Emptying the constructed self 1 Emptying the constructed self: Integrating mindfulness, awareness, acceptance and constructivist psychotherapy Spencer A. McWilliams Constructivist approaches to psychotherapy enjoy continuing and growing interest. Kelly (1955) introduced personal construct psychotherapy (PCT) more than fifty years ago, and recent volumes on constructivist psychotherapies (Mahoney, 2003; Neimeyer, 2009; Raskin & Bridges, 2008; Winter & Viney, 2005) and the increase in therapists employing constructivist epistemology (Neimeyer, Lee, Aksoy-Toska, & Phillip, 2008) demonstrate its continuing relevance and active elaboration. Similarly, while Suzuki, Fromm, and DeMartino (1960) and Watts (1961) drew attention to the relationship between Buddhism and Western psychotherapy nearly fifty years ago, recent authors have elaborated the use of Buddhist concepts, and practices such as mindfulness, awareness, and acceptance, in Western psychotherapy (Epstein, 2007; Hick & Bien, 2008; Kaklauskas, Himanheminda, Hoffman, & Jack, 2008; Kwee, Gergen, & Koshikawa, 2006; Magid, 2002; Segall, 2003; Watson, 1998). Kelly (1955) viewed PCT as technically eclectic, and his constructivist followers join productively in dialogue with, and appropriate techniques from, a variety of perspectives (Neimeyer & Neimeyer, 2002). Neimeyer (1988, 1993, 2009) labeled this process “Theoretically Progressive Integrationism,” in which approaches that share compatible metatheoretical assumptions provide a basis for explaining the value and relevance of particular interventions (Feixas & Botella, 2004; Raskin, 2007; Walker & Winter, 2007). Constructivism and Buddhism share fundamentally similar metatheoretical assumptions (Kwee, et al., 2006; McWilliams, 2009; in press), providing an opportunity for furthering the progressive theoretical integration of constructivist psychotherapies by examining Buddhist-inspired psychotherapeutic methods that enhance the client’s mindfulness, awareness and acceptance. This chapter: 1) summarizes some fundamental constructivist assumptions and approaches to dysfunction and psychotherapy, along with parallel assumptions and approaches in Buddhist-inspired psychology; 2) demonstrates that these approaches share substantially similar metatheoretical assumptions and compatible views of human dissatisfaction and dysfunction, 3) describes therapeutic approaches that exemplify the incorporation of mindfulness, awareness, and acceptance practices, and 4) discusses the relevance of these methods for constructivist psychotherapy and theoretically progressive integration. Constructivist and Buddhist assumptions agree that we cannot justify any belief as ultimately ‘true.’ Both view knowledge as evolving interdependently within personal and social contexts, and described in conventional, rather than ultimate, language. Thus, rather than proposing ‘the’ definitive explanation of these topics as an inherently absolute account, the article presents one perspective that inevitably reflects the author’s personal experience and understanding. Constructivist Perspectives Metatheory Foundationalism historically proposed that we can know a mind-independent ‘world as it is’ and that people possess cognitive capacities for accessing that world. This agenda has failed because we have never identified a way to grasp a mind-independent Emptying the constructed self 2 reality, shown that we can know the ‘world as it is,’ or proven what ‘representations’ of the world actually represent (Rockmore, 2004; Rorty, 1982). Rockmore (2005) promotes constructivism as the best successor to failed foundationalism, suggesting that humans only know what humans construct, constrained by human limitations. Rather than viewing knowledge as discovered or revealed, constructivism suggests that we invent it, as interpretations of experience, embedded in historical contexts, dependent on human activity, and revisable rather than fixed. A variety of perspectives relevant to constructivist psychotherapy share this viewpoint (Chiari & Nuzzo, 1996; Raskin, 2002), including Personal Construct Psychology (Fransella, 2003; Walker & Winter, 2007), radical constructivism (Glasersfeld, 1995), contextualism (Hayes, Hayes, Reese, & Sarbin, 1993; Sarbin, 1976), social constructionism (Gergen, 1999), and postmodern psychology (Gergen, 2001; Safran & Messer, 1997), although their differing emphases merit recognition and respect (Paris & Epting, 2004; Raskin, 2008; Raskin, Weihs, & Morano, 2005). Constructivism views the universe as integral, interconnected, and interrelated; in continuous change or flux; and lacking inherent nature or essence (Stojnov & Butt, 2002). Humans, collectively and personally, impose structure and assign meaning to phenomena based on human needs and experience. Ideas, explanations, and beliefs evolve within a context and a perspective, and reflect changing contexts and conventions rather than ‘the way the world is.’ Humans use language to reflect on experience, make meaning, and cope with life. We cannot know reality directly; we describe experience in a variety of ways with no objective way of justifying beliefs as ultimately true. Rather than concern about the ‘truth’ of beliefs, we judge them by pragmatic criteria: their usefulness in predicting events, their coherence, and their fit with subsequent experience. Human Dysfunction & Well-Being Constructivist perspectives view psychological dysfunction as occurring when the system of meaning that a person creates for organizing and understanding experience creates obstacles to meeting personal goals and considering viable alternative ways of thinking, behaving, and making meaning. Kelly (1955), for example, defined a psychological disorder as “a personal construction which is used repeatedly in spite of consistent invalidation” (p. 831). Psychological well-being transpires when identities and interpretations lead to effective anticipation of events and the ability to revise interpretations in light of their effectiveness. Psychotherapy When meanings that people create to understand and guide their lives fail to aid effective life negotiation, constructive approaches to psychotherapy help clients examine and reconsider these understandings. Therapists challenge existing constructions and assist clients in reconstructing their ‘life story,’ inventing new self identities, and experimenting with alternative, more effective ways of meaning making (Bridges & Raskin, 2008). G. Neimeyer (1995) describes “three central features of constructivist therapy: the primacy of personal experience, the importance of novel enactments, and the role of ‘languaging’ in developing new patterns of personal meaning” (p. 112). He views clients’ problems as reflecting their construction system and encourages exploration and elaboration of new meanings. R. Neimeyer (1995, 2009) describes characteristic constructivist therapy strategies such as assessing clients by exploring their personal narratives and life metaphors, promoting personal development and meaning making Emptying the constructed self 3 rather than correction, accepting negative emotions as a normal component of change, emphasizing the individual’s sense of self and core structures, empathically engaging in the client’s outlook, and viewing resistance as a reasonable protection of the client’s meaning-making system. Bridges & Raskin (2008) emphasize constructivist psychotherapy as a meaning-based practice concerned with the reality of the client’s experience, and they discuss examples of five clinical strategies or models of constructivist psychotherapies: encouraging clients to adopt new behaviors, bringing unconscious knowledge into conscious awareness, assisting clients with retelling their personal stories, connecting clients’ stories with their behavior, and viewing clients’ problems in terms of language and social and cultural factors. Buddhist Perspectives Many intriguing parallels exist between constructivist and Buddhist approaches to knowledge and psychology, although the term ‘Buddhism’ does not encompass a single set of concepts or teachings. Buddhist concepts most relevant to constructivism and psychotherapy and most frequently articulated by Western psychotherapists typically reflect esoteric, transformative (Wilber, 1983) teachings from Asian monasteries as brought to the West, and as interpreted in a contemporary context (McMahan, 2008). Metatheory The Middle Way, or Mādhyamika, School (Garfield, 1995; Luetchford, 2002; McWilliams, 2009; Streng, 1967) serves as a philosophical and metatheoretical foundation for much of Buddhism and provides an epistemology intriguingly similar to constructivist views. It describes phenomenal experience in terms of three characteristics: dependent origination, impermanence, and emptiness. Dependent origination means that ‘things’ depend on other ‘things’ for their identity. Composites consist of parts, gain identity only as an assembly of parts, and lose that identity when taken apart. Identifying and acknowledging ‘things’ requires the process of human perception and labeling. As a result of interdependence, we cannot identify intrinsic entities that maintain their identities independently across time (Garfield, 1995). The concept of impermanence proposes that no phenomenon has always existed in its current state or will always exist in that state or with those qualities. Phenomena come into existence when conditions supporting their existence occur, and when those conditions no longer transpire the phenomena no longer exist. Emptiness, or lack of essence, proposes that since phenomena exist only in interdependence on other phenomena and constantly change, we cannot identify an essence or identity that exists independently and that constitutes the entity itself, nor can we isolate a substance that gives a phenomenon identity independent of its attributes. Ultimately, if we attempt to analyze the identity of phenomena, we cannot find something to point to as the thing itself. From this perspective, ‘no thing’ exists on its own. As Garfield (1995) put it, focus on particular phenomena “depends more on our explanatory interests and language than on joints nature presents to us” (p. 113). Consistent with an epistemological constructivist view (Chiari & Nuzzo, 1996), the world and the phenomena we experience exist. However, since an entity does not possess its own independent, permanent, identity, any proposition suggesting that we know ‘ultimate truth’ proves incoherent. Although we cannot make assertions about ultimate reality, we can know conventional and relative reality and ‘truth,’ following ordinary human assertions as dependent on social convention. The historical Buddha encouraged his students to go Emptying the constructed self 4 along with conventional beliefs and perspectives that prove useful and deny views that people in general would reject as incoherent. Based on experiences and customary ways of understanding and speaking about them, we may regard ‘things’ relatively, and view ‘thing’ as a description rather than an entity (Watts, 1961). Conventional truth, as with constructivist perspectives, consists of ideas and beliefs that humans have developed, collectively and individually, by identifying recurrent patterns and themes in experience and using them to anticipate future events. Similarly to Kelly’s (1955) description of the construing process, we perceive similarities and differences, repeated themes and patterns, and invent word labels to describe the poles of the contrast dimensions. Contrasting poles arise together and depend on each other. For example, ‘good vs. bad,’ ‘light vs. dark,’ and ‘up vs. down’ describe ‘empty’ phenomena that do not possess these qualities inherently and depend on human assessment for their existence. Glasersfeld (1995) pointed out that we cannot create just any reality we wish. Since we desire a viable understanding that effectively serves human functions, environmental, biological, and social realities constrain it. Buddhist philosophy agrees that our conventions reflect biological, psychological, and social needs, as well as customs and language. Within these constraints, we can identify facts regarding what words mean and how to agree on empirical observations, but we cannot identify an independent viewpoint from which to justify these views as absolute (Garfield, 1995). Self Constructivist approaches view ‘self’ as a social and personal construction rather than an independently existing entity. Buddhist psychology applies the concepts of interdependence, impermanence, and emptiness to ‘person’ and ‘self’ (McWilliams, 2000, 2004a). It views a person as a composite of five parts, elements, or attributes: physical body, sensations, perceptions and cognitions, predispositions and volitions, and consciousness. Each ‘component’ arises in interdependent relationship with other phenomena, and they evolve and change from moment to moment and over the course of a human life. Thus, similar to social constructionism (Gergen, 1999; Raskin, 2002), we can find nothing to point to as the ‘person’ or a ‘self’ independent of the ever-changing body, sensations, and thoughts. We believe, however, that components must have a location, an inherent self, where they occur. We construct a sense of self and give it an illusory reality by appropriating experiences of physical sensations, perceptions, and volitions as possessions. We need not posit the existence of a self independent of our perceptions and actions in order to act as ‘ourselves’ in socially conventional ways. Human Dysfunction & Well-Being Viewing phenomena as dependent, impermanent, and empty and speaking about a conventional, constructed reality have practical purposes. Psychological problems arise by confusing empty conventional reality with inherent, ultimate reality, and treating conventional beliefs and concepts as ultimately ‘true.’ We reify concepts like self, objects we perceive, and values and beliefs because we believe that without a real self, world, and values, life would have no meaning and would appear hopeless (Garfield, 1995). However, reifying constructed interpretations leads to delusion. Suffering and dissatisfaction accompany attempts to impose permanence and independent essence on the flow of experience, and believing that ‘things’ actually exist. Clinging to reified concepts as a means of creating hope and meaning actively subverts this intention. A Emptying the constructed self 5 reified world in which events, phenomena, and things exist permanently, independently, and with a fixed essence provides no hope for change, progress, or human agency. But if instead we treat ourselves, others, and our values as empty, there is hope and a purpose to life. For then, in the context of impermanence and dependence, human action and knowledge make sense… It is only in the context of ultimate nonexistence that actual existence makes any sense at all (Garfield, 1995, p. 318). The historical Buddha articulated the foundation of human dysfunction and dissatisfaction by enumerating Four Noble Truths: 1) Life involves suffering, frustration, or dissatisfaction. 2) Suffering results from craving, attachment, or clinging to our desire that life suit our expectations. 3) Relief of suffering results from letting go of clinging, desire, and attachment to phenomena, which always change. 4) Certain disciplines and methods can assist us in the process of ridding ourselves of clinging. Frustration arises when we do not fulfill our desires and strivings and when we are faced with experiences that we do not want (Hayes, 2003). We try to reduce frustration by attempting to force the universe to conform to our desires. However, the universe does not bend to individual will. Adjusting desires and expectations to fit actual experience and reducing attachment to wishes and aversive labels of events results in a mentality open to possibilities and alternatives, and adaptable to change. Wallace and Shapiro (2006) describe a Buddhist view of psychological well-being in terms of mental balance among four interconnected components: conative (intention, volition, and goals), attentional (sustained mindful, voluntary, attention), cognitive (engaging with experience as it arises moment-by-moment without preconception) and affective (emotional regulation such as equanimity and lack of vacillation, apathy, or inappropriate emotion). Meditation, Mindfulness, Awareness, and Acceptance Cultivating awareness of the present moment, and the process of creating self and identity, helps overcome dissatisfaction and achieve well-being. By loosening identification with social roles we can see them as a ‘game’ with rules based on social convention rather than as the nature of the universe. Understanding emptiness and the conventional nature of reality requires moment-to-moment awareness of how we reify constructs and treat empty phenomena as real. Meditation techniques cultivate awareness of thoughts and experiencing the emptiness of phenomena, with the goal of liberation from dogmatic clinging to reified concepts, including self (McWilliams, 2003, 2004b). In contrast to inventing more effective ‘worldviews,’ meditation practices focus awareness on the process of creating a worldview, observing how we circumvent experiencing the present moment through beliefs and a sense of existence as independent selves. The sense of a separate self begins to fall away through the practice of observing thoughts and bodily sensations. From a perspective of ‘no self,’ meaning derives from immediate physical experience and awareness rather than from a constructed narrative. Beck (1989, 1993) describes Zen meditation practice as paying attention to the totality of the experience of the moment. Although sounding easy, it requires disciplined practice because we do not always experience the present as pleasant. We filter experience in terms of likes and dislikes, and imagine a future that fulfills our desires and expectations. Meditation practice shifts attention from ‘spinning’ in a mental world to ‘right-here-now’ awareness of physical sensations and thoughts. Comfort in life derives from living ‘right-here-now’ experience whether or not we like it. Emptying the constructed self 6 Many Buddhist practitioners have found four methods particularly useful (McWilliams, 2000). Focusing or concentration techniques such as following the breath help settle and quiet the mind and develop mental discipline. This provides a foundation for practice, but by itself tends to close out awareness of the wider world of experience. Observing and labeling thoughts help gain familiarity with favored thoughts, opinions, and beliefs and ultimately weaken and interrupt identification with them. Experiencing bodily sensations (sounds, touch, tensions) helps develop awareness of the physical reality of the present moment, which constitutes the only life ‘reality.’ Noting emotional reactivity, by attending to physical responses to pleasant or unpleasant experiences, helps develop awareness of reactions to events, reducing the strength of these reactions. To summarize, a Buddhist perspective, consistent with constructivist perspectives, proposes that we can never have ultimate knowledge of phenomena, including self, due to their interdependent, impermanent, empty nature. We can describe phenomena in conventional terms that assist in daily living. Reification of identities and roles and clinging to desires and beliefs creates suffering and dissatisfaction. Well-being evolves from declining attachment to ideas, beliefs, and self-centered desires, observing thoughts rather than believing them, embracing and accepting the present experience, whether it suits us or not, and acknowledging thoughts regarding the experience. Psychotherapy Attending to the process of thinking and feeling, rather than focusing on the content of thoughts and feelings and treating them as real, provides a crucial method for overcoming self-centered attachment. Psychotherapists incorporating Buddhism in psychotherapy, (Anderson, 2005; Epstein, 2007; Magid, 2002; Rubin, 1996; Segall, 2003; Watson, 1998) emphasize process over content. Observing thoughts allows experiences without either clinging to them or trying to change them, and facilitates seeing through the delusion of a fixed self. Psychotherapists using Buddhist practices typically use techniques such as awareness of breath and sensations, observing feelings, and other experiential meditation techniques (Mohan, 2003; Rothaupt and Morgan, 2007). Khong describes mindfulness practice that encourages clients to “label, acknowledge, experience, and let go of their experiences” (2003a p. 48), cultivate direct experience and attention to thoughts and sensations as they arise (2003b), and stressing the difference between modifying mental content and awareness of the mind’s processes (2006). Many Buddhist-inspired therapists strongly suggest that in order to teach awareness and mindfulness methods to clients appropriately and effectively, psychotherapists should adopt a disciplined meditation practice of their own (Hick & Bien, 2008), preferably under the tutelage of a recognized teacher. Grepmair et al. (2007) found that Zen mindfulness practice enhanced psychotherapists’ effectiveness. Segal, et al., (2002) initially intended to simply add mindfulness based methods to their preexisting approach to cognitive therapy, wishing to improve their ability to ‘fix’ clients’ problems. However, they found that the approach evolved from a ‘fixing’ orientation to solving a problem to helping clients experience the problem, welcoming and allowing thoughts and feelings, experienced as bodily sensations, without reacting to them. Initially regarding mindfulness practice as another therapeutic technique, they came to adopt their own mindfulness practice as essential in the change from their roles as a therapists or ‘fixers’ to their roles as instructors in mindfulness. Emptying the constructed self 7 Representative Psychotherapeutic Approaches Those interested in pursuing the integration of constructivist and Buddhist perspectives might benefit from examples of well-elaborated therapy approaches emphasizing awareness, mindfulness, acceptance, and reducing attachments to thoughts and emotions. The following therapeutic models address these themes. Experiential Personal Construct Therapy Awareness of the present moment includes bodily experiences as well as the experience of thoughts and beliefs. Experiential Personal Construct Therapy (Leitner & Faidley, 2008; Leitner & Thomas, 2003) elaborates the PCT approach by incorporating non-cognitive aspects, including embodiment. Based on the assumption of an integral universe, the arbitrary division between mind and body unnecessarily restricts the utility of psychotherapy. Personal meanings impact bodily systems, and psychological meaning-making processes manifest in the physiological experience of bodily sensations and events. Core construing develops prior to language, and the ability to trust bodily experiences, through confirmation and disconfirmation, evolves along with the development of pre-verbal constructs. As a verbalized meaning system develops, initially sensed bodily confirmations embed more deeply, but people tend to focus on verbal labels and descriptions rather than the bodily experience itself. Exercises that help clients develop greater bodily awareness, as well as explorations about how and why they prevent themselves from experiencing the bodily connection, can assist therapeutic growth. As clients attend to bodily communications about their core constructs, they gain greater clarity and understanding regarding how meanings facilitate and hinder effective living. Techniques that enhance awareness of bodily experiences, such as relaxation training and mindfulness training, may have psychotherapeutic power to the extent that therapy draws a connection between bodily processes and meaning-making (Leitner & Faidley, 2008). Context Centered Psychotherapy (CCP) CCP (Efran & Green, 1996; Efran, Lukens, & Lukens, 1990; Efran & Nash, 2004) describes human life as an inherently meaningless ‘drift’ to which people add purpose and infer meaning. Participation in this drift occurs without choice, and thoughts arise without conscious decision. Words like choice and free will, although they affect people’s lives, do not represent a separate reality. Thus, some words and concepts prove inaccurate, and effective living requires understanding how thought processes function. CCP addresses the context, the individual’s presuppositions that normally operate in the background. By labeling and describing contexts, clients can experience how contextualized thoughts arise and dissolve away. CCP distinguishes between ‘mind,’ self-centered survival mechanisms, and ‘self,’ the recognition of connection with the totality of the universe (Efran & Soler-Baillo, 2008). ‘Self’ views ‘mind’ as a component, rather than the whole person. However, protective mental strategies may dominate over experience and awareness. CCP assists clients mental operations, acknowledging and accepting them rather than trying to change the mind’s content. Like meditation, “the objective is not to directly banish troublesome thoughts or extinguish unwanted behaviors. In fact, as many therapists have learned, directly challenging the mind is generally a futile exercise” (Efran & Soler-Baillo, 2008, p. 91). CCP engages clients in a conversation focusing on the precise use of words, particularly those distinguishing between mind and self, and contrasts the mind’s Emptying the constructed self 8 emphasis on survival with the self’s focus on living. The therapist aligns with the client’s self to ‘tame’ the client’s overactive mind, shifting emphasis from “from the smaller context of mind to the larger context of self” (Efran & Soler-Baillo, p. 94). Life’s inherent lack of meaning provides an opportunity for people to create their own meaning, cultivating awareness of a larger view and a variety of available solutions. Identity Systems and Bridging Block (2005) focuses on the Human Identity System, which helps develop individual identity and a sense of self. It often evolves into a self-centered, rigid, and exclusive sense of overall identity that restricts the ability to attend to actual experience. Building on Beck’s (1989, 1993) Everyday Zen approach, thoughts, or ‘requirements,’ similar to core constructs (McWilliams, 2000), reinforce a sense of the self as damaged or defective. Requirements dictate how to behave and feel and how events in the world must unfold in order to meet them. Unfilled requirements lead to distress and fear, and futile attempts to satisfy them. Storylines about what must occur to repair the damage reinforce belief in this all-encompassing self-concept, defining the person as incomplete, lead to insensitivity to actual bodily experience. Block uses ‘bridging’ to shift awareness from the Identity System to immediate physical sensations, such as sights, sounds, or bodily sensations, ‘resting’ the Identity System or placing it on ‘idle.’ Bridging practice ‘befriends’ the Identify System, by gaining familiarity with its requirements, and experiencing how they restrict life experience. By shifting attention to immediate bodily experience, thoughts ‘take a backseat’ to sensations, awareness expands, and the body relaxes. Bridging practice does not strive for relaxation, which would constitute another requirement. Block describes several bridging exercises, formulations of Buddhist meditation techniques: ‘tuning in’ to background sounds, attending to bodily sensations, recognizing ‘Channel Me,’ (storylines, life dramas, fantasies, pet peeves), and labeling thoughts, to acknowledge, and befriend the Identity System. As with other awareness practices, bridging does not attempt to alter these experiences, but rather to gain awareness of them. Mind-Body Mapping exposes the workings of the Identity System by generating a ‘wordpicture’ of the system’s activity. Bridging practice begins with recognizing the Identity System as it arises (tension, worry, requirements) and attending to immediate sensations. It progresses to preventing thoughts from becoming requirements through labeling, and then to spontaneous, immediate acknowledgment of thoughts and ‘letting go.’ Mindfulness Based Cognitive Therapy (MBCT) MBCT adapts mindfulness-based stress reduction (Kabat-Zinn, 2005) to a psychotherapeutic context (Segal et al., 2002; Segal, Williams, & Teasdale, 2004; Teasdale, 1999). It distinguishes between metacognitive knowledge as used in cognitive behavioral therapies, which helps clients recognizes ‘inaccurate’ cognitions, and metacognitive insight, which assists clients in directly experiencing thoughts as events in awareness, rather than reflecting external reality. Therapy requires not just intellectual understanding but also experiential learning, assisting clients to view thoughts and feelings as ever-changing events, and to experience direct insight with respect to specific thoughts and feelings as they appear. They focus on changing the client’s relationship to thoughts and feelings, rather than the traditional cognitive therapy focus on the content of thoughts and feelings (Teasdale, 1999). MBCT helps clients to recognize their tendency toward “self-perpetuating patterns of ruminative negative thought” (Segal et al., 2002, p. Emptying the constructed self 9 75). It changes the focus from the content of the thought to the process, by identifying a ‘doing mode,’ which focuses on the discrepancy between desires and actual experience along with ‘shoulds’ and ‘oughts,’ which focus on changing an unsatisfactory experience. It teaches a contrasting ‘being mode’ in which the client accepts and allows thoughts and feelings to pass through awareness. By tolerating the discomfort that normally leads clients to ‘do something’ to fix it, clients experience freshness and freedom. Acceptance and Commitment Therapy (ACT) Resting on a contextual and pragmatic theory of language and cognition (Hayes, 2005; Hayes, Strosahl, & Wilson, 1999), ACT provides a well elaborated and empirically tested psychotherapy approach with clear parallels to Buddhist views (Hayes, 2002, 2004; Forsyth & Sheppard, 2009). It emphasizes how verbal evaluations and comparisons, useful for solving problems and planning for the future, amplify human suffering by comparing personal experience to desired or feared events. Attempts at avoiding experiences that arouse upsetting emotions and thoughts, etc., paradoxically sustain and evoke the experiences and deflect attention from the immediate environment. Attempts to explain and understand the situation, as a means of control, further exacerbate resistance to change and lead to useless rumination and worry. ACT defines psychological health as living in accordance with personally chosen values while also maintaining contact with immediately experienced bodily sensations, thoughts, and feelings. Its interventions aim to increase acceptance of experience, make personal choices, and take appropriate action by reducing the tendency to fuse thoughts with experience, weakening experiential avoidance, accepting troublesome sensations, feelings, and thoughts willingly, contacting a sense of self that transcends ever-changing thoughts and sensations, clarifying important life values, committing to behaving in accordance with those values, and continuously attending to, acknowledging, and accepting thoughts and feelings. Interventions include paradoxical language techniques, confronting clients with the consequences of avoidance, deliberate exposure to unpleasant experiences, observing self-processes, clarifying meaning and values, and monitoring commitment to actions. Dialectical Behavior Therapy (DBT) Linehan (1987) found that therapy focused exclusively on change led to increasing resistance and experiencing the therapist as invalidating. Alternatively, by dropping an emphasis on change and accepting the client, clients experienced the therapist as insensitive and uncaring. These polar alternatives led to a synthesis of the two, a model of maintaining a balanced emphasis on both acceptance and change. This synthesis led to the dialectical conception of this approach. Robins, Schmidt, and Linehan (2004) describe their model as rooted in Hegel’s conception of phenomena as arising and passing away, always in the process of change. It seeks an understanding of the whole, viewed as a relationship of parts that do not possess independent significance. The parts and the whole exist in interdependent, indivisible relation to one another, with the whole greater than the sum of the parts, embracings the dynamic nature of events, seeing reality as a verb rather than a noun, and a pragmatic notion of knowledge as a human process based on stated goals. DBT assists clients to develop a more accurate worldview and more effective behaviors. Mindfulness, on the part of the therapist and as a skill taught to clients, synthesizes acceptance, through observing and participating in the moment without judgment, and adopting effective new action. DBT teaches clients to Emptying the constructed self 10 accept life completely as it is as well as to change it, emphasizing that openness to experience without distortion or judgment does not mean appraising the experience positively. Extending Constructivist Psychotherapy Integration Constructivist psychotherapy and Buddhist-inspired psychotherapy share fundamental assumptions regarding the interconnected, integral, and ever-changing nature of the universe and a view of knowledge as constructed by humans as a means of organizing their experience, making meaning, guiding actions, and achieving goals. Such compatibility provides an opportunity to consider mindfulness, awareness, and acceptance methods as a means of expanding constructivist psychotherapy’s theoretically progressive integration. Metatheoretical compatibility provides a necessary condition for considering other approaches for integration. However, selecting methods for integration might also include assessing the approaches’ compatibility at the level of formal theory, clinical theory, and strategies and techniques (Neimeyer, 1993, 2009). In particular, the case for integrating mindfulness, awareness, and acceptance methods with constructivist psychotherapy could benefit from a rationale demonstrating the relevance of these Buddhist-inspired techniques to the goals of constructivist psychotherapy. Personal Construct Psychology’s ‘personal scientist’ metaphor might provide a useful context for considering this particular relevance. Kelly (1955) suggested that we can view people as operating similarly to scientists. People develop meaning-based theories or beliefs based on their perception of recurrent patterns of experience, test their beliefs and interpretations by identifying goals and establishing hypotheses for anticipating specific events, attend to the actual outcome of predicted events, and revise understanding based on the extent to which the current events validate the anticipation. As stated earlier, constructivism defines psychological well-being as the extent to which a person’s interpretations lead to validated anticipations and revision in light of their predictive effectiveness. A Buddhist view of psychological well-being can support the constructivist perspective by emphasizing how mental balance, and acknowledging the ever-changing essenceless nature of phenomenal experience, can assist in more effective anticipation. The four interconnected components of a Buddhist view of well-being (Conative-, Attentional-, Cognitive-, and AffectiveBalance; Wallace and Shapiro, 2006) described above represent mind-sets useful to the effective personal scientist’s anticipation of events and revision of understanding. Effective personal science includes creating meaningful hypotheses, which requires clear articulation of relevant and meaningful goals (Hayes, 1993). Conative balance emphasizes establishing realistic desires and goals that will lead to fulfillment for the self and others. Likewise, generating theories and testing hypotheses requires the ability to focus sustained attention on relevant events and the observation process itself. Mindful awareness practice enhances attentional balance and the ability to monitor mental states and interpretations of experience as they occur. Effective development of meaning-based understanding, testing hypotheses, and revising understanding requires openness to perceiving and experiencing events clearly and the ability to consider alternative perspectives. Wallace and Shapiro (2006) describe this capability as cognitive balance, which “entails engaging with the world of experience without imposing conceptual assumptions or ideas on events” (p. 696). Cognitive balance includes attending to present-moment experience of sensations, perceptions, emotions, and mental processes. Emptying the constructed self 11 Finally, well-being and effective meaning-making may benefit from emotional equilibrium, avoiding extremes of hyperactivity or apathy, by cultivating affective balance through equanimity, empathy, compassion, and caring. Buddhist-inspired methods that foster greater mindful awareness of thoughts, beliefs, and feelings, attention to immediate events, and acceptance of actual experience may enhance the effectiveness of constructivist psychotherapy. Focus on the processes underlying the use of thoughts and language, rather than only on their content, helps liberate clients from attachment to rigid dysfunctional thoughts and actions, promoting more effective construing and clearer perception of events. These skills support a larger sense of meaning, freedom from automatic responses and rigid identifications, and more flexible ways of addressing ever-changing events. 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