Getting Beyond I, Me, Mine Sati in Pali Connotes awareness , - - PDF document

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Getting Beyond I, Me, Mine

Mindfulness, Wisdom, and Compassion in Psychotherapy

Ronald Siegel, Psy.D.

What is Mindfulness?

• Sati in Pali
• Connotes awareness, attention, &

remembering

• In therapeutic arena, also includes
• Non-judgment
• Acceptance
• Adds kindness & friendliness

Therapeutic Mindfulness

• 1. Awareness
• 2. Of present experience
• 3. With acceptance

Mindlessness

• Operating on “autopilot”
• Being lost in fantasies of the past and

future

• Breaking or spilling things because

we’re not paying attention

• Rushing through activities without

attending to them

Life Is Difficult, for Everybody The Problem With Selfing

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Mindfulness Can Help Us

• To see and accept things as they are
• To loosen our preoccupation with “self”
• To experience the richness of the

moment

• To become free to act skillfully

Mindfulness Practice is Not:

• Having a “blank” mind
• Becoming emotionless
• Withdrawing from life
• Seeking bliss
• Escaping pain

Breath Awareness

How It Works

Fly

Overwhelmed?

Capacity to bear experience Intensity of experience

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The Thinking Disease

• Review past

pleasure and pain

• Try to maximize

future pleasure and avoid future pain

How Does Mindfulness Help?

• Reinforces experiential approach
• Helps free us from believing in our thoughts
• Reduces narcissistic orientation
• Connects us to the world beyond our

personal pleasure and pain

The Roles of Mindfulness

• Practicing Therapist
• Mindfulness Informed

Psychotherapy

• Mindfulness Based

Psychotherapy

Implicit Explicit

Dodo Bird Hypothesis

“Everybody has won, and all must have prizes.”

What Matters Most in Psychotherapy?

Patient variables Placebo & Expectation Model & technique Common Factors

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“Evenly Hovering Attention”

• “Listen and not to

trouble to keep in mind anything in particular” – Freud, 1912

And I, Sir, Can Be Run Through with a Sword Affect Tolerance

• Not “my,” but “the”
• Anger
• Fear
• Lust
• Joy

Embracing Affect

• Beyond affect tolerance

– embracing emotion

• Our patients can only be

with those emotions that we can embrace

• All emotions

experienced as transient

• A teaspoon of salt in a

pond

Not Knowing Beginner’s Mind

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Decisions, Decisions

• 1. Which skills to emphasize?
• 2. Formal or informal practice?
• 3. Which objects of attention?
• 4. Religious or secular practices?
• 5. Narrative or experiencing mode?
• 6. Relative or absolute truth?
• 7. Turning toward safety or sharp points?

Core Practice Skills

• 1. Concentration (focused attention)
• 2. Mindfulness per se (open monitoring)
• 3. Acceptance and Compassion

Focused Attention vs. Open Monitoring

• Concentration (FA)
• Choose an object

and follow it closely

• Mindfulness (OM)
• Attend to whatever
• bject rises to

forefront of consciousness

Acceptance Loving-kindness Practice

• “Metta” practices
• May I be happy,

peaceful, free from suffering

• May my loved
• nes be happy. . .
• May all beings be
• happy. . .

Continuum of Practice

Informal Mindfulness Practice Formal Meditation Practice Intensive Retreat Practice

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Informal Practice Taillight Meditation Shower Meditation Formal Practice

(Results May Vary)

• Data supports

effects of formal meditation

• Structural and

functional brain changes.

Intensive Retreat Practice

Resources at: meditationandpsychotherapy.org

Objects of Attention

• Feet touching ground
• Sights and sounds of nature
• Taste of food
• Sound of bell
• Breath in belly
• Mantra
• Air at tip of nose

Coarse Subtle

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Religious or Secular?

• “Spiritual” practices
• Devotional and theistic
• Secular practices
• Science grounded
• Seek cultural consonance

Narrative Mode

• Psychodynamic
• Earlier, transference, other relationships
• Behavioral
• How learned, how reinforced
• Systemic
• Maintained by family, community, culture

Experiencing Mode

• How is it felt in the body?
• How does the mind respond?
• Grasping
• Pushing away
• Ignoring

Relative Truth

• Human story
• Success & Failure
• Pleasure & Pain
• Longing
• Hurt
• Anger
• Envy
• Joy
• Pride

Absolute Truth

• Anicca

(impermanence)

• Dukkha

(unsatisfactoriness)

• Anatta (no enduring,

separate self)

Timing is Everything

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Turning toward Safety I

• Outer or distal focus
• Walking Meditation
• Listening Meditation
• Nature Meditation
• Eating Meditation
• Open eye practices

Turning toward Safety II

• Inner focus
• Mountain Meditation
• Guided Imagery
• Metta Practice
• DBT techniques

Turning Toward the Sharp Points

• Moving toward anything

unwanted or avoided

• How is it experienced in

the body?

• Pain, fear, sadness,

anger

• Unwanted images or

memories

• Urges toward

compulsive behaviors

Different Strokes

• Need for frequent adjustment of

exercises

• Elicit feedback about the experience
• Both during and after practice
• Titrate between Safety and Sharp

Points

When Mindfulness of Inner Experience Can Be Harmful

• When overwhelmed

by traumatic memories

• When terrified of

disintegration, loss

• f sense of self
• When suffering from

psychosis

Life Preservers

• Concentration

Practices

• Stepping out of the

thought stream

• Eyes open, external

sensory focus

• Ground, trees, sky,

wind, sounds

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Decisions, Decisions

• 1. Which skills to emphasize?
• 2. Formal or informal practice?
• 3. Which objects of attention?
• 4. Religious or secular practices?
• 5. Narrative or experiencing mode?
• 6. Relative or absolute truth?
• 7. Turning toward safety or sharp points?

Wisdom in Psychotherapy

“Hard core pornography is hard to define” [but] “I know it when I see it.”

• - Justice Potter Stewart (1964)

“If we are doomed to die —let us spend.”

• - Mesopotamia (3000 BCE)

“Be not puffed up with thy knowledge, and be not proud because thou are wise.”

• - Egypt (2000 BCE)

“The narrow intelligence flashing from the keen eye of a clever rogue” is not wisdom.

• - Socrates (400 BCE)

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A 15 year old girl wants to get married right away. What should she do?

Paul Baltes – Berlin Group

• 1. Factual knowledge
• 2. Procedural knowledge
• 3. Life-span contextualism
• 4. Value relativism
• 5. Awareness and management of

uncertainty

Monika Ardelt

“A fool can learn to say all the things a wise man says, and to say them

• n the same occasions, but this

isn’t real wisdom.”

• -John Kekes

Not Knowing Beginner’s Mind Buddhist Psychology

• Compilation of insights derived largely

from mindfulness practice

• Not a religion in Western sense, but the

results of a 2500 year old tradition of introspection

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Three Marks of Existence

• Anicca

(impermanence)

• Dukkha

(unsatisfactoriness)

• Anatta (no enduring,

separate self)

Mindfulness How Mindfulness Fosters Wisdom I

• Stepping Out Of the Thought Stream
• Being With Discomfort
• Disengaging From Automatic

Responses

How Mindfulness Fosters Wisdom II

• Transpersonal Insight
• Seeing How the Mind Creates Suffering
• Embracing Opposites
• Developing Compassion

R-A-I-N

• Recognize what is happening.
• Allow life to be just as it is.
• Investigate inner experience with

kindness.

• Nonidentification; rest in Natural

awareness.

• -Tara Brach

Anatta

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The Western View of the Self

• Emphasis on separateness vs.

connection to family, tribe, nature, etc.

• Healthy (Western) development:
• Individuated
• Aware of Boundaries
• Knowing one’s needs
• Clear identity and sense of self

Narcissism in Western Psychology

• DSM
• Character disorder
• Behavior therapy
• Self efficacy
• Psychodynamic psychotherapy
• Healthy narcissism or self esteem

Narcissism in Buddhist Psychology

• We suffer when we don’t know who we

really are

• Attempt to buttress self is central cause
• f suffering
• Our concept of “self” is based on a

fundamental misunderstanding

Therapeutic Benefits of Glimpsing Anatta

• Increased affect tolerance
• Radical acceptance of parts
• Freedom from self-esteem concerns
• Deeper connection to others

Thinking Homunculus?

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Default Mode Network Where do I Begin and End? What about Boundaries? Boundaries Superorganism Us and Them

Enemy Enemy Meat Meat Meat Meat Enemy Servant Servant Enemy Servant Servant Servant Servant

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Constructing “Me”

• Identity is a

construction project

• Mind is a world-

building organ

• Makes order out of

chaos

• Constructs reality

from data streaming in at break-neck speed

Sense Contact

• Coming together of
• Sense organ
• Sense object
• Awareness of object
• Six senses
• Seeing
• Hearing
• Smelling
• Tasting
• Touching
• Thinking

Perception

• Evaluates sense

experience

• Conditioned by

culture and language

• Constructs and

categorizes

• Omits details
• Fills in missing

information

VIDEO

Feeling

• We add an affective
• r hedonic tone to

all experience

• Pleasant
• Unpleasant
• Neutral

Intention and Disposition

• We try to
• Hold onto the pleasant
• Push away the unpleasant
• Ignore the neutral
• We develop habits of intention
• Dispositions
• Learned behaviors or conditioned responses
• Personality characteristics

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Intention Feeling Perception Consciousness Sense Organ Sense Object

The Construction of Experience

No one Home

• Continuous flow of

moment-to-moment experience

• New “self” born and

dies each moment

• Not even a stable

witness

• Just impersonal

experience unfolding A human being is part of the whole called by us universe ... We experience ourselves, our thoughts and feelings as something separate from the rest. A kind of optical delusion of

• consciousness. This delusion is a kind of prison

for us, restricting us to our personal desires and to affection for a few persons nearest to us. Our task must be to free ourselves from the prison by widening our circle of compassion to embrace all living creatures and the whole of nature in its

• beauty. The true value of a human being is

determined by the measure and the sense in which they have obtained liberation from the self.

The Self

• A verb, not a noun
• Selfing occurs
• We respond differently

when experiences belong to “me”

• Creates further

distortions

Copernicus of the Mind

• Identity is recreated

moment by moment

• Continuity of self is

illusory

• Like frames of a

movie

Affect Tolerance

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And I, Sir, Can Be Run Through with a Sword Selfing & Affect Tolerance

• Not “my,” but “the”
• Anger
• Fear
• Lust
• Joy

Embracing Affect

• Patients can only be

with those emotions that we can embrace

• Emotions experienced

as transient

• Teaspoon of salt in a

pond

Not Knowing Beginner’s Mind

Radical Acceptance

• f Parts

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Our Polytheistic Mind How Was Your Meditation?

• Part trying to attend to

the breath

• Part fantasizing about

the future

• Part judging myself
• Ask the committee!

Jung’s Shadow

• We identify with some

attributes while rejecting

• thers
• We become defensive

when shadow is illuminated

We’re all Bozos on this Bus

• Dandelions in a field
• Not a path to perfection, but a path to

wholeness

• Boundary of what we can accept in
• urselves is the boundary of our

freedom

– Zen Patriarch

The Trance of Unworthiness

• Eastern meditation teachers are

surprised by Western self-criticism

• Anxiety is primal mood of the separate

self (Tara Brach)

• Related to Western cultural emphasis
• n the separate self

Self-Esteem

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Self-Evaluation What Defines Me?

• Physical beauty
• Athletic talent
• Financial status
• Artistic creativity
• Academic degree
• Designer outfit
• Alma matter

Lake Wobegon

Where all the women are strong, all the men are good looking, and all the children are above average.

The Failure of Success

• The pain of I, me, me, mine
• Narcissistic recalibration
• Impossibility of winning consistently

Wrong Wall? As If by an Unseen Hand

• Adaptive value to

identifying with “self”

• Evolved through

natural selection

• Useful for survival
• Self-preservation

instinct shared by

• ther animals

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It’s Getting Worse

Egos Inflating Over Time: A Cross‐Temporal Meta‐Analysis of the Narcissistic Personality Inventory

Journal of Personality, Volume 76, Issue 4

Connecting to Others

Relational-Cultural Theory

• Grew out of feminist critique of conventional

psychology

• Benefits of mutual connection
• Energy and vitality
• Greater capacity to act
• Increased clarity
• Enhanced self-worth (efficacy)
• Desire and capacity for more connection

Three Objects of Awareness

• Mindfulness of sensations, thoughts,

feelings in “me”

• Mindfulness of the words, body

language, mood of the other

• Mindfulness of the flow of relationship

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“Do unto others as you would have them do unto you”

It’s not just a commandment, but a law of nature.

Judgments Life in a Space Suit

• Defenses against

pain insulate us from one another

• We imagine they

keep us safe, but they leave us more vulnerable

It’s About Other People

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Embracing Insignificance

Poor Prognosis King of England, 1387 Narcissistic Threats

• Anxiety often involves threats to us or
• ur loved ones
• Self image
• Health
• Wealth
• Fantasized loss of pleasure
• Anticipated disappointment

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Wat Tham Sua

Tiger Cave Temple Krabi, Thailand

Why Are You Unhappy? Because 99.9% of everything you think, and everything you do, is for yourself. And there isn’t one.

• - Wei Wu Wei

Compassion in Psychotherapy

Affect Regulation Systems .

Seeking pleasure Achieving and Activating Affiliative Soothing/safety Well-being Threat-focused Protection & Safety Seeking Activating/Inhibiting

Anger, anxiety, disgust Drive, excitement, vitality Contentment, safety, connection

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Compassion

• Latin: pati; Greek: pathein (“to suffer”)
• Latin: com (“with”)
• Compassion means to “suffer with”

another person.

Looking Through Another’s Eyes

For meditations & other resources: www.mindfulness-solution.com email: rsiegel@hms.harvard.edu