Buddhism and therapy - from the helpers perspective

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Johnny Dangerous
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Buddhism and therapy - from the helpers perspective

Post by Johnny Dangerous »

KristenM requested a thread on Buddhism and therapy, from the perspective of people who do those jobs.

I figure we can make it a place for anyone involved in therapeutic or helping professions to discuss how their work and studies might or might not intersect with Dharma.

So here is the thread, I’ll contribute a brief work bio and food for thought a bit later.
Meditate upon Bodhicitta when afflicted by disease

Meditate upon Bodhicitta when sad

Meditate upon Bodhicitta when suffering occurs

Meditate upon Bodhicitta when you are scared

-Khunu Lama
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Re: Buddhism and therapy - from the helpers perspective

Post by reiun »

The unifying stance Epstein identifies in Buddhism and in therapy at its best — such as in the work of the British child analyst D. W. Winnicott, champion of the “good-enough mother” — is the willingness to pay attention, while letting people and feelings be as they are. He finds it, too, in the creative approach of another of his heroes, the composer John Cage, who sought to “let the sounds be themselves.” “Kindness is the thread that runs through the work of Winnicott, Cage and the Buddha,” Epstein writes, “each of whom discovered that noninterfering attentiveness — in a mother, an artist, a meditator or a therapist — is, by its very nature, transformative.”

https://www.nytimes.com/2022/01/11/book ... stein.html
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Re: Buddhism and therapy - from the helpers perspective

Post by reiun »

It is good that therapy and Buddhism can share common ground in what is described above as a "stance". It should be clear, though, that therapeutic treatment involves specific ethics and tried-and-true protocols or techniques a therapist must master and demonstrate, including under supervision. (Note: It is problematic to practice therapy if carrying a diagnosis or diagnoses, because self-assessment will inevitably suffer. Outside observation would be called for, as well as forthright prior notification to client.)

(MSW from CUA. LCSW-C Maryland, LCSW Virginia. Retired psychotherapist; experience includes drug and alcohol clinic, county youth and family services bureau, private practice.)
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Re: Buddhism and therapy - from the helpers perspective

Post by KristenM »

Thanks Johnny for the thread. I’ll come back with more later, but I agree with the previous post that therapy should be evidence based and in line with our code of ethics. I’m licensed as well. I actually received my masters in psychology from a Buddhist university, University of the West, in Rosemead, CA. Currently I am a Mental Health Clinician for a county in central valley California and work in the Children’s system of care with foster youth.
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Re: Buddhism and therapy - from the helpers perspective

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KristenM wrote: Sun Jul 03, 2022 4:13 pm Thanks Johnny for the thread. I’ll come back with more later, but I agree with the previous post that therapy should be evidence based and in line with our code of ethics. I’m licensed as well. I actually received my masters in psychology from a Buddhist university, University of the West, in Rosemead, CA. Currently I am a Mental Health Clinician for a county in central valley California and work in the Children’s system of care with foster youth.
Yeah, I agree on evidence-based treatment, but at the same I don’t want to pretend that all evidence is of the same quality, or that psychology does not have a replication crisis.

Ethics are indispensable for sure, as at least for me they came into play right away once I started working, due to my field.

Anyway, I am licensed as a Substance Use Disorder Professional. I’ve done it for I think almost five years now, and started working in a high school ten months ago, which I like a lot.

I am working on more education so I can get dual licensure- mental health as well. It would likely not change the basic functions of my job, but being able to diagnose both mental health and SUD issues would be really valuable.

Anyway, in addition to the standard battery of Motivational Interviewing and CBT - based SUD stuff I also use ACT and DBT in my work where appropriate. I particularly like ACT.

I used to do a lot of meditation with clients when I first started working in the field, they actually requested it. Alan Marlatt and others created a Mindfulness Based Relapse Prevention program that is pretty good, and I had previous experiences in group meditation from doing Prison Dharma groups for a few years, which often was something closer to a therapeutic group than a Dharma one - the group members choice.

Now I work with high schoolers, which is a different ballgame altogether, but they are really fun to work with and I’m finding them refreshingly honest compared to adults.

As I’m sure you know though, sometimes working with kids in bad situations is really tough. I’d be interested to know how you deal with the sadder parts of your job.

One of the biggest issues in my field is that SUD treatment is often much easier to get into than mental health (especially with kids where I am), so you end up with a portion of kids who need a lot more than the SUD treatment, and can’t engage in it effectively. Unfortunately “the system” as it is will want them there anyway, usually because courts and schools expect stuff on paper even if it’s not always appropriate.
Meditate upon Bodhicitta when afflicted by disease

Meditate upon Bodhicitta when sad

Meditate upon Bodhicitta when suffering occurs

Meditate upon Bodhicitta when you are scared

-Khunu Lama
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Re: Buddhism and therapy - from the helpers perspective

Post by KristenM »

Johnny Dangerous wrote: Sun Jul 03, 2022 6:30 pm
KristenM wrote: Sun Jul 03, 2022 4:13 pm Thanks Johnny for the thread. I’ll come back with more later, but I agree with the previous post that therapy should be evidence based and in line with our code of ethics. I’m licensed as well. I actually received my masters in psychology from a Buddhist university, University of the West, in Rosemead, CA. Currently I am a Mental Health Clinician for a county in central valley California and work in the Children’s system of care with foster youth.
Yeah, I agree on evidence-based treatment, but at the same I don’t want to pretend that all evidence is of the same quality, or that psychology does not have a replication crisis.

For sure. I've also heard that the therapeutic relationship is the most important aspect of effective therapy, and that's not an easily quantifiable thing.

I studied ACT in school, but I'd like to at some point hear how you use it, like specific interventions. I'll have to go find my ACT books and get back to you with some questions. I generally used CBT and something called Cognitive Processing Therapy for PTSD with clients.

I can definitely say that my personal beliefs (as a Buddhist) help prevent me from burning out and feeling depressed when there doesn't appear to be a silver lining that you can find. None of the people I work with are Buddhist, so I keep my beliefs to myself and I'm totally comfortable with that. However, I do try to bring some "mindfulness and acceptance" to therapy, hopefully not in a heavy-handed or cheesy way. If I had a private practice, I don't know if I would put in my bio that I was a Buddhist. Maybe just out of curiosity to see what happened. Sometimes it does feel like I have a wish-fulfilling jewel that can't be disclosed. But, maybe suffering, impermanence, karma, and precious human birth etc. are things one can convey without even calling it Buddhist, perhaps?
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Re: Buddhism and therapy - from the helpers perspective

Post by Toenail »

reiun wrote: Sat Jul 02, 2022 3:28 am The unifying stance Epstein identifies in Buddhism and in therapy at its best — such as in the work of the British child analyst D. W. Winnicott, champion of the “good-enough mother” — is the willingness to pay attention, while letting people and feelings be as they are. He finds it, too, in the creative approach of another of his heroes, the composer John Cage, who sought to “let the sounds be themselves.” “Kindness is the thread that runs through the work of Winnicott, Cage and the Buddha,” Epstein writes, “each of whom discovered that noninterfering attentiveness — in a mother, an artist, a meditator or a therapist — is, by its very nature, transformative.”

https://www.nytimes.com/2022/01/11/book ... stein.html
I am a cbt therapist and my work is completly different. I do not just listen. I really want to help people with mental disorders to make their mental illnesses go away. I am an expert on mental disorders and I know what one must do to make them go away. I kind of tell my patients and help them get rid of it. I am very active and also interfering.
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Re: Buddhism and therapy - from the helpers perspective

Post by Toenail »

Johnny Dangerous wrote: Sun Jul 03, 2022 6:30 pm
Yeah, I agree on evidence-based treatment, but at the same I don’t want to pretend that all evidence is of the same quality, or that psychology does not have a replication crisis

Some areas of psychology have. Clinical psychology however has very good evidence in the case of for example cbt. Most of the studies are done for cbt and are conducted with scientific gold standard protocal, double blind controlled etc. It is very safe to say there is overwhelming evidence that it works very well, better than medications in most if not all mental disorders.
Personally, I could not work in addiction treatment again. It is too exhausting and very frustrating. Research shows that in germany only 7%-12% of the inpatient population are still abstinent after 5 years. I find it difficult with these numbers to justify treatment, although I get counter agruments about the success rates of cancer treatment etc..
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Re: Buddhism and therapy - from the helpers perspective

Post by reiun »

Toenail wrote: Tue Jul 05, 2022 8:13 pm I am an expert on mental disorders and I know what one must do to make them go away. I kind of tell my patients and help them get rid of it. I am very active and also interfering.
"expert"?

"patients"?
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Re: Buddhism and therapy - from the helpers perspective

Post by Toenail »

reiun wrote: Tue Jul 05, 2022 9:14 pm
Toenail wrote: Tue Jul 05, 2022 8:13 pm I am an expert on mental disorders and I know what one must do to make them go away. I kind of tell my patients and help them get rid of it. I am very active and also interfering.
"expert"?

"patients"?
Yes. In my country we call clients patients. And I am an expert on mental illnesses because I studied it for 8 years and have much work experience. In the same way in that a cook is an expert of his dishes, a teacher is an expert of his curriculum etc. It does not mean I know everything, i tried to convey that people usually come to me because I know more about their condition than themself. they actively seek help and they want someone to interfere (of course this interference is usually empowerment for self help by explaining maintaining behaviours of for example a mental illness like ptsd and then helping them to do less of it etc)
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Re: Buddhism and therapy - from the helpers perspective

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Toenail wrote: Tue Jul 05, 2022 8:21 pm
Johnny Dangerous wrote: Sun Jul 03, 2022 6:30 pm
Yeah, I agree on evidence-based treatment, but at the same I don’t want to pretend that all evidence is of the same quality, or that psychology does not have a replication crisis

Some areas of psychology have. Clinical psychology however has very good evidence in the case of for example cbt. Most of the studies are done for cbt and are conducted with scientific gold standard protocal, double blind controlled etc. It is very safe to say there is overwhelming evidence that it works very well, better than medications in most if not all mental disorders.
Personally, I could not work in addiction treatment again. It is too exhausting and very frustrating. Research shows that in germany only 7%-12% of the inpatient population are still abstinent after 5 years. I find it difficult with these numbers to justify treatment, although I get counter agruments about the success rates of cancer treatment etc..
Well, IMO a lot of the data surrounding treatment outcomes is next to useless. Short term abstinence from drugs immediately following a 1-3 month treatment regimen for what is often a lifetime problem is a friggin ridiculous measurement of “success”. In many other fields no one would take that seriously, but in treatment people use specious data sets and methods all the time to “prove” or “disprove” success, it’s a stupid game, but often it has to be played for funding.

This is one of the reasons I am an advocate of looking at things from a harm-reduction standpoint when appropriate, and always taking a holistic approach to person and their environment. Relatively short term data about drug use doesn’t
always mean anything with longer term outcomes.

But yes, treatment is miserable for both client and professional when it is solely about trying to get someone to not use drugs, I found that out pretty quickly and dropped that approach.
Meditate upon Bodhicitta when afflicted by disease

Meditate upon Bodhicitta when sad

Meditate upon Bodhicitta when suffering occurs

Meditate upon Bodhicitta when you are scared

-Khunu Lama
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Re: Buddhism and therapy - from the helpers perspective

Post by Johnny Dangerous »

KristenM wrote: Sun Jul 03, 2022 8:16 pm
Johnny Dangerous wrote: Sun Jul 03, 2022 6:30 pm
KristenM wrote: Sun Jul 03, 2022 4:13 pm Thanks Johnny for the thread. I’ll come back with more later, but I agree with the previous post that therapy should be evidence based and in line with our code of ethics. I’m licensed as well. I actually received my masters in psychology from a Buddhist university, University of the West, in Rosemead, CA. Currently I am a Mental Health Clinician for a county in central valley California and work in the Children’s system of care with foster youth.
Yeah, I agree on evidence-based treatment, but at the same I don’t want to pretend that all evidence is of the same quality, or that psychology does not have a replication crisis.

For sure. I've also heard that the therapeutic relationship is the most important aspect of effective therapy, and that's not an easily quantifiable thing.
That’s cool, you have more (and likely better) education than me. I have an associates in Human Services and am wrapping up my Bachelors, then planning to do the cheapest, easiest Masters program to get licensed as a Mental Health Professional. That way I can basically do what I’m doing now and earn internship hours.

Anyway yeah, simply being a compassionate person and good listener…”presence” if you like is the major part of therapeutic juice I think. It can be beneficial even without techniques, in that sense I think Carl Rogers was mostly right… it’s definitely a necessary condition for a therapeutic relationship.
I studied ACT in school, but I'd like to at some point hear how you use it, like specific interventions. I'll have to go find my ACT books and get back to you with some questions. I generally used CBT and something called Cognitive Processing Therapy for PTSD with clients.
On a mobile device but I’ll try to sum up my favorite stuff and add more detail later if needed. Keep in mind this is just my experiences, I am not formally certified in ACT, including explaining it!

The things I use most are:

1) ACT cognitive defusion techniques (they often avoid the term mindfulness) 2) The Choicepoint (look this up if you want, it’s a part of what ACT calls “creative hopelessness”) 3) values clarification exercises

The other part that is important to me is ACT does not purport to help people remove their negative experiences, and does not ask them to judge the content of their thoughts. I have a strong bias against classic CBT in that sense, as I do not think people can often just think their way out of being caught up in suffering or negative patterns.

I’d argue there’s a congruence with Buddhism there, imagine trying to apply antidotes to negative emotions without having the equanimity required to do so. So, in my opinion CBT needs mindfulness (or whatever term you prefer) to function.

The reason ACT takes this approach has to do with Relational Frame Theory, the linguistic theory behind it. I can try to explain my understanding of it if you want, but don’t know if I would do it justice. Basically it comes down to trying to apply strategies that work in the “outside” world to our thoughts and feelings, and then failing because the same logic to say, fixing a sink is counterproductive when dealing with mental suffering.

However, I have also seen Stephen K. Hayes say straight up that “wisdom traditions” in many ways are more advanced than Western Psych in helping people deal with negative internal experiences, and that ACT draws from, and is congruent with contemplative traditions. I share this bias too, based partially on professional experiences, and obviously personal ones.
I can definitely say that my personal beliefs (as a Buddhist) help prevent me from burning out and feeling depressed when there doesn't appear to be a silver lining that you can find. None of the people I work with are Buddhist, so I keep my beliefs to myself and I'm totally comfortable with that. However, I do try to bring some "mindfulness and acceptance" to therapy, hopefully not in a heavy-handed or cheesy way. If I had a private practice, I don't know if I would put in my bio that I was a Buddhist. Maybe just out of curiosity to see what happened. Sometimes it does feel like I have a wish-fulfilling jewel that can't be disclosed. But, maybe suffering, impermanence, karma, and precious human birth etc. are things one can convey without even calling it Buddhist, perhaps?
Oh yeah, I couldn’t do my job without my practice, and I don’t think I ever would have entered the helping professions in the first place without it.

You should really check our ACT, IMO it is about the most Dharma - congruent form of therapy out there. So whatever can be useful to non-Buddhists about Buddhist thought it neatly packaged there. I don’t want to say it is Dharma, it’s not, but lots of people have noted the similarities in how it approaches suffering.

Again to me the important part is that it does not pathologize suffering but sees it as inevitable, it also allows for a lot of flexibility, therapeutic self-disclosure and other things that are important for addiction treatment. My bias is that they are important for mental health generally too, but of course my experience is the addiction world.

Anyway, Stephen K. Hayes has some TED talks on ACT that explain stuff well, and I can recommend a couple books that dive right in to functionally using it if you are interested in them. As you can probably tell, I’m a bit of a fanboy of ACT, it’s made my work more effective-and- help me let go of some of my own counterproductive patterns I was bringing into it.

On “Buddhist therapy”: One of my main teachers is a Loppon and is a western trained therapist. I have seen another person who was a Dharma practitioner too when I needed that kind of help. At least for me it was a big difference to have a Dharma practitioner in that role because they take the same fundamental attitude towards suffering and the mind that I do. This isn’t necessarily there with other therapists.

Of course they both see non-Buddhist clients too, but with Buddhist clients there are way deeper tools to work with. I have experienced this on the other side too in my own work where Buddhist or “Buddhist” clients would directly ask about certain approaches. Of course I would stay far away from this now that I work in schools.
Meditate upon Bodhicitta when afflicted by disease

Meditate upon Bodhicitta when sad

Meditate upon Bodhicitta when suffering occurs

Meditate upon Bodhicitta when you are scared

-Khunu Lama
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Re: Buddhism and therapy - from the helpers perspective

Post by KristenM »

Johnny Dangerous wrote: Tue Jul 05, 2022 10:28 pm
KristenM wrote: Sun Jul 03, 2022 8:16 pm
Johnny Dangerous wrote: Sun Jul 03, 2022 6:30 pm

Yeah, I agree on evidence-based treatment, but at the same I don’t want to pretend that all evidence is of the same quality, or that psychology does not have a replication crisis.

For sure. I've also heard that the therapeutic relationship is the most important aspect of effective therapy, and that's not an easily quantifiable thing.
That’s cool, you have more (and likely better) education than me. I have an associates in Human Services and am wrapping up my Bachelors, then planning to do the cheapest, easiest Masters program to get licensed as a Mental Health Professional. That way I can basically do what I’m doing now and earn internship hours.

Anyway yeah, simply being a compassionate person and good listener…”presence” if you like is the major part of therapeutic juice I think. It can be beneficial even without techniques, in that sense I think Carl Rogers was mostly right… it’s definitely a necessary condition for a therapeutic relationship.
I studied ACT in school, but I'd like to at some point hear how you use it, like specific interventions. I'll have to go find my ACT books and get back to you with some questions. I generally used CBT and something called Cognitive Processing Therapy for PTSD with clients.
On a mobile device but I’ll try to sum up my favorite stuff and add more detail later if needed. Keep in mind this is just my experiences, I am not formally certified in ACT, including explaining it!

The things I use most are:

1) ACT cognitive defusion techniques (they often avoid the term mindfulness) 2) The Choicepoint (look this up if you want, it’s a part of what ACT calls “creative hopelessness”) 3) values clarification exercises

The other part that is important to me is ACT does not purport to help people remove their negative experiences, and does not ask them to judge the content of their thoughts. I have a strong bias against classic CBT in that sense, as I do not think people can often just think their way out of being caught up in suffering or negative patterns.

I’d argue there’s a congruence with Buddhism there, imagine trying to apply antidotes to negative emotions without having the equanimity required to do so. So, in my opinion CBT needs mindfulness (or whatever term you prefer) to function.

The reason ACT takes this approach has to do with Relational Frame Theory, the linguistic theory behind it. I can try to explain my understanding of it if you want, but don’t know if I would do it justice. Basically it comes down to trying to apply strategies that work in the “outside” world to our thoughts and feelings, and then failing because the same logic to say, fixing a sink is counterproductive when dealing with mental suffering.

However, I have also seen Stephen K. Hayes say straight up that “wisdom traditions” in many ways are more advanced than Western Psych in helping people deal with negative internal experiences, and that ACT draws from, and is congruent with contemplative traditions. I share this bias too, based partially on professional experiences, and obviously personal ones.
I can definitely say that my personal beliefs (as a Buddhist) help prevent me from burning out and feeling depressed when there doesn't appear to be a silver lining that you can find. None of the people I work with are Buddhist, so I keep my beliefs to myself and I'm totally comfortable with that. However, I do try to bring some "mindfulness and acceptance" to therapy, hopefully not in a heavy-handed or cheesy way. If I had a private practice, I don't know if I would put in my bio that I was a Buddhist. Maybe just out of curiosity to see what happened. Sometimes it does feel like I have a wish-fulfilling jewel that can't be disclosed. But, maybe suffering, impermanence, karma, and precious human birth etc. are things one can convey without even calling it Buddhist, perhaps?
Oh yeah, I couldn’t do my job without my practice, and I don’t think I ever would have entered the helping professions in the first place without it.

You should really check our ACT, IMO it is about the most Dharma - congruent form of therapy out there. So whatever can be useful to non-Buddhists about Buddhist thought it neatly packaged there. I don’t want to say it is Dharma, it’s not, but lots of people have noted the similarities in how it approaches suffering.

Again to me the important part is that it does not pathologize suffering but sees it as inevitable, it also allows for a lot of flexibility, therapeutic self-disclosure and other things that are important for addiction treatment. My bias is that they are important for mental health generally too, but of course my experience is the addiction world.

Anyway, Stephen K. Hayes has some TED talks on ACT that explain stuff well, and I can recommend a couple books that dive right in to functionally using it if you are interested in them. As you can probably tell, I’m a bit of a fanboy of ACT, it’s made my work more effective-and- help me let go of some of my own counterproductive patterns I was bringing into it.

On “Buddhist therapy”: One of my main teachers is a Loppon and is a western trained therapist. I have seen another person who was a Dharma practitioner too when I needed that kind of help. At least for me it was a big difference to have a Dharma practitioner in that role because they take the same fundamental attitude towards suffering and the mind that I do. This isn’t necessarily there with other therapists.

Of course they both see non-Buddhist clients too, but with Buddhist clients there are way deeper tools to work with. I have experienced this on the other side too in my own work where Buddhist or “Buddhist” clients would directly ask about certain approaches. Of course I would stay far away from this now that I work in schools.
My main professor was a big fan of ACT, too. I actually sat in on one of Steven Haye's lectures while I was in school. I think ACT may be (of course, I may be wrong) more appropriate for people who have a fair amount of insight, but I'm not sure. The whole linguistic part of ACT seems a bit hard to utilize with some clients (like mine). I've pondered how to explain that to a kid, and I haven't found the way to do it, yet. I will definitely have to get back to you with some specifics on what I mean, though. Right now I'm just conjecturing based upon vague ideas without looking over my books.

I agree with your thoughts on pure CBT. I tend to incorporate mindfulness, radical acceptance and self-compassion. It all sounds a bit cheesy, I know. But when I'm sitting with a young person who has been sexually abused, CBT alone usually doesn't suffice. And sad thing is that as much as we, or I, at least, mock these concepts for being too hokey and soft, the kids I work with have never been given any tools like that whatsoever in their lives. They have been raised by dysfunctional families to blame themselves and keep things hidden. So, for them these ideas really are eye-opening.
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Re: Buddhism and therapy - from the helpers perspective

Post by KristenM »

Toenail wrote: Tue Jul 05, 2022 9:33 pm
reiun wrote: Tue Jul 05, 2022 9:14 pm
Toenail wrote: Tue Jul 05, 2022 8:13 pm I am an expert on mental disorders and I know what one must do to make them go away. I kind of tell my patients and help them get rid of it. I am very active and also interfering.
"expert"?

"patients"?
Yes. In my country we call clients patients. And I am an expert on mental illnesses because I studied it for 8 years and have much work experience. In the same way in that a cook is an expert of his dishes, a teacher is an expert of his curriculum etc. It does not mean I know everything, i tried to convey that people usually come to me because I know more about their condition than themself. they actively seek help and they want someone to interfere (of course this interference is usually empowerment for self help by explaining maintaining behaviours of for example a mental illness like ptsd and then helping them to do less of it etc)
I want to make a point about this, especially as I know some people have some well-justified skepticism and distrust of the therapeutic profession in part due to this type of thinking, i.e. that therapists are the "Expert." Maybe in Germany things are different than in the US, but my training is quite the opposite. The client is the actual expert on themselves, not the therapist. We help empower clients to make their own decisions and choices.

There's a lot of distrust towards the psychological establishment because of many historical reasons, including dictating what is best for the client, diagnosing and labeling people wrongfully, and like Johhny said, pathologizing people as "abnormal." My training is that there is no such thing as "Normal" when it comes to human behavior, there's not a standard way of being/living for people to conform to. That said, you may be very helpful to people who are looking for someone to tell them what to do, but in California that is not considered best practice, it's actually more like Malpractice.
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Re: Buddhism and therapy - from the helpers perspective

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KristenM wrote: Wed Jul 06, 2022 12:34 am

My main professor was a big fan of ACT, too. I actually sat in on one of Steven Haye's lectures while I was in school. I think ACT may be (of course, I may be wrong) more appropriate for people who have a fair amount of insight, but I'm not sure. The whole linguistic part of ACT seems a bit hard to utilize with some clients (like mine). I've pondered how to explain that to a kid, and I haven't found the way to do it, yet. I will definitely have to get back to you with some specifics on what I mean, though. Right now I'm just conjecturing based upon vague ideas without looking over my books.
Hmm, I mean it shouldn't require any more insight than CBT does, perhaps even less. My test is always whether or not the person recognizes that that the way they view their thoughts and feelings is important. For sure plenty of people I've worked with, including adults, do not have that awareness.

I have had lots of clients (maybe a slim majority) that struggle to even understand the CBT-based treatment stuff that is a standard part of my job - stuff like substance abuse triggers, etc. Plenty of the people (well, especially men) I've worked with also lack basic emotional intelligence. Those would not be good candidates. With those people in an SUD environment it's all just Motivational Interviewing anyway - they are usually pre-contemplative and mandated to be there, and will have little buy in. I think the hardest thing about ACT is maybe figuring out how to present it to clients without seeming like you are trying to "teach meditation" and to make it feel natural.

I've found that slightly brighter, more neurotic types who get really fixated on their own dramas are some of the best candidates, and often seem open to learning news ways of dealing with things. A lot of it is learning how to effectively use metaphors to communicate cognitive defusion and other ideas to clients. The two best books I've found for that are ACT Made Simple by Russ Harris and ACT for adolescents by Sherry Turrell and Mary Bell. They are written in completely plain language and just meant to be used.

My favorite metaphor is to have them write their "big issue" (whether it's anxiety, family drama, whatever) on a sticky note and have them hold it really close to their face, so it takes up most of the visual field, then pan out so that it only takes up a small part of their vision. This kind of illustrates the goal, not that the issue somehow "goes away", but that it takes up less of their attention and they can focus on living life because it is not in the way anymore.

Kids seem to take to this kind of stuff, you can do more with this metaphor too, for instance have them crumple up their Big Issue and squeeze it as hard as they can in an effort to destroy it, as an illustration of how much energy we can spend fighting our thoughts. Then instead of squeezing it just ask them to let it go. Obviously these are pretty on the nose metaphors to anyone who has done meditation, but for some people they are a big revelation, I think.

I agree with your thoughts on pure CBT. I tend to incorporate mindfulness, radical acceptance and self-compassion. It all sounds a bit cheesy, I know. But when I'm sitting with a young person who has been sexually abused, CBT alone usually doesn't suffice. And sad thing is that as much as we, or I, at least, mock these concepts for being too hokey and soft, the kids I work with have never been given any tools like that whatsoever in their lives. They have been raised by dysfunctional families to blame themselves and keep things hidden. So, for them these ideas really are eye-opening.
Not at all, but honestly if you are doing that stuff you are already much of the same ground as ACT, which would probably just give you more tools. Advocating for self-compassion and acceptance with some of the hurt kiddos I've worked with so far is huge, so not cheezy to me at all and I'm on the same page with how vital that is.
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Re: Buddhism and therapy - from the helpers perspective

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Very interesting thread. Thank you.
So, by ACT you mean this? https://en.wikipedia.org/wiki/Acceptanc ... nt_therapy
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Re: Buddhism and therapy - from the helpers perspective

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Ayu wrote: Wed Jul 06, 2022 7:33 am Very interesting thread. Thank you.
So, by ACT you mean this? https://en.wikipedia.org/wiki/Acceptanc ... nt_therapy
Yes, that’s it.
Meditate upon Bodhicitta when afflicted by disease

Meditate upon Bodhicitta when sad

Meditate upon Bodhicitta when suffering occurs

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Re: Buddhism and therapy - from the helpers perspective

Post by Toenail »

KristenM wrote: Wed Jul 06, 2022 12:42 am
Toenail wrote: Tue Jul 05, 2022 9:33 pm
reiun wrote: Tue Jul 05, 2022 9:14 pm

"expert"?

"patients"?
Yes. In my country we call clients patients. And I am an expert on mental illnesses because I studied it for 8 years and have much work experience. In the same way in that a cook is an expert of his dishes, a teacher is an expert of his curriculum etc. It does not mean I know everything, i tried to convey that people usually come to me because I know more about their condition than themself. they actively seek help and they want someone to interfere (of course this interference is usually empowerment for self help by explaining maintaining behaviours of for example a mental illness like ptsd and then helping them to do less of it etc)
I want to make a point about this, especially as I know some people have some well-justified skepticism and distrust of the therapeutic profession in part due to this type of thinking, i.e. that therapists are the "Expert." Maybe in Germany things are different than in the US, but my training is quite the opposite. The client is the actual expert on themselves, not the therapist. We help empower clients to make their own decisions and choices.

There's a lot of distrust towards the psychological establishment because of many historical reasons, including dictating what is best for the client, diagnosing and labeling people wrongfully, and like Johhny said, pathologizing people as "abnormal." My training is that there is no such thing as "Normal" when it comes to human behavior, there's not a standard way of being/living for people to conform to. That said, you may be very helpful to people who are looking for someone to tell them what to do, but in California that is not considered best practice, it's actually more like Malpractice.
That is not true at all and it would not be considered malpractice. This is the standard framework in all cbt. You are just mixing things up and are irritated by my rough wordings. The therapist is the expert in regard to mental disorders. The patient dictates his or her goals and what he or she wants. Then based on his expert knowledge the therapist explains which methods lead to achieving the patients goal (which is usually to get rid of their mental disorder). A therapist without expert knowledge on mental disorders should not be practicing. It is however not the task of the therapist to dictate goals etc. or to tell the patient how to live. The patient comes to the therapist because they are suffering from a condition. The therapist knows methods of treatment and helps the patient to implement them.
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Re: Buddhism and therapy - from the helpers perspective

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Toenail wrote: Wed Jul 06, 2022 10:38 am
KristenM wrote: Wed Jul 06, 2022 12:42 am
Toenail wrote: Tue Jul 05, 2022 9:33 pm

Yes. In my country we call clients patients. And I am an expert on mental illnesses because I studied it for 8 years and have much work experience. In the same way in that a cook is an expert of his dishes, a teacher is an expert of his curriculum etc. It does not mean I know everything, i tried to convey that people usually come to me because I know more about their condition than themself. they actively seek help and they want someone to interfere (of course this interference is usually empowerment for self help by explaining maintaining behaviours of for example a mental illness like ptsd and then helping them to do less of it etc)
I want to make a point about this, especially as I know some people have some well-justified skepticism and distrust of the therapeutic profession in part due to this type of thinking, i.e. that therapists are the "Expert." Maybe in Germany things are different than in the US, but my training is quite the opposite. The client is the actual expert on themselves, not the therapist. We help empower clients to make their own decisions and choices.

There's a lot of distrust towards the psychological establishment because of many historical reasons, including dictating what is best for the client, diagnosing and labeling people wrongfully, and like Johhny said, pathologizing people as "abnormal." My training is that there is no such thing as "Normal" when it comes to human behavior, there's not a standard way of being/living for people to conform to. That said, you may be very helpful to people who are looking for someone to tell them what to do, but in California that is not considered best practice, it's actually more like Malpractice.
That is not true at all and it would not be considered malpractice. This is the standard framework in all cbt. You are just mixing things up and are irritated by my rough wordings. The therapist is the expert in regard to mental disorders. The patient dictates his or her goals and what he or she wants. Then based on his expert knowledge the therapist explains which methods lead to achieving the patients goal (which is usually to get rid of their mental disorder). A therapist without expert knowledge on mental disorders should not be practicing. It is however not the task of the therapist to dictate goals etc. or to tell the patient how to live. The patient comes to the therapist because they are suffering from a condition. The therapist knows methods of treatment and helps the patient to implement them.
I’ve had clients that would probably just stand up, flip me off, and walk out of the room forever if I presented myself as an “expert” in anything before serious rapport and trust building.

IME there is a wide spectrum from people who prefer non-directive approaches to people who have just directly asked me “what do I do about this”? This is even truer with adolescents, and has a lot to do with the culture they’ve grown up in.

An authoritative or even authoritarian approach is absolute poison in some therapeutic relationships, and in others it is practically expected. Knowing how to skillfully figure out which approach a client needs is a really important counseling skill, IMO.

In SUD treatment for example, authoritative and highly directive approaches can sometimes work with long term users who are already bought in to the idea of change. On the other hand, they can completely and utterly destroy the therapeutic relationship with people who are in early stages of the change process.
Meditate upon Bodhicitta when afflicted by disease

Meditate upon Bodhicitta when sad

Meditate upon Bodhicitta when suffering occurs

Meditate upon Bodhicitta when you are scared

-Khunu Lama
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Re: Buddhism and therapy - from the helpers perspective

Post by reiun »

Toenail wrote: Tue Jul 05, 2022 8:13 pm I am a cbt therapist and my work is completly different. I do not just listen. I really want to help people with mental disorders to make their mental illnesses go away. I am an expert on mental disorders and I know what one must do to make them go away. I kind of tell my patients and help them get rid of it. I am very active and also interfering.
CBT is not always a proper intervention. Since that is what you say you are, i.e. "cbt therapist", in total, then your expertise in dealing with mental disorders is limited, because certain of them will not respond to cbt expertise.

I am not familiar with all of the qualifications in Deutschland for such academic or professional titles as "Magister", "Sozialverhaltenswissenschaftler", etc., or how or if "cbt therapist" or "expert" fit into that hierarchy. I have no problem if those terms do not fit. In the U.S., I have worked with "counselors" in a drug and alcohol abuse clinic for mainly black, mainly male ex-offenders (and they were great, the counselors). Perhaps "counselor" may be similar to your status.
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