Hi Everyone,
During our MBSR teacher meeting this morning one of our facilitators said “UMASS CFM makes a point that MBSR is not therapy, what IS the difference between MBSR and therapy?”
Would love feedback and especially thoughts from practicing therapists who are also MBSR facilitators.
With much thanks and warmth,
Dorlie
Hey Dor,
I think therapy has the connotation of treating a disorder or healing an illness. I see MBSR as a program or plan of action that will eventually lead to a (better) way of life. I often recall JKZ’s statement; as long as your breathing, there’s more right with you than wrong…no matter how ill…
For me its a difference in approach, in MBSR we are turning towards and welcoming whatever state we are in (even those we don’t like), in therapy I think we are trying to change/heal/get rid of something we don’t like.
I agree that we are facilitators - trying to help people see a different way of approaching life.
But of course, I may be wrong…and that’s ok too :- )
btw, I am not a therapist
I think this is an incredibly important topic. Mindfulness practices techniques range from therapeutic interventions all the way to pure contemplative practices. Under these circumstances the role of the mindfulness guide varies from clinician to spiritual direction. For a description of the spectrum of helping relationships, from a Christian source, see:
http://www.sdiworld.org/sites/default/files/find-a-spiritual-director/Comparison%20of%20Helping%20Fields.pdf
The training needed for each function is entirely different and whilst we may be equipped through MBSR, MBCT, etc. to deal in the clinical setting we should note that the aptitudes, training and level of understanding that is required is entirely different for different roles, indeed the mindfulness practices subtly change too. There are are also a varied, changing and kaleidoscopic range of difficulties, dangers and “illnesses” , not always well understood and often little documented even in the contemplative traditions.
If we as mindfulness teachers are not fully aware of the different roles and our competence to undertake them we are heading for a fall. We will almost inevitable end up leading people astray, maybe even permanent harm, instead of pointing them to a practitioner with a more appropriate role, Being a mindfulness clinician is very different from being a mindfulness spiritual director, and being able to successfully eliding all the way from one to the other requires a range of skill sets, understandings and aptitudes that is rare.
Thanks for that wonderful resource you attached to your post, Mark, and for
your comments. Your remarks seem to me both timely and insightful. As the
emerging role of MBSR/mindfulness teacher/instructor in clinical, social
and spiritual settings becomes professionalized, we would be wise to more
fully define/develop its place in the specturm of helping relationships and
equip and assess people entering the profession accordingly.
Thank you for your considered response Mark. I have been researching the philosophical roots of well-being and find it includes both the body and the spiritual aspects. That is, as well as being central to a rich and fulfilling life it is also a start point for thinking about the nature of human life itself. Though they are deeply connected I agree its very important for us to be aware of the clinical vs the spiritual and the skill sets, knowledge and understanding required for both.
It’s great to read all the threads on this excellent question. Thanks for posing it, Dorlie. It feels rather like an ongoing teachers’ meeting dialogue, and so here are some of the broad considerations that I draw from, to explicate the differences between therapy and what happens in an MBSR classroom.
Therapy, especially in the Western world–and as differentiated from coaching—is problem-focused, often sought out when something feels broken or “wrong,” upon receiving a diagnosis (depression, anxiety), or suffering a trauma. The effort is to uncover something, usually from the past, and to become more aware in the process—to change—and to do that deliberately. The dialogue in therapy is all focused on this effort. The therapist’s keen skill is often guided by an hypothesis based on much study and experience. The question, “Why?” is a guiding question in much of therapy: Why did I do this? Why did this happen? Why did I react this way? It’s not the only question–but it’s present.
In the MBSR classroom, participants also often enter with a sense of something “not right,” a diagnosis, a sudden shift in life status (marriage, divorce, retirement, a new baby)—so all of that is similar to therapy.
But how we approach these topics really shifts the perspective from what is offered in a therapeutic alliance. And it starts right away. In the first class, the go-round: What brings you here? begins to highlight the universality of challenge, the ways that life tumbles all of us—and begins, in those moments, to create some unity, some sense of “Oh, I’m like him,” “I’m like her,” “she’s like me…” And there’s no deep diving into personal history. The story is important—but it is, by no means, the whole deal. We recognize the humanity, the emotion, the fullness of our lives, and then—we do this radical pivot: We turn to the body, right in the first class!, with the body scan. And then, we stay there… we plumb the depths not of our psychology, but of the immediacy of this moment with the body. Right here, we begin to re-orient (Jon’s “orthogonal shift”) to some different landscape. We begin to train our attention to a different data set—not the thoughts and story—but the actual, moment to moment arisings and departings of phenomena (which may also include thoughts and emotions, but we can begin to perceive them differently than through the psychological approach).
We lay aside the question, “Why?” and take up other questions: How is that? What is that? Who am I? What am I? and these questions are really, really different—often opening a space of not knowing that is fresh and, let’s be honest, sometimes terrifying. When meeting the array of participants’ responses to this mining of their own curriculum, their own life territory, we are resting in our own not-knowing—our own willingness to suspend the story, in order to be curious together.
As teachers, our sense of participants’ wholeness is also part of the equation that differs from therapy. From our own depths and practice (as well as our own therapy!), we have been honing skill in getting really curious about what’s happening. This allows us to trust our participants’ capacity and to support a gentle, consistent willingness to see, to look again, to consider, to let be…and also to know when to step back, to take a break, to shift practice in small or large ways.
I do think that the capacity to travel, often quite intimately with participants, takes a great deal of skill in relationality. This speaks volumes to a therapeutic presence that opens, invites, welcomes, and holds a person—and the class—in the thrum of practice and individual and collective investigation. There is less a place to “get to,” in MBSR than therapy, and so this ongoing sense of aliveness, wonder, and presence, in and of itself, is one of the outcomes of what people learn in MBSR. Out of this it’s not unusual for insight into patterns to arise, for a quality of healing to begin to emerge, as well as resilience, inspiration, creativity, freshness… these are also sometimes touched in therapy, but the process feels very different.
Importantly, therapy is often an important adjunct to MBSR… it’s not one or the other, but more, in any given time in one’s life, what’s needed to support what’s emerging?
Thanks Lynn for a great post. We need more open discussion about the outcomes of long term mindfulness practice. Mindfulness, in one form or another, is the central practice in most contemplative traditions both East and West. Indeed Kabat-Zinn openly declares that he developed MBSR from Buddhist contemplative mindfulness practices.
Given then that we are in some way re-arriving at what Leibiniz and Huxley called the Perrenial Philosophy we should make ourselves aware of the relevant advice and warnings of those who have travelled before us. It is true that few will probably even want, or choose, to venture far down ‘the path to the palace of nowhere’, to use Merton’s memorable phrase, but some will. The landscape in many ways is very different and ever changing along the contemplative path. And there are certainly more than one orthogonal turns along the way. We need urgently to lay out the ground work and foundations for building an evidence-based/scientific mindfulness way of following a contemplative life. MBSR, MBCT, etc are great at leading us to the start of the path but they don’t give much more indication of how to travel further and what to expect. The vast majority of those who take up mindfulness will probably be very happy with where they’ve got to but there will always be some who choose to travel further, or even accident!y venture down the path.
I have a more I think needs saying on this but have run out of time for the moment. I’ll return to it later if there is any interest.