Also from Christopher K. Germer and Ronald D. Siegel For Professionals Wisdom and Compassion in Psychotherapy: Deepening Mindfulness in Clinical Practice Edited by Christopher K. Germer and Ronald D. Siegel For General Readers e Mindful Path to Self-Compassion: Freeing Yourself from Destructive oughts and Emotions Christopher K. Germer e Mindfulness Solution: Everyday Practices for Everyday Problems Ronald D. Siegel Mindfulness and Psychotherapy SECOND EDITION Edited by CHRISTOPHER K. GERMER RONALD D. SIEGEL PAUL R. FULTON THE GUILFORD PRESS New York London Epub Edition ISBN: 9781462511679; Kindle Edition ISBN: 9781462511686 © 2013 e Guilford Press A Division of Guilford Publications, Inc. 72 Spring Street, New York, NY 10012 www.guilford.com All rights reserved No part of this book may be reproduced, translated, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the publisher. Last digit is print number: 9 8 7 6 5 4 3 2 1 e authors have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards of practice that are accepted at the time of publication. However, in view of the possibility of human error or changes in behavioral, mental health, or medical sciences, neither the authors, nor the editors and publisher, nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they are not responsible for any errors or omissions or the results obtained from the use of such information. Readers are encouraged to confirm the information contained in this book with other sources. Library of Congress Cataloging-in-Publication Data Mindfulness and psychotherapy, second edition / [edited by] Christopher K. Germer, Ronald D. Siegel, Paul R. Fulton. — Second edition. pages cm Includes bibliographical references and index. ISBN 978-1-4625-1137-2 (hardback : acid-free paper) 1. Meditation—erapeutic use. 2. Meditation—Buddhism. 3. Psychotherapy. I. Germer, Christopher K., editor of compilation. II. Siegel, Ronald D., editor of compilation. III. Fulton, Paul R., editor of compilation. RC489.M43M56 2013 616.89′14—dc23 2013004104 Clinical case illustrations either have been disguised or are composites of different individuals. About the Editors Christopher K. Germer, PhD, a clinical psychologist in private practice specializing in mindfulness- and compassion-oriented psychotherapy, is Clinical Instructor in Psychology at the Harvard Medical School/Cambridge Health Alliance, and a founding faculty member of the Institute for Meditation and Psychotherapy (IMP). He has been integrating the principles and practices of meditation into psychotherapy since 1978. Dr. Germer is a co-developer of the Mindful Self-Compassion training program, author of e Mindful Path to Self-Compassion, and coeditor of Wisdom and Compassion in Psychotherapy. He conducts workshops and lectures internationally on mindfulness and self-compassion. Ronald D. Siegel, PsyD, is Assistant Clinical Professor of Psychology at Harvard Medical School/Cambridge Health Alliance, where he has taught for over 30 years. He is a long-time student of mindfulness meditation and serves on the board of directors and faculty of IMP. Dr. Siegel teaches internationally about mindfulness and psychotherapy and mind–body treatment, while maintaining a private clinical practice in Lincoln, Massachusetts. His books include e Mindfulness Solution, Wisdom and Compassion in Psychotherapy, Back Sense, and Sitting Together: Essential Skills for Mindfulness-Based Psychotherapy. Paul R. Fulton, EdD, has a private practice in psychotherapy in Newton, Massachusetts, and is Clinical Instructor in Psychology at the Harvard Medical School/Cambridge Health Alliance. He was formerly the president of IMP and is currently director of the Certificate Program in Mindfulness and Psychotherapy. Dr. Fulton received lay ordination as a Zen Buddhist in 1972, has been a student of psychology and meditation for over 44 years, and is on the board of directors of the Barre Center for Buddhist Studies. He teaches mindfulness to clinicians internationally and has authored a number of book chapters and articles. Contributors Judson A. Brewer, MD, PhD, is an addiction psychiatrist at the Yale University School of Medicine and West Haven Veterans Hospital. He has been practicing insight meditation since 1996, studying with Ginny Morgan and Joseph Goldstein, among other teachers. Dr. Brewer has been studying and delivering mindfulness training to clinical populations since 2006, with an emphasis on individuals with addictions. His research focuses on testing the efficacy of mindfulness training for clinical populations with addictions and determining the underlying neurobiological mechanisms of mindfulness, using modalities such as neuroimaging. Dr. Brewer is currently Assistant Professor at Yale and Medical Director of the Yale erapeutic Neuroscience Clinic. John Briere, PhD, is Associate Professor of Psychiatry and Psychology, Director of the Psychological Trauma Program, and Center Director of the Adolescent Trauma Training Center (National Child Traumatic Stress Network) at the University of Southern California. A past president of the International Society for Traumatic Stress Studies (ISTSS), he is a recipient of the Award for Outstanding Contributions to the Science of Trauma Psychology from the American Psychological Association and the Robert S. Laufer Memorial Award for Scientific Achievement from ISTSS. Dr. Briere is author or coauthor of over 100 articles and chapters, 10 books, and 8 trauma-related psychological tests. He teaches on the topics of trauma, therapy, and mindfulness practices internationally. Paul R. Fulton, EdD (see “About the Editors”). Christopher K. Germer, PhD (see “About the Editors”). Trudy A. Goodman, PhD, is executive director, founder, and guiding teacher of InsightLA, a nonprofit organization for mindfulness education and meditation training since 2002. She is one of the first mindfulness-based stress reduction trainers, with its creator, Dr. Jon Kabat-Zinn. Dr. Goodman is also guiding teacher and cofounder of the Institute for Meditation and Psychotherapy (IMP) in Cambridge, Massachusetts. She created family mindfulness programs with Susan Kaiser Greenland and has worked with children all her life. Dr. Goodman teaches at retreats and workshops nationwide. She is a contributing author to Clinical Handbook of Mindfulness and Wisdom and Compassion in Psychotherapy. Gregory Kramer, PhD, is a meditation teacher, author, and cofounder and guiding teacher of the Metta Foundation. Since 1974, he has studied with esteemed monastics, including Anagarika Dhammadina, Ven. Balangoda Ananda Maitreya Mahanayaka era, Achan Sobin Namto, and Ven. Punnaji Mahathera. Dr. Kramer is author of Insight Dialogue: e Interpersonal Path to Freedom; Meditating Together, Speaking from Silence: e Practice of Insight Dialogue; Seeding the Heart: Practicing Lovingkindness with Children; and Dharma Contemplation: Meditating Together with Wisdom Texts. He pioneered online meditation and contemplation practices and cofounded Harvest with Heart, a hunger project in the Northeast United States, and Spiritual City Forum, an interfaith dialogue program in Portland, Oregon. Sara W. Lazar, PhD, is a scientist in the Psychiatry Department at Massachusetts General Hospital and Instructor in Psychology at Harvard Medical School. e focus of her research is the neurobiology of meditation. Dr. Lazar uses magnetic resonance imaging to investigate the neural correlates of beneficial changes associated with meditation practice, both in healthy individuals and clinical populations. She has been practicing yoga and mindfulness meditation since 1994 and serves as Science Advisor to IMP. Stephanie P. Morgan, PsyD, MSW, is a clinical psychologist and social worker. She has been a student of meditation in the vipassana and Zen traditions for the past 35 years. Dr. Morgan was Instructor in Psychology at Harvard Medical School from 1990 to 1994, where she trained psychology interns in mindfulness and self-care skills. She is currently on the faculty of IMP and in private practice in Manchester, Massachusetts. Susan T. Morgan, MSN, RN, CS, is a clinical nurse specialist in private practice in Cambridge, Massachusetts. She was Coordinator of the Yale Adult Pervasive Developmental Disorders Research Clinic for 5 years. Following this position, she was a clinician at the Harvard University Health Services and introduced mindfulness meditation to college students in the context of psychotherapy. Ms. Morgan has been practicing Buddhist meditation for 20 years and is currently completing a 4-year silent meditation retreat. Since 2000, she has co-led retreats for psychotherapists with an emphasis on loving-kindness and body awareness. William D. Morgan, PsyD, is a clinical psychologist in private practice in Cambridge and Quincy, Massachusetts. He is a board member of IMP and has participated in many years of intensive retreats in the eravadin, Zen, and Tibetan schools of Buddhism during his 40 years of meditation practice. Dr. Morgan has led mindfulness retreats for mental health professionals for the past 15 years. Andrew Olendzki, PhD, is Senior Scholar at the Barre Center for Buddhist Studies, an institution dedicated to the integration of academic understanding and meditative insight. He has taught at several New England colleges (including Harvard, Brandeis, Smith, Amherst, and Lesley) and was the executive director of the Insight Meditation Society. Dr. Olendzki is author of Unlimiting Mind: e Radically Experiential Psychology of Buddhism and a frequent contributor to Tricycle magazine. Susan M. Orsillo, PhD, is Professor of Psychology at Suffolk University in Boston. Her current research focuses on the role of emotional response styles, most notably experiential avoidance, in potentially maintaining psychological difficulties. In collaboration with her doctoral students in clinical psychology, Dr. Orsillo has developed and tested a number of prevention and treatment programs that integrate acceptance and mindfulness with evidence-based behavioral approaches. With Dr. Lizabeth Roemer, she has been studying the efficacy of an acceptance-based behavioral therapy for generalized anxiety disorder and comorbid conditions, mechanisms and processes of change, and applicability to clients from diverse backgrounds, with support from grants from the National Institute of Mental Health. omas Pedulla, LICSW, is a clinical social worker and psychotherapist in private practice in Arlington, Massachusetts, where he works with individuals and leads mindfulness-based cognitive therapy groups. Before a deepening interest in mindfulness meditation led him to change careers, he worked for over two decades as an advertising copywriter and creative director. A faculty and board member at IMP, Mr. Pedulla has also served on the board at the Cambridge Insight Meditation Center. He has been a practitioner of meditation in the vipassana tradition for over 25 years. He is coauthor of Sitting Together: Essential Skills for Mindfulness-Based Psychotherapy. Susan M. Pollak, MTS, EdD, is President of IMP and a psychologist in private practice in Cambridge, Massachusetts. She is Clinical Instructor in Psychology at the Cambridge Health Alliance/Harvard Medical School, where she has been teaching a course on meditation and psychotherapy since 1994. Dr. Pollak is coauthor of Sitting Together: Essential Skills for Mindfulness-Based Psychotherapy, coeditor of e Cultural Transition, and a contributing author to Mapping the Moral Domain and Evocative Objects. Lizabeth Roemer, PhD, is Professor of Psychology at the University of Massachusetts– Boston. Along with her clinical psychology doctoral students, her research examines the role of mindfulness, acceptance, and valued action in a range of clinical presentations, including anxiety disorders, posttraumatic functioning, and responses to racist experiences. With Dr. Susan Orsillo, she has been studying the efficacy of an acceptance-based behavioral therapy for generalized anxiety disorder and comorbid conditions, mechanisms and processes of change, and applicability to clients from diverse backgrounds, with support from grants from the National Institute of Mental Health. Ronald D. Siegel, PsyD (see “About the Editors”). Charles W. Styron, PsyD, is a clinical psychologist in private practice in Watertown and Walpole, Massachusetts, as well as a consulting psychologist for Caritas Norwood Hospital in Norwood, Massachusetts. He specializes in individual adult psychotherapy and neuropsychological testing. Dr. Styron has been a practitioner and teacher in the Shambhala and Tibetan Vajrayana Buddhist traditions for 34 years, and a faculty and board member of IMP since its inception. He was formerly an architect.