Mindfulness Meditation: Another Context for the Necessary and Sufficient Conditions

A psychoanalytic colleague once mentioned in casual conversation that for her, the initial encounter with a patient often contains the themes that characterize an entire course of treatment even if the first interaction is brief. I think of this idea, from the client’s perspective, when remembering my first meeting with Ram Dass in the early weeks of 1969 during the blizzard of that winter. Although Ram Dass’s way of helping others was based on his practice of vipassana or mindfulness meditation and devotional yoga, and although my session with him generated my first experience with both meditation and therapy, it is likely that this encounter turned out to be transformative because it embodied the Rogerian relational elements of effective psychotherapy: the therapist’s communication of empathy, unconditional positive regard, and genuineness (Rogers, 1957). And although mindfulness has been integrated into many therapeutic approaches and it is now an essential feature within the third wave of cognitive behavioral therapies, its centrality to humanistic/existential therapies has been overlooked even though this centrality predates its inclusion in cognitive behavioral therapies by years and even decades (Felder, Aten, Neudeck, Shiomi-Chen, & Robbins, 2014). Indeed, it is my experience that by itself, mindfulness meditation works, both as a spiritual practice and as a secular mental health intervention, precisely because it promotes its own form of what Rogers deemed to be the necessary and sufficient conditions for therapeutic personality change. In this essay, I will briefly review the interpersonal circumstances and conditions that led me to visit Ram Dass, the encounter itself, and the ways in which this meeting combined mindfulness meditation with the Rogerian core conditions.

For those readers who are not familiar with Ram Dass, in the 1960s, as Richard Alpert, PhD, he was a young and promising Harvard psychologist who, somewhat surprisingly, became a rogue psychedelic researcher and then when he left academia, became known as Ram Dass, a prolific author and eloquent interpreter (and practitioner) of Hindu and Buddhist thought. Indeed, much of the interest in Eastern philosophy and spirituality that became part of the youth culture in the 1960s and 1970s, and that has now morphed into the empirically supported and widespread practice of mindfulness meditation, was galvanized by his seminal book, Be Here Now (Dass, 1971) and his series of lectures across the United States and Europe. Ram Dass’s writings and talks functioned for many as a transition from psychedelic use to a spiritual practice that was much more grounded in everyday life. Ram Dass’s lectures became events in the counterculture community: They would last for hours and would include translations, into the vernacular of the time, of complex ideas in Hindu, Buddhist, and Taoist philosophy. Moreover, his quick wit, sparkling intelligence, fearless honesty about his own missteps on his spiritual journey, and self-deprecating humor provided a seamless and safe introduction to Buddhist meditation and bhakti or devotional yoga.

When I first met Ram Dass, I was a 19-year-old high school dropout, the product of a family, like many families of the time, with mental health concerns that were unacknowledged, hidden, and untreated. Although my parents did their best and I am grateful to them for giving me life, their personal histories compelled them to behave and have relationships in a frequently maladaptive and fragmented manner. My father, a hard-working, dignified, and perfectionistic son of Norwegian immigrants, was taciturn in the extreme. During the 14 years living with him (before his death from lung cancer) in a small apartment in the Bronx, New York with my mother and two older brothers, I cannot remember us ever having a conversation. And then there were those periods of a more concentrated and painful silence, when he was clearly struggling with prolonged episodes of a malignant anger and depression; he would spend hours staring out of our sixth floor living room window, unable to function, perhaps because he never had a relationship, as a child or an adult, where he learned or was taught how to put difficult feelings into words.

In contrast, my mother was someone who was chatty and bright but uneducated and very much ashamed of her impoverished, Irish Catholic roots. In her relationships at home and at work, she needed others to feel undermined, uncomfortable, and confused so that she would feel more certain about her own place in the world. Due, I think, to her relentless feelings of inadequacy, she became adept at gossip and finding ways to say the one thing that would make you feel as miserable and uncertain as I think she felt most of the time. Whatever coping strategies my father could employ, they were no match for my mother’s ability to pull the emotional rug out from under him. Later on, I found out that although my mother was a skilled Episcopal parish secretary for large churches in the Bronx and Greenwich Village, she was eventually fired from every job for the same reason: She had surreptitiously caused interpersonal turmoil in her workplace. And then there was her brief psychotic break sometime in the early 1960s.

Not surprisingly, I grew into adolescence with emotional difficulties of my own. Without parents or other caregivers who could, during my childhood, reliably recognize, validate, or respond empathically to my emotions, I developed an attachment style that moved between anxious and dismissive. Close relationships were difficult, I was quite vulnerable to both anxiety and depression, and I maintained an implicit but vigilant effort to conceal any aspect of my personality that might meet with disapproval. But then, in the midst of an especially difficult period in my young life, I reached out to an older friend who suggested that I travel from New York City to Franklin, New Hampshire to speak with Ram Dass. At the time, I knew nothing about, and was not interested in, Eastern philosophy, meditation, or psychotherapy, but Ram Dass’s counterculture credentials were impeccable, I was exhausted by my anxious depression, and I trusted that my friend had my best interests at heart. Arriving at the Alpert family estate in the midst of the aforementioned blizzard, I found him alone in an upper room in the main house, sitting on the floor, facing a wall. When Ram Dass heard me enter his meditation room, he stood up in his long, ankle length white kurta, made bitter Mu tea, and sat cross-legged in front of me on the floor where I had taken a seat among the cushions. Realizing that I had no way of understanding why I had come or how he might actually help lift my depression, I began asking innocuous questions about the Hindu posters on the wall and these questions served no other purpose than to maintain a conversational chatter.

Fortunately, having distressed strangers drop into his home unannounced and without knowing exactly why they had come seemed not to be an unusual experience for Ram Dass. After several minutes of my very anxious and pointless questions, he astutely suggested that we play a game that he sometimes called Guts Ball. The rules for this game were simple but difficult: We would continue to sit on the floor a foot or so apart and we would agree to maintain eye contact. Most important, Ram Dass proposed that any thought or feeling that either of us had that we felt we could not share, we would then express that thought or feeling all the while maintaining eye contact.

Although I was not at all used to this kind of transparency (indeed, I grew up in a family that had implicit rules against it), I somehow found the courage to agree. So, for the next 2 hours or more, we engaged in a therapeutic encounter that not only embodied the Rogerian principles of empathy, unconditional positive regard, and genuineness, this encounter also became my first experience with both empathy within a therapeutic context and meditation (Rogers, 1957). More important, this encounter soon became a template for my daily practice of Buddhist meditation and many years later, the basis for my practice as a clinical psychologist working primarily from the humanistic/experiential tradition. It turns out that, at least for me, my colleague was correct in her observation about how the themes within initial therapeutic encounters tend to characterize an entire course of treatment; in my case, the course of treatment has, in some respects, lasted a lifetime.

As both Ram Dass and I sat on the floor maintaining eye contact, I could not help but notice that no matter what thought or feeling that, after much anxious hesitation, I put into words, his affect did not change but only seemed to deepen. That is, whenever I managed to express a thought or feeling that I was certain would be met with a negative or critical reaction, his face, and especially his eyes, instead shone bright with understanding and compassion. This turned out to be true even when the first unacceptable feeling that I expressed, a thought/fear that he was gay, could easily have triggered a reaction in Ram Dass, generating an impatient or judgmental look or comment. After all, growing up in the 1940s and 1950s in a cultural atmosphere that promoted shame and denial, Ram Dass’s bisexuality had caused him great suffering, especially when as an adult, he navigated the high stakes world of ivy league status, achievement, and tenure. Nevertheless, his compassion toward me, a fragile teenager he knew nothing about, never wavered.

Without realizing it, I was authentically engaged in a two-person practice of meditation and psychotherapy that depended on the three relational Rogerian elements: the therapist’s communication of empathy, unconditional positive regard, and congruence or genuineness. Specifically, since mindfulness meditation is the practice of paying attention in the present moment, on purpose and nonjudgmentally (i.e., with acceptance) to one’s thoughts and feelings (Kabat-Zinn, 2003), sitting in this way generated an experience of both mindfulness and client centered therapy in that Ram Dass communicated empathy, authenticity, and unconditional positive regard while I paid attention in the present moment, with an increased capacity for acceptance, to my thoughts and feelings.

As I reflect on this experience from 50 years ago, I still distinctly remember that after about 90 minutes something in me seemed to stir. That is, I began to internalize Ram Dass’s unconditional acceptance, an ontological quality that I believe was made particularly potent because of his then recent history of a concentrated and authentic spiritual practice. To be sure, Ram Dass was intensely and almost unbearably present, and I sensed for the first time in my young life, the possibility of directing that same penetrating compassion toward myself. This was both exhilarating and terrifying. Finally, when I noticed that the snow was accumulating to the point where I might not be able to leave for several days, I jumped up, told Ram Dass I had to go home, and then, without hesitation, he put on Western clothes and drove me to the bus station in that small New Hampshire town.

The effect of this therapeutic and spiritually informed encounter was both enormous and subtle. Enormous in that this very different way of relating to myself lifted my depression and powerfully brought my awareness into the present moment but only for a short time. Not surprisingly (there are very few one-session therapeutic cures), as soon as I went home later that day, my capacity for self-acceptance diminished significantly and my anxiety and depression returned. But in a much more subtle, steady, and almost imperceptible reorganization of my sense of self, my experience of Ram Dass’s mostly nonverbal but nevertheless powerful expression of the Rogerian core conditions seemed, over time, slowly to awaken a dormant, internally generated movement toward health that soon found its most durable and consilient expression in my life long practice of meditation. Indeed, in my view this steady movement toward health can be best understood as expression of the self-actualizing tendency, a construct that is, of course, both fundamental and unique to humanistic approaches to psychotherapy (Cain, 2002).