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Guide XIII-078

Vietnamese Thien and Plum Village practice (Thich Nhat Hanh)

Thich Nhat HanhVietnam
A 40 · L 39 · M 2125 interventions in the Trinity explorer
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[source: …] where a claim comes from[uncertain] not confirmed in a primary source[synthesis] the writer's reconstruction

1. Introduction

Version followed: the Plum Village tradition (Làng Mai) as taught by Zen master Thich Nhat Hanh (1926–2022, "Thay") and his monastic community, as published by Plum Village (plumvillage.org, the Plum Village App, the Plum Village Online Monastery), the European Institute of Applied Buddhism (EIAB), Thich Nhat Hanh's book Teachings on Love (Parallax Press, 1998) and The Mindfulness Bell. The Order of Interbeing (Tiếp Hiện), founded by Thich Nhat Hanh in Saigon in 1966, describes itself as rooted in the Linji (Lâm Tế) lineage of Buddhist meditation. [source: Plum Village, Order of Interbeing; Lion's Roar reprint of Teachings on Love]

What it is: a living Vietnamese Thiền (Zen) tradition and a worldwide community, not a psychotherapy. It is a whole way of practice: mindfulness carried into ordinary acts (breathing, walking, eating, working), a bell that calls everyone back to the present, community (sangha) life, practices of reconciliation (Beginning Anew), bowing practices (Touching the Earth), and an ethical framework (the Five Mindfulness Trainings for everyone; the Fourteen Mindfulness Trainings for members of the Order of Interbeing). [source: EIAB, Basic Practices; Plum Village App, Essential practices]

How change happens, as the tradition teaches it: mindfulness is described as the energy of being aware and awake to the present moment, practised continuously in daily life rather than only on the cushion. The breath is presented as a stable refuge whatever the mental or emotional "weather"; the bell and short verses (gathas) repeatedly bring the practitioner "home" to body and present moment; strong emotions such as anger are held gently, like a mother holding a crying child, and looked into until they are understood; relationships are healed through deep listening and loving speech; and the community itself carries and supports each person's practice. The tradition frames these as spiritual practice in a Buddhist path; Buddhist concepts such as interbeing, the Three Jewels and ancestors are described here as the tradition holds them. [source: EIAB, Basic Practices; Plum Village App, Essential practices; Three Earth Touchings]

The psychotherapist's role: you do not teach Plum Village practice as a Dharma teacher. You support a client who already practises, or who wishes to, in integrating the practice into therapy with consent and in the client's own terms (often Vietnamese for Vietnamese Buddhist clients); you can use published secular adaptations (Domain II: MBSR, MBCT, MSC, CFT; Domain VII: contemplative and Buddhist psychotherapy, spiritually integrated psychotherapy; Domain IV: trauma-sensitive yoga); you refer to Plum Village monastics, Dharma teachers and local sanghas for teaching; and you watch for adverse effects. [synthesis]

2. Framework

The tradition has no clinical phases or session counts; no source gives a number of therapy sessions, and none should be assumed. Its own structure is rhythmic and communal. [source: EIAB; Plum Village Online Monastery course page]

Rhythms of practice as published

  • Moment to moment: stopping at the sound of a bell (any bell, telephone or clock), returning to the breath; short verses for daily acts (waking, eating, walking). [source: EIAB, Basic Practices]
  • Daily: sitting meditation, walking meditation, mindful eating, working meditation, mindful movements and deep (total) relaxation; Noble Silence from the end of evening sitting until after the next morning's breakfast. [source: EIAB; Plum Village App]
  • Weekly: Beginning Anew in a family or community circle, ideally weekly; a "lazy day" without a schedule; days without car, computer or internet. [source: Lion's Roar / Teachings on Love; Laity 1992; Plum Village App]
  • Retreat: a published example is a Vietnamese-language online retreat whose days included listening to the Great Bell (Nghe hô chuông Đại hồng), guided sitting and chanting, qigong or mindful movements, deep listening (lắng nghe sâu), total relaxation (thiền buông thư), a Dharma talk (pháp thoại), small-group Dharma sharing (pháp đàm), Earth Touching repentance (Sám Pháp Địa Xúc), a "lazy" day (làm biếng), and, at the close, a ceremony transmitting the Five Mindfulness Trainings (Năm Giới). [source: Plum Village Online Monastery, Thương Như Bụt Thương course page]
  • Commitment: receiving the Five Mindfulness Trainings in a transmission ceremony; for some, ordination into the Order of Interbeing (lay or monastic), committing to live by the Fourteen Mindfulness Trainings. Ordination requirements are set by the Order. [source: Plum Village, Order of Interbeing; course page] [uncertain: detailed ordination requirements not verified]

Therapist's working frame [synthesis]

  1. Enquiry and consent: learn what the client practises, with whom (sangha, monastery, app), in what language, and what it means to them; agree whether and how practice will be part of therapy.
  2. Screening: trauma history, dissociation, psychosis or bipolar history, current crisis, sleep, and any intensive retreat plans (see 4 and 5).
  3. Integration: bring in the client's own practices as resources (breath as refuge, bell, walking, Beginning Anew skills) or use secular adaptations, at a dose the client can tolerate.
  4. Coordination: with the client's permission, link with their Dharma teacher or sangha for teaching questions; with the doctor for health questions.
  5. Review: check regularly for benefit and for adverse experiences; reduce or change practice as needed.

Moving on: go from enquiry to integration only once consent is clear and screening shows no reason for caution; increase practice only while the client stays grounded and functioning; step back to stabilisation if adverse effects appear. [synthesis]

3. Guiding principles

Tradition principles, with their practical meaning for the therapist:

  • Mindfulness is continuous, in daily life. Integration happens in ordinary acts, so ask about walking, eating, washing up and phone calls, not only formal sitting. [source: EIAB]
  • The breath is a refuge. Offer one conscious breath as the first step in any distress, before analysis. [source: EIAB; Plum Village App, quoting "Conscious breathing is my anchor"]
  • Practice should energise, not exhaust. Knowing when to rest is itself practice; if a client is straining or driving themselves, reduce. [source: EIAB, "Knowing when to rest"]
  • Form serves presence ("To bow or not to bow is not the question"). Do not police ritual correctness; ask whether the client is present and at ease. [source: EIAB]
  • Hold emotions like a mother holds a crying child. Model gentleness towards anger and fear rather than suppression or catharsis. [source: EIAB, Taking Care of Anger]
  • Deep listening and loving speech. Listen to ease the other's suffering, not to judge or correct; speak frankly but not destructively. [source: Lion's Roar / Teachings on Love; Five Mindfulness Trainings]
  • Never blame or argue in Beginning Anew; correct a misperception privately and calmly later. Useful for couple and family work. [source: Lion's Roar / Teachings on Love]
  • Sangha as support. Practice is easier in community; ask about the client's sangha and "second body" (a fellow practitioner each person cares for). [source: EIAB]
  • Interbeing and continuation. The tradition teaches that one is not separate from ancestors, descendants and other beings. Explore this as the client's belief, neither asserting nor dismissing it. [source: Three Earth Touchings]
  • Trainings are a path, not hard and fast rules, and are described as non-sectarian. Frame ethics as aspiration; watch for rigid perfectionism. [source: Plum Village, Five Mindfulness Trainings]
  • Mindful consumption. The fifth training covers food, sense impressions and media, including not using consumption to escape loneliness or suffering. A natural bridge to work on substances and compulsive media use. [source: Five Mindfulness Trainings]

Therapist-role principles [synthesis]:

  • Client-led: the client decides whether practice enters therapy; you follow their tradition, language and teacher.
  • Not a teacher: you do not transmit trainings, lead ceremonies, interpret doctrine or act as Dharma teacher; refer for these. Avoid dual relationships (e.g. treating a client who is in your own sangha) and use self-disclosure about your own practice sparingly and only for the client's benefit. Follow your profession's ethics code on competence, multiple relationships and respect for religion. [synthesis] Published spiritual and religious competencies for psychologists (Vieten et al. 2013) support this stance [uncertain: not verified].
  • Safety over dose: less practice, shorter and eyes-open, is the default when in doubt.
  • No health claims: Plum Village speaks of "healing" in a spiritual and emotional sense; no practice here is presented as a treatment for physical disease. Evidence status for physical illness: not established. [synthesis]
  • Even-handedness: Buddhist concepts are the client's to hold; neither endorse nor debunk.

4. Intervention inventory

Part A gives the practices as Plum Village publishes them, with how a therapist can support a practising client in using them. Part B gives the therapist's own clinical procedures. In session, use a tradition practice only at the client's request or with their consent; otherwise use a secular adaptation. [synthesis]

Part A. Plum Village practices

1. Mindful breathing

  • Purpose: returning to the breath as a stable refuge when carried away by thinking or sunk in strong emotion; the base of every other practice. Use for acute distress, rumination, and as a re-entry point between topics. [source: EIAB; Plum Village App]
  • Steps (as taught): stop; notice the natural in-breath and out-breath without forcing them; silently pair a short phrase with each, for example Thich Nhat Hanh's "Breathing in, I feel well. Breathing out, I feel light"; let the body relax; return whenever the mind wanders. No breath holding, no deepening by force. [source: Thich Nhat Hanh, General Instructions, 2002]
  • In therapy: invite the client to use the phrases they already use in their own practice, in Vietnamese or English; keep it to a few breaths, eyes open if preferred. [synthesis]
  • Example language (illustrative): "Would it help to do what you do at the sangha: just a few breaths with your own words, and then we'll look at this together?"
  • Watch for: breath focus raising anxiety or panic (common in trauma and panic disorder); offer an external anchor instead (feet, sounds, an object). Working if the client reports feeling steadier and can then talk about the difficulty. [synthesis]

2. The bell of mindfulness

  • Purpose: stopping. At the sound of a bell (a temple bell, telephone or clock) everyone pauses talk and movement and returns to the breath. Thich Nhat Hanh taught that the bell calls us back "to our true home". [source: EIAB; Plum Village App, listening to the bell talk, 2013]
  • Steps (as taught): on hearing the bell, stop speaking and thinking; follow the breath; then continue. In community, a bell master invites the bell (the tradition's word for striking it); inviting the bell is taught in Plum Village video teachings. [source: EIAB; Plum Village App]
  • In therapy: a client may choose an everyday "bell" (phone notification, kettle, a traffic light) as a cue to pause and check in with body and mood between sessions. [synthesis]
  • Example language (illustrative): "Which sounds in your day could become your bell, a reminder to stop and breathe once?"
  • Watch for: cues becoming compulsive checks or rituals; loud or sudden sounds startling clients with PTSD (use soft or visual cues). Working if pauses happen naturally and the client notices emotional states earlier. [synthesis]

3. Sitting meditation

  • Purpose: returning home to oneself; described in the app as a celebration of being alive. [source: EIAB; Plum Village App]
  • Steps (as taught): sit upright with dignity and ease; return to the breath; let the body relax completely; smile gently. Thich Nhat Hanh's instruction: sit "upright, relaxed, smiling". [source: EIAB; Noble Silence and Mindful Nourishment talk, 2009]
  • In therapy: ask how long and how often the client sits; the sources cited prescribe no length [uncertain: not verified]. Support a gentle, regular practice rather than long sittings. [synthesis]
  • Example language (illustrative): "When you sit at home, what is it like? Does it leave you more settled, or more stirred up?"
  • Watch for: straining to sit long; intrusive memories, dissociation, depersonalisation, insomnia (see Part B). Working if sitting feels nourishing and daily functioning holds or improves. [synthesis]

4. Walking meditation

  • Purpose: arriving in the here and now with each step; walking "just for walking", with freedom and solidity, unhurried. A grounding practice that suits people who find sitting difficult. [source: EIAB; Plum Village App]
  • Steps (as taught): walk slowly and relaxed; coordinate steps with the natural breath, taking a few steps on each in-breath and each out-breath and letting the breath set the number; silently say "I have arrived" on the in-breath and "I am home" on the out-breath; stop walking if you want to talk. Thich Nhat Hanh named four elements: arriving home, here and now, solidity and freedom, and taking refuge in the island within. [source: General Instructions, 2002; Noble Silence talk, 2009; EIAB]
  • In therapy: a few minutes of slow walking in the room or outdoors, feet as anchor, is a good first step for agitated or dissociative clients. [synthesis]
  • Example language (illustrative): "Let's stand and take some slow steps. Feel each foot touch the floor. If the words 'I have arrived, I am home' help you, use them."
  • Watch for: dizziness or balance problems; self-consciousness. Working if the client feels more present and less pressured. [synthesis]

5. Mindful eating and eating together

  • Purpose: full presence at meals, beginning while serving the food; reflecting on the many elements (rain, sunshine, earth, air, love) that brought the food to the table. Linked by Thich Nhat Hanh to mindful consumption in the fifth training. Meals in practice centres are often taken in silence. [source: EIAB; Noble Silence and Mindful Nourishment talk; Five Mindfulness Trainings]
  • Steps (as taught): serve mindfully; before eating, pause and contemplate where the food came from; eat with attention, enjoying the food and the company. The detailed pre-meal contemplations used in Plum Village are not given here. [uncertain: not verified]
  • In therapy: useful for gratitude and for slowing down; with eating disorders, coordinate with the eating-disorder team and avoid any food rules or targets. [synthesis]
  • Example language (illustrative): "Before your next meal, could you take one breath and think of the people and weather that brought it to you?"
  • Watch for: mindful eating turning into restriction, scrupulous rules or guilt; fasting is not part of this practice and is not prescribed here. Working if meals feel calmer and more enjoyable. [synthesis]

6. Deep (total) relaxation

  • Purpose: resting and caring for the body; listed with mindful movements as a way to stay healthy and in touch with the body. A daily item in retreats (thiền buông thư), often guided by monastics. [source: EIAB; Online Monastery course page]
  • Steps: a guided lying-down relaxation. The exact Plum Village script is not given here. [uncertain: not verified] A therapist may use a short secular body-awareness relaxation instead (Domain II). [synthesis]
  • Example language (illustrative): "Let the floor hold you. You don't need to do anything right now."
  • Watch for: lying down and closing eyes can feel unsafe for trauma survivors; offer sitting, eyes open, and choice at every step. Working if the client rests and sleeps better. [synthesis]

7. Working meditation and the kitchen

  • Purpose: practising mindfulness while working (cooking, cleaning, chopping wood, compost): aware of body and breath, relaxed, with few words. [source: EIAB; Plum Village App]
  • Steps (as taught): choose a task; keep a relaxed posture; follow the breath; keep attention on the task; work with lightness rather than hurry. [source: EIAB]
  • In therapy: a behavioural-activation bridge, and a way to practise without sitting still. [synthesis]
  • Example language (illustrative): "Which chore could you do this week as your practice, slowly and with your breath?"
  • Watch for: perfectionism about "doing it mindfully". Working if tasks feel less burdensome. [synthesis]

8. Gathas (practice verses)

  • Purpose: short verses that open and deepen everyday acts and bring one back to oneself, for example on waking (start the day with a smile and an aspiration to love and understanding), walking, or hearing the bell. [source: EIAB]
  • Steps (as taught): link a short verse to a daily act; recite silently in rhythm with the breath. Plum Village publishes verse booklets for retreats. [source: EIAB; Online Monastery course page] The specific verse texts are not reproduced here.
  • In therapy: the client may write a personal verse for a hard moment (for example before a difficult phone call), in their own language. [synthesis]
  • Example language (illustrative): "Is there a verse you already use? Or would you like to write your own one-line verse for that moment?"
  • Watch for: verses becoming compulsive, "must say it perfectly" rituals (scrupulosity, Part B). Working if the verse brings ease. [synthesis]

9. Noble Silence, lazy day and rest

  • Purpose: Noble Silence is a period of deep silence from the end of evening sitting until after breakfast, described as healing. The lazy day is a day with no schedule, letting time unfold, and looking deeply at oneself and one's relationships; Plum Village also keeps days without car, computer or internet. Rest is itself practice; practice should energise, not tire. [source: EIAB; Plum Village App]
  • In therapy: a client can choose a short period of quiet or a technology-free half day; treat rest as legitimate, not lazy. [synthesis]
  • Example language (illustrative): "Your tradition says rest is part of practice. What would a lazy morning look like for you?"
  • Watch for: silence increasing isolation or rumination in depressed clients; keep contact with others. Working if the client feels restored. [synthesis]

10. Taking care of anger and strong emotions

  • Purpose: anger is likened to a crying baby; the practitioner holds it gently like a mother, listens and looks carefully to understand what is wrong; compassion grows by understanding one's own suffering and that of those who caused hurt, which may take time. [source: EIAB; Plum Village App] The fourth training also names breathing and walking as ways to work with anger. [source: Five Mindfulness Trainings]
  • Steps (as taught): recognise the anger; return to the breath or go for a walking meditation rather than speaking or acting; hold the feeling with tenderness; later, look deeply at its roots. [source: EIAB; Five Mindfulness Trainings]
  • In therapy: maps well onto emotion-regulation work: pause, ground, label, then explore needs. [synthesis]
  • Example language (illustrative): "If the anger were a crying child, how would you hold it right now?"
  • Watch for: using the image to suppress justified anger or to stay in an unsafe relationship; compassion for someone who hurt you is not a duty to stay or reconcile. Working if outbursts lessen and the client can speak about the anger. [synthesis]

11. Beginning Anew

  • Purpose: looking deeply and honestly at one's actions, speech and thoughts to make a fresh start with oneself and others; clearing wrong perceptions in relationships. Thich Nhat Hanh traces it to the Buddha's monastic communities on full and new moon days. Use with clients whose family, couple or community already practises it, or as a structured repair conversation. [source: EIAB; Lion's Roar / Teachings on Love; Plum Village App]
  • Version note: Teachings on Love (reprinted in Lion's Roar) and Annabel Laity's 1992 Mindfulness Bell article describe three stages; the Plum Village App calls it a four-step practice without listing the steps. [uncertain: the fourth step is not verified] The three-stage version is followed here.
  • Steps (as taught, in brief): (1) participants sit in a circle, ideally weekly, around a vase of fresh flowers, following their breath; (2) flower watering: whoever is ready joins palms, takes the vase, and names, honestly and without flattery, the good qualities they see in others, uninterrupted, then returns the vase; (3) expressing regrets for what one said or did that hurt others; (4) expressing hurts and difficulties with loving speech, frank but not destructive, with no blaming or arguing; listeners just listen and do not reply or correct; Laity adds inviting others to name one's own shortcomings, asking more than once because people hold back; (5) close with a song, holding hands and breathing together, or hugging meditation. A misperception is corrected privately and calmly a few days later. [source: Lion's Roar / Teachings on Love; Laity 1992]
  • Family use: a senior member or experienced facilitator models it; children follow the example; choose a day when people are not overloaded; expect a first session in a family with deep pain to only scratch the surface. [source: Laity 1992]
  • In therapy: in couple or family work, use the sequence as a scaffold: appreciation first, then own regrets, then hurts in "I" language, with the therapist protecting the no-interruption rule. Clients may also rehearse a Beginning Anew conversation in individual sessions. [synthesis]
  • Example language (illustrative): "Before we get to the hard part, would each of you water a flower: one quality you truly value in the other?" / "Right now your only job is to listen, not to correct."
  • Watch for: blame slipping in (Laity names this as a major risk); flower watering used to placate an abusive partner; unequal power. Do not use joint repair formats where there is intimate partner violence or coercive control; assess separately first. [synthesis] Working if partners report feeling heard and misperceptions are cleared later without escalation.

12. Dharma sharing, deep listening and loving speech

  • Purpose: members share experiences, joys, difficulties and questions about practice, learning from each other's insight; others listen deeply. The fourth training commits to truthful, kind speech, compassionate listening and not spreading uncertain news or divisive words. [source: EIAB; Plum Village App; Five Mindfulness Trainings]
  • Steps (as taught): speak from your own experience; listen without interrupting or debating; keep what others share. [source: EIAB; Plum Village App] Detailed facilitation guidelines are not covered here. [uncertain: not verified]
  • In therapy: explore what the client finds hard to say in their sharing group; use deep-listening skills in communication training. [synthesis]
  • Example language (illustrative): "What would you say in Dharma sharing if you felt completely safe?"
  • Watch for: disclosure of trauma in groups without support; pressure to speak. Working if the client feels supported by the group. [synthesis]

13. Hugging meditation

  • Purpose: as Plum Village teaches it, mindful, concentrated hugging between practitioners who both wish it, said to support reconciliation, healing and understanding. [source: EIAB; Plum Village App]
  • In therapy: this is a practice for the client with consenting family members or friends outside sessions. The therapist never hugs or otherwise touches a client, in this or any practice, and does not demonstrate it. [synthesis]
  • Example language (illustrative): "Is a mindful hug something that feels right with your sister, or would words be easier?"
  • Watch for: touch being unwelcome, or pressure to hug someone who caused harm. Hugging is always optional: it needs the clear consent of both people, and either can withdraw consent at any time. [synthesis]

14. Touching the Earth (Earth Touchings)

  • Purpose: returning to one's roots and to spiritual and blood ancestors; recognising that one is not alone; touching interbeing across time and space; gratitude; and in retreats a repentance form (Sám Pháp Địa Xúc). Plum Village publishes Three and Five Earth Touchings texts and encourages practitioners later to write their own. [source: EIAB; Three Earth Touchings; Online Monastery course page]
  • Public outline: from standing with palms joined, the practitioner lowers to the ground so that limbs and forehead rest on the floor, palms turned up as a sign of openness to the Three Jewels; while down, they breathe in the Earth's stability and breathe out suffering (anger, fear, grief, a sense of inadequacy), for a few natural breaths, then rise. A bell master invites the bell and reads the text; alone, one reads it aloud. The three themes are (1) ancestors and descendants, accepting their strengths and weaknesses; (2) oneness with all people and species, including those who suffer and those who cause harm; (3) letting go of the idea of being only this body with a limited lifespan. [source: Three Earth Touchings]
  • In therapy: useful for grief, intergenerational themes (for example Vietnamese family histories of war and migration), shame and belonging, if the client already practises it. The therapist explores the experience; the client does the practice at home or in the sangha. [synthesis]
  • Example language (illustrative): "When you touch the Earth for your ancestors, who comes to mind? What do you receive from them, and what do you want to set down?"
  • Watch for: grief or trauma surfacing (ancestors who were abusers; war losses); the second theme (oneness with those who cause harm) can feel invalidating for victims, so the client may skip or adapt it with their teacher; physical limits on kneeling (sitting versions can be discussed with a teacher). Working if the client feels connected and lighter. [synthesis]

15. The Five Mindfulness Trainings

  • Purpose: Plum Village's ethical path, described as non-sectarian and as a way to cultivate actions of body, speech and mind "rather than hard and fast rules": (1) reverence for life; (2) true happiness (generosity, right livelihood, not exploiting); (3) true love (responsible sexual conduct, consent, protecting children, non-discrimination); (4) loving speech and deep listening; (5) nourishment and healing (mindful consumption of food, sense impressions and media; avoiding alcohol, drugs, gambling and toxic media; not consuming to escape suffering). They are received in a transmission ceremony (Năm Giới) and recited in community. [source: Five Mindfulness Trainings; Online Monastery course page; EIAB]
  • In therapy: the trainings can frame values work, and the fifth supports substance and media goals in the client's own vocabulary. [synthesis]
  • Example language (illustrative): "You've received the trainings. Which one feels most alive for you right now, and which feels hardest?"
  • Watch for: harsh self-judgment over perceived breaches; trainings used as a stick (scrupulosity, Part B); questions about what a training requires go to the client's teacher. Working if the trainings feel like a guide, not a verdict. [synthesis]

16. The Fourteen Mindfulness Trainings and the Order of Interbeing

  • Description: the Order of Interbeing (Tiếp Hiện) was founded in 1966 in Saigon; its first six members, colleagues in the School of Youth for Social Service's war-relief work, were ordained on 5 February 1966. It includes monastic and lay members who commit to the Fourteen Mindfulness Trainings, described as a distillation of Mahayana bodhisattva teachings, and to the Four Spirits of the Order: non-attachment from views, direct experimentation on interdependent origination through meditation, appropriateness, and skilful means. Ordinations resumed in the West in 1981 and in Vietnam in 2006. [source: Plum Village, Order of Interbeing] The individual themes of the Fourteen Trainings are not summarised here. [uncertain: not verified]
  • In therapy: membership can be a central identity and source of support; ask what it asks of the client and whether it nourishes them. Questions about the trainings go to the Order and its teachers. [synthesis]
  • Example language (illustrative): "How does being in the Order shape the way you see this decision?"
  • Watch for: over-commitment, burnout from engaged service, or guilt about not living up to the trainings. [synthesis]

17. Sangha, second body, going home and tea meditation

  • Purpose: building community like growing a sunflower; every practitioner is part of the sangha body; each person may care for a fellow member as their "second body"; on returning home, practitioners remember that sangha friends everywhere are breathing too; tea meditation is a joyful shared time. [source: EIAB]
  • In therapy: map the client's support network; encourage regular contact with a local sangha if wished. Plum Village also runs programmes for educators (Wake Up Schools / applied ethics) and young adults (Wake Up). [uncertain: not verified]
  • Example language (illustrative): "Who is your second body? Who in the sangha knows how you're really doing?"
  • Watch for: isolation after leaving a residential retreat; conflict within a sangha. Working if the client feels held by community. [synthesis]

Part B. The psychotherapist's work

18. Enquiry and consent for client-led integration

  • Purpose: learning what the practice means to the client and agreeing whether it enters therapy, within spiritually integrated psychotherapy (Domain VII). [synthesis]
  • Steps: (1) ask open questions about practice history, teacher or sangha, language, practices used, frequency, retreats, and whether the trainings have been received; (2) ask how practice has helped and whether anything about it has been difficult; (3) for clients from Vietnamese Buddhist families, explore family and temple context, migration and war history in their own words; the DSM-5-TR Cultural Formulation Interview, including its supplementary module on spirituality, religion and moral traditions, can structure this [uncertain: not verified]; (4) explain options (using their own practices, a secular adaptation, or keeping practice out of therapy) and record the client's choice; (5) revisit consent as therapy develops. [synthesis]
  • Example language (illustrative): "Some people want their practice to be part of our work, others prefer to keep it separate. What would you like?"
  • Watch for: a client assuming you share or reject their beliefs; family pressure to practise (or not). Working if the client speaks freely about practice, including doubts. [synthesis]

19. Using published secular adaptations

  • Purpose: offering mindfulness and compassion skills without religious form, for clients who want skills but not Buddhist practice. [synthesis]
  • Steps: choose the relevant Domain II programme (MBSR, MBCT for recurrent depression, MSC, CFT) or Domain IV trauma-sensitive yoga, delivered by a trained clinician; say plainly that these are adaptations, not Plum Village teaching; avoid presenting Buddhist concepts as clinical facts. [synthesis]
  • Example language (illustrative): "This is a secular exercise drawn partly from Buddhist practice. You don't need to adopt any belief to use it."
  • Watch for: a Buddhist client feeling their tradition is being diluted, or a non-Buddhist client feeling proselytised. Ask. [synthesis]

20. Referral to and coordination with teachers and sangha

  • Purpose: teaching, ceremonies, training transmission and doctrinal questions belong to Plum Village monastics, Dharma teachers and Order of Interbeing members, through practice centres and local sanghas. [source: Plum Village, Order of Interbeing; EIAB] [synthesis for the clinical procedure]
  • Steps: (1) when a question is about how to practise, what a training requires or whether to attend a retreat, suggest the client ask their teacher; (2) with written consent, the therapist may talk with the teacher about safety (for example reducing intensity after adverse effects); (3) keep clinical and spiritual roles separate. [synthesis]
  • Example language (illustrative): "That's a question for a Dharma teacher. Would you like to ask a monastic at the retreat, and we can talk about what they say?"
  • Watch for: a client using therapy to bypass a teacher, or a teacher's advice conflicting with clinical safety; discuss openly with the client. [synthesis]

21. Trauma-sensitive adaptation

  • Purpose: making practice safe for clients with trauma histories. Published research associates childhood trauma and subclinical PTSD symptoms with adverse effects in mindfulness programmes. [source: Britton lab, Varieties of Contemplative Experience project] Treleaven's Trauma-Sensitive Mindfulness (2018) is a published adaptation [uncertain: not verified].
  • Steps: (1) offer choices (eyes open, external anchors such as feet, sounds or walking instead of breath); (2) keep practices short and stop at any sign of overwhelm; (3) prefer movement (walking meditation, working meditation) to long stillness; (4) teach the client to step out of a practice at any time; (5) adapt prostrations and lying-down relaxation for safety and dignity; (6) process material that arises in therapy, not in the practice. [synthesis]
  • Example language (illustrative): "You're in charge. If anything feels like too much, open your eyes, look around the room, and we'll stop."
  • Watch for: flashbacks, numbing, dissociation, startle at bells. Working if the client stays within a tolerable range and feels more choice. [synthesis]

22. Monitoring adverse effects and screening before retreats

  • Purpose: meditation can produce challenging experiences. A mixed-methods study of Western Buddhist meditators in Theravada, Zen and Tibetan traditions (Lindahl et al. 2017, PLOS ONE) documented 59 kinds of experience across seven domains: cognitive, perceptual, affective, somatic, conative, sense of self and social; examples include hypersensitivity to light or sound, insomnia, involuntary movements, fear, panic and loss of emotion. Effects ranged from days to more than a decade; some felt positive on retreat but impaired functioning afterwards; challenges did not occur only in people with prior psychiatric or trauma history. Influencing factors fell into practitioner, practice, relationship (including the teacher) and health-behaviour (diet, sleep, exercise) domains. [source: Brown University news, 2017; Britton lab] Case literature reports psychosis and mania after meditation in some people. [source: Meditating in Safety, research evidence] Farias et al. 2020 (Acta Psychiatrica Scandinavica) is a systematic review of adverse effects [uncertain: not verified]. Cheetah House (cheetahhouse.org) offers resources and support for meditation-related difficulties. [source: Britton lab]
  • Steps: (1) ask about difficult experiences routinely, normalising them as known and not the client's fault; (2) before an intensive or silent retreat, review psychosis or bipolar history, recent trauma or crisis, sleep, medication changes (via the doctor, not you) and supports; advise the client to tell the retreat team; (3) if difficulties arise, reduce dose (shorter, fewer sittings), shift to grounding (walking, physical work, time outdoors, regular meals and sleep, social contact), and pause intensive practice; (4) refer to psychiatry urgently for psychotic or manic symptoms, severe insomnia or risk. [synthesis, drawing on the factors above]
  • Example language (illustrative): "Some people find meditation brings up unusual or hard experiences. That's documented and not a sign you're doing it wrong. Has anything like that happened?"
  • Watch for: sleep loss, agitation, depersonalisation, perceptual changes, emotional flatness, withdrawal. Working if symptoms settle with reduced practice and grounding. [synthesis]

23. Telling spiritual experience apart from illness

  • Purpose: neither pathologising meaningful experience nor missing psychosis, mania, depression or dissociation. DSM-5-TR includes a non-disorder category, "Religious or Spiritual Problem", for distressing religious or spiritual experiences or questions (Z65.8).
  • Steps: (1) get a detailed description in the client's words and tradition's terms; (2) ask how the teacher and sangha understand it; (3) assess function (sleep, eating, work, relationships), insight, risk, and classic signs of psychosis or mania (fixed false beliefs, hallucinations beyond the practice context, pressured speech, reduced need for sleep); (4) consider medical causes; (5) if in doubt, arrange psychiatric assessment while respecting the spiritual meaning; (6) with consent, coordinate with the teacher. [synthesis]
  • Example language (illustrative): "I want to understand this both as it matters in your practice and in terms of your health. Can you tell me how your sleep and daily life have been?"
  • Watch for: rapid deterioration; the client stopping sleep or food. [synthesis]

24. Scrupulosity and moral self-accounting

  • Purpose: Beginning Anew (regrets), training recitation and Earth Touching repentance involve moral self-review, which can feed scrupulosity in vulnerable clients. [synthesis]
  • Steps: (1) look for repeated confession or apology, reassurance seeking, fear of having broken a training, need to recite perfectly; (2) treat with ERP adapted to the tradition, ideally after consultation with the client's teacher about what the tradition actually asks (for example that the trainings are not "hard and fast rules") [source for that framing: Five Mindfulness Trainings]; exposure only with consent, graded and with a clear rationale; (3) the International OCD Foundation describes scrupulosity and its treatment [uncertain: not verified]. [synthesis]
  • Example language (illustrative): "Your teacher has said the trainings are a direction, not a test. What would it be like to let a small imperfection stand?"
  • Watch for: ERP being experienced as asking the client to sin; involve the teacher. [synthesis]

25. Role boundaries and ethics

  • Purpose: keeping the therapist out of the teacher role. [synthesis]
  • Steps: do not lead ceremonies, transmit trainings, give Dharma talks or act as a client's spiritual guide; avoid treating members of your own sangha; disclose your own practice only for the client's benefit; follow your professional ethics code on competence, multiple relationships and respect for religious diversity; seek consultation when out of your depth. [synthesis]
  • Example language (illustrative): "I'm glad to work with your practice, but I'm not a Dharma teacher, and I'd like you to keep your teacher for that."
  • Watch for: the client idealising you as a teacher; your own beliefs (for or against Buddhism) colouring the work. [synthesis]

5. Handling problems

The tradition's own sources speak to a few of these (rest, blame, anger); the rest is clinical synthesis and is marked so.

  • Stuck or flat practice. The tradition says practice should energise, not tire, and that rest is practice. [source: EIAB] Reduce effort, return to enjoyable forms (walking outdoors, tea, eating together), reconnect with the sangha. If flatness persists, assess for depression, and for loss of emotion as a possible meditation-related effect. [synthesis; Brown 2017 for loss of emotion]
  • Striving and perfectionism ("I'm bad at mindfulness"). Use the tradition's own framing: form matters less than presence; the trainings are a path, not hard and fast rules. [source: EIAB; Five Mindfulness Trainings] Shorten practice and praise any single mindful breath. [synthesis]
  • Resistance to practice in therapy. Respect it; the client may want practice kept separate, may be in a phase of doubt, or may have had a painful sangha experience. Keep practice out unless invited. [synthesis]
  • Non-adherence to home practice. Link practice to existing acts (bell cues, gathas for daily acts, working meditation) rather than adding long sittings; agree small, specific steps. [source for daily-life practice: EIAB; plan: synthesis]
  • Overwhelm during or after practice. Stop; open eyes; orient to the room; walk; name five things seen; slow, natural breathing without forcing; regular meals, sleep and contact. Reduce or pause formal practice and review at the next session; if symptoms persist or include psychosis, mania or risk, refer urgently. [synthesis, informed by Lindahl et al. 2017 via Brown 2017]
  • Bypassing difficult emotions (using "letting go" or interbeing ideas to avoid anger, grief or conflict). Draw on the tradition's own image of holding anger to understand it, not to bury it. [source: EIAB] Name the pattern gently and work with the emotion directly. [synthesis]
  • Forgiveness and reconciliation pressure. Compassion for those who caused hurt is taught as something that may take time. [source: Plum Village App] The therapist makes clear that safety comes first; Beginning Anew and hugging are never required with an abuser; joint formats are unsuitable where there is violence or coercive control. [synthesis]
  • Blame in Beginning Anew. Laity names blame as a major risk and advises listening rather than replying. [source: Laity 1992] In family or couple sessions, slow the pace, return to flower watering, and reframe accusations as "I" statements; stop if escalation continues. [synthesis]
  • Ruptures over religion. If the client feels you are either dismissing or appropriating their tradition, acknowledge it, ask what was hurtful, and re-agree how practice enters therapy. [synthesis]
  • Grief and intergenerational trauma surfacing in Touching the Earth. Slow down; allow the client to adapt or skip a theme in consultation with their teacher; process the material in therapy. [synthesis]
  • Retreat plans during instability. Discuss postponing intensive or silent retreats until stable; if the client goes, plan supports, tell the retreat team, and schedule a session soon after return, when problems may first show. [synthesis; the post-retreat impairment pattern is reported by Brown 2017]
  • Teacher relationship and power. The relationship with the teacher is one of the factors that can shape meditation difficulties. [source: Brown 2017; Britton lab] Explore the client's relationship with teachers and community; signs of coercive control in any group include isolation from family, financial or sexual exploitation, punishment for questioning, and pressure to keep secrets. No independent investigation of Plum Village teachers is covered here. If a client discloses abuse by any teacher, follow safeguarding and reporting duties, believe and support the client, and do not name others. [synthesis]
  • Leaving a sangha or the Order. Treat as a loss of community and identity; explore grief, guilt about the trainings, and any religious trauma, without judging either staying or leaving. [synthesis]
  • Children. Plum Village family practice includes children (for example in family Beginning Anew, where children follow adult example). [source: Laity 1992] Children's participation should be voluntary, age-appropriate and never coerced; usual safeguarding duties apply; children's assent and parents' consent are both needed for anything in therapy. [synthesis]
  • Health questions. Questions about diet, sleep, medicines or physical illness go to the client's doctor; therapists do not advise on medicines. Plum Village practice is not a treatment for physical disease. [synthesis]
  • Language and culture. Vietnamese-speaking clients may practise with Vietnamese terms (thiền hành, pháp đàm, chuông, Năm Giới). [source: Online Monastery course page] Use interpreters who are not family members, and learn the client's own terms. [synthesis]

Sources

Web sources:

Books and papers cited:

  • Thich Nhat Hanh (1998). Teachings on Love. Parallax Press (Beginning Anew chapter, as reprinted by Lion's Roar).
  • Lindahl, J. R., et al. (2017). The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists. PLOS ONE, 12(5).

Also cited [uncertain: not verified]: Farias et al. (2020), systematic review of adverse effects of meditation, Acta Psychiatrica Scandinavica; Treleaven, D. (2018), Trauma-Sensitive Mindfulness; Vieten et al. (2013), spiritual and religious competencies for psychologists; DSM-5-TR Cultural Formulation Interview and "Religious or Spiritual Problem"; International OCD Foundation material on scrupulosity; the Fourteen Mindfulness Trainings text (plumvillage.org); Plum Village Wake Up Schools; APA Ethical Principles of Psychologists and Code of Conduct.

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