Category Archives: Social Science

Buddhist Psychotherapy

The following was an email response on a topical group mailing list I’m on. There is a connection between spirituality and therapy that I am trying to learn within myself. I find it interesting that so many of my clients ascribe the label “Buddhist” to me when I am not formally a practitioner.

As you are seeking to practice psychotherapy from a buddhist perspective, you may want to consider what a “buddhist psychotherapist” is. There are as many ways to practice buddhist psychotherapy as there are — well — ways to practice Buddhism. How you and your client/patient experience therapy may vary depending on the approach you follow. There are Buddhist therapists from firmly psychodynamic and analytic camps (e.g., Mark Epstein; Barry Magid), and from cognitive behavioral schools (e.g., Tara Bennett-Goleman), as well as from every other therapeutic perspective I’m sure. Likewise, if your own meditation practice is rooted in Vipassana or in Zen traditions,for example, your therapeutic foci may differ. I mention all of this (which may be obvious) because I think a necessary foundation for practicing Dharma informed therapy, is to establish your own practice and to observe your experiences first. In fact, I’ve always understood that that was the Buddha’s instruction: “Don’t accept my teachings on faith. See for yourself.”

I think what triggered this commentary from me, was my reaction to your questioning how to label character types based on grasping, aversion, and delusion. One Buddhist tradition may view this typology as critical, but the Soto Zen practice I follow, for example, suggests to me that such classification is both dualistic and unnecessary — greed, greed hate and delusion have the same root. As with using other psychological labels (consider the DSM-IV-R), there is a risk of assuming too much about the human sitting before you, and in possibly relying too heavily on “prescriptive” treatments.

Let me very humbly offer that you allow your Buddhist practice to aid you in understanding yourself first, then in understanding your client, and PERHAPS later in knowing what to prescribe, if anything.

Merely another opinion.

Repression Serves a Purpose

Some time ago I read an article from the New York Times Magazine that proposes the potential benefit of repressing traumatic experiences rather than verbally re-living the story over and over. What I appreciated about the article is the consideration given to the fact that not all people cope in the same way. For some, talking about their experience is healing, while for others it only serves to prolong the trauma.

The article featured techniques practiced by an abuse survivor-turned psychologist, Dusty Miller, who works on the faculty of the Family Institute of Cambridge, as well as practicing and consulting. Two of them caught my attention as potentially useful in my work. To wit:

She began to consider directing her clients away from their traumas and toward the parts of their lives that ”gave them more juice.” She found that it worked. With trauma survivors, Miller now never begins a group session by asking, ”How are you feeling?” ”Oh, my God, that would just be a disaster,” she says. ”All I’d get was, ‘Terrible, fearful, awful.’ Instead I say, ‘What strengths do you need to focus on today?”’ In one session, Miller hands out paper dolls and bits of colored paper. Trauma survivors are told to glue the colored paper onto body parts that hurt or have been hurt, ”but then,” Miller says, ”we don’t stop there. We turn the dolls over, onto a fresh side, and participants use the same bits of paper to design a body of resilience.”

What powerful, lovely concepts: focusing on strengths, creating a body of resilience. This article calls into question the efficacy of long-term talk therapy, which is certainly worth examination. While I don’t favor psychotherapy being rigidly ruled by administrators of HMOs, I do think that effective therapy does not need to be lengthy or soul-excavating in all cases. I am reminded just now of the book, We’ve Had a Hundred Years of Psychotherapy and the World’s Getting Worse, a dialogue/debate written by psychotherapist James Hillman and essayist Michael Ventura. It’s worth a read.

Therapy, Bright and Dark*

Does therapy help, or is it simply an expensive way to pass the time? An article in Salon, Off the couch, summarizes the author’s many years of therapy and her decision to quit. She raises questions about the value of therapy and whether it really is of any use, when other pursuits might work just as well. She was taken to a therapist in her childhood, and it became part of her self-definition, the way in which she learned to cope with life. She writes:

The choice, as I see it, is not between doing therapy and getting better versus not doing therapy and staying screwed up. The choice for me — and I keep making it, one day at a time — is whether to be screwed up and broke and dependent on someone I pay to care about me, or screwed up and less broke and more self-sufficient. People who choose to stay in therapy have harder decisions to make: who to see, how to know if it’s working, when to move on.

The author states that she thinks therapy has its place in being part of a solution for “for people with mental illness, people in true life crises, people who are court-ordered or girlfriend-ordered into self-examination.” While the essay makes good points about the alternatives to therapy, the tone was sour. I sent it to my brother, Tony, for his thoughts. He responded, and with his permission I post it.

I found I had a couple reactions to it. In particular, I’m amused and a little irritated at the universal tendency to generalize one’s experience — e.g., I got addicted to therapy, so it must be bad for everyone.

It also had me thinking about the whole notion of therapy and personal authority. This person very much sounds like she was expecting to be “fixed” and grew dependent on the therapeutic context for comfort. I tend to view the prospective success of therapy as dependent on a client’s willingness to actively work and learn, not simply sit back and have all of their neuroses normalized.

Which is not to say that normalization — by which I mean being reassured that one’s various impulses and recurring behavior patterns which one is tempted to pathologize are in fact very much part of the “human condition” — is not an important part of the therapeutic experience. You can’t hope to decondition defenses when they’re constantly aroused. But at some point, each of us must come to grips with our hatred of authority, whether in others or in ourselves, and a therapeutic context in which this issue is not actively explored could easily lead to the sort of (dysfunctional) dependence this author describes.

I think there are indeed questionable therapists out there whose goals are primarily to ensure lifetime income from their clients. But I think there are others who truly seek to help their clients learn to reclaim their own authority and autonomy in taking care of themselves and others around them. Those clients (and therapists) who choose to follow/be led into the unknown, and to muster the courage to bear the uncertainty that accompanies that path, will learn something. Those who seek only comfort will probably keep returning to what they “know” to be comfortable — which may in fact be fueling their unhappiness. For clients and therapists both.

One of the tenets of SCT is that talking explaining one’s experience tends to take us back to what we already know, e.g. by verbalizing and cognizing in terms of our reference experience, while exploring one’s experience tends to take us into what we don’t yet know, opening the possibility for learning. I think this is relevant to this thread, as is Senge’s notion that certainty is the enemy of openness and discovery.

Just some food for thought from my inimitable brother.

*The post title is derived from a novel I read as a teenager, Lisa, Bright and Dark, by John Neufeld.

The Body Remembers

We often think life is “mind over matter,” that what one thinks can impact physical reality, or at least one’s perception of it. This is perhaps how people who experience constant, debilitating physical pain learn to cope. However, life is not so clear-cut. It seems that the body has a memory of its own, and its memories influence psychological well-being. Traumatic experiences may be tucked out of the mind’s eye in various parts of the body. When memories are evoked, the body responds; for example, one might feel nauseous, or a tightening of muscles in the chest, and so on.

Additionally, any part of the body that has experienced trauma also carries a memory of it. Take, for example, the condition of vaginismus, a painful and prolonged contraction or spasm of the vagina. Generally, it is a spasm of the muscles of the floor of the pelvis. It causes pain with penetration, often making intercourse impossible. One blogger I know well struggles with this. Kat’s frustration was eloquently described in a post titled All the King’s Horses:

I keep thinking about the tests I had each year at Children’s Hospital where I was held down and a catheter was inserted into my urethra. My mom says that now they have different size tubes for different ages (what a novel idea!), but when I was three they only had a one-size-fits-all tube. I liken the experience to rape. Sanctioned rape by white-robed doctors you’re supposed to trust. It makes me very angry to think what they put me and so many other young girls through. I’ve gotta think there’s a better way. My mom says the tubes caused scarring in me, but the scarring was more than physical. She thinks it’s a combination of the constant urinary tract infections I had that were mis-diagnosed and the regular catheter tests that engrained this physical pattern into my body. My mom says it can be un-learned. A new script has to be written. I think this physical therapist will be able to help me. But what I expressed to my mom tonight, is what my biggest fear really is…which is that I’m just broken, plain and simple, and there’s no fixing me.

Trauma stored in the body is treatable, though it may take a combination of various therapies. A quick surf via Google led me to a number of sites focused on physcial trauma in childhood and its psychological effects. A few that caught my eye:

These links provide a wealth of articles and resources.

Connections

Last year I participated in a women’s group that focused on movement and creativity. Shortly after it began, the therapist’s new office opened, and this is what I wrote of my experience on the first night there.

We spent much of the session exploring the new therapy studio, an open, airy room with satiny wood floors. We began by being aware of our space, then turning attention inward to that space, and then returning awareness outward to connect both. Afterward, we drew or wrote whatever came to mind. This experience was so good, because I so often ignore my body’s needs for movement. My leg muscles have been stiff from lack of movement, and they radiate their discomfort. This is my meditative writing:

My thighs ached to stretch in
full frontal contact on cool wood,
extended and still, my blood pulsing,
body heat flowing into it.

My body tells me how exhausted it is,
parched for sleep’s refreshment,
neglected, pushed beyond tolerance;
yet still it serves me.

I have a home. It breathes, moves,
eats, sleeps. It belongs to me.
Amazing how much it does. I will
never be homeless in this life.

As a child, I would lie for hours
on the grass, resting, breathing.
Being.

I was friends with the earth,
the floor. I used my body. It
connected. Touching is relationship.
Contact–to move the body through space,
to manipulate the limbs, interacting,
pushing, yielding.
This is making love.

People make love to the world. Two
thousand miles away, my sister awakes
each day, feeds her dog, pads her slippered
feet through a chilly house to
prepare for work. At about the same time,
my morning ritual unfolds.

Everywhere, people are moving, being still,
breathing, having sex, dying, and living
in relationship with this dimension.
We make love with the world. We do this
constantly, in tandem with others.
So we make love, by extension, to
each other.

We are connected at all times.