NP0010 Is Mindfulness Enough?

This blog focuses on discussion regarding the course NP0010 Is Mindfulness Enough?

NP0010, Mindfulness, Session 4, Michael Yapko

What do mindfulness practices and clinical hypnosis have in common? Michael Yapko, a clinical psychologist internationally recognized for his work in clinical hypnosis, will expound upon the practical lessons hypnosis may have to teach therapists about the vital role of suggestion in the change process. Explore the similarities between mindfulness and clinical hypnosis, and decide for yourself whether there are clinically significant connections between mindfulness and hypnosis techniques.

After the session, please take a few minutes to take a look at the Comment Board and let us know what you think. Do you have any experience with clinical hypnosis practices? If not, would you consider bringing these techniques into the consulting room? Do you have any questions for the presenter or your colleagues? We invite you to share your thoughts and questions, as well as sharing your name and hometown with your comments. If you have any technical questions, please feel free to contact support@psychotherapynetworker.org. Thanks for your participation.
10.17.2011   Posted In: NP0010 Is Mindfulness Enough?   By Psychotherapy Networker
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  • Not available avatar Merrilee Gibson 10.19.2011 13:22
    As always, I appreciated hearing the viewpoint of the presenter. Dr. Yapko presents a very liberating and encompassing view with a wealth of valuable ideas. As I listened, I was writing comments on what I was hearing. I kept coming back to the ideas of Carl Rogers, the idea of the the central importance of the therapeutic relationship, on the therapist being a mirror for the client’s presentations. We are so in love, as therapists, with new ideas, with finding that one magical component that will enable us to be instruments of healing for those who come to us. Rogers emphasized importance of relating to the individual, of recognizing the power within each individual. I get from his work that it is not so much our cleverness as therapists that we need to put forward. It is recognizing the individual, the power within that individual, and working with that individual in a one-on-one process in the moment--a relational process. Winnicott, also, asserted that it was not about how clever he could be, but on how he could appreciate and communicate to each individual.

    What I appreciated most about Dr Yapko’s presentation was his emphasis on focusing on the individual, and of finding meaningful ways to relate to that individual with a full appreciation of his process as well as an acute realization that “one size fits all” does not make for effective therapy. Perhaps therapy is not a “spiritual” presentation in terms of individual belief systems (i.e., the Buddha, Christian teachings, etc.) but I believe it DOES require a recognition and appreciation of a dimension beyond that which is visible.

  • Not available avatar Susan StPierre 10.19.2011 13:23
    I loved this common sense and scientific addition to the conversation on mindfulness, but I missed the good feelings that the more Eastern approach evokes. In terms of which individuals are responsive to focussing techniques, has anyone looked at developmental stages, ie Robert Kegan and the Evolving Self. I have always assumed that mindfulness would be most appreciated by those negotiating the transition between Stage 4 and 5. Also, an MBTI lens might find mindfulness most helpful to Intuitives.
  • 0 avatar Wallace Kahn Jr. 10.19.2011 15:32
    I was very surpurised that Dr. Yapko did not mention solution focused foundation and practice. Everything he said had applications for a solution focused approach. For example, reframing in integral to both hypnosis, mindfulness and solution focused interventions.
  • 0 avatar Brian O'Connor 10.19.2011 17:14
    As one who has studied and practiced Ericksonian Hypnotherapy since the early 80's and practiced mindfulness since the mid-70's, I would like to comment. Dr. Yapko appears to be comparing hypnosis and guided meditation,not hypnosis and mindfulness. There is a difference.
    Guided meditation & hypnosis have a number of things in common, including suggestion and dissociation. They also have mindfulness in common (i.e.: attention). But mindfulness is more than a technique or therapeutic strategy.It is a practice, that if done consistently, allows one to frequently experience the rawness, vividness and immediacy of momentary existence, as well as knowing the habitual everyday trance experience. In essence, one becomes more familiar with ones overall process, which of course can help when relating to others. Mindfulness can be done either as a secular or a spiritual practice.
    Brian O'Connor MA LMHC, CDP
    • Not available avatar Audrey Bloom, LCSW 10.22.2011 15:40
      Hello Brian O'Connor and others. I have been following the Mindfulness series with great interest. I am a psychotherapist and practiced mindfulness for 25 years. I have not yet listened to Michael Yapko, but I was hoping/suspecting I would find a comment regarding the mistaken notion that mindfulness is akin to hypnosis. It is unfortunate to have misinformation from a presenter, who dosen't fully understand a topic.
    • 0 avatar Melanie Bryan 10.24.2011 09:22
      Thank you Brian for this important distinction. Guided meditation is certainly not mindfulness although it is akin to hypnosis, depending on the focus of the guided meditation.
      And although this wonderfully rich discussion had mindfulness and hypnosis as its focus, mindfulness is only one part of the Buddhist path of study, which also emphasizes taking teachings and contemplative (analytic) meditation. It's a tough path. Yet being deeply mindful of and open to, one's "monkey mind" of habitual responses and experiences during such meditation, can lead to change through the process of mind training. Mindfulness is an immediate and frequently uncomfortable experience, while hypnosis usually has quite specific goals, at times remarkable outcomes, and is often pleasant and future oriented.
      I am more than most appreciative of this series and of
      Dr. Yapko's extensive contributions to the field of hypnosis and of his acute and informed observations of aspects of mindfulness. I will buy his book and consider his trainings.
      Melanie Bryan, Psy.D.
  • 0 avatar Adam Szmerling 10.20.2011 17:56
    Reminded me instantly of my first Vipassana retreat. They were loath to accept someone with a "Hypnosis background" because, according to the then meditation instructor, Vipassana does NOT use "suggestion or in any such way influence the mind in one way or the other, it's about self-observation". Somehow I was accepted into the retreat though, and on the first day I lost count of how many hypnotic suggestions Goenka was using, but I was clear when he would use his 'hypnotic voice' and his 'usual voice'.

    Michael Yapko drove the point home when he used the term ‘self-deception’. I think such deception in spiritual communities leads to further repression of other important experiences too, like Desire. But Desire is the motor force of any experience, including mindfulness meditation!

    I don't think any conception of mindfulness would be complete without a discussion of Transference... A very important point was made about how the Buddha in the background, or any spiritual teacher, in and of itself can evoke expectancy from practitioners and potentially place the practice on a pedestal (positive transference). Transference is, of course, far more complex than that.

    In my view a massive problem in psychotherapy is a reductionist attempt to commercialize methodologies (and make them out to be superior than others), whether it be hypnosis, mindfulness or CBT. My main practice is psychoanalytic psychotherapy and I am constantly hearing criticisms of CBT. But CBT is just as natural as hypnosis, or mindfulness, in its pure form, is it not (how many times a day do we change our view about something!)? I mean, the problem I have with specific methods is the way they’re advertised/marketed as the holy grail of mental health, as though it can somehow be separated from its original context (devoid of things like affect, personal history, relationships etc - as a medical model which reduces people into symptoms/parts)...much like mindfulness is being taken out of its broader context... which was never intended as a 'technique' alone...

    Maybe mindfulness meditation and hypnosis are but ‘meta-rituals’ in that they can help open people up to deeper aspects of ourselves.

    Another fascinating point raised in the talk: dissociation. I had previously assumed this was often pathological (except when used for say pain conditions). Some mindfulness teachers may argue that the aim is not to dissociate. I would like some clarity on this point. I heard an elegant description the other day: ‘therapists need to be BOTH in and above the transference.’ I think this could involve something other than dissociation, perhaps as a form of mind training to be both ‘in experience’ and ‘observing’ simultaneously?
  • Not available avatar Diane Renz, LPC 10.24.2011 00:54
    I am curious about all modalities for healing, and how each has something of value to offer. In listening, I did feel a bit of an edge from Dr Yapko, "the Mindfulness people", creating camps of opposition. My hope is that we can have a useful dialogue that takes "opposing views" and finds how each informs the other. I fully agree, as Ron Siegel has pointed out, we need to be acutely aware of the impact of Mindfulness, and who it is appropriate for and what type of practice will allow the integration we are seeking. We need to be sure to question deeply the latest "trends" in psychotherapy and be well qualified to implement them.

    Some parts of Dr Yapko's presentation stand out for me that I wanted to comment on:
    1. I am not sure that Jack Kornfield said he makes no distinction between psychotherapy and spirituality. He clarified that it is essential that we do not bypass our psychological work by utilizing only spiritual practices, and that we can not work through the wounds found in relationship only within our own minds but requires exploration within relationship. His distinction was relative to his presence with another at this point of his evolution as a spiritual teacher/human being.
    2. yes context is everything, and I would say that this is the essential element of Mindfulness-- that for each person it is learning how to approach all content of mind/experience within a new context of non judgment where otherwise we might be reflexively critical and attacking of self/other/the situation.
    3. I am not certain about dissociation within Mindfulness. Yes,in practice, it is learning how to notice thought/feeling/sensation/images and refrain from immediate reaction/action, possibly discover a witness that is not "identified" with only that part of experience, but it is not by dissociation, but by being fully embodied, knowing the qualities of each, coming to know one's own experience, letting that be the final authority, not the ideas of another.
    4. and yes, relationship alters us. We, in the power position as therapist need to know that, and continually check ourselves, our beliefs, and our impact on our clients

    finally, yes to hypnosis, yes to mindfulness, and yes to understanding how to use these techniques appropriately and knowing more about how they can be used as agents of change. Any "structural components" of psychotherapeutic techniques that provide outcomes of increasing capacity for emotional regulation, compassion, ability to approach, pause before acting, awareness beyond self interest, choice, openness to others perspectives...etc, call it what you like...matters not what your spiritual perspectives are, or orientation is....
  • Not available avatar Peter Culross 10.24.2011 01:01
    Awakening your inner Buddha, getting in touch with your inner Rocky... meh, what's the difference Michael?

    Poor Rich didn't seem to enjoy Michael taking the cold, masculine / intellectual scalpel to slice and dice the warm fuzzy, feminine / feeling, smiling Buddha-ists (and Buddha-isms)...and pricking his party balloon in the process?

    As a spiritually-oriented therapist, I have found that understanding the different levels of the self - the conscious self, subconscious self, and higher self - helpful in providing practices tailored to each level. In my Self Help Psychology program, I reference the spiritual or higher self in the following way, to distinguish it from the psychological:

    "Unlike the other modules in this program, we are not dealing with a concept that can be intellectually understood, a capacity that can be measured by the mind, or a problem that can be solved.

    As is said in the Tao te Ching, "The Tao that can be spoken is not the eternal Tao”. There is a similar notion in Hinduism in which spiritual experience is thought of as nirguna-brahman, the Ground of Being without form or name, that is beyond human comprehension and expression.

    As the saying goes, “To those who have had the experience, no explanation is necessary; To those who have not had the experience, no explanation is possible”.

    This module is a different ball game to the other ones. This is not psychological. This is something more. This is something else. This is somewhere else.

    Rather than try to measure or assess something so intrinsically unfathomable, I prefer to simply invite you to go there.

    Are you interested in going there? Do you want to go there?

    It is your option and your choice. This module will support you moving ‘there’, crossing over and opening to and connecting with another dimension of yourself, your spirituality, your higher self, your true self.

    May you simply experience the experiencer experiencing the experience."
  • 0 avatar Jim Brillon 10.24.2011 01:17
    Fascinating counterpoint and some insightful comments about it too… I love the idea of empirically justifying things and finding common language. But I also see that Dr. Yapko makes a fundamental distinction that may be incorrect: The way I see it is that mindfulness is not dissociation (being outside one's body) but it actually leads us to embodying all of our experience. This is a crucial distinction that he may not embrace because he is trying so hard to quantify scientifically the principles in a language he understands. Just a thought...
  • Not available avatar Michael Yapko 10.24.2011 17:26
    My thanks to those of you who have taken the time to write comments about my presentation on Mindfulness and Hypnosis. As I'm sure you can acknowledge, not everything that can be said was said on the topic. It is easy to appreciate that some of you may have wanted related concepts or ideas to be addressed or developed further, but a one hour presentation simply can't address each viewer’s personal area of interest or correct any misunderstandings that might arise.

    My major points are actually quite straightforward: The primary point is that there is a significant difference between mindfulness as applied in an independent spiritual practice and the use of guided mindfulness meditations conducted in the context of therapy. The aims are different, the methods are different, and the outcomes are judged differently. The clinical context makes a huge difference in many ways that I hoped to highlight in my presentation. My consideration is not on mindfulness as a solo spiritual practice. Some of the comments seemed to miss this point. Rather, I examine the power of guided meditations - an interpersonal process - in helping people discover resources in themselves that foster the therapeutic goals for which we offer them such guided experiences, including anxiety reduction, pain reduction, and so forth.

    My second major point is that guiding someone through an experiential process necessarily involves the use of suggestions within a relationship defined as therapeutic. Examining the structure and intent of guided meditations many clinicians perform, one cannot help but acknowledge that there is a huge overlap with the interpersonal process of hypnosis on many levels ranging from semantic to phenomenological to neurological. Analyzing the quality of the suggestions clinicians offer to their clients during guided meditations enables us to better understand the interface between the use of experiential processes which may have a scientific basis but are clearly beyond logic in their subjective qualities and the enhanced therapeutic outcomes they engender.

    Why people sometimes react poorly to the notion of hypnosis as relevant to the practice of guided mindfulness meditations is a bit of a mystery to me. It's as if the use of guided mindfulness meditations will somehow be contaminated or distorted by my examining their structure, intent, methods and outcomes. I can assure you, they won't. To the contrary, as someone who has similarly examined the role of suggestion in other approaches ranging from cognitive therapies to strategic therapies in my previous books, the insights gleaned from such examinations have been invaluable in identifying ways to honor the uniqueness of each client by adapting interventions accordingly.

    I strongly advocate for experiential therapies involving such processes as mindfulness and hypnosis, but want people to grasp my final major point: Many of the things that take place phenomenologically during the course of guided mindfulness meditations are well described in the hypnosis literature (such as dissociation which is not a disembodied experience as one person commented). I suggest these insights are potentially valuable to clinicians and should not be dismissed because of ignorance or prejudice.

    Lama Surya Das is a leading Buddhist teacher who understood my points perfectly well, and honored me by writing a Foreword to my Mindfulness and Hypnosis book. Allow me to close by quoting him:

    Through a ground-breaking integration of Eastern philosophy Western psychotherapy, Michael Yapko presents us with a highly original and immensely accessible answer. He demonstrates that entirely subjective states of absorption and a focus on questionable self-suggestions are the glue that binds our symptoms together--the vehicle that selects how we perceive, interpret, and internalize our subjective world. Our attention/intention and every word we say to ourselves and others serve as virtual post-hypnotic suggestions that alter our perceptions of reality--and thereby reality itself--for good or ill.

    Thanks again for your comments.
    Michael Yapko
    • Not available avatar Patrea 10.25.2011 01:55
      Dear Michael (and Rich),
      Thank-you for yet another interesting presentation. Michael, I am grateful for you sharing Lama Surya Das' comments - there is a lot of richness in those few sentences. I also appreciate the emphasis that you placed throughout the presentation on the quality of the person's thinking, expectations of the future, relational style, and the impact of context. How I've heard your presentation implies the importance of explanatory style (cognitive component), behavioural activation (doing what matters - behavioural component), relational style and context, developed skills of focus and attention (mindfulness); this breadth of emphasis is reassuring since some schools of thought espouse a 'purist' approach. My curiosity has been piqued to explore in greater detail the concepts articulated in the hypnosis literature. With thanks to you for your presentation - and to Rich for the opportunity for making these interviews happen.
  • 0 avatar jean geffen 10.25.2011 13:55
    Really enjoyed this webinar and stimulated me to buy your book and study further. Practicing 30 years and happily married like you 32 years and mindful and appreciative of what I have, particularly when things are tough. I am not in a "hypnotic trance state" (joking), but when I am annoyed or hurt (which is unavoidable in long term relationships), I do try to be mindful and conjure up positive thoughts, experiences and images and ... try to share (or suggest) this approach or tool with patients when appropriate.

    Question: I just saw a patient yesterday who I have been working with many years (stopped for a while and came back a few years ago.) She asked " Do people ever end ...how do you know when to stop? Explored and said she doesn't feel she's improving and then she moved on to talking about her job(nurse) and how she is mistreated by many of the other nurses..."they can get angry and criticize me, but when I dish it back they can't take it...used to be quiet and just take it, but not keeping quiet anymore". (not a new issue) For purposes of brevity, I'll just mention that we explored this issue, but first, I expressed that I didn't want to ignore her comments about "not improving". Explored and she said, "I'm still feeling bad". (Many early losses-father died when she was 8yo, she is divorced with 28 y.o. daughter who she raised on her own, and mother died last year (complications and difficult relationship). I did not get defensive and mentioned that she had a recent loss, as well as past losses and work triggers her feeling of being "pushed aside, unimportant and alone." ( her words and feelings that we discuss). Try to deal with her thoughts about being a victim and hopeless. After your webinar, recognized more clearly on another level that she feels hopeless about therapy and me. I do try to gently explore her action outside therapy and her beliefs (and need to explore with her how her "automatic beliefs" get in the way.)

    But how do I explore her action without her feeling pressured or criticized that she's not doing enough (she gets frustrated). Also, I don't want her to think that I'm being defensive and saying, "you're not doing enough to feel better". Your discussion about thoughts, beliefs, expectations and automaticity is helpful and I do address this in our work, , but I think it will be helpful to focus more on the automatic thoughts and expectations.

    I just realized that I am looking forward to the next session with greater hope on my part which I know is important. (Previously, I left the session questioning myself whether she needs a change, but I think she would feel "automatically" hopeless, abandoned and rejected.)I would greatly appreciate your feedback. Thank you very much.

    Jean Geffen

  • Not available avatar jay schlechter 10.26.2011 14:07
  • Not available avatar Scot Liepack 10.26.2011 23:07
    Over the course of these series I have frequently been wowed by the presentations. (Thank you, Rich.) This presentation certainly gets placed in that category. Yet the wealth of commonalities and the lesser but critical differences between the presenters goes largely unexplored, despite Rich's efforts in how the series are structured to have alternative view points. In this case, as example, and as much as I appreciate Rich's interviewing, I would have really appreciated hearing Michael and Jack Kornfield having a dialogue. I hope you will consider this for future series.

    Thanks much,
    Scot Liepack
    Phoenix, AZ
  • 0 avatar Geri Weitzman 10.30.2011 21:01
    I've definitely come away from this video with a sense that clinical hypnosis is a useful thing to incorporate into mindfulness; that's a good thing.

    But, I was disappointed that Yapko didn't include in his talk a few simple examples of how to go about this. While we cannot learn everything about how to take this into our practice from a short video, it would still be good to come away from this lecture with even a small sense of having learned a new skill.
  • Not available avatar Michael Yapko 10.31.2011 10:00
    Again, I want to start by thank people for taking the time to write. I'd love to write lengthy and detailed replies, but there is neither time or space for that.

    First, regarding the hopeless client. The hopelessness of depression - negative expectancy - is what keeps people from trying to help themselves and constrains them from trying new things. I talk at length about the power of expectancy in my books and presentations simply because expectancy is the single greatest predictor of whether and how a client will respond to treatment. It is the first target of treatment with the goal of shifting the person from a stable attributional style (i.e., hopelessness) to an unstable attributional style (i.e., a belief that things can change).

    How a therapist responds to negative expectations is crucial, and this is perhaps the best of all times to employ experiential processes like mindfulness and hypnosis. These can quickly alter the client's subjective experience and thereby start to get across the hopeful message, "your experience can change." Mindfulness is helpful in this endeavor. It can provide the client with a direct experience of feeling more focused, relaxed, and present with much less agitation or rumination. These are good outcomes. Hypnosis does the same things but goes a step further in using suggestions to directly address and alter the person's negative expectations. For example, one of the best uses of hypnosis in depressed clients involves a hypnotic phenomenon called age progression, defined as an experiential orientation to the future. Simply put, it involves utilizing self-fulfilling prophecy by instilling an expectation that things can and will change for the better by proactively taking sensible action and adopting more helpful perspectives. This bypasses the self-blame issue to prevent the client from feeling criticized.

    I wrote about approaches such as these in detail in several of my books, but especially in Treating Depression With Hypnosis (2001, Routledge). More material is available on my website (www.yapko.com) as well. I also published an article in last year's special issue of the International Journal of Clinical and Experimental Hypnosis I guest edited on the topic of "Hypnosis and Treating Depression" about other ways to use hypnosis in treatment. It includes sample transcripts so you can see examples of the wording of suggestions. If you or any other reader would like a reprint of that article just write to me at michaelyapko@yapko.com, and I'll be happy to send one to you.

    I hope the above helps respond to the comment about wanting something practical to walk away with. If you read my current article in the Networker, called "Suggesting Mindfulness," you'll find additional ideas.

    Finally, as a part of the Networker's State of the Art" program, you'll see a dialogue I had with Ron Siegel that was lively and informative. We both enjoyed the process immensely and I think viewers will find it inspiring.

    Thanks again for your comments and queries.
    • 0 avatar Adam Szmerling 10.31.2011 17:51
      I just wanted to add a possible distinction between the two methods. Mindfulness (whether therapy or 'spiritually' based) involves developing the witness (conscious mind??), whereas hypnotherapy does not. This does not mean that hypnosis is sleep (like the word 'hypno'), but there seems to me a development of the sub-conscious (through trance) to engage in some kind of therapy. Where the two practices may converge is at least the fact that the sub-conscious is engaged regardless in both methods, but mindfulness does not stress trance, or engaging the unconscious, but rather, the witness or observer. My question to this forum therefore, what or who is the witness? Who or what is aware? The ego, or some deeper aspect of a 'self' (which Buddhism tells us doesnt even exist), in which case is there really and difference between hypnosis/mindfulness (conscious/unconscious awareness)?
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