Introduction
I would like to start today by thinking about something that touches us all - the issue of suffering and how we can find a meaningful way to understand it and find healing. The sixth century Buddhist saint, Shantideva gives us a prayer for this aspiration that many today still find powerful.
May I know happiness and the roots of happiness
May I be free of suffering and the roots of suffering
May all being know happiness and the roots of happiness
May all beings be free of suffering and the roots of suffering
Suffering
Psychotherapy and Buddhism both start from the point of suffering.
Each of us first becomes conscious of our suffering in different ways.
Soon after I started my first analysis I painted a triptych of three selves that I had become particularly aware of. The first I painted naturalistically - an image of myself as others saw me - a young man at that time. The second I painted in reds, oranges and browns. A devilish man with little horns and a wicked glint in his eyes. A self I knew quite well. However the last was unfamiliar and very painful to admit. In dull blues and greys a third man emerged, small, crushed and very sad. He was the pain I had only just realised was inside of me. An image of my own unacknowledged suffering.
This should not have been a surprise. Two and a half thousand years ago the Buddha tells a story about a woman who has just lost her child coming to him for solace. He asks her to collect a mustard seed from each of the houses in her village that have not experienced a bereavement and then return to him. When she returns she arrives empty handed. The Buddha, an expert on suffering, knew that her experience was universal - not one of us escapes the suffering of loss.
As counsellors and psychotherapists we too have people who bring their suffering to us in the hope that we can find a way to help them be with it. If I think about my own clinical practice I have those who bring the experiences of:
- being valueless
- being invisible and being lost within an imaginal world
- being with an absence of feeling being expected to be clever
- being with abusive alcoholic and violent parents
- being with self destructive unexpressed rage
- being the renegade child
- being the victim of long term sexual abuse
- being made always wrong and humiliated
- being crushed being mummies girl and daddies failure
- being abandoned being terrified of emotional vulnerability
- being stiff upper lipped
- being ignored, emotionally undernourished and shamed
- being the survivor of a family decimated by illness
- being in fear of fathers unpredictable depressions
- being special
- being annihilated by ones own goodness
The Buddha before he became enlightened, as the Prince Siddartha, also had his wake up experience when he first became conscious of suffering. Discovering his pleasures were only distractions he went out onto the streets and saw illness, old age and something now mostly hid from us - death. This deeply shocked him - if this happened to other people it would surely happen to him also. He too could know insecurity, being sick, being infirmed and dying.
The Buddha’s response was to go towards the experience and try to understand it by examining exactly where suffering came from. He identified suffering arising from four sources. The first is the biological aspects of being alive: birth, aging, sickness and death. The second is the emotional pain that comes from the ups and downs of life - emotional experience that can be on a scale between uncomfortable to deeply traumatising. The third is about desire - the truth that we can not control getting what we want or don’t want. And the last reaches down into the roots of suffering and sees that in a constantly changing and shifting world any grasping at anything will always bring dissatisfaction, loss and frustration.
The Buddha took these observations and spoke of different types of suffering. The first he called the suffering of suffering. By this he meant the obvious suffering that arises from the many sources of suffering that our lives provide. The biological and psychological sources we have just listed. The second he called the suffering of change. The experience of life as a sequence of separations. Separations that are often welcomed and valued but which when they come unbidden can be unbearably painful and distressing. The last he called the suffering of conditioned existence. This one is both the most profound and also easily missed. Freud may have put his finger on it when he said that the ego is the seat of anxiety. That there is something just about being a person that creates a deep uneasiness and uncertainty. We could also see this as the suffering that arises from not knowing who we are.
The Buddha’s word which we translate here as suffering is dukkha. However, as we have seen dukkha covers a broad range of unhappy emotional experiences. These range from an all pervasive unsatisfactoriness about everything, the feeling that nothing is quite right even if it is superficially OK, to experiences of deep despair, emotional anguish, to the rubbing uneasiness that there is something more, an unanswered spiritual hunger. This last can also build into yet another category of suffering, the awareness of the suffering of others.
This makes me think of C. G. Jung who said that he had found that in a long analysis the suffering of the broader world came to replace the suffering of the individual. That after we had gone through our own pain, the pain of the world and how to be with that moved to the fore front. Pema Chodron, a wonderfully compassionate American Buddhist nun says much the same thing. That as we open our hearts we begin to feel the pain of the world around us. A pain which if anything is more difficult than our own because it seems there is nothing we can do to really help it.
I think many of us will have felt this - it is hard not to when we have daily news updates on the unimaginable suffering others feel around us. Even as I write this I am aware that a ten hour flight arriving in Burma would put me amongst people who have experienced grandparents, mothers and fathers, aunts and uncles, brothers and sisters, cousins, friends, children and tiny babies all being swept away and killed in their tens of thousands. Millions of people all simultaneously violently bereaved, family, home, occupation all suddenly destroyed. Did I read on the internet that their plight was now like a thousand people all marooned on an island in the sea with only one bottle of water amongst them? And likewise South West China and its earth quakes with over 80,000 dead. I find myself having the horrible fantasy of what it must be like to be partially crushed within a collapsed building knowing there is no hope of escape. In the face of such suffering I observe myself escaping defensively into anger and outrage at the lack of care I feel others express, finding in this, my own suffering, a defensive refuge from the suffering of others.
The Buddha as health professional
Some of us may find all this talk on suffering a source of suffering itself. That it is frightening and depressing to focus on what hurts us and others.
The Buddha was also criticised for this. His answer to this criticism - and we as counsellors and psychotherapists may borrow it - was to describe three types of doctors. The first is a reckless optimist. Called to the patient he declares there is nothing wrong. The second is a defeated pessimist. Called to the patient he says the patient is indeed ill but there is nothing that may be done. The third is a realist. Called to the patient he sees there is a problem but he also can see its cause, knows it cure and the medicine it will take to bring the cure about.
This cause, cure and medicine is what we shall next look at. Do not despair, there is hope!
The cause
The Buddha’s diagnosis for the cause of suffering is what he calls ‘craving’ - tanha.
Craving here means the experience of being driven by demanding desires and instincts which are always striving for gratification but which, on achieving gratification, need it again. We can never be lastingly satisfied. This causes suffering in three ways: Firstly lasting fulfillment is frustrated by a transitory world. Secondly craving causes us to commit actions and inhabit belief systems that simply perpetuate our own and others suffering. And lastly craving leads to conflicts within us, with others, and between groups. It is the source of all wars.
In his first teaching the Buddha identified three different types of craving. The craving for sensual pleasures. The craving for existence. The craving for nonexistence.
The first, craving for sensual pleasures, is clear - particularly when displayed as some form of addiction. Then its nature is fully revealed - a nightmarish compulsion that recreates itself without hope of full or lasting satisfaction. Thinking about this I am reminded of Freud’s rather bleak belief that there is something inside of each of us that he called the ‘it’, that is an insatiable appetite that simply wants what it wants. An unreflective mouth that gobbles everything up yet never knows enough. That experience of wandering around our house wanting something without knowing what. Turning on the TV when there is nothing on, looking in the fridge when it is empty.
The second and third, craving existence and nonexistence, represent existential crises which psychoanalysis has come to recognise as narcissism - a pandemic psychological disorder in our western world. Narcissism is the hurt we feel when we don’t know who we are.
The beautiful young man Narcissus lends his name to the disorder. In the Greek myth the nymph Echo dies from the grief of unrequited love because Narcissus can not love anyone but himself. The god Nemesis, as a punishment for this, causes Narcissus to fall in love with his own beautiful image reflected in a pool. At the waters edge, captivated by his own face he remains trapped until he too pines away and dies.
The wound of narcissism is a loveless, cold and barren place that constantly demands others and the world around us to reconfirm that we are of value and worth. But underneath what may be a highly successful mask in the world and a striving, pleasing persona is a desperately impoverished sense of self that feels depressed, worthless and inferior. It craves existence while real affection and attachment to another is alien and absent. Acknowledging the real emotions behind the mask is extraordinarily painful because it feels shameful and vulnerable, two emotions that the rather grandiose persona of the narcissistic wound can not tolerate.
Carl had been interested in spirituality since his early teens. He had read many books about meditation and transpersonal psychology. He also took lots of hallucinogenic drugs and believed that the states of non ordinary consciousness he had read about he had experientially achieved. Now, inhabiting what he believed to be an exalted state, he tried to join a spiritual group under the guidance of a teacher. This experience however brought some problems. Firstly his relationships with the other students was made difficult by his need for them to recognise his spiritual superiority, cloaked in a persona of caring and seeming detachment.
Several of the younger women within the group had been seduced by this and then had been badly hurt by his inability to appropriately meet their emotional needs. Secondly his relationship with the teacher was marred by a deep ambivalence on his part. Initially he had listened attentively, keen to be seen as a central and important student, but once the teacher actually recognised his presence and began to invite him into a student teacher relationship he immediately drew back feeling angry and defensive. Carl was incapable of the relationship that the spiritual teaching demanded. While he wanted the teacher to acknowledge his spiritual insights, stolen through drugs, he was not prepared to actually undergo any real initiation that entailed a surrender of his narcissistic self.
Carl’s story closely mirrors the Narcissus myth. Driven by a mixture of perfectionism and escapism health draws him into searching for relationship with something other and greater than himself. However he does not have the ability to love - he can neither give nor surrender and so without the necessary reflecting of himself within the eyes of another ends up as he always has been, alone. His legitimate psychological needs for the existence of a healthy, robust ego is sabotaged by his narcissistic craving for acknowledgment of his empty grandiose persona. While his repressed inferiority draws him into acts of self destruction, acts craving nonexistence from fear of the naked vulnerability of intimacy with another, with himself.
Ultimately the issue of narcissism is one of identity. The story offers one last twist that strangely links its insight to that of the Buddha. The reflection that Narcissus becomes mesmerized by is actually nothing but an illusion. While it appears that Narcissus looks at himself there is really no one there. This strangely mirrors Buddhism’s position which suggests that behind all our experiences there is no experiencer, no person who is having the experience. All there is is the experience itself and part of it is the feeling of a continuing self that it happens to.
Buddhism links this absence of an enduring self to its understanding of shunyata, the emptiness or absence of an enduring and separate self discovered under close analysis. The insight meditation teacher Joseph Goldstein says that one way of understanding emptiness is to think of it as an absence of self-centeredness. This reveals a deeper understanding of narcissism. Narcissism is more than believing the universe revolves around us. Rather it is the mistaken belief that there is enduring self around which the universe revolves. The craving for existence and nonexistence creates suffering because it grasps for a control that is impossible to achieve by a self that on close analysis dissolves. A fearful contraction that can not let go and with confidence and trust.
Observation confirms the value of this insight. All of us experiences flow states - listening to music, arts, sports - without having to be aware of our sense of self while engaged in them. And actually when we stop grasping fearfully things become more spacious, less anxious, more related and accepting.
The Cure
What are our images of “cure” in psychotherapy?
Freud offers ‘ordinary unhappiness’ instead of neurotic unhappiness. Something more manageable and less unrelated to the consensus reality.
Jung offers ‘individuation’, an image of psychological wholeness which includes all those parts of the self repressed. A kind of superman who has a life full of meaning.
Object Relations therapists value object relations - the ability to become related to another, to love and be loved.
Humanistic psychotherapy wants us to realise our human potential. To express a full spectrum of emotional experience.
Buddhism imagines something more which it calls nirvana, the irreversible burning away of craving which brings all suffering to an end forever.
My own feeling on this is that the goals different modalities of psychotherapy and counselling offer are all ideal states. Complex narratives that easily obscure where we actually are and who we actually are. Do any of us really ever learn how to express our self fully, love sanely, become whole, let alone become enlightened? In practice are we all not more muddily, subscribing to an ideal which, while we may not ever realise it, never make it experientially real, none the less acts as a valuable light on a horizon we may never reach?
Buddhism is certainly also prone to such idealism. What could be more idealistic than the goal to bring all suffering to an end forever? But it also has another face, a more close the ground one that simply invites us to stay with ‘what simply is’, consciously, mindfully. Not to rush on along the path wishing to be what we are not. Seeing in such rushing a subtle form of self abuse. A non-acceptance of who we are, a narcissistic grasping at being more. That the rushing, grasping relationship to ideals, to narratives - including Buddhist ones - is in itself a source of suffering.
In contrast it values something plainer and simpler. It’s cure consists of being able to stay with our experience fully, without needing the protection of defensive closure. This is not the same as Freud’s ordinary unhappiness because it is the source of happiness. It is not Jung’s individuation - the creation of individual meaning is much less important here than the finding of a genuinely kind quality of awareness. And it is not just about human love or emotional expression in any ordinary sense because while it values these qualities it also mindfully discriminates their often hidden and obscure motivations.
The Buddha’s cure, though a narrative itself, is something that begins where we are, with who we are, in the emotions we have. It is the ability to be with our self without fear and to dissolve the grasping of our narcissism so that we dare to experience our sameness with the world around us. That we are all changing, that we all suffer when we protectively contract around the idea of who we are and that inside of each of us is a limitless expanse of compassionate well being - our Buddha Nature. Knowing this, directly, nakedly, right here and now is Buddha’s cure. A cure psychotherapy can comfortably share in.
The Medicine
Buddha’s medicine which effects this cure comes in three parts: an ethical relationship with our self and the world, meditation and the cultivation of wisdom. In my experience as a psychotherapist while it may be necessary to be wary of spiritual ideals - particularly when they threaten to invade the consulting room - we need not fear the medicine as its therapeutic qualities are immediately apparent and are widely applicable within and without an explicitly Buddhist context. Let’s look at each of them.
Ethics.
Buddhist ethics are governed by the belief that all our thoughts and actions have repercussions and therefore it is important to create good causes and this is best done by wishing to do good and actively avoiding doing harm. From this comes two central values: unconditional friendliness and compassion. Maitri and karuna. Winnicott says something similar when he speaks of the ‘facilitating environment’ - we flourish in an atmosphere of kindness and generosity and we may exemplify and encourage this in our psychotherapeutic practice.
Imogen was menopausal. Each night she awoke overheated and bombarded with self critical thoughts which left her shattered and with no sense of her very real qualities and talents. At times her thinking was plainly paranoid and quite unrelated to reality. However she was also a practitioner of mindfulness and she found that frequently her practice - done in the early morning hours next to her sleeping husband - enabled her to disidentify with what she recognised as the internalised voice of her viciously critical father and find a place of rest. Although this was difficult to achieve and not always possible, it gradually became clear that this period in her life represented an initiatory threshold and that Imogen was meeting her own destructive self each night when she descended towards sleep. Her ability to allow herself to stay with and experience the fullness of her nocturnal struggles was the fruit of her mindfulness and the care and kindness she brought to the struggle - not making herself wrong or bad for having it - was the expression of the unconditional friendliness and compassion she could - mostly - extend to herself.
Imogen’s story in principle I have come across again and again. It seems that a common component in much of the suffering that comes into the consulting room is self criticism and loathing. A young woman arrives and tells me of a life time of depression, loneliness and self recrimination. Why does she blame herself? She blames herself for having her depressive moods and thoughts. It is not enough to be bleak and leaden she is wrong and stupid as well. She says to her self “You are a fuck wit, a looser.” The Buddhist notion of unconditional friendliness, maitri, fiercely challenges this. It asks we bring an intelligent kindness to our woundedness because only once a wound is accepted can the process of healing begin. Further more, as the contemplative psychotherapist John Welwood points out, a psychotherapy that is always pushing for change is in itself subtly abusive if it is colluding with the abusive inner voice of the patient that says to be loved I must be different.
As Henry James said: “There are three important things in the world. The first is kindness. The second is kindness. And the third is kindness.”
Mindfulness Meditation
Mindfulness is to be consciously aware of what is happening inside of us and around us from moment to moment. This conscious awareness stays close to the sensory facts of the situation and tries not to become distracted by thoughts about what we are aware of. If I choose to focus my mindfulness on the sounds around me I just hear the sounds and come back from thinking about the wind and how much damage its blowing is doing to my garden. If I choose my breath I just stay with the sensations within each breath, intentionally adding nothing more and when I do, non-judgementally returning to the breath. If I choose my emotions - a common choice in psychotherapy - I just stay with the felt sense of the emotion located within my body - I don’t immediately go off into the history of the emotion nor speculation where it might lead.
In mindfulness based psychotherapy kindness and curiosity are central. Mindfulness does not observe with a cold eye dispassionately but more with a gentle interest. What ever it finds is Ok, what is important is the awareness. This mindful position is always the position of the therapist and, when appropriate, also the position of the one who sits in the opposite chair. Nina Coltart, a psychoanalyst and Buddhist describes her experience of this:
“As regards my own practice, and how Buddhism has affected my clinical work with patients, one of the earliest things I noticed was the deepening of attention. I’d written a paper on attention in my first book, where I refer to “bare attention,” which is a very Buddhist phrase. Bare attention has a sort of purity about it. It’s not a cluttered concept. It’s that you simply become better, as any good analyst knows, at concentrating more and more directly, more purely, on what’s going on in a session. You come to concentrate more and more fully on this person who is with you, here and now, and on what it is they experience with you: to the point that many sessions become similar to meditations. When this happens, I usually don’t say very much, but am very, very closely attending to the patient, with my thought processes in suspension, moving toward what Bion called “O”: a state which I see as being “unthought-out,” involving a quality of intuitive apperception of another person’s evolving truth”.
To this I would add that I have found the work of Eugene Gendlin and his technique of Focusing invaluable. It provides a bridge between the reflective work of psychotherapy and the being present with what arises as it arises - the experience of being mindful. Focusing invites us to be present with our emotional experience in our body, the felt sense. To find words, phrases or images that express the felt sense and remain attentive to any changes without attachment to change. Making paramount the ability to ‘stay with’ rather than descend into long stories ‘about’ what is felt.
Ted described his life long fear of depression. He had realised that whenever he had a leaden feeling in his guts and limbs and a sense of hopelessness and not caring, he would jump up immediately and engage himself in an activity. When he started practicing mindfulness he became aware of this defensive maneuver and instead decided to simply remain mindfully present with the basic feeling. Quite a brave thing to do given his aversion to this particular fear. Doing this it became plain to him that the basic feeling, leaden guts and legs, feelings of hopelessness and lethargy, generated secondary emotions of fear and alarm, causing him to do anything but stay with his actual experience. In time his ability to reverse this process grew. Initially he began to consciously notice the depression and his defensive avoidance of it when it occurred. Then gradually he was able to stay present with the feelings and allow himself to have them without any desire to articulate them, change them or understand them in any way. Just leaving what was, as it was, a sensation and a feeling, and remaining present with it until it finally passed of its own accord.
Staying with rather than stories about.
Wisdom.
Talking about wisdom in psychotherapy is difficult. I observe in my self a shying away, a fear that I may get too inflated and fall into the fascism of ideals, of unhelpful narratives, that we spoke of earlier.
However in Buddhism wisdom is equated with knowing how things really are, not just how they appear, and the way to do this is - again - simply being present with what is happening with out adding any of our own ‘stuff’ to the experience. The act of mindfulness already described. Something that some forms of psychotherapy are beginning to recognise as extremely valuable.
Where Buddhism and psychotherapy do not meet is on how deep this process can go. At its worst psychotherapy is often satisfied with a general understanding of how wounded patterns of being happened, somehow trusting that once we have a rational view of our neurosis that will be enough. In my experience such knowledge is never enough, it has no ability to actually be conscious of the thoughts and emotions that arise out of the patterns of hurt, complexes, as they occur and therefor is all too prone to either further acting out or repression. Personally I neither believe in nor trust those who think they have had a full analysis and now know what is theirs and what is their patients. My observation of myself and others over twenty years of clinical practice is that our identification with our wounding is very deep, perhaps so deep it colours the whole personality, and therefor we are always acting out of it one way or another.
The Buddhist take on this is to see the personality and all its woundedness as a narrative, a story of who we are, that we tell our self all the time. A story we defend when any threat to it comes near. Most psychotherapists and counsellors will recognise a particularly obvious manifestation of this in the patients or clients that steadfastly cling to their material, actively resisting change. Their fear is probably of the unknown that would emerge if they were to let go. However it is the Buddhist belief that we are all doing this all the time - its just that most of us do it less obviously.
Thus in a mindfulness based psychotherapy the narrative is less important than an awareness of how the narrative is used. The belief that being with our experience openly is more important than knowing how we became so closed. Of course to be human is to spin our own tale and the meaning that comes from this is an important element in keeping happy and sane. However the narrative can be and is frequently used defensively - a closed story about who we are, what we like and don’t like and how far we can travel. Becoming aware of our narrative, not just its content, its story lines, but also how we use it to defend our self against the fullness of our experience is central to the work.
As the Lotus Sutra says:
“The Great Way is not for those who pick and choose.”
We could say as a contemplative psychotherapist: Psychological health happens when we mindfully open, within an atmosphere of kindness, to the fullness of our being. Just staying present with what immediately is and not so hung up on the story.
Nigel Wellings July 2009
Tags: ethics, meditation, wisdom