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Two Different Modes of Listening:

Close Process Attention vs. Mindfulness of Connection

It may be instructive for the reader to distinguish two kinds of clinical focus. Here, I will describe them; in a later section of the chapter, they will be illustrated in two detailed clinical vignettes. Both modes of listening are interwoven in psychotherapy; both involve the therapist listening with the “third ear” to what is said, as well as to what is not said. Listening in this way helps uncover currents of the mind- stream that lie beneath the surface of awareness. As was described in Chapter 5, the therapist listens to the patient and also listens to the listening of the patient.

Close process attention is the exploration of psychotherapeutic content and process with interpretive focus on anxieties and the way the mind defends against them (Gray, 1994).14 Close process attention can be applied to anything the patient talks about, but in the psychoanalytic paradigm, emphasis is placed on the interpersonal encounter in the therapeutic here and now. Awareness of what goes on interactively in psychotherapy reveals the internal surface of relationship in the mind.

Inquiring deeply as a psychoanalytic approach focuses close process attention on what Darlene Ehrenberg (1991) calls in the title of her book “the intimate edge” of experience. Roughly equivalent to what is referred to elsewhere in this book as the intersubjective intersection, the intimate edge between self and other is defined as “the nature of the integration, the quality of contact, what goes on between, including what is enacted and what is communicated affectively or unconsciously ... it is the point of maximum and acknowledged contact at any given moment in a relationship without fusion, and without violation of the separateness and integrity of each participant” (Ehrenberg, 1991, p. 33). It is the living surface of our relationship with others.

Awareness of the intimate edge of experience is valuable therapeutically because each time something is identified and explicitly acknowledged, it also changes what is occurring. Over time, new experiences that happen in the therapy relationship become incorporated into an evolving process of change and growth.

Mindfulness of connection is the second of two basic aspects of clinical attention in inquiring deeply. It is the process of paying mindful attention to the living reality of relationship with the other in the moment: body sensation, breath, feelings, body language, facial expression, words, and thoughts. These comprise the patient’s lived experience of being in relationship. An especially important focus in inquiring deeply is the felt sense of the therapist-patient relationship and the shifting quality of connection or disconnection between.

Mindfulness of connection as I use the term does not necessarily entail any specific category of experience or explicit meditative focus. It refers to conscious awareness of any aspect of the experience of being with someone else: the experience of connection, plus the knowing that this is one’s experience, moment by moment as it is occurring.

MindfUl awareness of connection encompasses the entire spectrum of experience that arises in the mind. It includes sensations, feelings, and mind states (“objects of mind” familiar from Buddhist mindfulness practice), but also psychological awareness, inclusive of the narratives and psychological explanations that are generally eschewed in Buddhist practice.

The scope of mindful awareness gradually deepens as we bring conscious attention to the interwoven threads in the rich fabric of subjective experience. Because the therapist is a relationship partner in this work, his or her mindfulness has a big influence on the deepening of the shared experience.

Mindfulness of connection in inquiring deeply is somewhat distinct from relational (interpersonal) mindfulness practice per se. Whereas the latter is a form of Buddhist-based mindfulness meditation (sometimes taught in MBSR format), mindfulness of connection focuses instead on psychological awareness rather than dharma practice. This difference can be further delineated by contrast with “Insight Dialogue,” a form of relational dharma practice developed by Gregory Kramer and now widely taught (Kramer, 2007).

Though secular in language and format, Insight Dialogue is deeply rooted in Buddhist psychology. It is a process of contemplative inquiry with another (or others) in which attention is focused on each of the four foundations of mindfulness, facilitated by meditative guidelines (instructions) for relaxing, allowing, and observing what comes up during the process. Essentially, Insight Dialogue is a process of meditating out loud with a partner, focusing in parallel on various topics of contemplation.

In contrast, inquiring deeply unfolds as a process of interaction, a deep conversation about what is happening between us, as it is happening. It is more interactive than Insight Dialogue and emphasizes the personal experience of the relationship between self and other in the moment.

In inquiring deeply, psychotherapeutic awareness may gradually deepen to include the various phenomena of “Buddhist mind” that comprise the third and fourth foundations of mindfulness (mindfulness of mind). For example, inquiry may be expanded to include attention to experiences such as greed, aversion, delusion, and other aspects of the mind which are described in Buddhism. Among the most important areas of inquiry are various aspects of self-experience and self-identity, discussed under the heading of Subjectivity in the next chapter.

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