Meditation For Psychotherapy

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In 2009, I interviewed Dr. Christopher Walsh, a consultant psychiatrist for Turning Point Alcohol and Drug Centre in Melbourne, Australia, who prescribed meditation as part of treatment for his patients. This was what he had to say:

I was doing it [meditation] for a long, long time before I decide to formally introduce it to patients. Firstly, I felt it was very helpful in my own life: it helped me to be more flexible, to cope with stress, to remain compassionate and not be reactive to things in a bad way. So I could stay calm and help people through crisis. So, I found that the first application of meditation to my work was actually just to create a healing space for patients by me meditating, not by teaching them to meditate. That’s probably the most important application,’
‘You’d find that when you’re creating a meditation space, even without saying anything about it, you’d find your patients becoming a bit more flexible and more capable of responding in a good way to the challenges around them. I think we’ve all had our experiences too, when we’re in the presence of meditation masters, that our minds become open. So we can all create that opening, that meditation space.

Dr. Christopher Walsh also had a private practice in North Carlton, Victoria. He explained how he came to use meditation in practice:

When I went into private practice I wasn’t dealing with people who were quite so sick. [But] when I was in public sector psychiatry I was dealing with people who were psychotic and they weren’t really up to doing the kind of meditation practices that I had learned. And in fact, that could in some ways make them worse. So I didn’t teach them that,’ he said.
 
But when I went into private practice I was dealing with a different population of people who were suffering from depression and anxiety. And I started to experiment with it.
 
And then a number of years later a lot of researches start to appear showing the value of mindfulness meditation, and so I started to be more formally teaching it, at that point, once I had the confidence of having the research and the professional support, rather than being something that was a bit on the outside.

Dr. Christopher Walsh had researched and published papers on mindfulness meditation in psychotherapy.

Dr. Walsh said he suspected some psychiatrists had been incorporating meditation into psychotherapy very quietly for decades, but only in the last decade it had become more overt. He thought meditation could be adapted to benefit a wide range of mental conditions, besides depression.

‘There is certainly good proof for it [meditation] being helpful in preventing relapse in people with chronic relapses in depression. There’s good research for that. But I think it’s applicable in a whole lot of range of conditions, but it needs to be approached in different ways,’ he said.

People who have problems with personality disorders or drug addictions or serious psychotic illnesses like schizophrenia – first you need to get them reasonably stable and then you can teach them meditation techniques, but often in an adapted way

‘Say, you might start with what we might call “Meditation In Action” – merely bringing mindfulness to day to day activities like brushing your teeth, washing the dishes, or driving the car. In that way, it doesn’t bring up too many difficult feelings. Normal meditation can bring up a lot of problems like agitation, boredom, grief, and that can overwhelm some people,’ he explained.

‘What I’m saying is that you can use to it most population but you just have to tailor it, tailor how you introduce people to it’

Dr. Walsh took a step-by-step approach in introducing meditation to his patients and encouraged them to apply it in everyday situations:

‘Generally, I’d do some exercises in the therapy room. Explain to them what the technique is and actually do the meditation with them for a little while and ask them about their experience afterwards, and clarify any simple misunderstandings. And then to encourage them to experiment with it in their lives, and then gradually introduce [to] them Mindfulness in Action practices and see which they go with: whether they go with Mindfulness in Action or sitting meditation or both. Sometimes, that experience is enough for them to realize that they are more than their thoughts, which is a good start,’ he said.

‘Sometimes, people just find they get so much agitation that I would send them along to yoga classes or some kind of movement work, which can be very helpful as well, and also it may get them ready for meditation practice further down the track.’

Though Dr. Walsh admitted it was hard to establish ‘a success rate’ because meditation was part of the general therapy, so it was not easy to work out what was causing the success. However, he noticed that people who had developed a regular sitting practice had progressed quite a bit faster in their therapy than those who hadn’t.

‘I have seen people plodding along and not doing very well and then starting to meditate and going ahead much faster once they started to meditate so that I guess is pretty good evidence [of the beneficial effects of meditation],’ he added.

Dr. Walsh said most people started to notice some benefits after a couple of weeks, if they were meditating every day, for about 20 minutes or more.

‘Then they start to notice some things: for a start, they notice they are not identifying with their thoughts so much, and they often find that they are a bit calmer during the day. Later on, they start to notice some more significant things, like they become more flexible and dealing with more difficult situations.’


Transcribed from a telephone interview conducted by Quyen Ngo in 2009

My sincere thanks to Dr. Chris Walsh, a psychiatrist working in private practice in North Carlton (Melbourne, Australia).

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Quyen Ngo

Quyen Ngo

Quyen Ngo is a Buddhist studies scholar.​ He has a master’s degree in Buddhist Studies and is an author of a number of books and articles on meditation and Buddhism. He has done numerous meditation retreats around the world.

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