The Case for Contemplative Psychotherapy

by Joe Loizzo

Joe Loizzo MD, PhD, is the founder and Academic Director of the Nalanda Institute for Contemplative Science. The following essay has been adapted from the forthcoming 2nd edition of Advances in Contemplative Psychotherapy to be published by Routledge in January 2023. To learn more about the Contemplative Psychotherapy Program visit our information page. 

Contemplative psychotherapy is a hybrid therapeutic approach that blends the meditative insights, ethics and practices of Buddhism with the theory and application of Western neuropsychology, social psychology and psychotherapy. This amalgam may invoke cognitive dissonance for some. “Contemplation” and “contemplative” — terms derived from the Latin contemplatio — have historically been used to describe a discipline of individual and group reflection considered central to introspective learning, especially the meditative and ethical learning practiced by lay and professional people in traditional Western religious communities. Psychotherapy, on the other hand, has evolved as a healing discipline of introspective learning based mainly on a dyadic method of reflection, informed by scientific views of human nature, and practiced in confidential relationships by mental health professionals and their clients in modern clinical settings.

The Roots of Psychotherapy

In his Civilization and Its Discontents, Freud made the broadest possible case for a new science and art of psychotherapy: as a modern answer to the age-old dilemma described by the pre-Socratic thinker Empedocles. Caught between the self-protective instinct for survival and the self-transcendent instinct for generativity, we human beings must learn to override stress and to embody love and compassion instead, in order to gradually adapt to the increasingly social conditions of civilized life. The main thrust of Freud’s argument was to contrast the views and methods of psychotherapy with those of religion — Eastern and Western — and to offer his new science and art as a modern, secular, and pragmatic alternative to the age-old experiences of boundless communion and love cultivated through meditation and yoga.

The fact that Freud felt a need to go back to the Greeks to find the roots of psychotherapy is not surprising given the genesis story of modern science — that it emerged in the fifteenth century as a renaissance of previously lost Greek science. What should be surprising is that he had to bypass twenty centuries to find another case of healing, re-parenting dialogue to cite as a precedent for his re-discovery. Obviously, it is not the case that humanity altogether stopped this universal practice for twenty centuries. Having grown up a young Jewish man in Catholic Vienna, Freud was well aware of two such practices embedded in the religious traditions of the Judeo-Christian West: the rabbinate and the confessional.

Caught between the self-protective instinct for survival and the self-transcendent instinct for generativity, we human beings must learn to override stress and to embody love and compassion instead, in order to gradually adapt to the increasingly social conditions of civilized life.

So his return to the Greeks suggests a move to avoid any association with these forms of spiritual counseling. In contrast, his erstwhile successor Carl Jung, the son of a Protestant minister, did not shy away from the ambiguity between the role of psychotherapist and spiritual counselor or guide. So Freud’s rejection of these precedents, along with their analogues in the Hindu and Buddhist mentoring bonds explored by his contemporaries Romain Rolland and Jung, may be most simply explained as an expression of his intention to align psychotherapy decisively with the side of modern science in the European Enlightenment rift between science and religion.

To his credit, Freud correctly read the landscape of modern culture and made a tactical decision that allowed psychotherapy to become a mainstream institution in an era in which scientific modernity obliged us to leave contemplative healing, pedagogy, and ethical community behind, as artifacts of humanity’s religious past.

Bridging Psychotherapy and Contemplative Science

Now that the modern rift between science and contemplation is increasingly being bridged, we are in a position to bring contemplative practice and its emphasis on group learning and healing community back into dialogue with neuropsychology and the practice of psychotherapy.

In the long view, the convergence of breakthroughs in neuroscience, positive psychology, meditation research, and mindfulness interventions over the last two decades has been both timely and effective. It was robust enough to clear the way for a broader integration of psychotherapy with contemplative healing, more along the lines envisioned by proponents of contemplative traditions, like Jung. While the growing confluence of such long-divergent fields still strikes many as unlikely or novel, there is no denying the deep resemblance in methods and mechanisms of action underlying these human practices.

At the same time, the confluence has been further deepened by the growing awareness of the critical role played by broader social factors like systemic racial, gender, and economic stress, and trauma on individual suffering. And this awareness has coincided with shifts in science suggesting that positive social emotional factors, both at the dyadic level of individual work and at the group level of family and community work, are far more crucial to deepening and accelerating healing than mainstream approaches to mental health have assumed. This shift towards greater appreciation of the role of culture and community as key variables in illness and healing has further fueled the confluence of contemporary psychotherapy with timeless contemplative traditions, since contemplative approaches to healing, as exemplified by Jung, rely as much or more on healing culture and community than on conventional psychotherapy dyads.

The evidence that mindfulness works largely by empowering the prefrontal cortex to enhance self-awareness, neocortical integration, and social engagement is consistent with current thinking about insight-oriented and cognitive psychotherapy. Recent evidence that compassion meditation works by empowering the limbic cortex to enhance self-regulation of social-emotional stress-reactivity and to foster the integration of prosocial emotions, empathic resonance, and proactive responses is consistent with current thinking about object-relational, interpersonal, and couples therapy.

Now that the modern rift between science and contemplation is increasingly being bridged, we are in a position to bring contemplative practice and its emphasis on group learning and healing community back into dialogue with neuropsychology and the practice of psychotherapy.

And preliminary findings that role-modeling imagery, affirmative recitation, arousing breath-control, and gentle movement work by transcending traumatic defenses and integrating the hypothalamic-brainstem social engagement system are consistent with current thinking about embodied approaches like Jungian analysis, Gestalt therapy, Somatic Experiencing (SE), Sensorimotor Psychotherapy (SP), and Accelerated Experiential Dynamic Psychotherapy (AEDP).

The fact that we find synergies between such an array of contemplative practices and psychotherapies may seem improbable, but it is quite consistent with what early studies concluded about the general effects and mechanisms of meditation and psychotherapy. Meditation and psychotherapy appear to have their effects by the same common pathway: a sustained strategic amalgam of two complementary mechanisms. Both practices reduce stress using relaxation techniques to lower sympathetic arousal and boost vagal tone; and both also simultaneously enhance learning using techniques that heighten attention and promote neural plasticity.

In this way, meditation and psychotherapy work to create an optimal internal environment that disarms stress-reactive resistances and fosters the enrichment of learning. By optimizing the brain’s full capacity for social learning, these practices expand the mind’s openness to shared introspection and healing dialogue; and by cultivating that shift in a stable, supportive, and equitable social learning environment, they sustain that openness through repeated practice over time. As a result, they facilitate a gradual dismantling of dissociative barriers to integration, and cultivate the growth of higher self-awareness, self-regulation, and self-transcendence through the development of integrative, socially engaged structures and processes in the brain.

As a society we find ourselves in a pivotal moment facing a number of systemic challenges, including racial, gender and income inequality, political polarization and climate crisis, that require us to reclaim our full humanity in order to solve. Contemplative psychotherapy as a humanizing practice can help give us the insights and skills we need to once again unite science, wisdom and ethics with our increasingly complex and interdependent way of life.

Photo: Rutpratheep Nilpechr