Presence, Contact and Mindfulness in Psychotherapy
A mindful therapist is present in the “here and now” of the therapeutic process with the client. They can be fully involved and available in the therapeutic relationship, accepting of the client and of whatever feelings and thoughts the client is experiencing. A mindful therapist is able to attune to the current state and processes of the client, with active curiosity and awareness of the subtlest signals of the client's body language and expressions.
Presence is not something unique to relational therapy. It extends to being courteous in caring for the client’s sense of being accepted and considered (Pinkerton, 2008), the use of the body (Avstreih, 2008; Kepner, 2001), and the trust that develops between therapist and client (Barth, 2008). This is a particular kind of trust; it’s the belief that the therapist will not deceive or take advantage of the client, that the therapist will “be real.”
The idea of contact is an important part of Relational Psychotherapy. According to Erskine and Trautmann (1997), contact happens at an internal and external level within an individual. This includes awareness of thoughts, feelings, needs and memories which occur within the individual.
My experience as an Integrative Psychotherapist and wellbeing Supervisor has led me to an awareness of how mindfulness can help implement the core methods of attunement, inquiry, and involvement (Erskine et al., 1998). In the context of gestalt therapy, contact means “aware meeting with the other. Such contact is possible only where there is awareness of difference, of what is not-me” (Crocker, 2008, p. 132).
A mindful therapist is present in the “here and now” of the therapeutic process with the client. They can be fully involved and available in the therapeutic relationship, accepting of the client and of whatever feelings and thoughts the client is experiencing. A mindful therapist is able to attune to the current state and processes of the client, with active curiosity and awareness of the subtlest signals of the client's body language and expressions.
Gaining internal and external contact involves hard work and the client cannot do it alone, for it is based on the unfolding of awareness within a relationship with another (Erskine et al., 1998). The therapist nurtures the therapeutic relationship with the client and that relationship becomes a vehicle for enhancing contact for the purpose of growth and healing. The contact between the therapist and the client supports the client's contactful experiences with themselves and others (Erskine & Moursund, 1998).
The therapeutic relationship is a key factor in Integrative Psychotherapy for increasing the client's contact functions, and mindfulness can be of great help in promoting this awareness. The nature of mindful awareness is non-judgemental and non-threatening, and as such, it enables the client to open up to their own experience and allow them to come more towards the relational, co-created space with the therapist, which increases contact. Mindfulness thus becomes a facilitator of internal and external contact, of the client's relationship with themself, as well as with others and the world around them.
The quality of the therapeutic relationship becomes the heart of everything else that happens in the therapy. The psychotherapeutic relationship is about being fully present.
Affective attunement is the ability to go beyond empathy (Richard Erskine). It is the ability to provide a reciprocal meeting with the person’s affect. We are built for contacting, and we are programmed to learn and grow through contact. At a basic developmental and sensory level, the reaching-for and the touching-while-seeing of objects in early infancy lays down an initial neural map for physical contact between a human being and his or her environment that provides a neural capacity for subsequent contactful experience (Corbetta & Snapp-Childs, 2009).