Presented on Contemplative Psychotherapy and Bipolar Disorder at Lewis and Clark

Last week I had the pleasure of presenting to a group of graduate students in the counseling program at Lewis and Clark College. The students were attentive and engaged, and I was glad to have Megan’s expert guidance in preparing for the course and tailoring my presentations to the students.

I lectured in three parts. For the first section, I presented on Contemplative Psychotherapy and the Common Factors, based largely on an article I have under review. Basically, I covered how mindfulness, brilliant sanity, maitri, and exchange are core concepts and practices of Contemplative Psychotherapy, and talked about how they can help enhance the common therapeutic factors.

Brilliant sanity is the notion that human beings are fundamentally wakeful, and sanity precedes all ignorance, suffering, and confusion. Maitri is an attitude of unconditional friendliness towards life, oneself, and others, including all situations, thoughts, and emotions. Exchange is the phenomenon of limbic resonance, or the fact that as human beings, we can subtly sense other peoples’ emotions in our own experience. Mindfulness ties them all together, because therapists who practice mindfulness guided by these principles are able to use mindfulness in the therapeutic relationship to develop unconditional confidence in clients’ brilliant sanity, express unconditional friendliness and openness towards clients and their experience, and work with the subtle information that comes through in the exchange without shutting down or blocking their emotional connection with clients. In this sense, they are all interrelated.

Clinician mindfulness serves to investigate, validate, deepen, and actualize the core theories within the therapeutic encounter. Therapist capacities and attitudes that were cultivated in mindfulness practice become available within therapy and in the rest of life.

In the common factors model, the most important ingredients of therapy are common to all forms of therapy, rather than residing in specific ingredients that are unique to different models of therapy.

The most important common factors are:

  • the therapeutic relationship
  • client variables, including motivation for change, capacity to relate, and resources in their social environment
  • therapist variables, such as presence, empathy, humor, compassion
  • expectancy/placebo

The common factors model is supported by research, including large meta-analyses of psychotherapy outcome studies. Within the rest of the clinical picture, the common factors fit in like this:

Data from “% of Improvement in Psychotherapy Patients as a Function of Therapeutic Factors” (Norcross & Lambert, 2011, p. 13)

I suggested to students that clinician mindfulness practice using the guiding principles of Contemplative Psychotherapy may be an effective means of enhancing the common factors and becoming better therapists, no matter what techniques or other schools of therapy one incorporates into one’s practice.

Then we took a nice break, and when we came back, I presented on bipolar disorder and some preliminary results from a qualitative study I’m doing as part of my dissertation. I went over the costs of bipolar disorder and some of the theories of how it comes to arise in people, and talked about the wide variance in functional outcomes among people who have this diagnosis. (Some people perform as exceptionally creative and functional human beings, some folks have a long downward spiral towards chronic disability, and some folks wind up between these two extremes.)

Levy & Manove (2012) discussed the broad range in functional outcome for folks with bipolar disorder, and presented a model of the pathways to suffering in bipolar disorder.

Because of my own experience recovering from bipolar disorder in my early twenties using mindfulness and Buddhist ideas, I set out to research how people recover using a similar approach. I’m currently coding and analyzing the interviews from a qualitative study, which asked the question “What is the lived experience of people who recover from bipolar disorder using mindfulness meditation and Buddhist psychology and philosophy?” the parameters of the study and a recruitment poster are displayed here.

Summary of method and recruitment criteria for a qualitative study on recovery from bipolar disorder using mindfulness meditation and Buddhism

To wrap it up, I discussed some preliminary results from my dissertation research. The key points of this included the fact that recovery from bipolar disorder is possible, some people found mindfulness meditation and Buddhist ideas extremely helpful, and folks usually included a number of other wellness practices in their recovery. These included:

  • sleep hygiene
  • steady routine
  • exercise
  • healthy diet
  • community connections
  • reducing use of drugs and alcohol
  • a meaningful life role

For the third section, I presented on Hakomi tracking and contact methods, and we did a live demo with a student volunteer. I asked the students to track what they observed in the volunteer ‘client,’ and then we checked in with the client about the other students’ hunches and observations. It was fun to show the students some of these principles at work, and discuss how mindful therapists can help bring client present-moment experience into the therapy room in a non-violent, organic, and loving way.

References:

Norcross, J. C., & Lambert, M. J. (2011). Evidence-based therapy relationships. In J. C. Norcross (Ed.), Psychotherapy relationships that work: Evidence-based responsiveness (2nd
ed, pp. 3–21). New York, NY: Oxford University Press

Levy, B., & Manove, E. (2012). Functional outcome in bipolar disorder: The big picture. Depression Research and Treatment, 2012, 1–12. https://doi.org/
10.1155/2012/949248


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