Mindfulness and Psychoanalysis

This post refers to a passage taken from a book by Elio Frattaroli, M.D. entitled Healing the Soul in the Age of the Brain: Why Medication Isn’t Enough, pages 190-193. Frattaroli argues against modern therapeutic practice, where all too often psychiatrists (in the U.S.) are pressured by managed health care to medicate with short length-of-stays in hospitals and in therapy. He advocates for a more balanced system, where the scientific method is not the “be-all and end-all” when it comes to understanding the human experience.

In his book, Dr. Frattaroli had a conversation with a patient, who was considering suddenly ending treatment because she felt she no longer needed therapy. Dr. Frattaroli felt that this urgency to end treatment came from resistance to repressed emotion(s).

Although he does not explicitly mention it, it seems to me that Frattaroli (who is a strong advocate for psychoanalysis) implies a Buddhist philosophy in his understanding of human nature and the origin of symptoms. He discusses allowing feelings to emerge without trying to control them, and remaining open to the human experience while noting what feelings come up spontaneously. These are some of the concepts discussed within Zen Buddhism and mindfulness. In recent years mindfulness and meditation have been successfully incorporated into several theories and practices in the United States. For example, dialectical behavioral therapy has been successful in the treatment of individuals with Borderline Personality Disorder.

These passages inspire me to rethink the application of mindfulness to art therapy practice, which is traditionally rooted in psychoanalytic philosophy. Teaching the lessons of mindfulness may aid the client to be more open to their inner experiences without judgment, while creating and processing artwork is in many instances less anxiety-provoking than talking. Intuitively, it seems that using both together may allow the client to cope more effectively while examining him/herself as the unconscious is made conscious. This may mean less resistance to treatment and more effective ways of coping with negative emotional states.

However, the therapist must always ask him/herself whether the client has the ego strength for treatment using a psychodynamic combined with a mindfulness approach. For example, if a client has difficulty describing/understanding/managing emotions and their emotional states due to cognitive deficits, perhaps this approach would be both frustrating and ineffective. Above all, the therapist must meet the client where they’re at.