Mindfulness and Psychotherapy

MINDFULNESS AND PSYCHOTHERAPY Mindfulness and Psychotherapy Edited by CHRISTOPHER K. GERMER RONALD D. SIEGEL PAUL R. FULTON THE GUILFORD PRESS New York London © 2005 The Guilford Press A Division of Guilford Publications, Inc. 72 Spring Street, New York, NY 10012 www.guilford.com All rights reserved No part of this book may be reproduced, translated, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher. Printed in the United States of America This book is printed on acid-free paper. Last digit is print number:987654321 Library of Congress Cataloging-in-Publication Data Mindfulness and psychotherapy / Christopher K. Germer, Ronald D. Siegel, Paul R. Fulton, editors.— 1st ed. p. cm. Includes bibliographical references and index. ISBN 1-59385-139-1 1. Meditation—Therapeutic use. 2. Meditation—Buddhism. 3. Psychotherapy. I. Germer, Christopher K. II. Siegel, Ronald D. III. Fulton, Paul R. RC489.M43M56 2005 615.8′52—dc22 2004028821 In memory of Phil About the Editors About the Editors Christopher K. Germer, PhD, is a clinical psychologist in private practice, specializing in mindfulness-based treatment of anxiety and panic. He has been integrating meditation and mindfulness principles into psychotherapy since 1978. Dr. Germer has taken over a dozen trips to India to explore the varieties of meditation and yoga. He is currently the Di- rector of Continuing Education for the Institute for Meditation and Psy- chotherapy and is a clinical instructor in psychology at Harvard Medical School. Ronald D. Siegel, PsyD, is a clinical psychologist, a member of the clinical faculty of Harvard Medical School for over 20 years, and a long- term student of mindfulness meditation. His personal recovery from disabling back pain led him to develop the Back Sense program, a step- by-step mind–body approach to treating chronic back pain, which inte- grates Western psychological and medical interventions with mindfulness practice. He teaches nationally about mind–body treatment and maintains a private clinical practice in Lincoln, Massachusetts. Dr. Siegel is coauthor, with Michael H. Urdang and Douglas R. Johnson, of Back Sense: A Revolutionary Approach to Halting the Cycle of Chronic Back Pain (Broadway Books). Paul R. Fulton, EdD, is the Director of Mental Health for Tufts Health Plan in Massachusetts, a clinical psychologist in private psychotherapy practice, and a forensic psychologist. He received lay ordination as a Zen Buddhist in 1972, and has been a student of psychology and medi- vii viii About the Editors tation for 35 years. He was the clinical director of a large state psychiatric facility, and later the program director for a private psychiatric hospital. Dr. Fulton has been teaching about psychology and meditation for many years, is on the board of directors of the Barre Center for Buddhist Studies, and is President of the Institute for Meditation and Psychother- apy. Contributors Contributors Paul R. Fulton, EdD (see “About the Editors”). Christopher K. Germer, PhD (see “About the Editors”). Trudy A. Goodman, EdM, LMFT, studied child development with Jean Piaget in Geneva. She was a dharma teacher with Zen Master Seung Sahn, and studied with Maurine Stuart Roshi until her death. Ms. Good- man was an early mindfulness meditation student of Joseph Goldstein and Sharon Salzberg, and she received additional training as a teacher with Jack Kornfield. She began teaching about the integration of psychotherapy and meditation in 1976, and is the Guiding Teacher of the Insti- tute for Meditation and Psychotherapy. After years at the Cambridge Buddhist Association teaching Zen, Ms. Goodman now teaches mindfulness meditation at the Spirit Rock Meditation Center, the Barre Center for Buddhist Studies, and the Insight Meditation Society. She founded In- sight LA in Los Angeles. Sara W. Lazar, PhD, is a scientist in the Psychiatry Department at Mas- sachusetts General Hospital and an instructor in psychology at Harvard Medical School. The focus of her research is the neurobiology of meditation. Dr. Lazar uses functional magnetic resonance imaging to investi- gate the neural correlates of changes in autonomic function during the practice of meditation. She has been practicing yoga and mindfulness meditation since 1994, and serves as Science Advisor to the Institute for Meditation and Psychotherapy. ix x Contributors Stephanie P. Morgan, PsyD, MSW, is a clinical psychologist and social worker. She has been a student of meditation in the mindfulness and Zen traditions for the past 25 years. She was an instructor in psychology at Harvard Medical School from 1990 to 1994, training psychology in- terns in mindfulness and self-care skills. Dr. Morgan is currently in private practice in Manchester, Massachusetts, specializing in depression treatment and consultation to meditation communities on mental health issues. Susan T. Morgan, MSN, RN, CS, is a clinical nurse specialist in private practice in Cambridge, Massachusetts. She was Coordinator of the Yale Adult Pervasive Developmental Disorders Research Clinic for 5 years. Following this, she became a clinician at the Harvard University Health Services and introduced mindfulness meditation to college students in the context of psychotherapy. Ms. Morgan participates in a 6-week si- lent mindfulness retreat each year. When not practicing psychotherapy, she is mindfully throwing clay pots. William D. Morgan, PsyD, is a clinical psychologist in private practice in Cambridge and Braintree, Massachusetts. He has participated in inten- sive retreats in the Theravadin, Zen, and Tibetan schools of Buddhism during his 30 years of meditation practice. Dr. Morgan’s graduate research focused on the meaning of making progress in meditation. Since 1987, he has led retreats and taught mindfulness meditation, most re- cently to psychotherapists. Andrew Olendzki, PhD, a scholar of the early Buddhist tradition, trained at Lancaster University (England), Harvard University, and at the University of Sri Lanka (Perediniya). In addition to teaching at vari- ous New England colleges, he was the Executive Director of the Insight Meditation Society for 6 years, and is currently the Executive Director and core faculty member of the Barre Center for Buddhist Studies, Barre, Massachusetts. Dr. Olendzki is also the editor of the Insight Journal. Ronald D. Siegel, PsyD (see “About the Editors”). Charles W. Styron, PsyD, is a clinical psychologist in private practice in Watertown, Massachusetts, as well as a consulting psychologist for Caritas Norwood Hospital in Norwood, Massachusetts. He is the founder of Everest Coaching, for which he does professional and executive coaching, and he is also a former architect. Dr. Styron has been a practitioner and teacher in the Shambhala and Tibetan Vajrayana Bud- Contributors xi dhist traditions for 25 years. He is married, has a 9-year-old daughter, and is a collagist and an amateur mountain climber. Janet L. Surrey, PhD, is a clinical psychologist and a Founding Scholar of the Jean Baker Miller Training Institute at the Stone Center, Wellesley College. She is on the faculty of the Institute for Meditation and Psycho- therapy and the Andover–Newton Theological School. Dr. Surrey has been consulting and teaching relational–cultural theory nationally and internationally for over 20 years, and has been working to synthesize Buddhist and relational psychology. Her publications include Women’s Growth in Connection (coauthored with Judith V. Jordan, Alexandra G. Kaplan, Jean Baker Miller, and Irene P. Stiver; Guilford Press), Mothering Against the Odds: Diverse Voices of Contemporary Mothers (coedited with Cynthia García Coll and Kathy Weingarten; Guilford Press), We Have to Talk: Healing Dialogues between Women and Men (coauthored with Samuel Shem; Basic Books), and Bill W. and Dr. Bob: The Story of the Founding of Alcoholics Anonymous (coauthored with Samuel Shem; Samuel French). Preface Preface his book is not about anything special. It is about a simple Tform of awareness—mindfulness—that is available to every- one at any moment. As you start to read this preface, for example, your attention may be absorbed in the words or you may be wondering whether this book will be worth your trouble. Do you know where your attention is? Has it already wandered from this page? It is natural for the mind to wander, but are you aware when it does so, and what you are thinking about? Mindfulness is simply about being aware of where your mind is from one moment to the next, with gentle acceptance. This kind of simple attention can have a deeply transformative effect on our daily lives. We can learn to enjoy very ordinary things, such as the flavor of an apple, or tolerate great hardship, such as the death of a loved one, just by learning to be aware. This is also a book by clinicians for clinicians. It is the fruit of over 20 years of monthly meetings by a small group of psychotherapists who found themselves drawn to the twin practices of mindfulness meditation and psychotherapy. Most of our meditation practices have evolved over somewhat longer periods of time than our therapy practices. Some of the authors managed to write dissertations in graduate school on subjects related to Buddhist psychology or meditation. Over the years, a robust conversation on a wide range of professional topics developed. Many of the fruits of this exchange are shared in this volume. Although the authors of this book have grown older over the past two decades, the experience of mindfulness has not grown old. Mindfulness is a renewable source of energy and delight. It can easily be experienced by anyone but cannot adequately be described. Mindful awareness is mostly experiential and nonverbal (i.e., sensory, somatic, intuitive, emotional), and it requires some practice to develop. Like any acquired skill, the experience of mindfulness becomes steadier with increased practice.

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