Mindfulness Meditation in Psychotherapy: An Integrated Model for Clinicians

234 Pages·2016·22.66 MB·English

by  Steven A Alper

“Mindfulness Meditation in Psychotherapy by Steven Alper is a wonderful book that’s
wise, scholarly, and practical. For anyone interested in bringing mindfulness into
therapy, it is a must- read. This book lies at the intersection of mindfulness and psy-
chotherapy, and clearly illustrates how mindfulness intersects with psychotherapy.”
— Bob Stahl, PhD, coauthor of A Mindfulness- Based Stress Reduction
Workbook, Living With Your Heart Wide Open, Calming the Rush of
Panic, A Mindfulness- Based Stress Reduction Workbook for Anxiety,
and MBSR Every Day
“This book brings mindfulness literature to a refreshing and academic new depth.
Scholarly, yet deeply personal, the writing is clear, readily accessible, and eloquent.
Alper’s brilliant presentation of the mindfulness pyramid model illustrates how thera-
peutic interdependence is alive and creative. This is an essential book for any thera-
pist interested in mindfulness.”
— Paula Carmona, MSN, RN, PMHCNS- BC, coauthor of Peaceful Mind
“Mindfulness Meditation in Psychotherapy offers a beautifully integrated model for
incorporating mindfulness in psychotherapy. Steven Alper weaves together years of
contemplative practice and clinical wisdom with current research on mindfulness,
emphasizing it as a way of being and a method for investigating subjectivity. This com-
prehensive and artful book will benefit therapist and client. I highly recommend it.”
—S hauna Shapiro, coauthor of The Art and Science of Mindfulness
and Mindful Discipline
“Steven Alper has poured his deep understanding of practice and of psychotherapy
into this wise and accessible book. His candor about his own struggles ground the
book in humility and wisdom, and he speaks directly to his reader in a voice that is
reassuring, confident, and deeply humane. Psychotherapists with established medita-
tion practices, as well as those who want to begin, will both find much of value here.”
— Barbara Davenport, LCS, graduate of the Chicago Institute for
Psychoanalysis Program in Child Psychotherapy, and author of The
Worst Loss and Grit and Hope: 5 Latino Students & the Program That
Helped Them Get to College (UC Press, 2016)
“Mindfulness in psychotherapy has often been reduced to a cognitive tool or a stress
reduction technique, missing the deepest and most liberating levels of this ancient
practice. In this important contribution, Steven Alper presents an original model
that integrates different domains and levels of mindfulness in the therapeutic rela-
tionship, offering a clear, step- by- step training to integrate mindfulness in therapy—
starting from the necessary foundation of the therapist’s own mindfulness practice.
For its depth and applicability, this book will bring clarity and inspiration to new and
experienced therapists alike.”
— Gonzalo Brito Pons, PhD, psychotherapist and coauthor of
The Mindfulness- Based Emotional Balance Workbook
“Steven Alper has created an excellent and practical mindfulness guide for the psy-
chotherapist who wishes to bring mindfulness forward more intentionally and explic-
itly in their own life and work. I strongly recommend this comprehensive and
accessible book. It is a treasure for any therapist who is seeking to build a personal
mindfulness practice, planning to deliver mindfulness- based psychotherapy, or who
wishes to directly explore the profound power of mindfulness for healing and
transformation.”
— Jeffrey Brantley, MD, DFAPA, director of the Mindfulness Based
Stress Reduction Program at Duke Integrative Medicine, author of
Calming Your Angry Mind, and coauthor of Daily Meditations for
Calming Your Angry Mind
“Moving persuasively beyond diagnosis and technique, this accessible and sure- footed
guide reveals the more general and enduring gains that come from incorporating
mindfulness into your psychotherapy practice.”
— Zindel V. Segal, PhD, coauthor of The Mindful Way Workbook
“What a lovely book. Steven Alper manages to artfully weave three important tales
into one— detailing the importance of mindfulness practice, guiding the reader on
how to bring such practice into one’s own life, and illustrating how to then deepen
and enliven the practice of psychotherapy with the art of mindfulness. For any psy-
chotherapist, this is critical and valuable stuff!”
— William H. Polonsky, PhD, CDE, president of the Behavioral
Diabetes Institute; associate clinical professor at the University
of California, San Diego; and author of Diabetes Burnout
“Reading Steven Alper’s book, I was impressed by its thoroughness and comprehensibility.
He takes the complicated task of weaving mindfulness meditation into the therapeutic
process and makes it philosophical and practical. The model he creates is dynamic, clear,
and relational, and reflects his embodiment of mindfulness. I appreciated the range of
meditations included in the book and the depth of understanding and clarity he brings to
their usage. The breadth of the book makes it indispensable as a resource for all serious-
minded therapists who want to maintain the integrity of meditation and deepen not only
their own practice, but healing itself.”
— Elana Rosenbaum, LICSW, certified mindfulness- based stress
reduction (MBSR) teacher, psychotherapist, speaker, and author
of Being Well (Even When You’re Sick) and Here for Now
“Steve Alper has given the world a remarkable synthesis that will be profoundly beneficial
for therapists both personally and professionally if engaged in wholeheartedly as a way of
being. How could their clients not benefit as well?”
— Jon Kabat- Zinn, founder of mindfulness- based stress reduction (MBSR),
and author of Full Catastrophe Living and Coming to Our Senses
“Drawing on decades of personal mindfulness practice, dedicated exploration of wisdom
traditions, and thoughtful psychotherapeutic work, Steven Alper offers us a detailed,
comprehensive, well- researched, and up- to- date exploration of how mindfulness practices
can enrich and inform virtually any form of psychotherapy.”
— Ronald D. Siegel, PsyD, author of The Mindfulness Solution, coeditor
of Mindfulness and Psychotherapy, and part- time assistant professor of
psychology at Harvard Medical School
“Every once in a while a book comes along that exactly fits a need for our profession.
Alper’s Mindfulness Meditation in Psychotherapy is one of those books. With the burst of
energy and popularity of mindfulness meditation, this book guides therapists to integrat-
ing these skills into our own self- awareness and into a toolbox for our clients. Packed with
sophisticated depth applications, as well as handy little tips, this book belongs on every
clinician’s shelf.”
— David B. Wexler, PhD, author of When Good Men Behave Badly
and Is He Depressed or What?
“This is the sine qua non book for any psychotherapist who integrates mindfulness into
their psychotherapy practice, or wishes to and desires a road map. To the best of my
knowledge, there is no one out there in the field that has put the pieces together in quite
this unique fashion. Steven Alper has synthesized three major theoretical paradigms
extant in contemporary psychotherapy: Buddhist psychology and practice, the mindful-
ness movement, and relational psychotherapy. However imposing that may sound, all of it
is highly readable and immediately applicable to an ongoing psychotherapy practice.”
— Richard F. Avery, LCSW, assistant professor in the department of
psychiatry at the University of California, San Diego School of Medicine;
and certified teacher of Compassion Cultivation Training (CCT) through
the Center for Compassion and Altruism Research and Education
(CCARE) at Stanford University
“Steven Alper has written the best set of guidelines I have read for integrating mindful-
ness meditation into psychotherapy, in a format that will benefit the beginning and the
experienced meditator. He writes with great integrity to the spaciousness and nonverbal
wisdom of meditation practice, at the same time that he offers essential practical advice
and integration of evidence- based approaches. As an experienced meditator, I have
already benefited from using his illuminating ‘pyramid’ model in my work with clients and
in teaching students how the therapist’s embodied meditation practice stabilizes the cli-
ent’s capacity for emotional experience.”
— Roberta Isberg, MD, assistant professor of psychiatry at Harvard Medical
School, teacher of psychotherapy— including dialectical behavior therapy
(DBT) and parent- child interaction therapy— in the Child Fellows program
at Boston Children’s Hospital, and graduate and current member of the
Boston Psychoanalytic Society and Institute
“Brilliant and highly accessible, this book is not only about how to bring mindfulness into
your practice of psychotherapy, it’s about how to be a great therapist. In other words,
mindfulness as described in this book is not a specialized form of therapy; it constitutes a
basis for the foundational ingredients that make for excellent psychotherapy, such as
authenticity, present- moment attention, curiosity, compassion, and unconditional positive
regard. I hope this book is integrated into basic training for psychotherapists.”
— Cassandra Vieten, PhD, president and CEO of the Institute of Noetic
Sciences, author of Mindful Motherhood, and coauthor of Spiritual and
Religious Competencies in Clinical Practice
Mindfulness
M e d i t a t i o n
in Psychotherapy
An Integrated Model for Clinicians
Steven A. Alper, MSW, LCSW
C P
ontext ress
An Imprint of New Harbinger Publications, Inc.
Publisher’s Note
This publication is designed to provide accurate and authoritative information in regard to the subject
matter covered. It is sold with the understanding that the publisher is not engaged in rendering psychologi-
cal, financial, legal, or other professional services. If expert assistance or counseling is needed, the services
of a competent professional should be sought.
Distributed in Canada by Raincoast Books
Copyright © 2016 by S teven A. Alper
Context Press
An Imprint of New Harbinger Publications, Inc.
5674 Shattuck Avenue
Oakland, CA 94609
www.newharbinger.com
Cover design by Sara Christian
Acquired by Jess O’Brien
Edited by James Lainsbury
All Rights Reserved
Library of Congress Cataloging-in-Publication Data
Names: Alper, Steven A., author.
Title: Mindfulness meditation in psychotherapy : an integrated model for
counselors and clinicians / Steven A. Alper, MSW, LCSW.
Description: Oakland, CA : New Harbinger Publications, Inc., [2016] |
Includes bibliographical references and index.
Identifiers: LCCN 2015039306| ISBN 9781626252752 (paperback) | ISBN
9781626252769 (pdf e-book) | ISBN 9781626252776 (epub)
Subjects: LCSH: Mindfulness-based cognitive therapy. | Psychotherapist and
patient. | BISAC: PSYCHOLOGY / Psychotherapy / General. | BODY, MIND &
SPIRIT / Meditation. | SOCIAL SCIENCE / Social Work. | MEDICAL /
Psychiatry / General.
Classification: LCC RC489.M55 A47 2016 | DDC 616.89/1425--dc23 LC record available at
http://lccn.loc.gov/2015039306
Printed in the United States of America
18 17 16
10 9 8 7 6 5 4 3 2 1 First printing
Contents
Acknowledgments v
Introduction 1
1 What Mindfulness Meditation Isn’t and Is 10
2 Why Mindfulness in Psychotherapy? 19
3 How Mindfulness Heals 26
4 The Mindfulness Pyramid: An Integrated Model of
Mindfulness in Psychotherapy 35
5 The Therapist’s Mindfulness Practice as Foundation 51
6 Therapist’s Practice: Formal Meditations 64
7 Therapist’s Practice: Skills, Inner Capacities, Attitudes,
and Perspectives 98
8 Therapist’s Practice: Method of Inquiry and Investigation
and Mode of Knowing 132
9 Therapist’s Practice: Way of Being and Relating to Experience 140
10 Doing Therapy as a Mindfulness Practice 150
11 The Intersubjective Diamond: Accounting for Interbeing 162
12 The Client’s Mindfulness Practice 176
Conclusion: Mindfulness in Psychotherapy, Now and in the Future 195
Appendix A: Mindfulness Resources 197
Appendix B: Meditation Practice Log and Mindfulness Journal 200
Bibliography 203
Other Relevant Readings 210
Index 215

Acknowledgments
This book reflects both my professional development and my development as a
dharma practitioner, as well as the larger stream where the two seemingly separate
streams merged in me. I first want to thank New Harbinger Publications—particu-
larly my editors Jess O’Brien; production staff Michele Waters, Vicraj Gill, and Jesse
Burson; Nicola Skidmore and freelance copyeditor James Lainsbury, without whose
guidance and encouragement this book would not have been possible. I also want to
thank Barbara Davenport and the Sunday night writers’ group for encouragement
and critical feedback on early versions of the manuscript, and Dale Featherling for his
early editorial assistance.
Gratitude to Swami Muktananda, from the Kashmir Shaivism tradition, through
whom I caught my first glimpses of the vastness of mind beyond ego- centeredness.
Gratitude to my day treatment mentor and dharma brother Bill Bradshaw, who skill-
fully directed me to the dharma through Shambhala training, and through whose
generosity I had the good fortune to receive teachings from H. H. the Dalai Lama,
Chögyam Trungpa Rinpoche, Kalu Rinpoche, Tai Situ Rinpoche, and Jamgong
Kongtrul Rinpoche, among other Tibetan teachers. Gratitude to the senior students
of the Plum Village sangha, and to Prittam Singh in particular, who hosted me and
my young family at the Plum Village summer opening of 1997, where we received
teachings from Thich Nhat Hanh and the Plum Village Sangha.
Gratitude to my first dharma sisters and brother, Alby Quinlan, Nancy Newhouse,
and Rick Avery, who formed the nucleus of what became the San Diego Thursday
Night Sitting Group, and my spiritual home for the past nearly thirty- five years.
Thanks also to Nancy Newhouse for arranging for my invitation, in 1994, to establish
an MBSR program at UCSD Department of Psychiatry, and to Rick Avery for both
his friendship and valued clinical mentorship in group and couples therapy, as well as
self- psychology and intersubjectivity theory. Thanks to Sanford Shapiro and the San
Diego Self- Psychology Study Group, whose peer mentorship, supervision groups, and
professional training workshops greatly enriched and deepened my understanding of
intersubjectivity theory and relational psychotherapy.
I also want to thank my dear friend Richard Gelbard, by way of whose steady
encouragement I attended my first ten- day vipassana retreat through Insight
Meditation West, in 1984, and to my first vipassana teachers from that retreat,
Christopher Titmus and James Baraz, who broke open my heart. Thanks also to Jack