Modular Constructivism

I believe that therapy is successful only to the extent that it changes your life in the present. Whether you’re seeking to change a behavioral or relationship pattern that doesn’t serve you, painful memories, or just a sense of life not being as brilliant as it could be, therapy should improve your life in the present. At the beginning of therapy, we will define a specific change you want to see in your life and how we’ll know when you’ve achieved it.

Our experience of the present moment is powerfully colored by everything we’ve experienced in the past. As we move through life, our brains are constantly creating a model of who we are, how the world works, and how to get what we need. As a child, if crying gets positive attention, the brain will continue to expect that. If crying is ignored, the brain will expect that. We come into each new situation with an existing model of how the world works, and the model is literally made out of our past experiences. I don’t mean merely our conscious belief system, but rather the deeper structures that shape our emotional responses. The most effective therapy transforms your model of the world, so you experience life in the present moment differently.

I specialize in working with people who are trying to make a change and feeling stuck. It could be that you’re trying to resolve a trauma, or experience the world with more freedom and joy. The experience of trying to change something and feeling stuck usually indicates there is a neuro-emotional schema (or mental knot) that is blocking your efforts. Specifically, some deep aspect of your model of the world is making change impossible. We must identify where this knot exists, what experience caused it, and rewire that aspect of your model of the world. This is deep and intensive work, but it’s also capable of truly changing your life.

Modular Constructivism

If I ask you “How you hold your thumb when you brush your teeth?”, what do you need to do to access that information? You will either imagine yourself brushing, or you will pretend to grip a toothbrush. If you don’t engage in one of those actions, you will have no access to the information you need. This is an example of context-dependent recall. In therapy, we will utilize this principle to access all of the information we need about what is preventing you from achieving the change you seek. We will use guided meditations and visualizations to navigate your mental model of the world, and identify your mental knot.

Then we will revisit the experience (usually a painful one) that caused your knot. We heal the painful memory through focused self-compassion practices, and its impact on your experience of the world changes. The experience of care and compassion is deeply rooted in our mammalian physiology. Affective neuroscientists have shown that the experience of care is one of the primary tools for emotional regulation in every mammal. By revisiting a painful memory while practicing self-compassion, we engage in a process called “memory reconsolidation” which changes how the memory is stored in the brain. A traumatic or painful memory can be healed through this process.

Self-Compassion · Trauma, Addiction, and Psychosis

I have had the good fortune of learning from some amazing teachers in my lifetime. I spent more than 20 years studying directly with Zen Master Thich Nhat Hanh before his death in 2022. For most of that time, I spent 1-3 months each year on retreat with Thich Nhat Hanh. Later, I co-founded Morning Sun Mindfulness Center in New Hampshire based on his teachings. Thich Nhat Hanh taught that the root of each “mental knot” is an experience of suffering combined with a misperception. He emphasized that all suffering can be healed, but it requires that we get in touch with our suffering and embrace it with compassion. I learned countless specific techniques for accomplishing this from him.

I’ve also worked with leading neuroscientists such as Richard Davidson (who wrote the foreword to my first book) and have been strongly influenced by computational neuroscientist Karl Friston. Davidson researches the impact of deliberate practice on our brain function and structure. Friston has revolutionized neuroscience by showing us how the brain constructs predictive models of our environment based on past experiences. I believe his frame is the clearest way to understand how emotionally painful experiences can shape the way we model the world and all of our expectations.

What I learned from Thich Nhat Hanh was also mirrored in my studies of somatic psychotherapy and parts-based psychotherapy, particularly Internal Family Systems.

Most meditation is taught the way it is taught on retreat: the teacher gives the instructions, the students sit in silence, and whatever happens inside each person stays inside. That works well for experienced practitioners working with subtle states. It works badly for someone in the middle of strong emotion, which is most people who come to therapy. The same instruction to enjoy the breath can give one person the best sit of their life and leave another feeling constricted and ashamed, and the teacher never finds out.

In Dialogue-Based Mindfulness Training the person practicing tells me what is happening while it is happening. I adjust the instructions to what they report. If a sensation is too much, we work with that. If a thought has hijacked the exercise, we work with that. The practice gets built around the person’s actual experience rather than an average one.

Three things follow. People hit obstacles in these practices, and with dialogue I can see the obstacle and guide them through it instead of losing them to it. People give up on practices that do not help quickly, and with dialogue most people get real benefit in the first session. And it works: I have used it with hundreds of clients and taught it to thousands of therapists, and it is the way every practice in my books is meant to be used.

It is also how I do meditation coaching.

Dialogue-Based Mindfulness Training