บูรณาการของจิตบำบัดเชิงพลศาสตร์ และการพัฒนาสติ

Abstract

Currently, the integration of mindfulness development or mindfulness-based intervention (MBI) with psychotherapy and its clinical applications is increasing. Clinical practice has combined new psychotherapies with mindfulness development such as mindfulness-based stress reduction (MBSR), acceptance and commitment therapy (ACT), dialectical behavioral therapy (DBT) and mindfulness-based cognitive therapy (MBCT). However, the application of mindfulness to the practice of psychotherapy has been limited mostly to cognitive behavioral therapy. Therefore, the authors of this article would like to introduce the concept of mindfulness-based dynamic psychotherapy (MBDP), which integrates the practice of mindfulness with dynamic psychotherapy. From a Buddhist viewpoint, attachment to oneself or the fi ve aggregates of attachment (upadanakkhandha) is the core of human suffering in both physical and mental aspects. During insight meditation (vipassana), the meditator gradually develops not only mindfulness (sati), but also clear comprehension (sampajanna) or wisdom (panna) of oneself, which is a combination of body and mind and subject to the three universal characteristics, namely i) impermanence (anicca), ii) suffering (dukkha), and iii) no ego or non-self (anatta). This experiential wisdom occurs repetitively, and gradually becomes more mature and profound. This process is similar to “working-through” in dynamic psychotherapy and this kind of wisdom or insight at the experiential level can diminish or eradicate the attachment to self, which is the core of suffering. To follow insight in the practice of mediation, the meditator shares his or her merits, metta (lovingkindness), and karuna (compassion) to all sentient beings. Loving-kindness and compassion are effective antidotes for sexual and aggressive drives. Three clinical case reports are presented in order to illustrate the integration techniques of mindfulness development with dynamic psychotherapy.