Psychotherapy and Mindfulness
- The following article includes excerpts from an article written by Dr Lipp in the September/October 2011 issue of The Therapist.
“Who are you? said the Caterpillar. Alice replied, rather shyly, “I-I hardly know, Sir, just at present-at least I know who I was when I got up this morning, but I must have changed several times since then (1).”
“It all began with a decision to take care of myself. I had been in private practice since 1981, in charge of a large non-profit psychological service agency, teaching in a Master’s program and co-leading a traineeship program at a graduate school for those learning to become psychotherapists. I had just completed six week-long classes in which I taught mindfulness based strategies to a hospital staff who wished to include these strategies in their alcohol/drug treatment and eating disorders treatment units. Flying back and forth to the hospital, maintaining my work with clients at home as well, I was wired, tired and disconnected from my own felt experience. The tipping point! I had been diagnosed with a chronic illness as well as what is called a catastrophic illness and realized that it was time for me to stop for a while and look at myself. Really look at myself.
I came to San Francisco Zen Center (SFZC) for a year respite from 12 years or so of many professional activities. The mindfulness based Buddhist teacher who I had been meeting with for years was also a Zen Buddhist teacher. He helped me meet and relate to my own pain, anxiety, depression, feelings of overwhelm and belief that I was simply not enough. When I told him that I wanted to move to a Buddhist center for one year to focus more on how to relate to my own pain, he suggested SFZC. I stayed for 10 years.
When I answered the phone the third week after moving out of residency at SFZC, I was pleased to hear the voice of a potential new client. The call opened the gate of re-entry into the activity of being with people again as a psychotherapist. The person I spoke with that day referred to me as Dr. Lipp, a title I had left at the Buddhist temple door 10 years before, and it was a bit disorienting to be referred to in this way. My experience in that moment might have reflected how it was for Alice when she emerged after falling down the rabbit hole in Alice’s Adventures in Wonderland “Who are you? said the Caterpillar. Alice replied, rather shyly, “I-I hardly know, Sir, just at present-at least I know who I was when I got up this morning, but I must have changed several times since then (1).”
Laughing at the idea that I would simply enter the mental health field as the same person I was when I left it I realized that this was simply not possible--after all everything changes. How I had identified myself in the role of psychotherapist when I entered temple life was not an identity I could or wanted to hold onto anymore. Some fear accompanied the thought that I didn’t know who I was anymore. When the Buddhist teacher I referred to earlier called me and asked what I was doing and I responded, I-I hardly know, I’m sitting by the side of the road to see what comes along it and I don’t know who I am anymore.….
He listened and then asked me to teach at his center with a focus on relating to depression and anxiety. I responded to him that even though I had learned how to relate to and tame the fiery thoughts and feelings of what I then still called anxiety and depression, I still had a lot more to learn. I didn’t feel ready to teach and I surely didn’t know who I was as a clinician anymore. A side note: In some Zen Buddhist temples, when your teacher asks you to do something three times, it is a custom that on the third request, the student says ‘yes’. We set a date for me to teach a series of classes at his center on how to use mindfulness strategies to relate to depression. I became very interested in what and how I could do this and set out on a research journey to help me discover and make decisions about what to include….
Research subject: Me
Research question: What’s going on here?
“…When we ask the question, “What’s going on here” we are using the innate mindfulness ability of the human being that’s available to us at birth. We know this as we see how this ability develops in babies: What’s going on here? Right now? Hmmm, do I like the taste of grass? And now? Dirt? Cookies? Regardless of individual temperaments and personalities and the conditions we find ourselves in with our families, cultural and societal circumstances, our mind/body wants to survive, be safe, avoid pain and moves towards pleasure. As we mature, memories and dreams of how to stay safe and secure and get what we want in the future keeps us engaged and moves us away from what is actually happening right here, right now in the present. This process is the same for all human beings…”
Before I continue, “…it would probably be helpful to provide a working definition for mindfulness. Simply stated, mindfulness can be viewed as the ability to recognize what is happening right where we are in the present moment. As far as I know we are different than other animals in that we have the ability to be self-reflective... In relationship to studying ourselves we can offer ourselves a mindfulness practice as a self-reflective tool. We can, or maybe already do, ask ourselves “What’s going on right now.”
We can learn to be with whatever experience comes along, even with the fiery, scary and sometimes depleting experiences…”Instead of fighting with experience, (we) can stay close to what is happening internally with the (metaphoric) umbrella of mindfulness as protection…as we stay close to fiery experience, without fighting or pretending that internal fiery experience isn’t happening, we can explore the conditions in which fires gets started, what keeps them going and what helps them calm down. As we stay close to our direct experience with (internal) fire, we can discover much about fire’s nature, how to relate to it when you notice its approach and since fire doesn’t continue if it isn’t feed by fuel, we might even get a glimpse of fire finding its own way out”…
“…sometimes when we stay close to our experiences, without blaming ourselves for them, we begin to realize that the burdens of our own stories about ourselves and other people’s stories about us can be left at the side of the road…stories about our own life and who we think we are don’t have to be the boss of us. The stories are fabricated by thoughts, feelings, and body sensations that appear as a chain of links that are permanently fused together. When we stop and examine this fabrication we begin to see that there is space between the links. The moment we notice this we have interrupted the story and fabrication has an opportunity to fall away itself. We can see how this happens in the present moment and it is here that we can taste freedom from the story.
As we engage with a mindfulness practice again and again, in the midst of whatever comes up, we are literally re-sculpting the brain and teaching the nervous system that it can become free from old-fashioned stories and the reactivity patterns that accompany them. Sometimes I see a time out from our usual activities to practice mindfulness as entering remediation camp. No one else can do this for us…” and we can look for a mindfulness based psychotherapist and/or a mindfulness teacher who can offer us re-sculpting tools and show us how to use them. And then, as you engage with the tools yourself, you can learn how to be the skillful scultptor.
“As the essence of mindfulness-based interventions can best be understood through our own experience, I invite you to stop for a moment right now to see how it is to simply be with your direct experience of what is happening internally right here. It can be helpful to notice breath as the body receives it and to notice breath as the body releases it. Most of us don’t have to do anything for breathing to happen, and that may be what we notice first, the body breathes itself. And now if we decide to enter the research journey for a few minutes we can ask, “What’s going on here?” And as aspects of internal experience show themselves to you right now, you may notice that the mind has wandered from the question as the oldest part of our brain, the primitive brain in the interest of survival, keeps scanning the territory. OK… as we bring the attention back to “What’s going on here?” we can affirm to ourselves that we have more then our primitive brain available to us. And we wait for the answer to reveal itself.
Research subject: You.