Nothing could have prepared me for the human suffering I saw in nursing facilities.
As a doctoral student in 2006, I provided mental health services to nursing-facility residents, clients who were most frequently diagnosed with some form of adjustment disorder or depression. Although my doctoral program was not a clinical one, I wanted to experience conventional therapeutic intervention — to deepen my understanding of the theories I was studying as a transpersonal psychologist. I wanted to see, firsthand, how to apply humanistic and cognitive approaches.
But no reading, lecturing, or studying was the same as witnessing, in person, what these clients went through. Their suffering pulled me in. I absorbed it to the point where I felt, after just a few months of working in a clinical capacity, that I may not be a good candidate for clinical work.
Perhaps it was a shortcoming on my part, but the experience gave me enormous respect for the strength, empathy, and compassionate endurance required of clinical psychologists.
I was privileged to work under the supervision of an extraordinarily thoughtful clinician. She shared with me an invaluable piece of advice that helped me successfully complete those few months in the nursing facility. She told me that while it was important to actively listen to and compassionately hear the clients, it was equally important to not absorb their suffering.
“You have to be present with each client,” she said, “but you also have to be able to let their pain go before you interact with the next person.”
Reading Karen Kissel Wegela’s Contemplative Psychotherapy Essentials: Enriching Your Practice With Buddhist Psychology, that advice rang true on a different level. What the supervisor was suggesting, whether or not she realized it, was a form of the Buddhist practice called tonglen.
At the most basic level, tonglen instructs us to breathe in pain and suffering, and to breathe out relief and openness. Most therapists and mental health professionals practice some form of tonglen in their work, whether or not they label it as such. It is this type of seamless, and most often unconscious, melding of Eastern and Western philosophy that is at the foundation of contemplative psychotherapy.
Wegela, a therapist in private practice and a professor of contemplative psychology at the Buddhist-inspired Naropa University in Boulder, Colorado, defines contemplative psychotherapy as “the child of two different parents: the Western psychological traditions of talk therapy and the ancient Eastern teachings of the sixth-century BCE teacher known to us as Buddha or ‘the awakened one.’ ”
The intended audience for this book is therapists and clinicians who are interested in what Buddhist psychology can offer, or who might integrate mindfulness and contemplative tenants into their own practice. For the novice, Wegela provides a thoughtful and beautifully written summary on the foundations of contemplative psychotherapy. Her descriptions of Buddhist philosophy, and her concise explanations of how to integrate those concepts into conventional therapy, are masterful.
Wegela provides scenarios from her own therapeutic practice throughout the book and uses those very real, very contemporary problems as examples. The contemplative approach does not seem starkly different than, say, a talk therapy–based humanistic style. The chief difference rests with how Wegela integrates Buddhist philosophy into her sessions.
“Buddhist psychology,” she writes, “and the contemplative approach based on it, emphasize the importance of direct experience.” This method, she explains, “is especially appropriate for helping clients whose emotions trigger memories of past trauma that they do not yet have the resources to deal with.”
To use this approach, Wegela advises her clients to “pay attention to something other than the emotion with which you are having a hard time.” She suggests a focus upon the breath and, at times, that clients close their eyes and allow themselves to hear and simply be present.
Above all, she asks them to be gentle with themselves.
Wegela is keenly aware that the contemplative approach is not a utopia, and she readily identifies drawbacks to the different methods she describes. She does, however, hold that some techniques — including breathing and thought reframing — can be helpful not just during a session but for the client to learn and use at home.
If you’re curious about how Eastern philosophy can seamlessly combine with and enhance an otherwise Western-based approach to mental health, this book is a must-read.
Contemplative Psychotherapy Essentials: Enriching Your Practice With Buddhist Psychology
W. W. Norton & Company, October 2014
Hardcover, 304 pages