In 1975, Herbert Benson of Harvard University wrote that to achieve a “relaxation response” you only need four ingredients. These included (a) a quiet place, (b) a comfortable position, (c) a mental device, and (d) a passive attitude. Benson’s relaxation response was, of course, roughly equivalent to the meditative mental state. His work presaged the mindfulness movement in psychotherapy. He identified a psychological place of exploration, discovery, and acceptance. His research linked the relaxation response to a variety of physiological and psychological benefits.

Carl Rogers and his daughter Natalie have often lamented that modern American therapists simply don’t understand person-centered counseling. As I watch students and professional therapists all-too-often engaging in premature problem-solving with clients, it’s easy to agree with Carl and Natalie. No one values listening much; it’s too slow and plodding for our caffeinated culture. Therapists wish to be helpful. Clients wish for solutions. And together they conspire to avoid whatever might lurk beneath the surface. At my present institution we even have a one-session group counseling experience called, “Feel Better Fast.” Perhaps what’s most amazing is that these explicit efforts to embrace and engage in the quick-fix are sometimes effective. This may be nothing more than a testimonial to the power of expectation and placebo.

But it’s equally likely that the help that happens comes primarily from two valid sources: First, clients may perceive their therapists as genuine and sincere. This is perhaps a small measure of Rogers’s person-centered congruence communicated through a fog of directive or solution-focused problem-solving. Second, some clients show up for therapy ready to learn. This is an example of Prochaska’s readiness to change—a pleasant situation wherein whatever stray skill that happens to graze the client’s psyche may be adopted, adapted, and applied, with some success, to the client’s particular life or problem. Obviously there are some good skills out there (including mindfulness meditation) and, as Otto Fenichel might have said—referring to psychoanalytic interpretations—timing is nearly everything.

Instead of indiscriminately engaging in procedures or firing off solutions, I wish that students and young professionals could step back and experience listening as meditation. I wish they could follow Benson’s advice and get comfortable, breathe deeply, and let their clients’ words into a quiet space. And while continuing to breathe, I wish for them to explore, discover, and accept what their clients are thinking, feeling, and experiencing.

Sometimes, when listening to therapy recordings with students I ask questions like:
  • Do you hear a value rising up in your client’s voice? Just listen and accept it and reflect it back.
  • Do you sense that your client is expressing perhaps a taste of bitterness mixed with unhappiness? If so, help your client hear and understand her or his own emotional state.
  • I wonder if you could tune into the call of the psychodynamic here; let the repeating interpersonal relationship patterns become clear; and then, collaboratively explore and discover with the client the nature, cost, and alternatives to these patterns, keeping your mutual and evidence-based goals in mind.
  • Do you notice in your client’s words the scent of the somatic or the spiritual? That’s okay, just notice it and then try to be the mirror that enables your client to see it right along with you.
Lately, the main message I’ve been trying to give my students, my supervisees, and myself is to integrate Benson’s and Rogers’s perspectives and use listening as meditation. The point is to let what the client says become the central focal point (Benson’s mental device). This is then followed with mindful acceptance and empathy, leading to a collaborative and interactive search for meaning or solutions or insight or behavioral prescriptions or cognitive reframing. And it ends with my conclusion that one of the coolest things about listening as meditation is that you can do it using virtually any theoretical perspective because excellence in the art of listening is the foundation that virtually all excellent therapists share.

File under: The Art of Psychotherapy