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Cushion
and
Couch
Winter 2019-20
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In this issue:
Cushion and Couch
is IMP's quarterly e-journal, featuring articles, interviews, and book reviews written by and for members of the community. If you are interested in
contributing, or just want to give us feedback, please send us an
e-mail
.
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Are You Paying Attention??
By Edward R. Ryan
Edward Ryan, PhD is an Associate Clinical Professor in the Yale Psychiatry Department, a training and supervising psychologist in the Yale Long-Term Care Clinic, and a clinician in private practice in New Haven, Connecticut. Dr. Ryan has practiced insight meditation for thirty years, and has served on the Board of Directors of the Insight Meditation Society, in Barre, Massachusetts. With his wife, the poet Sylvia Forges-Ryan, he published Take A Deep Breath: The Haiku Way to Inner Peace.
Some time ago I was attending an evening dharma talk at a retreat at IMS, led by U Pandita, the revered Burmese meditation teacher. It was a few days into the month-long retreat, and the meditation hall was full to overflowing with American meditation teachers and retreatants. U Pandita began his talk in Burmese, and his assistant translated, saying, "The Sayadaw says: when you come for interviews do not tell your personal stories. He is not interested in your personal stories. He is interested in your experience of the inbreath coming in and the outbreath going out. Pay attention to this experience." There was a palpable gasp among the retreatants, as they were being instructed to pay attention to their breathing, and more importantly, in this American therapy/memoir/self-oriented culture, not to tell their personal stories. U Pandita was asking: Are you paying attention? And he was requiring that this attention be paid to the experience of the breath, consistent with the goals of Buddhist meditation.
This question was repeated a few years later while I was attending another retreat at IMS. After about a week of daily silent meditation I had the experience of my body being entirely filled with light, or better put, what had been my body was now light. This experience continued over a full day, and I was excited and amazed. "Am I enlightened?" I asked myself. "Have I achieved a special status?" I was very pleased. When I went for my interview with Sharon Salzberg, I proudly announced my experience, and I expected to talk about it and to discover my place in the history of great meditation experiences. So, to my surprise, she responded by smiling and asking: "Are you paying attention to the experience?" Immediately I knew what she was talking about, and I hated to know-simply bringing attention to the experience and simply seeing what is there. In other words, just continue being mindful. What? No party to celebrate?
Are you paying attention? The central question (and instruction) in the development of mindfulness meditation.
It is, I think, also the central question in psychotherapy-but in a different way. Here the person coming to do therapy and I want to hear the personal story-and pay attention to it.
These days there are many words we use to codify a whole world of different and unique psychological experiences. There are two we see all the time: anxiety and depression. How many referrals do we see on our listservs that include basic demographic information and then these two words? But these words are not experiences, and after practicing therapy for fifty years, I no longer know what they mean. And so, when a person coming to do therapy uses one of these words, I ask her/him to tell me the experience she/he is referring to.
Let's begin with depression. Many years ago, a woman introduced herself to me as "chronically depressed," and while she said she had some response to medications and short-term therapy, she remained depressed. Despite her description of herself I was struck with how likable she was-intelligent, talented, successful, and funny. However, in talking about herself she described herself as a loser-an inept, unhappy person who was responsible for a great deal of unhappiness in herself and others. She used the words "depression" and "depressed" a lot, and gradually I invited her to describe the experience she was talking about. Over time, she gradually talked more and more about how unhappy she was, and as she looked into that experience, she discovered-through reflection and dreams-that she was angry as well. As time went on, and she told me more and more about her life, she began to realize that she was unhappily married and had been for many years. As she became aware, by paying attention to her actual experience, her demeanor gradually changed, her outlook changed, and the quality of her life changed. She gradually stopped taking the medications. When she eventually got a divorce, she also changed her job, and became a much happier person. I think she learned to pay attention to her experience and out of that emerged a new way of being herself.
Similarly, it is possible to pay attention to the experiences that are codified into the word "anxiety." A young, vital, successful man with whom I had been meeting received the diagnosis of a chronic illness. Naturally he was surprised and shocked. He then began saying that he was "anxious" all the time. But as I encouraged him to pay attention to his experience, his first awareness was that he was frightened (not "anxious.") As he paid attention to the fear he realized it was partly a fear of the unknown, but mostly it was a memory of having been left alone as a child, as a result of divorce and addiction in his family, to deal with things on his own. He had developed ways of coping, a child's ways: bravado, imagining he knew more than adults, the comfort of transitional objects-anything to ward off the feelings of fear and helplessness. Now, in response to the diagnosis, he was experiencing the situation as if he was still that child. Once he realized now was not then, that he was not an abandoned child, and he began grudgingly but effectively to teach himself how to care for himself in new ways now, as a loving and steadfast adult.
I think this comes down to mindfulness-one kind in meditation consistent with its aims, what we might call the exploration of ultimate reality; and another kind in psychotherapy consistent with its aims, what we might call the exploration of relative reality. In both, paying attention to actual experience is essential.
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Permission to Rest: Mindfulness for Burnout
By Susan M. Pollak
Susan M. Pollak, MTS, EdD, is a psychologist in private practice in Cambridge, Massachusetts. She is a longtime student of meditation and yoga who has been integrating the practices of meditation into psychotherapy since the 1980s. Dr. Pollak is cofounder and teacher at the Center for Mindfulness and Compassion at Harvard Medical School/ Cambridge Health Alliance and president of the Institute for Meditation and Psychotherapy. Dr. Pollak is a co-editor of The Cultural Transition;
and a contributing author of Mapping the Moral Domain; Evocative Objects;
and Mindfulness and Psychotherapy,
2nd Edition. She is the coauthor of Sitting Together: Essential Skills for Mindfulness-Based Psychotherapy
and the author of the new book Self-Compassion for Parents: Nurture Your Child by Caring for Yourself.
You can learn more about her work at DrSusanPollak.com.
The bright green poster on the bulletin board at the meditation center caught my eye. "Finding Emotional Balance Amidst Uncertainty." I knew I needed a break, but clearing an entire day seemed impossible. I sighed and walked away.
The past few months had been difficult. A beloved friend, a talented painter, a master of color and light, died suddenly. My 95-year-old mother fell and needed to be hospitalized. My husband contracted an illness and has been in severe pain for months. And another friend, who struggled with cancer for over a decade, just had some devastating news. I was worn-down, beginning to have migraines and aware that I was holding accumulated stress in my body that my weekly (well, on a good week) yoga class didn't touch.
Trying to find some more balance in my life, I'd started listening to the
Ten Percent Happier app, enjoying the playfulness, kindness, and intelligence of Alexis Santos, one of the meditation teachers. When I noticed that Santos was teaching the retreat, my uncertainly vanished and I ruthlessly juggled my schedule so I could attend.
The retreat was held at the Tang Institute in Andover on the idyllic New England campus of the Phillips Academy. The Institute, directed by Andrew Housiaux, supports innovative learning and teaching. They host a series on Mindfulness Meditation which is open, free of charge, to the entire community.
I settled in, glad to be out of the city and to have a cloudless deep blue sky overhead. I found myself relaxing into the comforting rhythm of a mindfulness retreat-lectures and stories punctuated with sitting meditation, walking meditation, and questions from the audience. As I slowed down I could feel myself begin to unwind and let go of the grief, stress, and worry I'd been carrying.
There was something new for me in this retreat. Santos has studied with Sayadaw U Tejaniya, an iconoclastic monk in Myanmar who lived and worked in the world before donning monastic robes. In his tradition, the focus is not on sitting with the eyes closed, bringing attention to just the breath or sensations, but in developing an awareness of the whole of life. We practiced bringing mindfulness to the habitual moments of the day, to places where we don't normally think to practice-those in-between moments of life. By noticing what is usually unnoticed, I began to feel less fragmented. It was almost like seeing into the shadows. By including everything and pushing nothing away I could be with the complexity of my feelings. All of them.
The chance to truly rest and let go felt radical, against the stream of how so many of us live our lives. Our world allows us so little opportunity to slow down and stop, little chance to grieve. In retrospect, it seemed humorous that I turned taking a day off to meditate into an epic battle.
What Santos taught was worlds beyond a relaxation response. He gave us full permission to rest, to tune into our deepest needs. It was even ok to fall asleep if that is what happened. He even gave us permission to snore. Really? This was an instruction I'd never heard. Usually, students are told that they will be woken up if they snore. I was deeply moved. It felt incredibly compassionate to allow us to fully be in our experience. And to include the totality of life. I think this departure from tradition is where things shifted for me. I didn't have to keep everything together. I could let myself grieve. At the end of the day, I felt deeply and profoundly restored, finding a balance and an acceptance of life that I hadn't had when I walked in the door.
I didn't take notes during the meditation, but I have tried to recreate the instructions as best I can, incorporating some self-compassion as well.
Permission to Rest
1. Start by lying down. For this practice, you don't need to sit upright.
2. Let your body sink into the ground. Feel yourself held and supported by the earth. Allow the body to be natural. Include the entire body.
3. Let go of any tension or tightness. Allow the face to soften, the forehead, the eyes, the jaw, the throat, the chest and shoulders, the arms and fingers, the back, the belly, the buttocks, legs and feet. Sense the whole body.
4. What is easy to be aware of in this moment? What is the general state of mind? What are you feeling?
5. Are you alert or sleepy? Let it be. Don't struggle.
6. Let yourself rest as fully as possible. Give yourself permission to sleep if that is what you need.
7. Give yourself permission to snore.
8. Bring some kindness and compassion to your body in the moment. If you like, you can put a hand, or two hands, on your heart.
9. Be aware of what is happening in your body and mind.
10. Rest.
11. When you are ready, slowly open the eyes. Take a moment to notice the space you are in and be aware of what you are seeing-the light, the colors, the shadows.
12. See if you can let this natural awareness accompany you through the rest of the day. If you get distracted or forget, don't worry. With the lightest touch, the awareness will return.
When the meditation ended, we all went outside for a walk in the sunshine. We would turn the clocks back that evening. It felt like the last glorious day of autumn. Looking at one golden ginkgo tree, seemingly lit from within, I felt I sense of joy. It was a tree my friend would have treasured.
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Book Review: Teaching the Mindful Self-Compassion Program: A Guide for Professionals
Review by
Michel Selva
by Christopher Germer and Kristin Neff
Guilford Press, 2019
Michel Selva is a psychologist in private practice in Cambridge, MA. He completed the PsyD program at William James College (formerly known as Massachusetts School of Professional Psychology), and did his post-doctoral training at Mount Auburn Hospital. He is a longtime practitioner of meditation, and he is an active member of the Cambridge Zen Center. In his clinical practice, he uses mindfulness-based approaches including Acceptance & Commitment Therapy.
Mindful Self Compassion (MSC) is a training program that was launched in 2010 by Christopher Germer and Kristin Neff. Participants in MSC meet for 2.5 hours every week for 8 weeks in addition to a half-day retreat. Each class session introduces specific methods and allows the participants time to practice them and then reflect on their experiences in a group discussion. This book is directed primarily at people who wish to become certified teachers of MSC. There is an intensive six-day residential training program for prospective MSC teachers. Prior to attending this training, participants must fulfill several prerequisites including a daily mindfulness practice of at least two years duration, attendance at least one 5-day silent teacher-led retreat, and completion of an 8-week MSC program. Although many MSC teachers are clinicians, this is not a requirement.
The Mindful Self Compassion program introduces participants to a variety of practices that have been demonstrated to be effective in controlled studies. Germer and Neff categorize these practices using the terms yin and yang derived from Chinese philosophy. The yin practices are those which are focused on being with and accepting oneself in a compassionate way. This is accomplished by comforting, soothing, and validating. Specific yin practices include the "Self-Compassion Break, "Soothing Touch," and "Being a Compassion Mess." The yang practices focus on effective ways of acting in the world by protecting, providing, and motivating oneself. These include "Fierce Compassion," "Discovering Our Core Values," and "Compassionate Letter to Myself." There are over 50 specific practices in the program, many of which are accompanied by audio recordings by the authors.
The MSC program grew out of Dr. Neff's research at the University of Texas in Austin. In 2003, she published an article in the Self and Identity journal in which she introduced the Self-Compassion Scale (SCS). The arrival of the SCS led to a growing body of research: As of 2017, nearly two thousand journal articles, book chapters, and dissertations had been published related to self-compassion.
Neff's research with the Self-Compassion Scale showed that self-compassion involves three factors. Self-kindness involves the ability to forgive oneself for making mistakes, and to offer comfort to ourselves in the same way that we might comfort a child or friend in a similar situation. Common humanity is a sense of interconnectedness, a recognition that every human being is fallible. In the MSC program, Mindfulness is defined specifically as the ability to turn toward our own suffering and to fully acknowledge it.
The self-compassion scale also measures three factors that are the opposite of the above factors. In the absence of self-kindness, we tend toward
self-criticism. When we lose sight of our common humanity, we tend toward
isolation from others. When we are unable to be mindful of our own pain, we tend toward
over-identification with negative thoughts and feelings. Neff has suggested that these three factors are biologically rooted in the fight-flight-freeze response to external threat. While this biological response is quite useful when we are face to face with a grizzly bear or a tiger, it does not give us an optimal response to challenges that arise from within.
As a clinician, I found this book useful for learning about Mindful Self Compassion and exploring the research base that supports it. However, another book by the same authors might be a better choice for a lay audience: The Mindful Self-Compassion Workbook (Guilford, 2018).
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About the Institute for Meditation and Psychotherapy
The Institute for Meditation and Psychotherapy (IMP)
is a non-profit organization dedicated to the education and training of mental health professionals in the integration of mindfulness meditation and psychotherapy.
The vision of IMP is practice-based, and all teaching faculty have extensive personal and professional experience in the practice of mindfulness meditation or other mindfulness practices. Most educational programs offer CE credit for psychologists, social workers, licensed mental health counselors, licensed marital and family therapists, and nurses. Secondary activities of IMP include psychological consultation to meditation centers, clinical supervision, psychotherapy referrals, and networking for interested clinicians.
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