Siddharta Gotama, the Buddha, became curious about how his vipassana mindfulness meditation technique was holding up after 2,500 B.C., so he made an appointment with clinical psychologist Ben K. Tilton, Psy.D. (PSY19609) in Huntington Beach, CA to ask a few questions. The Buddha wondered if modern therapists were using vipassana, and if they were, how it was working. He was delighted to find Tilton so knowledgeable and eager to answer his questions. They had a great conversation and afterwards Tilton took Buddha to Kean’s Coffee in Newport Beach for a triple espresso.
Q. What do meditation and psychotherapy have in common?
A. Both are self-exploration processes. Cognitive insights learned from psychotherapy can guide meditative process and the meditative process can inform the psychotherapy. Meditation is a highly-personal spiritual process involving connection with one’s higher power. Psychotherapy is a collaborative, interactive process that involves dialogue. It is self-exploration and inner work as well, just using a different vehicle to get there.
Q. What psychological problems is meditation most helpful for?
A. Meditation most benefits patients living with anxiety disorders, because the meditative state contrasts so sharply with their accustomed anxious state of being. From a coping skills perspective, learning to meditate can be an effective way to manage stress. You can assume that when stress is well-managed, patients can focus on the deeper psychological issues in counseling as opposed to crisis management of daily anxiety.
Q. When and how do introduce meditation to a psychotherapy patient?
A. I ask clients how they deal with stress and what they do to relax. If they don’t relax, I would then ask if they have ever tried meditation or yoga. I introduce a simple meditation by having the client focus on his or her breath. I like to teach the “heart breath.” If they want more formal instruction, I refer them to a mindfulness meditation professional and to educational resources.
Q. What is your clinical definition of mindfulness?
A. Mindfulness is the art of living in the present moment with acute sensory experiences. It means seeing things for what they truly are, with great clarity and wisdom and without emotional and mental distortions. It is the ability to observe oneself in the present moment and be thoughtful and deliberate with actions. It is definitely a byproduct of both psychotherapy and meditation.
Q. The Diagnostic and Statistical Manual of Mental Disorders (DSM V-TR) clinicians use for treatment planning and insurance documentation contains only two lines on Religious or Spiritual Problem (Z65.8). No discussion of criteria for giving a patient this diagnosis is included. When would you diagnose a patient with a religious or spiritual problem, and how would you determine clinical progress?
A. If concerns over religious issues cause significant mental or emotional problems, then it’s of clinical concern because it effects the patient’s quality of life. I would help them deal with their bothersome symptoms and then explore the religious issue underlying their unhappiness. Often clarification of spiritual values is a significant step toward helping with religious concerns.
Q. What do you see as the future working relationship between meditation and psychotherapy?
A. Meditation and psychotherapy will be integrated into practice because they compliment each other. Meditating therapy patients can observe thoughts and feelings from a non-attached perspective. This leads to additional insights that might be otherwise overlooked in the talk therapy process. In addition, one can meditate on the insights learned through the psychotherapy process to increase the chances of it having long-lasting and significant effects.
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