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Mindfulness - a bridge between paradigms
Mindfulness – A Bridge Between Paradigms – Destination Wise Mind
The first version of this article was published in the Spring 1998 edition of "Ordinary Mind" as “No Paradigm – Buddhism & Psychotherapy” This is a quarterly magazine published by the E-Vam institute in Melbourne. http://www.evaminstitute.org.au This was about 5 years before the flood of western mindfulness literature began. It is interesting for me to read it now as it is a reflection of the insights I had before being informed by the Western literature.
In this article I would like to share two of the main ways Mindfulness and Buddhist psychology has affected my professional practice. The first is the ability that Buddhist psychology has given me to jump from one psychological paradigm to another i.e. from psychoanalytical to Jungian to cognitive-behavioural to family therapies etc. Secondly, Buddhist psychology has given me a method to remain truly present with my clients. This in fact has put me in the happy position where the larger part of my day to day work has become a conscious part of my mindfulness practice.
In regard to the first point you are probably aware that Western Psychology consists of a multiplicity of competing paradigms. The extreme adherents of each of these paradigms can be just as frightening in their fundamentalism as any fundamentalist religious fanatic. Even among the more reasonable adherents the sense of righteousness can be somewhat overwhelming. They forget that a paradigm is just a way of making sense of events, not the events themselves. The map indeed is not the territory.
Fortunately, especially over the last 20 years, the different paradigms have become quite a bit more tolerant of each other. It has become more acceptable for therapists to describe themselves as "eclectic" i.e. therapists who mix and match from different paradigms. This allows us to be more flexible and open. Some therapists even describe their theoretical disposition as “integrational”. These therapists try to integrate different paradigms into a cohesive whole. This of course becomes another paradigm.
One of the oldest and most intense paradigm conflicts in Western Psychology is that between the psychoanalytic and cognitive-behavioural approaches. One of the central issues in this conflict has been the relationship between thoughts and emotional states. While both paradigms agreed that neurosis can largely be accounted for by habitual patterns of thoughts and feelings, there was a raging debate between the two as to which is primary.
Psychoanalytic schools regard emotions as largely being primary. According to psychoanalytic theory our thinking processes are often nothing more than a distorted attempt to keep unpleasant feelings and impulses out of conscious awareness. For instance, a person who can't tolerate the experience of their own anger might project the image of their own anger onto someone else. This would then lead to the erroneous thought "That person is angry with me."
On the other hand Cognitive-Behavioural schools traditionally maintained that our thinking processes filter our perceptions. Therefore these thinking processes affect the emotional responses that we have to our perceptions. For example, if I find my back door open when I return to my house I may have the thought "I can be so absent minded. I must be careful not to leave the door unlocked when I go out." Alternatively, I could think "Oh my god! The door is opened. I must have been robbed." Clearly these differently interpretations of the same event will lead to quite distinct emotional responses.
These two paradigms have lead to quite different approaches to therapy, as well as causing the ongoing and often-heated debate about which comes first. This debate is now beginning to be resolved by both sides agreeing that emotions and thoughts both affect each other.
Emotions beget thoughts
Rage on a Screen, Poetry, Art Music
Thoughts beget emotions
Poor Descartes better not meditate or he might cease to exist
The frog jumps into the pond - Plop!
Ripples disappear [i]
Interestingly, both schools rely on a heightened awareness of internal processes in order for their therapies to work. As a result of this point, some adherents of both schools have turned to Buddhist awareness practices (i.e. meditation) to enhance their therapy (Linehan M. 1993 [ii], Epstein M. 1995 [iii]). So far the interventionist quality of Western Psychology (and for that matter western culture as a whole) has made it very difficult for these schools to perceive the healing potential of awareness alone.
In the 1980’s and 90’s the Buddhist paradigm gave me a way of dealing with this quandary. Buddhist psychology emphasizes the concept of impermanence, which of course applies as much to our emotional states as anything else. In Buddhist practice we validate this through mindful experience. Once we can sit quietly with thoughts and feelings, without entering into a struggle with ourselves they run their course. A neurosis can even be self-liberating when dealt with in this way. I found this attitude could easily be brought into therapy sessions without formally teaching meditation or laying any Buddhist trips on my clients. It is even easier now that mindfulness has become an acceptable technique in western psychology and now that there is quite a lot of scientific evidence that validates its efficacy.
In the 80’s and 90’s I was left with a paradigm, was very useful in day to day therapy, but nonetheless left me isolated from my professional peers. I still had exams to pass and quoting Buddhist canons or expounding the value of the meditative approach was not going to get me through. I had to learn to explain my work in more conventional ways. Sometimes I had to accept that I couldn't explain it simply because the recipient was not capable of hearing the explanation. On those occasions it was simpler to say nothing. Fortunately since then a veritable library of western scientific mindful literature has appeared. I can now communicate much more easily with my professional peers.
Interestingly the tension of the debate regarding primacy of thoughts over feelings is reflected in pop psychology. People who are more attached to their emotions are more likely to come up with statements like "You can't bottle your feelings up inside of you. You have to get it out. Otherwise it'll just make you sick. It could even give you a heart attack." These people believe that expression is the way to deal with unpleasant feelings. Of course this approach can be very helpful at times. It validates people’s emotional experience. This is especially helpful when it happens in the presence of another person who can both validate and tolerate the others experience. When this happens in therapy it is called validation or mirroring and holding.
For example, a good cry can both relieve tension and be a valid communication of distress. In therapy, expression of emotion verbally, physically or through artistic media can help dramatically by allowing previously repressed thoughts and feelings to enter awareness. Once repressed material comes into awareness it can be dealt with. For example, a man may have an aggressive attitude toward women in general because of a repressed anger toward his own mother. When this repressed anger is brought into awareness his attitude towards women is likely to improve and he has the possibility of dealing with his feelings towards his mother in a positive way.
However, this approach of solving emotional problems can be problematic. If, for example, we were very busy expressing upset feelings at the scene of a car crash, we may not be able to take skilful action to rescue someone from a burning wreck. Similarly a scared wife whose husband is angrily punching holes in walls may have problems with him expressing his emotions in that way. Most psychotherapists will have come across clients who express massive amounts of emotion without making progress. So this approach is clearly limited.
Alternatively, people who have a predominantly aversive approach to these feeling states will make statements like "You have to put those feelings out of your mind and get on with your life." A sneakier version of this aversion expressed in Buddhist jargon may be "It is all just illusion anyway. Don't indulge in negative feeling states. Instead dwell in equanimity."
Whilst this approach can be very useful in emergency situations its limitations become very obvious in grief. This approach can become the psychological equivalent of samadhi[iv] death. This is a state that a meditator that is calm but foggy and unaware. A meditator in this state can easily delude him/herself that they are in a state of high realisation. In fact it is a state of disconnected ignorance of one's own mental processes. So a grieving person using this approach can rationalise away their pain at the cost of becoming emotionally numb. This is ultimately a very uncompassionate thing to do to ourselves as it robs us of our spontaneity and our ability to relate empathetically to other people's pain. It also ultimately robs us of true mental clarity.
Clearly then mindfulness offers us another alternative apart from expression or repression of unpleasant feelings. That alternative is a space of non-judgemental awareness. Within this space we can learn to watch these mind-body events rise and fall without identifying with them. We can then see they are not solid. Indeed they are impermanent. We can also see that despite this, we often get ourselves into trouble by acting as if they were permanent. I found when I really experienced this insight in the very marrow of my bones (as opposed to just intellectually understanding this concept) that it was incredibly liberating.
After I passed my specialist psychiatry exams, I read Traleg Rinpoche's "Meditation through the Three Yanas" In that discourse I discovered the concept of "conceptual paraphernalia". As I understand it, these are the conceptual filters through which we interpret our experiences. This was a very useful concept for me. I could suddenly see that even Buddhist writings were nothing more than conceptual paraphernalia. The word "paraphernalia" seemed to have its own special humour, as if it were laughing at me like some wise old Tibetan Geshe, who is amused at the absurdity of clinging. All of a sudden I was able to relieve myself from any need to be loyal to any particular psychological conceptual framework, including my own homespun one. I felt as if I could leap from one paradigm to another with the freedom of a Dakini[v] sky dancer.
This leads to the second way Buddhist psychology affected my professional practice that I wish to discuss in this article. This freedom to move easily between paradigms meant I developed a veritable armamentarium of therapeutic approaches and techniques. I was free to mix and match as I pleased. For those who are interested other writers have begun to explore how to decide what therapy to use in what situation (Wilber K. 1991[vi]).
Despite being loaded up with so many tricks I would still get stuck with some clients. Sometimes I can accept this. Other times it is extremely painful. An example is when a client is relentlessly feeding their own neurosis and subjecting me to a tirade of a much distorted worldview. On several occasions when this happened I gave up trying to help the client and simply concentrated on my breathing and my internal body sensations in a meditative way. At the same time I would stay mindfully present to my client and his feelings, even though I didn't have a clue what to do or say. Sometimes I could feel enormous pain coming from the client. Sometimes I would resort to saying a mantra under my breath. All of these manoeuvres were driven by pure desperation on my part.
Much to my surprise I discovered that out of giving up the struggle to fix things that the solution would occur by itself. Somehow the client would do something different. What that something different might be, would be unpredictable. One client stopped precipitously as if he heard his own neurosis raging meaninglessly in the midst of a vast void, and began to quietly sob. Another gradually moved out of circular thinking that consisted mostly of blaming others for her problems into a practical problem-solving mode.
"What a wonderful discovery!" I thought. "All I have to do is let go of the desire to control when I feel stuck and the solution will appear magically." - The creative guile of the ego[vii] is a wonderful thing! Of course as soon as I deliberately tried to reproduce the above situations, the magic didn't happen. I was no longer desperate and the whole exercise was now in the service of the glorification of the ego. Here was an unpredictable phenomenon over which I had no control and was therefore threatening to my ego. So I attempted to control it and make it part of myself.
The magic would still happen occasionally, when I had given up. My ego, being extremely devious then calculated "All I have to do is give up and the magic will happen." This of course is an impossible situation. Giving up in order to get the magic is not really giving up. It is like a thief dressing up in monk's clothes. The ego's ingenuity deserves deep respect.
However, my folly was not complete. I continued to adopt a meditative approach to my therapy in general. I'm not sure why I did that. I didn't think about it much. It just felt right; probably because I had been doing sitting meditation for years and because these situations born out of desperation showed me it was possible. At least this meditative approach has allowed me to be much more aware of events occurring in the therapeutic relationship. This includes being more aware of the client's words, non-verbal communications and feelings, as well as my own internal processes. In short I now feel much more present in my therapy.
One of my supervisors said to me once that while giving therapy we should always be making hypotheses and asking ourselves questions during the sessions. I now believe it is much saner and much more useful to quieten the mind and sharpen the awareness. With that quieter mind it is even possible for me to see agitation or cloudiness when they arise in my mind. Closer observation can then reveal what precipitated these mind states. This has proved very useful in removing confusion from the therapeutic relationship.
Like a tiger wandering in the forest
The Siddha hunts his prey
Jumping from under the lotus flowers
He ambushes the deer
Dead Meat he eats voraciously
Suddenly no meat, no deer, no lotus flowers, no forest, no tiger, no siddha [viii]
Of course my ego has not given up on its amusing tricks! In regard to these issues its voice has become subtler. Most recently I have noticed that in the moment of giving up that the ego will suddenly appear saying, "Look closely. There's going to be some magic now." Of course it never happens then. It still happens when I don't expect it, sometimes when I haven't even given up. Somehow now it seems more normal and less magical as I get used to it.
As I reflect on the writing of this article, I realise this experience is not so new to me. I often find it occurring in a less intense way in my day to day life, as meditation in action. Moreover, I have spontaneously resorted to the same approach throughout the years of my psychiatry training. The difference was that during those years it was psychotic patients that elicited the meditative response. Their craziness would fling me very directly into that meditative space. I was tempted to attribute this response to confusion or fear. That would make a lot of sense. However, it felt much more direct than that. I didn't feel much confusion and I certainly didn't feel much fear except when someone was being physically threatening, I think it was actually love, but that's another story.
i] René Descartes (1596-1650) is often regarded as the father of modern western philosophy. He is famous for saying "I think therefore I am" which indicates he took his own thought processes as ultimate proof of his own existence
[ii] Marsha Linehan (1993) Cognitive-Behavioural Treatment of Borderline Personality Disorder Guilford Press New York, ISBN 0-89862-183-6
Professor Linehan has developed a cognitive-behavioural approach to treating a condition that is so difficult that many clinicians will simply refuse to treat people with this condition. Her book is written in a very compassionate manner and is quite overt in acknowledging the influence of Zen Buddhism on her treatment methods.
[iii] Mark Epstein (1995) Thoughts Without a Thinker Harper Collins ISBN 0-465-08595-7
This is an account of the integration of psychoanalytic and Buddhist perspectives
[iv] Samadhi is a state of meditation where the distinction between subject and object disappears
[v] A Dakini is literally "She who moves through space" or "She who enjoys the expanse of emptiness". Dakinis are the feminine energy principle, associated with knowledge and intelligence, which can be either destructive or creative. They are clearly both beautiful and wrathful.
[vi] Ken Wilber (1991) Grace and Grit Collins Dove, ISBN 1-96371-413-8
Chapter 11:Psychotherapy and Spirituality pp173-202
[vii] This article uses the word “ego” a lot. This word deserves some explanation because in Buddhist psychology it doesn’t mean what Freud meant by it, nor does it mean what is meant in popular culture. In Buddhist psychology “ego” means an unchanging view of your own self identity which needs to be preserved and defended.
So if you conceive of yourself as being a nice person then you may do all sorts of mental gymnastics to preserve that concept of yourself including lying to yourself about your own behavior or acting in a way that is really unhelpful because you are trying so hard to be nice. Attachment to this permanent sense of the self called the ego also results in a striving for certainty. When certainty is not possible we come to premature conclusions because we can tolerate the uncertainty. This of course leads to unskillful behavior. This idea of ego shouldn’t be confused with a sense of self as some sort of coherent identity. We need that. People who don’t have it generally function very poorly, struggling with a chronic sense of emptiness and alienation
[viii] A Siddha is a highly evolved spiritual practitioner, who traditionally lives in the forests outside of the monastic systems. They often superficially appear crazy. They have been responsible for maintaining the transmission of Buddhist practices and understandings, especially during periods when the monastic system has become corrupt.