Contemplative psychotherapy, a branch of therapy integrating Eastern Buddhist philosophy and practice with the clinical traditions of modern Western psychology, is rooted in the belief that all people are granted the internal wisdom necessary to heal from pain.
People seeking therapy to increase self-awareness, improve overall health, and promote a general sense of well-being may find contemplative therapy to be a beneficial approach.
Contemplative psychotherapy was developed in the 1970s by Tibetan meditation master, Chögyam Trungpa Rinpoche, who was influential in bringing Buddhism to the West. In his efforts to do so, he was challenged by the view many held of Buddhism as solely a religious ideology. To clarify the philosophy of Buddhism and make the concepts more accessible to Westerners, Rinpoche adopted the language and theory of Western psychology, using terms and phrases like “depression” and “unconscious mental pattern” to help people see meditation as something other than an esoteric religious practice. He founded Naropa Institute (which later became Naropa University) in Boulder, Colorado in 1974 to offer classes in contemplative psychology.
Since that time, contemplative psychotherapy has evolved into a therapeutic practice that blends the meditative techniques of Buddhism with the theory and application of traditional Western psychology. Contemplative psychotherapy integrates such aspects of Buddhism as meditation, mindfulness, and the concept of “brilliant sanity” with the distinct language of mental health, the use of an intimate therapeutic relationship, and the exploration of the stages of human development.
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Contemplative psychotherapists believe people are inherently good and have the capacity for what is known as brilliant sanity. This core concept describes what contemplative psychotherapy upholds as the fundamental nature of human beings: all people have natural wisdom within them, and this wisdom can be used to achieve healing and self-awareness. Brilliant sanity is believed to be ever-present, even if it is not fully manifested. The goal of contemplative psychotherapy is to help people uncover this brilliant sanity and tap inner resources to achieve improved well-being.
Contemplative psychotherapy is built upon the tenets of Buddhism and uses the Buddhist philosophy as its primary theoretical framework, though the approach also incorporates theory from traditional psychology models like the psychodynamic and humanistic approaches.
The Four Noble Truths of Buddhism form the foundation of the contemplative psychotherapy approach:
- The Truth of Suffering: People tend to deny, ignore, or dispute their painful experiences, but in reality all people have these experiences, and their lives will always be patterned with suffering.
- The Truth of the Origin of Suffering: Pain originates from the attempt to create a solid, unchanging sense of self, or ego. By its very nature, this process creates suffering according to Buddhist beliefs because there is no such thing as a permanent, distinct self. People are ever-changing.
- The Truth of the Cessation of Suffering: People have the ability to stop suffering once they realize their efforts to establish a permanent self are futile. They can accept who they really are and relax into their genuine selves by releasing the facade of an illusory ego.
- The Truth of the Path: Once people accept their true selves, they are “awakened” to the path that is unique to them. This long, steady process of development is the way to achieve their goals. For some, psychotherapy may play a role in this journey.
These truths guide the overall direction of treatment while the principles of Western psychology provide the structure. The Four Noble Truths can be considered as a kind of map for the treatment journey while the therapeutic relationship and techniques are the vehicles.
The influence of psychodynamic theory can be seen in the way contemplative psychotherapy conceptualizes the interactions occurring in the therapy session. This method also incorporates humanistic theory, notably in its emphasis on the value of the therapeutic relationship and on the importance of remaining present in the “here-and-now” during session. The following facets of traditional psychology are considered essential to contemplative psychotherapy:
- Therapeutic relationship: Like person-centered and Gestalt therapies, contemplative psychotherapists believe the therapeutic relationship is of paramount importance.
- Therapeutic practice: In the same way traditional psychotherapists seek supervision or therapy to attend to their own areas of challenge, contemplative psychotherapists are encouraged to participate in various types of mindfulness practices. Practices such as shamatha, tonglen, and maitri are all intended to help therapists stay centered and present during therapy. Therapists also teach these practices to those they work with. For example, a therapist who practices maitri in order to achieve “unconditional friendliness” may be better able to remain centered when working with a person experiencing anger issues.
- Therapeutic exchange: Contemplative psychotherapy's version of countertransference, therapeutic exchange refers to the therapist's direct experience with the person in therapy. Whereas a countertransference reaction often relates to something in the therapist's past, exchange only involves the present experience and is not related to anything else. For example, a therapist may become aware of a prickling feeling on the skin while sitting with someone who is having a panic attack. The exchange in this scenario involves the therapist's physical response to the anxious energy in the room.
The overarching goal of contemplative psychotherapy is to increase self-awareness and improve well-being. The role of the contemplative psychotherapist is to help people uncover and understand their most authentic selves. Contemplative psychotherapists are trained to see the strength and “sanity” in each and every person in therapy. Therapists work to support people in acknowledging their strengths and their pain in order to use both to achieve inner peace.
Some of the techniques and practices utilized by contemplative psychotherapists include the following:
- Shamatha Mindfulness Sitting Meditation: Therapists help people explore the difference between being present and non-present through this sitting meditation. This mindfulness practice allows people to identify the biases and ego expectations keeping their brilliant sanity buried.
- Maitri: Therapists help people in therapy accept their entire selves and all of their experiences. People typically are taught space awareness and may discover ways to resist challenging their true selves. People in therapy can also learn ways to approach all experiences with curiosity and warmth instead of rejecting things that do not fit into their idea of "permanent self." The goal is often to instill a sense of “unconditional friendliness” toward the self and toward others.
- Touch and Go: Therapists use this technique to stay present for those in therapy. They “touch” their experience as it rises up and then let it go in order to avoid getting lost in the emotional response. This process incorporates both mindfulness and maitri: in mindfulness, the therapist focuses on the experience as arises, and in maitri, the therapist allows the experience to be what it is and lets it go. For example, if a person becomes angry and yells at the therapist, the therapist might initially feel defensive. The therapist will note the defensive response, accept it for what it is, and then let it go. This rhythm can often have a positive impact on the exchange between the therapist and person in therapy.
One difference between mainstream psychotherapy and contemplative psychotherapy is the perspective of the latter on mental health conditions and symptoms. Most Western approaches tend to focus on the source of an individual’s pain and address those concerns in order to improve symptoms. Contemplative psychotherapy, on the other hand, views the effects of past trauma and emotional challenges as barriers that can prevent a person’s internal wisdom from helping the person to heal from these effects. Proponents of contemplative psychotherapy believe awakening the self as it is, while fully experiencing moments of challenge and difficulty, is the key to achieving healing.
Many traditional Western therapies aim to help people move toward a new state of being, when they express the desire to do so. Contemplative psychotherapy instead works to help individuals clarify and accept their authentic selves in order to achieve healing from acceptance and internal wisdom.
People wishing to increase mindfulness may be helped by contemplative psychotherapy. Increased mindfulness may help individuals recognize and dealt with the effects of mental health concerns. For example, a person whose shopping habits both result from and lead to anxiety and stress can learn to track when the desire to shop arises, examine any difficult or feelings present at the time, and work to develop a new practice to reduce anxiety that will not lead to further anxiety.
Those who have faced trauma or abuse may be able to, through contemplative psychotherapy, address and accept any pain they may carry from these events. Proponents of contemplative psychotherapy believe by being open to painful experiences and visualizing them clearly, people can uncover the so-called brilliant sanity that will help them heal and continue through life in a state of greater well-being.
Negative feelings, including those experienced as a result of conditions such as anxiety or depression, may persist throughout life. A contemplative psychotherapy approach may help individuals accept this fact and learn ways to modify their relationship with these feelings rather than simply try to eliminate them.
One study found a contemplative self-healing approach to be helpful in improving well-being in women who were treated for breast cancer. After a 20-week program, most of the study participants reported fewer feelings of stress and fear and said they had learned skills they thought would help them cope with negative feelings and interactions following treatment. This program may be effective for cancer patients and others facing serious or terminal illness, because it does not simply emphasize positive thinking—which, if it does not acknowledge the realities of cancer or a person's negative thoughts about the illness, may lead to further distress—but encourages open contemplation and exploration of all thoughts and images, negative and positive.
Contemplative psychotherapy is still a relatively new approach, but mental health practitioners and other health professionals interested in the approach can complete a continuing education course to obtain certification in a number of training programs throughout Europe and the United States.
Perhaps one of the most well-known training programs is The Nalanda Institute's intensive two-year course in contemplative psychotherapy. This program offers distance learning and satellite training options, in addition to classes that can be taken locally in Toronto, New York, and Barcelona.
Students at Naropa University (formerly the Naropa Institute) in Boulder, Colorado can pursue an undergraduate degree in contemplative psychology and can also obtain a master's degree in clinical mental health counseling with a focus in contemplative psychotherapy and other mindfulness-based approaches. This university is considered the national leader in contemplative higher education. Interested professionals can find more information on the Naropa University website.
Available resources are limited, as this method is not yet widely known, and minimal research has been conducted to determine its efficacy. Nonetheless, the practice is expanding, and future studies may support the benefits of this alternative therapy method.
Contemplative psychotherapy emphasizes meditation and mindfulness and may be considered spiritual by some, and some people seeking treatment may not be comfortable with this type of approach. Individuals who find it challenging to explore and accept negative aspects of the self and/or difficult or painful memories may choose to seek a method of therapy that addresses these issues in a different manner.
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