Reality Attunement Therapy: An Innovative Blend of Buddhist Psychology, Gestalt, and Existential Approaches


Reality Attunement Therapy (RAT) represents a novel approach to psychotherapy, synthesizing key elements from Buddhist psychology, Gestalt therapy, and existential approaches. At its core, RAT seeks to foster deep attunement to the reality of one’s present moment experience, advocating for awareness, acceptance, and authenticity. These principles promote mental wellbeing, guide individuals towards self-discovery, and provide tools to face the existential dilemmas that life presents.

Overview of Influences

Before delving into the specifics of RAT, it’s worth outlining the key influences from its three root disciplines.

Buddhist psychology provides a practical framework to understand the nature of suffering and its cessation. It emphasizes mindfulness, compassion, impermanence, non-self, and the interdependence of all phenomena. Central to its philosophy is the Four Noble Truths, which state that suffering exists, it has a cause, it has an end, and there is a path leading to its cessation.

Gestalt therapy focuses on the individual’s experience in the present moment, the therapist-client relationship, the environmental and social contexts in which these occur, and the self-regulating adjustments people make as a result of the overall situation. It emphasizes direct experience, personal responsibility, and the power of the ‘here and now.’

Existential therapy concentrates on free will, self-determination, and the search for meaning, emphasizing personal responsibility for one’s existence. This approach confronts the four ‘givens’ of existence – death, freedom, isolation, and meaninglessness – and encourages a life lived with authenticity and intentionality.

Principals of Reality Attunement Therapy

  1. Mindfulness and Presence: Borrowing heavily from Buddhist psychology, RAT prioritizes mindfulness as a pathway to attunement with reality. Therapists teach clients to observe their thoughts, feelings, and sensations without judgment or avoidance. This non-reactive awareness of the present moment allows individuals to see reality more clearly and accurately, unclouded by anxieties about the future or ruminations on the past.
  2. Authenticity and Personal Responsibility: Influenced by both Gestalt and existential therapy, RAT encourages clients to take ownership of their actions, feelings, and experiences. Therapists guide individuals towards living in alignment with their true selves, challenging them to accept personal responsibility for their lives and to make choices that are congruent with their values and desires.
  3. Acceptance of Life’s ‘Givens’: Existential underpinnings are evident in the RAT’s focus on the realities of existence. This includes acknowledging and confronting the inevitability of death, the reality of freedom and its accompanying responsibility, existential isolation, and the challenge of meaning-making. By coming to terms with these fundamental aspects of life, clients can experience a profound shift in their perspective, allowing them to live with greater authenticity and purpose.
  4. Compassionate Engagement: Drawing on Buddhist psychology’s emphasis on compassion, RAT promotes an attitude of kindness towards oneself and others. Clients learn to reduce self-judgment and cultivate compassion, enhancing their capacity to engage with life’s challenges in a healthier, more balanced way.

Therapeutic Process

The therapeutic process in RAT is characterized by a supportive, empathetic relationship between the therapist and client. In line with the Gestalt approach, the therapist actively engages with the client, focusing on the ‘here and now’ to increase awareness and understanding of their immediate thoughts, feelings, and behaviors.

Therapists using RAT leverage mindfulness exercises to ground clients in the present moment and help them gain insights into their internal processes. Dialogues may touch upon existential concerns

to help clients navigate life’s ‘givens,’ fostering courage, resilience, and personal growth.

Mindfulness techniques, meditation practices, guided self-reflection, and experiential exercises are all crucial components of the RAT process. The goal is to cultivate a deep, nonjudgmental awareness of the self and the world, fostering a sense of interconnection and alleviating the distress caused by the denial of existential realities.


Reality Attunement Therapy presents a unique blend of Buddhist psychology, Gestalt therapy, and existential approaches. By fostering mindfulness, encouraging authenticity, and grappling with life’s ‘givens,’ RAT offers individuals a profound avenue for personal growth and self-discovery. As a therapeutic approach, it provides a nuanced framework for understanding human suffering and offers practical tools to navigate life with greater resilience, compassion, and authenticity.

The Introduction of Meditation Into Reality Attunement Therapy

Individuals seek out psychotherapy often presenting with concerns that commonly include anxiety, depression, and/or a general lack of clarity in the past unfolding and future direction of their lives. In addition to the forging of the essential therapeutic alliance between client and therapist, the initial phase of reality Attunement Therapy strives to unearth layers of conditioned thinking and habitual ways of relating to one’s experience that may be producing experiential disconnect. This disconnect is often identified as a precursor of client’s presenting concerns.

Mindfulness exercises and/or formal meditation practice is introduced in the second phase of Reality Attunement Therapy as an integral means of uncovering and acknowledging layers of conditioned thought and recurrent, habitual reactions to historical experience. It is often only through a deepened connection with our underlying somatic experience that one begins to more clearly identify the roots of long-term suffering. Meditation facilitates this connection by creating essential space between one’s experience and cerebral interpretations or judgments about this experience. Until one is able to create this space, his or her “reality” will remain dictated by these thoughts and judgments; we essentially mistake what we think for reality.

Thus the second phase of Reality Attunement Therapy often includes in-session guided meditation. I work with clients to address common misperceptions about meditation practice. For example, while it is true that meditation can reduce somatic reactions to stress, the aim of meditation within the context of Reality Attunement goes further in cultivating the aforementioned space between thought and experiential reality. In this phase, we work collaboratively to create a commitment plan for meditation practice between sessions. Execution of this plan will help the client reverse the tide of conditioned thinking and judgment. In the absence of regular practice, clients are soon likely to gravitate back toward the familiarity of thought-driven reality, and remain mired in suffering occasioned by experiential disconnect.

Reality Attunement Therapy Explained

If you have spent time either studying psychology and/or researching therapists, it has probably become apparent that there are many therapeutic approaches adopted by therapists for decades. These theories include cognitive-behavioral, existential, Gestalt, dialectical behavior therapy, etc. At the core of each theory is a goal of heightening one’s alignment with the momentary, experiential unfolding of life or the “true” nature of things. When I refer to “truth” I refer not to an objective, scientifically verifiable truth, but rather to a reality found in a felt, experiential sense beyond thought-driven notions about this experience.

The “truth” that each of us strives to realize equates to what is commonly referred to as “reality.” Most psychological or existential suffering follows from an internalized, usually unconscious, rejection or denial of the true nature of things. This “rejection” often manifests in the form of delusional thinking such as if only certain external outcomes would materialize, then I will reach a state that I conceive of as “happiness.”

Such thinking gives rise to strategies and defenses often resulting from early childhood interactions with primary caretaker(s) that led to an internalized notion that the world is unsafe/threatening to one’s survival. This underlying fear then leads one to reject or distort his or her experience, avoid situations that he or she might consider potentially threatening, or seek artificial means of mood elevation that chemically approximate the illusion that everything is good.

As one proceeds into and through adulthood relying on these increasingly entrenched strategies and defenses, life becomes increasingly narrow, limited, isolated and precarious. Many people then try to find happiness or contentment by changing partners, employment, geographical location, etc. Ultimately such changes lead to disappointment as they are inherently unsatisfying. As these disappointments grow, unhappiness mounts.

It is at this point that many adults will initially seek out psychotherapy. My Reality Attunement Therapy works to help clients heighten their awareness of such outmoded strategies and defenses. It is this awareness that facilitates conscious processing, and it is such processing that can ultimately allow one to transcend their maladaptive approaches to experience. Clients become increasingly attuned to reality.

Reality Attunement Therapy may draw on other more “classic” theories of therapeutic change. For example, a cognitive approach is often instrumental in helping clients effectively challenge entrenched beliefs about the ways in which external circumstances must manifest in order to become “happy.” An existential approach may be employed to help clients effectively face basic questions surrounding existence and death ultimately heightening a client’s realization that these fundamental realities of life need not be experientially crippling.

For a free initial consultation to learn more about Reality Attunement Therapy, contact Mike Lubofsky, J.D., M.A. at (415) 508-6263 or visit Mike is a psychotherapist based in Oakland, California and also offers psychotherapy online at