Theoretical Integration of Mindfulness and Psychoanalysis: Perspectives and Clinical Implica-tions

Ding-Zhong Huang

School of Health Sciences, Universiti Sains Malaysia Health Campus, 16150, Kota Bharu, Kelantan, Malaysia

Rohani Ismail

School of Health Sciences, Universiti Sains Malaysia Health Campus, 16150, Kota Bharu, Kelantan, Malaysia

Affizal Ahmad

School of Health Sciences, Universiti Sains Malaysia Health Campus, 16150, Kota Bharu, Kelantan, Malaysia

Kar Kheng Yeoh

School of Chemical Sciences, Universiti Sains Malaysia, 11800 Ge-lugor, Penang, Malaysia

Abstract

Conventional mindfulness protocols may prove inadequate for individuals with histories of trauma, developmental disruptions, or cultural backgrounds in which the language and framework of Western mindfulness are not meaningful. Psychodynamic concepts present valuable resources for enriching mindfulness practice while preserving its conceptual coherence and authenticity. This systematic review explores the potential of psychodynamic concepts to enhance mindfulness practice in the context of complex clinical presentations, culminating in the development of an innovative framework—the Mindfulness-Centred Psychodynamic Integration (MCPI) model. A systematic review was undertaken by searching the PsycINFO, Web of Science, and PubMed databases for articles published between 1990 and 2024, employing search terms such as "mindfulness AND psychoanalysis," "mindfulness AND psychodynamic," and "meditation AND unconscious processes." Out of the 273 articles initially identified, 60 fulfilled the inclusion criteria, concentrating on adaptations and applications of mindfulness for complex clinical presentations. The analysis revealed four domains in which psychodynamic concepts can enrich mindfulness practice: (1) attentional flexibility; (2) developmental approaches to self-observation; (3) transforming one's relationship to suffering; and (4) therapeutic presence. Additionally, four areas for potential expansion were identified: temporal integration, the balance between experiential and conceptual understanding, developmental approaches to self-experience, and adaptable intervention strategies. Furthermore, five enhancement frameworks emerged from the literature, which informed the formulation of the proposed MCPI model. The MCPI framework retains mindfulness practices as the core therapeutic component while strategically integrating psychodynamic concepts to deepen practice and enhance its efficacy. This approach holds value for complex clinical presentations in which conventional mindfulness protocols may prove inadequate. Future research should empirically assess these enriched mindfulness practices, establish training protocols for mindfulness instructors, and investigate cultural adaptations across varied populations.

Mindfulness, Complex Presentations, Culturally Adapted Mindfulness, MCPI Framework, Developmental Approaches