanton offers eleven fundamental interventions to fit the needs of clients (including silence, empathy, and teaching contemplative prayer) and a practical four-stage process for helping clients change, using examples from his own counseling experience and from the Bible. Ultimately, contemplative prayer leads us to the healing power of love. How we view our clients, the ways that we relate with them, and the strategies that we use to help them change are all informed by our loving search for God in contemplative prayer. Particular topics include- how Christian contemplation compares with therapeutic uses of mindfulness- insights from interpersonal neurobiology understood in light of Scripture- psychological and spiritual benefits of lectio divina and centering prayer- how practicing contemplative prayer can help counselors develop traits that correlate with positive client outcomes- when and how to teach contemplative practices to clients- the role of the body, emotions, conscious and unconscious mind, and behavior in contemplative practice and counselingChristian Association for Psychological Studies (CAPS) Books explore how Christianity relates to mental health and behavioral sciences including psychology, counseling, social work, and marriage and family therapy in order to equip Christian clinicians to support the well-being of their clients.

OUR JOURNEY INTO a Christian contemplative-oriented approach to counseling begins. We are building an integrated, holistic model for understanding Christian contemplative prayer in psychotherapy. Our goal is to comprehend what happens in counseling from the perspective of Christian contemplative prayer.

The design that guides our treatment rests on three pillars: Christian contemplative prayer, theology, and science. This approach is similar to that of Mark McMinn (2012), who argues for a model that integrates psychology, theology, and spirituality. However, the plan we are devising is different in that it includes other disciplines of science—such as neuroscience—alongside psychology. In addition, instead of addressing the broad topic of spirituality, this approach focuses on one particular area of spirituality: Christian contemplative prayer.

Where do we begin? In this chapter, we will examine two underpinnings of our model: science and theology. In the process of listening to these two voices, we will uncover several principles that will become central to our model for integrating Christian contemplation and counseling.

THE SCIENCE OF CONTEMPLATION

In our study of the science of contemplation, we must seriously consider the extraordinary interest that clinicians and researchers have shown in mindfulness over the past forty years. The New York Times recently described mindfulness as “perhaps the most popular new psychotherapy technique in the past decade” (Carey, 2008). A recent survey of over two thousand practicing social workers, counselors, and psychologists found that 41% of the sample utilized mindfulness as part of their counseling practice (Stratton, 2015). However, mindfulness has not always been so well embraced by the counseling community. What happened in order for the field of mental health to alter its original skeptical view of mindfulness? How did mindfulness move into mainstream psychotherapy? To answer these question, we must become acquainted with the premier pioneer of mindfulness work: Jon Kabat-Zinn.

Origins of mindfulness work. Jon Kabat-Zinn, professor of medicine at the University of Massachusetts, began his work in the late 1970s. His goal was to apply mindfulness in a modern medical setting. With the support of the medical faculty at the university, Kabat-Zinn developed a clinic that brought mindfulness to individuals with a wide range of medical conditions.

As his work progressed, Kabat-Zinn made the following contributions to the integration of mindfulness and psychotherapy: (1) an operational definition of mindfulness, (2) a treatment model, (3) a bridge to the mindulness-based treatment of psychological disorders, and (4) an emphasis upon scientific research.

Most of the literature and practice around mindfulness focuses on its Buddhist roots, and this was indeed Kabat-Zinn’s original source of inspiration. However, Kabat-Zinn was searching for a way to make mindfulness available and accessible to a Western audience. His goal was to develop a secular definition of mindfulness that was also true to the essence of Buddhist teaching.

Kabat-Zinn (2003) settled on the following definition: “An operational working definition of mindfulness is: the awareness that emerges through paying attention on purpose, in the present moment, and nonjudgmentally to the unfolding experience moment by moment” (pp. 145-46). The key elements of Kabat-Zinn’s definition are (1) paying attention, (2) the present moment, and (3) without judgment. Mindfulness is about focusing the mind in a very specific way. “On purpose” includes the intention of focusing on the present moment (D. Siegel, 2007). Being nonjudgmental means letting go of judgments of how the present moment should be and simply accepting what is.

With this secular-sounding definition of mindfulness, Kabat-Zinn went on to develop a treatment procedure to serve patients with difficult-to-treat medical issues. Kabat-Zinn introduced his program at the mindfulness-based stress reduction (MBSR) clinic at the University of Massachusetts in 1979. By 2012, there were over seven hundred MBSR programs being offered worldwide.

MBSR is an intensive eight-week program with a well-defined curriculum. The core program of MBSR consists of two- to three-hour weekly classes and one daylong class. The curriculum includes mindfulness breath meditation, mindfulness-based body scans, yoga with mindfulness, and loving-kindness meditation. Group members are expected to engage in a daily practice of twenty to forty-five minutes during the eight-week period. In the first phase of the program, participants are encouraged to pay attention to sensations within the body. After gaining this skill, group members then learn how to expand this awareness to their thoughts and feelings. Although MBSR is a demanding program, follow-up studies indicate that 80-95% of participants continue to practice mindfulness (Gehart, 2012).

From the outset, Kabat-Zinn and his colleagues wanted to demonstrate scientifically that MBSR training could improve physical health and accelerate rates of healing. A range of studies now demonstrates that mindfulness can help improve the medical conditions of people with psoriasis, fibromyalgia, multiple sclerosis, and hypertension. Mindfulness has been shown to enhance immune function and even raise the level of the enzyme telomerase, which is instrumental in maintaining and repairing the ends of chromosomes (D. Siegel, 2017).

MBSR, which originally proved effective in bringing about physiological improvements, has since produced remarkable results in the treatment of psychological concerns. The first counseling model to apply Kabat-Zinn’s program to the treatment of psychological problems was mindfulness-based cognitive therapy (MBCT). In consultation with Kabat-Zinn, the originators of MBCT included many of the same mindfulness practices used in MBSR. Even though MBCT was designed to prevent relapse in participants with a history of depressive episodes, recent research indicates that it is effective for people with ongoing depression (Baer, 2010).

Within a few short decades, the mental health community has moved from a skeptical view of Kabat-Zinn’s MBSR program to an enthusiastic embrace of his mindfulness-based approach. His remarkable success can be attributed to the careful, systematic research of his program. New research continues to provide growing evidence of the efficacy of mindfulness-based approaches in the treatment of both physical and psychological concerns.

Mindfulness-oriented therapies. Based on the success of MBSR, other mindfulness therapies emerged in the application of mindfulness to other symptoms and concerns. The three most widely known mindfulness therapies used in the treatment of psychological disorders are MBCT, acceptance and commitment therapy (ACT), and dialectical behavior therapy (DBT). All these approaches, which have received increasing empirical support for their efficacy, are rooted in the cognitive-behavioral tradition.

Described as the third wave of behavioral therapy, mindfulness therapies add a twist to traditional cognitive-behavioral therapies (Gehart, 2016). Mindfulness models are designed to help clients relate to their thoughts and internal dialogue with acceptance. Rather than approaching cognitions and feelings with the intention of changing them, clients are encouraged to deal with disturbing thoughts and emotions with inquisitiveness and compassion. The goal is to teach clients to approach their problems with curiosity and acceptance rather than with avoidance.

Mindfulness approaches are typically classified as either mindfulness based or mindfulness informed. MBCT, patterned after MBSR, is an example of a mindfulness-based model. MBCT is designed for small groups with up to twelve participants. In contrast to MBSR, which focuses on stress and the stress response, the teaching material of MBCT applies to depression. However, like MBSR, MBCT emphasizes formal guided meditations and requires therapists to have their own practice of mindfulness.

Even though MBCT is rooted in the tradition of cognitive therapy, it emphasizes the acceptance of thoughts rather than trying to get clients to change the content of their thinking. Instead of trying to replace negative thoughts with positive ones, as traditional cognitive therapy might do, MBCT focuses on noticing the effects of negative thoughts on the body in terms of body sensations.

The other two dominant mindfulness approaches—ACT and DBT—fit within the mindfulness-informed category. DBT was developed at the University of Washington in the late 1970s by Marsha Linehan. To learn more about acceptance, her area of interest, Linehan studied Zen Buddhism. With the concepts she acquired, Linehan began to integrate acceptance and mindfulness with traditional cognitive-behavioral strategies.

DBT is characterized by the tension between acceptance and change (Gehart, 2016). On the one hand, the counselor accepts the client just as he or she is at the present moment. DBT acceptance involves embracing the good and bad without judgment or the need to change anything. On the other hand, the counselor recognizes that change is continuous and necessary. The counselor embodies this synthesis by balancing acceptance of the client with recognizing that change is needed.

DBT is a well-regarded, widely used evidence-based treatment for borderline personality disorder (Gehart, 2016). Over time, it has been used increasingly to treat eating disorders, depressive disorders, bipolar disorders, substance-abuse disorders, and self-harming disorders in adolescents. Treatment of clients generally involves attendance at weekly individual sessions and weekly group sessions. In their group meetings, clients are taught four basic sets of skills. One of these core components is mindfulness. (Linehan, along with Kabat-Zinn, was one of the first to include mindfulness as part of her therapeutic model.) The six mindfulness skills taught in DBT are divided into three “what” skills—observing, describing, and participating—and three “how” skills—nonjudgmentally, mindfully, and effectively.

The second major mindfulness-informed therapy is ACT. ACT, like the other third-wave behavioral approaches, asserts that any attempt to control thoughts is the problem, not the solution. Instead, ACT incorporates mindfulness exercises that facilitate awareness and acceptance of thoughts and feelings. The acronym, ACT, outlines the basic process of this model: (1) A refers to the acceptance of difficult thoughts and feelings, (2) C refers to the client’s choices and commitment to a life direction that reflects who the client truly is, and (3) T refers to the action steps that the client is willing to take toward her or his life direction.

ACT has been used to treat a variety of client problems. The current literature describes the use of ACT with depression, anxiety, anger, substance abuse, chronic pain, and work stress (Baer, 2010). The empirical evidence supporting the effectiveness of ACT, which has grown significantly over the past decade, is both noteworthy and promising.

The mindfulness approaches discussed in this section share some similarities, yet they also differ. They all encourage clients to mindfully experience thoughts and feelings that they typically avoid. Using these mindfulness approaches, clients learn to accept cognitions and emotions; then they commit to choosing more effective behaviors. MBCT, the mindfulness-based approach, teaches formal mindfulness to clients as a primary intervention. In contrast, clients who participate in the mindfulness-informed approaches—DBT and ACT—are not expected to engage in formal mindfulness practices. Instead, these clients are introduced to mindfulness principles and informal mindfulness skills within the context of broader therapeutic models.

The neurobiology of mindfulness. In 2003, the path of Jon Kabat-Zinn intersected with that of Daniel Siegel, professor of psychiatry at the UCLA School of Medicine and co-director of UCLA’s Mindful Research Center. Since the early 1990s, Siegel had been working on an interdisciplinary view of the mind and mental health. Soon after meeting Kabat-Zinn, Siegel attended a series of trainings in mindfulness being led by Kabat-Zinn. Siegel began to practice mindfulness in his personal life and included mindfulness as an important element of his model, called interpersonal neurobiology (IPNB).

Siegel and his IPNB model are now at the forefront of research in the interconnections of mindfulness, mental health, psychotherapy, and the brain. Siegel’s work has been important in (1) explaining mindfulness, (2) exploring the effects of mindfulness, (3) researching how mindfulness affects the brain, and (4) enlarging mindfulness research to include other forms of religious contemplation.

Siegel’s perspective of mindfulness. Daniel Siegel (2017) builds his work upon a simple assertion: “What we do with our mind matters” (p. 308). What are we supposed to do with our minds? According to Siegel, we have the wonderful opportunity of using our minds to focus our attention. This is what mindfulness is about, focusing the mind in specific ways (D. Siegel, 2007).

Focusing is about paying attention in the present moment. This creates a special form of awareness called mindfulness. Daniel Siegel (2007) divides attention into three dimensions: orienting, alerting, and executive. We are orienting when we select an object upon which to focus. Orienting is the “aiming” part of attention. Alerting is when we maintain our focus on the selected object. Alerting is the “sustaining” part of attention. When we notice that our focus has drifted away from our selected target and then return our focus to that object, we are using the executive function.

Aiming and sustaining our attention are central to the practice of mindfulness. To practice mindfulness, we must have the intention of aiming and sustaining our focus on a selected object. We must also have the capacity to realize that our attention has wandered and then be able to refocus our attention. Orienting, alerting, and executing are the essential elements of mindfulness.

For example, a common first step in mindfulness is for practitioners to focus their attention on their breath. When they notice that their attention has drifted off to something else, as it invariably does, they return their attention to their breathing. Over and over again, by returning their focus to their breath, they develop the aim and sustain dimensions of the mind’s attention.

Drawing a direct line between mindfulness and attention, Siegel (2007) observes, “Mindfulness involves attuning our attention to our own intention” (p. 164). This description highlights two vital concepts that are related to attention: intention and attuning. What is intention? Siegel (2017) explains that intention is about “developing a state of mind with purpose and direction” (p. 284). Practitioners must be aiming their attention at a selected object (e.g., breath, a candle, the sound of a bell, etc.). And they must have the purpose of sustaining their attention on th...

Indice dei contenuti

• Cover
• Title Page
• Dedication Page
• Contents
• Acknowledgments
• Introduction
• Abbreviations
• 1 Two Voices
• 2 Contemplative Prayer
• 3 On Being Human
• 4 How People Change
• 5 The Counselor's Presence
• 6 An Overview of Treatment
• 7 Therapeutic Tasks
• 8 Building a House
• 9 Captured by Love
• References
• Author Index
• Subject Index
• Christian Association for Psychological Studies
• Praise for Contemplation & Counseling
• About the Author
• More Titles from InterVarsity Press
• Copyright