The Use Of Mindfulness In

Psychodynamic
& Body Oriented Psychotherapy
Halko Weiss, Ph.D., Dipl.-Psych.

Editor’s Note: In this article Halko Weiss outlines the use of mindfulness in body-oriented psychotherapy within the more general realm
of psychodynamic psychotherapy. The article first appeared in Body, Movement and Dance in Psychotherapy (Vol. 4, No. 1, April 2009,
pp. 5-16)
Halko Weiss, Ph.D., Dipl.-Psych., is a Founding Trainer of the Hakomi Institute in Boulder, Colorado, and the Director of the Hakomi
Institute of Europe in Germany. In Germany he is a licensed psychotherapist and psychotherapy lecturer, and the co-editor (with Gustle
Marlock) of the Handbuch der Koeperpsychotherapie (Stuttgart: Schattauer), the world’s leading authority on bodypsychotherapy. In
addition to his affiliations with Hakomi in America, Germany, and Australia, he is a member of the Landespsychotherapeutenkammer
(Chamber of Licensed Clinical Psychologists); Deutsche Gesellschaft fur Koeperpsychotherapie DGK (German Association of Body
Psychotherapy); European Association of Body Psychotherapy EABP; and the Berufsverband Deutscher Psychologen BDP (Professional
Union of German Psychologists.) He can be contacted at [email protected].

ABSTRACT: This article summarizes some of the ways that ‘mindfulness’ starts to appear in Western psychotherapy and
medicine, showing that it has become a legitimate area of scientific inquiry and that it shares common objectives with Western
treatment approaches. It then explores its origin in Buddhism as well as the meaning of the concept and aspects of its practice.
Claiming that the use of mindfulness can move psychodynamic therapy from a ‘thinking’ to an ‘observing’ mode, the role and
power of the Buddhist concept of an ‘internal observer’ is explained and discussed. Then the author outlines the reasons why
body psychotherapy is particularly predisposed to embrace mindfulness as a core concept and shows how, using the example of
the Hakomi Method, it would have a deep impact on the way psychodynamic therapy is conducted. He argues that the
therapeutic relationship would have to be shaped according to a radical understanding of ‘acceptance’ and an ‘experimental’
attitude.

Keywords: mindfulness; body psychotherapy; psychodynamic therapy; Hakomi; Hakomi Method; Buddhist psychology;
acceptance.

The West Listening to the East and even the business world has started to embrace
mindfulness as the core ingredient to emotional
Mindfulness has become a red hot item for psychotherapy intelligence (Goleman et al., 2002; Dietz & Dietz, 2007).
in the last decade. It comes as a surprise that of all the
major modalities Cognitive Behavioral Therapy (CBT) In line with these developments, mindfulness has become
would take a leading role in selecting an ancient Buddhist a legitimate subject for academic psychology and
technology of mind to enhance their work. But they did-- neuroscience inquiry. Research in neurobiology, in
and we will see why. particular, has started to provide a solid base for critical
minds through demonstrating, among other things, that
In the wake of Jon Kabat-Zinn’s research, who was able even short-term training of mindfulness can improve
to clearly show that mindfulness not only reduces stress, functioning of the brain and the immune system
but contributes significantly towards the healing process (Davidson et al., 2003, Smith et al., 2004), and further,
for a wide range of diseases (Kabat-Zinn, 2005) that the practice of mindful observation and naming of
psychotherapist Marsha Linehan created a crucial place feelings produces therapeutic effects (Creswell et al.,
for mindfulness in many therapeutic treatment protocols 2007).
and spearheaded a movement that rippled through the
international psychotherapeutic community (Linehan, There is a clear understanding in academic psychology
1993). Patients suffering from borderline syndrome that Buddhist psychology is not a religion in the familiar
(Linehan, 1993), depression (Segal, Williams & Teasdale, theistic sense, but a classical wisdom teaching about how
2002) or trauma (Ogden, Minton & Pain, 2006) are to reduce suffering (Fulton & Siegel, 2005). In the light
among those that are benefiting from understanding the of this understanding both Western psychotherapy and the
workings of the mind through Buddhist psychology. Buddhist teachings pursue similar goals. The academic
world is considering more seriously what was discovered
Psychoanalysis has renewed its dialogue with these by a very different type of science some 2500 years ago.
ancient teachings as well (Safran, 2003; Germer, 2005),
 Halko Weiss
In this article I will first review the core concept of If we take a brief look at Western science at this point, it
mindfulness and it’s potential. Then I will reflect on its is a fairly safe assumption that the well-researched theory
use in psychodynamic therapy, and in body psychotherapy of neuroplasticity (Kandel, 1995) applies to this process,
in particular. Finally, I will show how its inclusion in namely that a growing "internal observer" would be
psychotherapy impacts the very way therapists work and accompanied by the establishment of long-lasting neural
how they relate to their clients. connections that represent a change of the brains
architecture, as well as an acquired skill. That takes time.
A Classical Tool for the Pursuit
of True Happiness As the practitioner does her daily session(s), there are a
number of benefits that are expected to show up as the
In the satipatthana sutra, (his teaching about mindfulness), result of the routine: Equanimity of mind, expansion of
the Buddha presents this seemingly simple technique as awareness, improved focus, a sense of freedom, better self
the very heart of the path towards liberation from regulation, increase of vitality, etc., and, at the far end,
suffering (Nyanponika 1976a and 1976b; Gunaratna, experiences of deeply absorbed states called "samadhi", or
1970). Teaching the mind to stay in the present moment even enlightenment. Generally, it is expected that the
and observing the person’s own being for seconds or, practitioner will become calmer, wiser, and happier over
eventually, continuously is understood as a way to time, though these are byproducts, as opposed to the
"awaken" from identification with mental and emotional object of the practice.
processes. Such processes are seen as delusional and not
fit to deal with impermanence, the very source of all Shared Objectives
suffering.
Assuming that the East really did find a way to move a
Although the terms mindfulness and meditation are not person in these directions, and that the practitioner does
interchangeable, as there are a number of different indeed benefit in some of the ways described above, we
meditation techniques, the classical practice, passed down can see that psychotherapy and the mindfulness tradition
from the Buddha is called insight meditation (Vipassana). in fact share common goals.
It centers on the idea of "sati" ("mindfulness" in the Pali
language). From the point of view of body psychotherapy there is a
particularly interesting and practical element in this mix
Mindfulness can be understood as a special state of that can support our work in a number of different ways:
consciousness that can passively observe the present The "internal observer"--sometimes called the "witness."
moment, pleasant or unpleasant, just as it is, neither It is worthwhile to look at this phenomenon for a moment.
clinging to it, nor rejecting it. Typically, it is focused Western psychotherapists like Roberto Assagioli, Ernest
inward, on internal experience in general, or on specific Hilgard and Fritz Perls already started searching in this
features of its landscape (Johanson, 2006). direction in the first part of the 20th century. The
Freudian tradition also seems to address something like an
That sounds simple enough, but turns out to be a lifelong internal observer when it speaks about the "reflexive ego"
project if taken up in earnest. For the mind rambles. It for instance, even though its particular understanding is
jumps and moves and twists away from present deeply steeped in notions about internal battles to be won.
experience all the time. It is sometimes likened to a
young dog that runs here and there relentlessly and From the Buddhist point of view practicing the observer
enthusiastically without any plan. Even though we do not creates a greater "detachment" from identifications with
notice this in everyday life, the phenomenon is quite everything that seems to be part of the "I": Emotions,
obvious as soon as we try to follow the Buddhist thoughts, memories, sensations, impulses, etc. For once a
prescription. While a beginning meditator is attempting practitioner starts being an observer of himself, he also
to maintain observation of a present moment object, like starts creating a distance between the observer and the
her breathing, she may be gone on a thinking and reliving observed. Whatever is observing is looking at an object
journey for minutes at a time before this comes into her (for instance a strong emotional state), and consequently
awareness, and she can return to present experience. ceases being that emotion to a certain extent.

And there is another major problem: It is our human habit Through practice, observer and the observed are pried
to not just observe, but to observe with a critical, apart. Over time, a person slowly lets go of actually
comparing or judgmental mind. In contrast, Buddhism experiencing their being or ego states as the only reality,
claims that we all are equipped with a potential to have an as something they are pulled into and merged with.
internal "observer," which if correctly trained, will be able Instead, they experience a position of observation from
to look at ourselves without judgment, with equanimity, where they can see those states come and go, and from
benevolence, acceptance, curiosity, passivity, and calm. where they can gain curiosity and compassion for them.
This internal observer, or the state of internal observation,
is a skill that becomes stronger only when we practice it. It is important to note that this process is fundamentally
Just like each child is equipped to learn languages, for different from that of dissociation. There is, in contrast, a
instance, but will not ever know one if it does not get a strong compassionate and aware connection between the
chance to practice one. observer and the observed--not a disconnection. As a
matter of fact, the process actually creates integration, as
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the observed elements are not controlled or pushed away, therapeutic relationship), meaning is also reflected.
but allowed to show their true face, their sources, and However, neuroscience has shown us that mental
their meaning (Perrin, 2007). From a systems theory, as reflection is a very dubious process, always prone to bend
well as from a communications theory, perspective we are and distort towards social desirability, defense of our
looking at a meta-level capacity that grows through a behavior, and habitual thought patterns (Roth, 2003;
concrete training process. Weiss & Harrer, 2006). The conscious, explicit, mind
also has very little power over the implicit. We all know
Here it becomes obvious why CBT would jump on the this from our own experience: It is much harder to feel
wagon along with all the other freedom seekers. differently than to think differently.
"Distancing" (Beck, Rush, Shaw & Emery, 1979) from
unpleasant and burdening emotional states like The situation changes with a trained internal observer.
depression, and finding a position from where the habitual This type of observer is not used to interpret, judge or
feelings and thought patterns become less and less reflect. It simply observes the implicit memory at work as
important, from where a person is not easily sucked into it responds to events inside and out. Here is a typical
them, and from where the "I" seems to rest more in the example from a couple’s therapy session:
observer than in the observed, presents as a very desirable
goal. Along with, for instance, improved flexibility, Alan was quite convinced that he was very open to
mindsight (Siegel & Hartzell, 2004), and self-regulation connecting deeply with his wife Gail on an issue that
(the ability to modulate emotional reactions), the package she saw quite differently, and had complained about
appears to encompass valued objectives of Western over and over again. In an experimental context the
therapist had her slowly move closer to him while
psychotherapy.
Alan mindfully observed his internal experience. As
Gail inched closer, he noticed that something started
From Thinking to Observing to tense up deep inside himself, and that his eyes
seemed to be compelled to look past her--without
Yet, training such an internal observer opens up an any awareness of why he might be doing that. When
additional advance for Western psychotherapy. When she moved even closer, Alan noticed that his
practiced enough and used with the support of an breathing started to restrict subtly, and that his
muscles began to harden ever so slightly. He was
experienced psychotherapist, it allows unlocking the gates
very surprised, and became quite curious about what
of "implicit memory" (Schacter 1996; Roth, 2003), our was happening to him.
reservoir of unconscious knowledge about the world and
how to deal with it, our learned and habitual patterns of Such a process can be understood as the internal observer
self-organization that keep repeating whether they still observing the "unconscious" (the implicit and emotional
work well or not. This knowledge manifests as feelings, memory) at work. Alan did not know or remember
emotions, attitudes, and habitual patterns of behavior. anything related to his reaction. He could just see that
there must have been some kind of learning process in his
Neuroscientists have clearly shown that some aspects of life that now steered an automatic response pattern that he
Freud’s concept of the unconscious seem to be right on. could not control, or had even been aware of. He could
The "explicit" memory system, which can be not name any reasons, nor any events in his life that could
distinguished from the "implicit," not only functionally, have lead him to be that way.
but also anatomically and histologically, does seem to be
close to Freud’s understanding of the conscious ego, even That is particularly important because, (again, we can
though it proves to be a lot less in control than what Freud build on neurobiological research—Roth, 2003) in our
would have liked it to be. particularly formative years, the first two years of our
lives, we cannot yet form autobiographic memory. What
The bad news is that the parts of the brain that are not we learn during that time is absorbed and represented in
conscious (implicit memory), but very fast, very efficient unique patterns of somatic, motoric, and emotional self-
and very powerful pull the strings in our lives. They have organization; patterns that are fundamental to our
absorbed knowledge, confirmed by repetitive experiences character (Stern, 1995; Downing, 1996), and define the
or strong emotional ones, that is deeply connected in the quality of our lives. The memories that we hold in
very tissue of the body (Damasio, 1999). One important explicit memory on the other hand, are very unreliable
aspect of this is that, contrary to what Freud emphasized, and may not represent meaningful elements of self-
these experiences are not so much repressed, but moved organization (Weiss & Harrer, 2006).
into "implicit" and "emotional" memory for economic
reasons. The explicit memory just cannot store the Therefore, in order to significantly connect to what is
amount of data needed. Gerhard Roth for instance, a truly forming our habitual character patterns, we be able
renowned German neuroscientist, says that “. . . our to observe and study their emergence in the present
conditioned feelings . . . are nothing but concentrated life moment from a somewhat removed position--like the
experience" (Roth 2003, p. 375, translation by the author). internal observer. Psychotherapeutic modalities that
follow this course will therefore not center around
Traditional psychodynamic therapy has learned to lean on thinking and reflecting, but around observing thoughts,
our conscious capacities to reflect thinking, feeling and feelings, sensations, impulses, etc. arising from moment
memories. As unconscious information is uncovered by to moment. This allows implicit memory to reveal itself;
using a variety of paths (dreams for instance, or the
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 Halko Weiss
this part of our memory that holds such power over our state, and has a number of ways to help the client back
lives. into a more observing state. This process can be
understood as the co-regulation of attention processes by
A Body-Psychotherapy Tool an "external interactive regulator" (Schore 1994).

The use of mindfulness in body-psychotherapy makes Typically, the therapist proposes little "experiments"
particular sense, for even in the classical Eastern literature related to the issues at hand that engage the client’s
and practice the body is the first and easiest object to observer, and eventually leads towards "formative"
observe in mindfulness. The somatic realm is also not experiences--experiences that left imprints in the implicit
only deeply tied into all our emotional and mental memory that have the power to organize day-to-day
processes (Damasio, 1999), but it reflects them precisely, experiences and behaviors. (See example above). She
allowing us to uncover fundamental issues and memories also has techniques available to deepen the state of
that gave rise to them (Marlock & Weiss, 2006). mindfulness and help the client stay with their experience
until these fundamental layers appear in consciousness,
It is no surprise that most approaches to body and can be worked through.
psychotherapy, starting with the grandmother of the art--
Elsa Gindler, have emphasized ways to become "aware" This form of working can be interpreted as "assisted
or more conscious of bodily processes in some way. meditation" where, other than in many meditation
Patients are usually encouraged to sense, feel and observe techniques, an experience is not just observed and then
their bodies at great length. Mindfulness sets itself apart, dropped, but the therapist gets constant reports about what
as it is particularly well defined and much more elaborate is going on inside the client and then helps him to stay
than all other methods of supporting consciousness. with, and deepen that experience towards its formative
sources. Powerful emotional memories and experiences
Consequently, it was a body psychotherapist--Ron Kurtz, may spontaneously emerge as formative material is
who pioneered the integration of mindfulness into evoked. However, they are always accompanied and
psychodynamic therapy in the 1970s (Kurtz, 1990). His modified by the monitoring quality of the internal
approach, the Hakomi® Method, is so tightly built around observer.
the notion of mindfulness that he considered using the
term "mindfulness" as part of the very name of the Some core benefits of this approach are:
approach. It certainly shapes the essence, the feel, and the a) Powerful work with the body also requires a powerful
process of Hakomi. tool for observing internal somatic processes,
especially if that tool can be taught to grow and
expand.
A therapist trained in this method constantly monitors the b) Mindfulness allows for comparatively easy conscious
state of consciousness of her client and helps to regulate regulation of attentional processes that do not follow
it. In the course of a successful therapeutic Hakomi the automatic and habitual patterns of already
process there is normally an expanding sense of established pathways of self-organization. Instead,
mindfulness, and the core of the process actually takes it allows for a slow but direct exploration of hitherto
place in this state. The client is guided towards observing unconscious processes.
himself from a mindful perspective, while the therapist c) Mindfulness supports a non-judgmental exploration of
has an eye on a number of specific characteristics, some self. It creates a gentle and accepting relationship
towards "parts" of a person that were previously
of which are adaptations of the original concept for
seen negatively or became somewhat dissociated.
psychotherapy. Generally, the process is created around: d) Mindfulness strengthens reflexive ego functions, or, in
a) the conscious regulation of attentional processes the words of Schwartz (1995), "Self"-type states that
inward serve progressive objectives, and give protection
b) the conscious regulation of attentional processes in from the dangers of regressive therapy processes that
relation to time, including a lot of spaciousness and body psychotherapy has been prone to, and
lingering with perceived phenomena sometimes embraces as part of its methodology.
c) the establishment of an internal observer with a e) Establishing a stronger and stronger "internal
number of its critical characteristics observer" over time is already a transformatory
d) a therapeutic approach that consequently needs to let element. The observer allows for a process of
go of goals and become experimental instead, and "disidentification" from the trancelike pull of
e) a therapeutic relationship that necessarily becomes limiting states of being, like depressive states.
radically non-directive in order to not interfere with
mindfulness. When completely in tune with
mindfulness, the therapist will manifest a being state No Preferences
that Kurtz calls "loving presence."
As mindfulness reflects Eastern thought, it stands opposed
In practical terms, working in mindfulness requires the to some of the intuitive attitudes towards healing in the
therapist to introduce the idea of an internal observer and West. Among the critical differences is the Eastern
guide her client towards this style of self-observation. In willingness to be accepting of all things.
the process she monitors the client’s state of
consciousness and contacts his experience in ways that CBT therapists and others have embraced the idea of
support the internal observer. She is acutely aware if the "acceptance" along with mindfulness, because there is no
client becomes highly identified with, lets say, a feeling way to keep an observing mind when the notion arises

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 Halko Weiss
that something is wrong and should be different (Hayes et Here we are at the core of Buddhist psychology. Even
al., 2004). This understanding is an integral part of though Buddhism does not deal with psychological
Buddhist psychology. suffering in the pathological sense (Engler 1984, 2003),
the idea of what calms internal turmoil is clear:
Such acceptance is easily claimed, but hardly ever Observing, knowing, and deeply understanding it in a
realized with the conviction and depth of the original heartfelt way (Germer, 2006).
concept. The reasons are manifold: From the clients own
beliefs that something is wrong and needs to change, to Treatment plans, psychopathological concepts, and ideas
transformational concepts and techniques that imply some about a desirable outcome can counteract mindfulness.
sort of disorder, and to the therapists attitudes deeply Because therapists model attitudes towards healing, their
engrained by science, culture and personal upbringing. own intuitive relationships to those concepts have great
Even very soft approaches like saying: ". . . have you ever impact. Research has shown that successful therapy
thought about trying . . . ," is directing the client’s mind to proceeds with the client’s world view enlarging to that of
alternatives that imply that the original approach is the therapist (??).
lacking something.
Integrating mindfulness into psychodynamic treatment
By contrast, mindfulness is very radical. It fundamentally can therefore not be understood as a mere addition of a
strips away any fantasies about how the world should be potent tool. It requires an attitude and a process that
different. Instead it just studies, it listens to reality in contradicts typical Western medical models. It also
order to see and understand it more clearly. There is requires that the therapist immerses herself in its practice
absolutely nothing to strive for. It is an expression of (Segal, Williams & Teasdale, 2002; Hayes et al., 2004) so
Eastern “non-doing,” though it is not the same as Western that its spirit and effects come to life.
“doing nothing.”
When done with any depth and utilizing its powers fully,
So, while a therapist working with mindfulness will the therapeutic relationship will shift in a number of
certainly hold the intention of assisting a client in his meaningful ways that the Hakomi Method, as one
growth on one level, at another level, in the present example, has attempted to embody:
moment within the shared presence of the process, there • Therapists will have to become truly accepting, which
should be absolutely no preference for the client to be any means that they will have to learn to be in different
other way than he is. Some psychotherapist readers may states of being than in ordinary life: A state that
have had moments like this with their clients. Some will allows them to be present in a radically
compassionate and mindful manner; a state that does
realize how difficult that it is to maintain this stance when
not have preferences, but makes room to embrace
the other is suffering, for instance, or giving them a hard and understand absolutely everything.
time. For a therapist, learning to stay with such an • Methods and processes used will have to organize
attitude in a consistent manner usually requires substantial around a curious and exploratory style, rather than
training and personal growth. be directed towards specific goals.
• Input towards change will have to wait until the client
The requirements for a therapist to work in a mindful and therapist together have uncovered and inspected
way, and foster a mindful attitude in clients, are radical normally unconscious beliefs held by implicit
and challenging. This is especially true in a world where memory, and both understand clearly what kind of
positive learning from what kind of experiences
the medical model of diagnosis and treatment goals is
have not happened in life and still yearn to happen1.
guiding the understanding and professional processes of
the therapeutic community on all levels.

Of course there have been early pioneers with a different Conclusion

attitude: Carl Rogers and Heinz Kohut being two
respected ones. In practice, however, such a path is As body psychotherapists seek to enhance and advance
exceedingly difficult. Fritz Perls, the godfather of here- their methodologies, mindfulness is certainly an
and-now self awareness, for instance, was clearly extremely powerful tool to consider. It makes therapy
influenced by Eastern thought, but was also infamous for faster, easier, and more loving. It sharpens awareness,
his sometimes harsh and demanding style that was and starts opening the tremendous resource of an internal
designed to show the client what was NOT OK. observer.
Experientially, such a style leads a person away from self-
understanding. However, its use also requires a fundamental shift in
attitude that is hard to fathom for those who have not yet
Mindfulness instead, is meant to explore exactly what a fully experienced its possibilities and challenges. Having
certain emotion, thought, or behavior is designed for; why trained therapists from all walks of life for more than 25
it makes sense; why it has to be that way. It needs a full years, this author has seen the struggles and subsequent
receptiveness to open up, a total willingness to let it be the
1
way it is. Then the emerging understanding is enveloped Here we are at the issue of human change and how to bring it
with another of the core concepts of Buddhism: about that goes beyond the scope of this article. A short
Compassion. summary of an underlying concept can be found in Weiss, 2006.

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conquests of those therapists who have learned the Kabat-Zinn, J. (2005). Coming to our senses: Healing
traditional ways of Western psychotherapy first. It takes a ourselves and the world through mindfulness. New York:
few years to find a firm standing within a mindful Hyperion.
approach. Yet, body psychotherapists, in particular, are Kandel, E. R., Schwarz, J. H. & Jessell, T. J. (1995). Essentials
of neuronal science and behavior. New York: Appleton
predisposed to embrace this way of working since they
& Lange
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internal world, rather than simply thinking about it. Elsa CA: LifeRhythm.
Gindler, Wilhelm Reich, Charlotte Selver, Fritz Perls, Linehan, M. M. (1993). Cognitive-behavioral treatment of
David Boadella, and many others have opened the door borderline personality disorders. New York: The
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Marlock, G. & Weiss, H. (Eds.). (2006). Handbuch der
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