Mindful Happiness

Anthony Quintiliani, Ph.D, LADC

By

The Power of Interpersonal Mindfulness

Interpersonal Mindfulness

Various forms of mindfulness-based compassion training help us to care more about the needs, happiness, and health of other people. However, direct applications of interpersonal mindfulness activates these influences into direct action on behalf of others.  Thus, if lucky, we learn to care more about others and less about ourselves.  The self-centered ego gives way to compassionate tolerance. Buddhist practices and meditations may improve our interpersonal relations, both intimate and distant.  Today our world, nation, regions, and families are locked in bitter conflict; the entitled view of “my ideas are right” holds sway and prevents any forward movement for negotiated co-existence of different ideas and people.  If we hope to save ourselves as well as our world, we MUST practice more interpersonal mindfulness. Such practices of random acts of kindness, general compassion, taking in suffering and giving out joy, tolerance, openness to differences, general gratitude and others all support  more inter-personally cooperative thoughts and behaviors. Such thoughts and behaviors will improve self, dyads, relationship, family, community, race, ethnic group, religion, state, nation, and world. The need for this shift is highly urgent! We must change our being from greed, aversion, and hate to generosity, inclusivity, and love. If not our species and our world may fail.

In some ways this conflictual existence is the outcome of our old limbic brain structures (my own survival above all else), and our aggressive greediness as a species. According to very old Buddhists writings, one thing we can do right now if practice deep, active listening. By listening more to others and their opinions, and talking less about ourselves, we may achieve an emotional balance of mutuality. Basic mutuality (we are BOTH important) may lead to more deep listening and personal reflections of what is happening right now in this present moment.  What, exactly, is it that is upsetting me? What, exactly, is it that may lead to mutual satisfaction here now?  Begin your changes by starting with yourself.  Notice what conflictual inner self-messages continue to play and re-play themselves over and over again in your own mind.  Begin by listening to your own inner conflicts, and work at listening and reflecting deeply on both sides of this dynamic. Work on a solution, even if it is not a perfect one. First practice more radical acceptance with your own inner conflicts, then gently move to outer conflicts – begin gently with significant others.  Practice, practice, practice and practice more.  There cannot be a winner! Once you feel the sensations and emotions of successful compromise, begin to practice beyond intimate circles and into your general world environments. It is all about sharing your love and acceptance of self with others, and being for the betterment of others. On this path also practice good self-care.

Practice letting go of harsh self-centered judgments and learn to appreciate both similarities and differences – even BIG differences. After all, impermanence is real – as is the time-limited life you now have. Better to work at compassion and openness NOW. Better to work on caring about others and loving people NOW. Our total interdependence causes great energetic frictions at times. Learn how to find the MIDDLE WAY and encourage others to follow that path. The subtle energies of love and the very powerful energies of hatred both have immense influence in our lives. Live for love! Live to reduce hatred and reed! Be authentically intelligent and kind-hearted in your relatively short life.

For more information refer to Musho Hamilton, D. (2017). The Zen of You and Me: A Guide to Getting Along with Just About Anyone. Boulder, CO: Shambhala Publications.

Anthony R. Quintiliani, PhD., LADC

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, VermontChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

Mindful Happiness cover designs.indd

New Edition of Mindful Happiness in Production…Coming soon!

By

Helping Therapists Work with Diversity

Help For Therapists: Working with Diversity

Clinical interventions, especially strongly evidence-based interventions, impact clients via new skills and practices in mind-body clinical realities. No matter how good (or “good enough” ) a clinical intervention is it requires a highly positive, active therapeutic relationship. As ample research suggests, a strong and positive therapeutic relationship in therapy enhances client trust and courage – thus expanding their experimenting with new ways of being, thinking, and doing. A huge problem is establishing such a therapeutic relationship is the inability of some therapist to bond with diverse people – people not exactly like the therapist. Below I will present information from clinical  and social psychology about
what general variables/differences to be most mindful about.  This information will be noted in three categories: Universals; Group Differences; and, Individual Self-Development (within groups). If therapists practice paying more attention to some of these basic realities in their clients, the expectation is that their therapeutic relationship/alliance will improve along with their clinical outcomes.

UNIVERSALS: Here is the listing – Similar Life Experiences/History, Biological Similarities, Social Similarities, Psychological Similarities, Emotional Similarities, Self-Awareness Valences, Use of Symbols, Use of Art, Compassion and Aggression, Love and Hate, and, Differences in the Above. Noticing, being mindful of, and using these realities in therapy should improve alliance and clinical outcomes.

GROUP DIFFERENCES AND SIMILARITIES: Here is the listing – Gender, SES, Age, Geography, Race, Ethnicity, Culture, Abilities, Disabilities, Religion, Marital Realities, Sexual Orientation, Urban/Rural, Education, Environmental Exposure (good/bad), etc. Again, therapists who are highly mindful of these realities will do their best to integrate them into their work with clients.  Good work here will improve the alliance and clinical outcomes.

INDIVIDUAL SELF-DEVELOPMENT: Here is the list – Genetic Transfer, Modeling Transfer, Familial Transfer, and All Non-Shared Experiences in Life. Therapist who make it a norm to differentiate carefully between individuals in therapy – and who actively use these differences in their work – will most likely experience stronger emotional ties/alliances and better clinical outcomes.

If you have not been fully conscious of using such differences and similarities in working with your clients, you may want to select a few variables and begin.  Begin NOW!

For more information refer to Pomerantz, A. M. (2017). Clinical Psychology: Science, Practice, and Culture. Los Angeles, CA: SAGE Publications, pp. 69-93. See also the DSM-V emphasis on culture and diversity in treatment.

Anthony R. Quintiliani, PhD., LADC

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, VermontChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

Mindful Happiness cover designs.indd

New Edition of Mindful Happiness in Production…Coming soon!

 

By

How to Improve Client/Patient Collaboration

Improving Client/Patient Collaboration  in Treatment

To improve collaboration between you and your clients/patients, simply practice the following behaviors as your norms.  See the

list below, and practice, practice, practice.

  1. Present with an attitude of helpfulness and authentic caring. Empathy and authentic concern are required.
  2. Recognize the reality that clients/patients are at different levels of readiness to make changes – almost alway NOT where you are in the process.
  3. Know how to use cognitive-behavioral therapies, mindfulness-based stress reduction, deepo psychodynamics in alliance building, and other effective approaches.
  4. Complete a cost-benefit analysis grid with the person, and work with pros/cons of staying the same vs changing.
  5. Do whatever you can to enhance the quality of the clinical relationship.
  6. Act within an understanding of equality; you are not able to control any person who is suffering.
  7. Provide psychoeducation where needed.
  8. Anticipate barriers to making desired changes; offer concrete support and help in doing so.
  9. Your clinical interventions should be evidence-based for a higher probability of success.
  10. Use the person’s personal hopes, goals, and motivations.
  11. Use task analysis as a behavioral method to break down larger tasks into smaller, more manageable tasks.
  12. Be willing to try harm reduction when people appear pre-contemplative in stages of change.
  13. Provide direct feedback, with more emphasis on reinforcing praise rather than scolding.
  14. Remain in the Middle Way regarding too much/too little expected change, as well as the timing and time required for any changes to occur.
  15. Be highly mindful of both your own emotion regulation and that of the person you are working with. Practice emotion regulation skills often.
  16. Intervene quickly in anxiety, depression, substance misuse, and trauma.  Intervene carefully, intelligently, and again with evidence-based actions.
  17. Remember in crisis situations that  safety is first, stabilization is second.
  18. Identify people, places, and things that help and hinder progress into healthier life patterns.
  19. Monitor serious symptoms and act accordingly.  If medications are required, be part of the monitoring system and do “check-ins” often.
  20. Use self-help groups if the client/patient finds them helpful.  One needs to participate to know the correct answer here.
  21. Do GOOD self-care and get effective clinical supervision when needed.

For more information refer to Daley, D. C. and Zuckoff, A. (1999). Improving Treatment Compliance: Counseling and Systems Strategies for Substance Abuse and Dual Disorders. Center City, MINN. Hazelden.

Anthony R. Quintiliani, PhD., LADC

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, VermontChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

Mindful Happiness cover designs.indd

New Edition of Mindful Happiness in Production…Coming soon!

By

Even More Psychoanalytic Gems

Psychoanalytic Gems – Even More

D. W. Winnicott has made significant clinical contributions to both building therapeutic alliance and maintaining a positive, helpful focus in psychotherapy. Below I have noted various approaches to
use in your therapy.  Use of these “gems” requires considerable knowledge and skill by the therapist.  Here is the list:

  1. Respect the client’s agency, and do nothing to exert direct control over her/him.
  2. Continue to support personal goals, striving, and motivation in your client.  Promote healthy maturational processes in this growth.
  3. If you understand how, use transitional space/transitional objects in our therapy to enhance positive emotional holding and nurturing of the client’s true self. Build more safety.
  4. Work to improve the client’s self-identifications, self-image, and self-objects. Where helpful note that initial introjections are the product of attachment experience. They occupy both intrapsychic and interpersonal space and time.
  5. Introduce playful free association as a method in your therapy. Use interpretation only when it is helpful.
  6. Support directly the client’s need for “continuity of being” in both therapy and day-to-day life experiences. This often includes integration of the true self and false self.
  7. Use gentle reflection to help move insight into action: changes in thoughts, emotions, and behaviors.
  8. Notice both transference and cuntertransference experiences in therapy. Use these to better understand your client, as well as yourself.
  9. When possible enhance the client’s safe use of self soothing behaviors as a form of “primal satisfaction.”
  10. Help your client to integrate fragments of unhelpful past experiences.  This process should help to enhance the presence of a coherent self-narrative.   Such narratives often involve early traumatic experiences, and may be activated in the here-and-now of therapy.
  11. Do whatever is possible to re-integrate the sense of a secure self.  Maintain a safe and accepting therapeutic environment to do so.

For more refer to  Giovacchini, P. L. (1990). Tactics and Techniques in Psychoanalytic Therapy. Vol. 3, The Implications of Winnicott’s Contributions. Northvale, NJ: J. Aronson, pp.1- 243.

Anthony R. Quintiliani, PhD., LADC

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, VermontChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

Mindful Happiness cover designs.indd

New Edition of Mindful Happiness in Production…Coming soon!

 

By

Object Relations Therapy for Trauma

Trauma: Object Relations Therapy

Object relations therapists, D. W. Winnicott especially, have presented a logical analysis on how to provide object-relations-oriented therapy to people suffering from the effects of psychological trauma. Such attachment-based trauma therapy provides support and healing from trauma, loss and long-term trauma-effects.  The interventions below combine the best of object relations therapy, mindfulness therapy (MBSR, ACT), and cognitive-behavioral therapy. Here is the listing of therapeutic functions and interventions.

  1. Provide support for “going-on-being” in the therapeutic alliance and the therapy itself. (Winnicott)
  2. Unconditional positive regard is a must. (Rogers)
  3. Recognize, work with and work through the splitting process as it activates in therapy. (Lineman)
  4. Safely and with effective skill help to re-connect the person with safe transitional space. (Winnicott)
  5. Carefully build and monitor the emotional “holding environment” in both alliance and therapy. (Rogers, Winnicott)
  6. Include contextual stimuli and symbols of the traumatic experience, from very general to specific and shift slowly over time. (Briere)
  7. Once there is a firm alliance and safety in the therapy, be more specific in exposure to traumatic experiences – monitor carefully. (Briere)
  8. In all exposure work, best to utilize SUDs scores from 0 to 100 – larger range between numbers allows deeper investigation and specificity.
  9. Work hard to understand and utilize body-based communications. (Ogden, Fisher, van der Kolk)
  10. Use mindfulness attention and skills (MBSR, ACT) to remain in The Middle Way between traumatic re-exposure and the safety of “going-on-being.” (Briere, van der Kolk)
  11. Check in with the experiences of transference and countertransference as you use images and defenses to support progress. (A. Freud)
  12. Use multi-sensory interventions in gentle, safe, re-exposure to traumatic materials – using one step removed and cognitive processes first. (Quintiliani)
  13. If skilled in its use, utilize the Attachment-CABs-VAKGO-IS-Rels formula for interventions. (Quintiliani – see mindfulhappiness.org for more details)
  14. Using items #s 8-13 above, aim for development of a safe cognitive schema and narrative clarification about the traumatic event/s.
  15. Work closely with the person to help them internalize the growth-benefits of all of the above. Take time with this process.
  16. Be a “good object” and always return to safety over and over again – check-in and stabilizes often.
  17. Slowly and with safety move up the hierarchy of trauma exposure process, possibly experiencing the full array of sensory experience. (Briere, Foa)
  18. Listen, support emotionally, radically accept, validate and understand the process and the person. This is your best way to develop a “good enough” self-object via “transmuting internalization.” (Kohut)  Various mindfulness and CBT skills will be used here.
  19. Use mindfulness and good CBT to make space for acceptance and validation for post-traumatic growth. (Lineman)
  20. Help to impact these positive changes into a “different” memory system as you expand and deepen the narrative.
  21. Support and directly reinforce (behaviorally) the improved self – a “felt sense” of a healthier self psychologically and physically.
  22. Place more and more safety into the transitional space, and generalize this process into therapy and life practices.
  23. Finally, expand the person’s capacity for pleasure, joy, self-esteem, success and HAPPINESS before therapy ends.

For more information refer to Savage Scharff, J. and Scharff, D. E. (1994).  Object Relations Therapy of Physical and Sexual Trauma. Northvale, NJ: J. Aronson.

Note: The ideas have been presented in this text, but I have added more current interventions and details based on new research and treatments.

Anthony R. Quintiliani, PhD., LADC

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, VermontChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

Mindful Happiness cover designs.indd

New Edition of Mindful Happiness in Production…Coming soon!