I have received some interesting comments from a couple of friends on my last post about R. D. Laing which raise a number of questions that go beyond his career and personality. To be sure, Laing is still capable of stirring controversy twenty five years after his death. But I am not so much interested in Laing here, as I am in the greater issue of the nature of the therapeutic relationship. One friend, a highly experienced psychoanalyst, expressed doubts about Laing's achievements, as well as his moral fitness for practising psychotherapy. He also noted that charisma in a therapist does not necessarily make him an effective one. Another friend sent some material about Masud Khan, a prominent London psychoanalyst and a contemporary (though not an associate) of Laing, who was accused of gross professional misconduct by one of his patients. I won't go into the details of either Laing's or Khan's case, but I will say that therapeutic misconduct in general haunts therapy like a dreadful family secret. Of course, therapy's family secret is no secret at all as case after case of professional and even criminal misconduct by psychotherapists have come to light. In my previous entry I mentioned how Laing's diatribes against medical psychiatry had the unintended effect of bolstering his opponents who rejected psychotherapy in favour psycho-pharmacology. But much the same thing happens whenever any psychotherapist commits an ethical transgression that casts serious doubt on the trust that is essential for therapy. When a therapist proves so dangerously untrustworthy you can see why the pill pushers may suddenly appear in a more attractive light.
Fortunately, most therapists subscribe to a code of professional conduct, which I believe is as essential for psychotherapy as it is for any other profession. While such codes cannot provide an ironclad guarantee against misconduct, they can and should be used to hold therapists to account for their misdeeds. I also believe that most therapists are ethical enough, which is to say that they can be trusted to abide by the ethical codes to which they subscribe. But is this enough? After all, therapists may be highly ethical, yet still fail to help their clients. So the question of competence or effectiveness must also figure into the question of trust. Therapists, of course, are supposed to acquire competence by their training which should help them develop essential skills in listening, empathy and the more subtle dynamics of the therapeutic interaction. But talking about competence as if it were a measurable quantity can be somewhat misleading. For competence often involves a certain intuitiveness that escapes any easy assessment. And there is another factor which undercuts any attempt to reduce psychotherapy to a set of teachable methods and techniques. Although good therapists will always try to draw on the skills they have developed, therapy, as Jung observed, depends on the presence of unpredictable influences that are impossible to account for. Still, the question remains, as much for clients as for therapists: how does therapy actually work? Or as Jeff Harrison puts it, what is actually therapeutic?
The question has been central to psychotherapy from its inception, but it should still be asked whenever a course of therapy begins. Some things, such as the attentiveness and reliability of the therapist, are obvious prerequisites for making therapy work. Yet, although the onus of responsibility is thought to lie primarily with the therapist, in fact therapy only finds traction once the client begins to take greater responsibility for the therapeutic process. A friend of mine states the matter bluntly whenever he begins with a new client. "We are going to have work hard," he says encouragingly. "But by 'we' I mean 'you'. You are going to have to do all the hard work. I am only going to help you." I think my friend is right. Yet, this shouldn't lead us to underestimate the importance of the therapist's efforts. The therapist has to work hard, too. But how?
I favour the idea of attunement as a way of describing how good therapists work. Once all the necessary background information about the client has been gathered--which is a crucially important skill in itself--there is then the matter of what to do with it all. Although the next step involves interpreting the client's material, attunement goes far beyond making an interpretation of the client's character. It also demands sensitive appreciation of the client's experience so that the therapist communicates the depth of his understanding without necessarily making his understanding explicit. It is a kind of intimacy that respects the client's opinion and point of view, yet maintains a certain critical edge that plies towards truthfulness. Most fundamentally, attunement depends on the therapist's attitude of care for the well being of the client which must begin by being in sympathy with him (David Black's wonderful book Why Things Matter offers a superb analysis on the importance of sympathy for therapy). What makes attunement so difficult is that to maintain the delicate balance of critical attention, good will and sympathy in pursuit of the client' s best personal interest requires ongoing vigilance throughout the course of therapy until its conclusion. Such attunement also requires an openness to those unpredictable factors that Jung observed were so essential for the success of therapy.
This entry was prompted by some critical remarks about Laing which to some degree I endorse. But I have to confess that is spite of his flaws, Laing remains an important influence for me. So let me close with a quotation of his that serves as a motto for me as a therapist: "Psychotherapy must be an obstinate attempt by two people to recover the wholeness of being human through the relationship between them."
Twenty five years ago today, RD Laing, the famous radical psychiatrist died of a heart attack while playing tennis in St Tropez. I remember receiving this news at a rather sombre time in my life as my father had died just a month earlier. "I feel like a light has gone out in my life," I said to my mother. " But not knowing anything about Laing, she didn't share in my feeling of loss. "Well, a bigger light has gone out in mine," she replied with some puzzlement. In truth, even if she had known about Laing she would not have been impressed by him and would have felt little, if any sadness at the news of his death. Nowadays, no one younger than fifty seems to know anything about Laing and many of the older people who do remember him tend to place him within the anti-psychiatry movement of the 1960's. In fact, Laing hated being called an anti-psychiatrist, but given his circle of associates as well as his radical politics, it was certain that he would be seen as one. Indeed, his most famous book, The Politics of Experience, was one of the widely most celebrated books of the counter culture and made Laing something of a celebrity. But when the radical fervour of those times faded so did his reputation.
Although I am more a child of the Seventies than of the Sixties, reading Laing's work in my youth still had a great influence on my view of psychotherapy. Indeed, I had fallen under the spell of a thinker who appeared to be both a searing social critic as well as a visionary psychotherapist who truly seemed to grasp what it is to be human. Perhaps I was all too receptive to any claim that it was mad to be normal, but no one made that case with greater brio than Laing did. Only much later in 2007 when I was writing a dissertation on Laing for an MA, did I revise my view of both Laing's ideas and his character. In my later reading many of his ideas struck me as wild and romantic and entirely typical of the '60's radical zeitgeist. But my research into his life changed my view of the man, as well, as it revealed what a profoundly conflicted character Laing was. His conflicts not only shaped his adult character, they also drove the life he led. "They say we live a life, but it is better to say we are lived by life," wrote Georg Groddeck, an early, "wild", psychoanalyst whom Laing once quoted with approval in an interview. Laing's extraordinary talent as a therapist--I am still inclined to call it genius--owed as much to the baleful influence of his disturbed mother as it did to his exceptionally high innate intelligence. Yet, his career as a psychotherapist ended in dismal failure, in large part because he had failed to come to terms with the emotional inheritance that he had received from his parents. In my dissertation I called Laing a wounded healer which is an archetype that applies to many, perhaps even most psychotherapists. But his case might serve as a cautionary example for those who believe that the childhood suffering of a therapist inevitably makes him wise. Although a psychic wound in a therapist may indeed be source of empathic insight for him, it can still retain the power to bring about the ruin of even the most gifted healer.
Laing's talent as a therapist showed most dramatically in his work with schizophrenic patients. A gifted linguist who was at home in several European languages, he had an uncanny knack for decoding "schizophrenese", the apparently meaningless babble that is regarded as a symptom of acute psychosis. In his biography of his father, Adrian Laing recounts how Laing was once visiting a mental hospital in America and was presented with a female patient in a padded cell who sat naked and hunched in a fetal position, rocking back and forth, muttering incomprehensibly to herself. Just what would this eminent critic of psychiatry be able to do with such a hopeless case who had not been heard to speak intelligibly in several months? Without prompting, Laing immediately undressed, entered the cell and began to move and mutter just as the patient was doing. Ten minutes later, she and Laing and were engaged in a perfectly understandable conversation. Emerging from the cell, he put his clothes back on and briskly turning away from his astonished observers, asked : "Why didn't you think of doing that?"
This incident displayed two sides of Laing's highly complex character. On the one hand, he appeared as a rather defiant trickster who never lost an opportunity to insult institutional authority. On the other, he showed himself to be a highly intuitive and imaginative therapist whose powers of empathy verged on the shamanic. Although his defiant attitude contributed much to his counter-cultural celebrity, in the long run Laing's vendetta against authority worked against his reputation as he became chiefly known for being the radical scourge of mainstream psychiatry. Unfortunately, it also worked against the cause of psychotherapy as it roused strong and unyielding opposition to therapy and advanced a biomedical view of psychological suffering which has continued to dominate psychiatry from the Seventies until the present day. Robert Spitzer and Irving Kirshner, the two psychiatrists who had the greatest influence in turning psychiatry into psychopharmacology, even called themselves "neo-Kraeplinians" after Emil Kraeplin, the father of modern psychiatry whom Laing had often reviled as the forerunner of all that was wrong with psychiatry. Spitzer and Kirshner were certainly aware of and alarmed by the dangerous and radical direction which Laing had been advancing as a psychotherapist. They were only too eager to adopt Kraeplin's legacy and wear it proudly on their banner, as much to oppose Laing, as to honour Kraeplin. It seems clear that anti-psychiatry--of which Laing, unfairly or not, was seen as the leading figure--provoked a backlash from mainstream psychiatry from which psychotherapy continues to suffer.
The great pity was that Laing had all the necessary talents to make a powerful case for psychotherapy as a vitally important healing art. In his first book The Divided Self, he demonstrated those talents brilliantly. Few other books offer such a penetrating phenomenological analysis of schizophrenic breakdown as a human experience. Though there are some excellent first person accounts of going insane (such as Ellyn Saks's fairly recent The Centre Will Not Hold), which deserve attention for their testimonial force, The Divided Self brought theoretical insight, as well as a considerable literary skill to the experience of going mad. In reading it you not only feel what it is like to suffer the disintegration of schizophrenia, you also appreciate the emotional dynamics that would drive someone insane. Laing regarded his attempt to describe the emotional dynamics involved in psychotic breakdown from an existential, phenomenological perspective as the first step of what he termed a "science of persons". In fact, a perfectly disinterested scientific understanding of human experience, even from a phenomenological perspective, is probably impossible to attain. But seeing human experience as irreducibly human should still be a guiding principle for virtually every form of psychotherapy. As a corollary of this, Laing's argument against the psuedo-objectivity of the diagnostics at work in most psychological theories still deserves great respect. Indeed, as the field of mental health is now dominated by the bogus science of the DSM, his argument may have never been more persuasive and relevant than it is now.
So why did Laing fail? Booze certainly played a great part in his downfall, as did the burden of fame, for Laing had always wanted to be famous, yet hated the vulgarity of celebrity. But there was something else involved in his downfall, which was noted by Daniel Burston, his most perceptive biographer. Among his many other talents--he was a superb musician, as well as a gifted linguist--Laing was a natural at meditation. And in 1971, at the height of his fame, he spent the year in Sri Lanka and India in dedicated study of the discipline. He proved remarkably adept at it and impressed both his Buddhist and Hindu teachers with his powers of concentration. Laing also relished the ascetic lifestyle that his meditation practice required, so much so that he was strongly tempted to turn his back on his worldly life and become a saddhu. But in the end he decided to return to his life back in London where things immediately began to take a downward turn which never really stopped until his death in 1989. Under great financial pressure, he began to drink heavily, his second marriage failed and his writing became increasingly self indulgent and lost its keen polemical edge. Why? It could be speculated that Laing's spiritual pursuits introduced a new element into his life that could not be reconciled with his previous way of being. But as a Buddhist therapist, I often wonder what might have happened if Laing had been able to develop his spirituality more fully. Perhaps he would have just remained in India as a renunciate and nothing more would have been heard of him. But it is also possible that he might have brought his spiritual insights into psychotherapy and changed the way we look at the possibilities of therapy. Who knows? Perhaps the therapist who wrote so insightfully about the divided self might have taught us something about the realised self. But maybe this is just fanciful. Twenty five years ago, I felt that Laing's death had turned out a light for me. And though his influence has more or less endured, my admiration has become hedged with all sorts of doubts and critical reservations. I also realise that his light had begun to dim long before I encountered his work. My regret now is that his light could have been so much brighter.
I am now reading a terrific book by a New York psychotherapist, Gary Greenberg, entitled The Book of Woe which is about the writing and publication of the DSM, the Diagnostic Statistical Manual. The DSM is the official handbook of the American Psychiatric Association and has long been the standard guide for mainstream psychiatry. I won't say much more about Greenberg's book now as I need to finish reading it first and may want to write a formal review of it later. But suffice it to say that the book belongs on the same shelf as Robert Whitaker's Anatomy of an Epidemic and Richard Bentall's Doctoring the Mind, both of which present scathing critiques of contemporary psychiatric theory and practice. It seems, in fact, that there is something of a backlash against psychiatry these days which would resemble anti-psychiatry some forty odd years ago were it not for the more temperate and cautious style of argument of psychiatry's more recent critics (Bentall, in fact, calls his approach rational anti-psychiatry to distinguish it from the wilder pronouncements of people like Laing, Esterson and Cooper). Even so, there is one important point which would seem to unite the old renegades of anti-psychiatry and the new critics of contemporary psychiatry. Both the old radicals and the new iconoclasts doubt the medical reality of what is thoughtlessly and perhaps misleadingly called mental illness.
The Myth of Mental Illness, was a highly influential tract published in 1961 by Thomas Szasz, an American psychiatrist who, though often called an anti-psychiatrist, vigorously denied any association with that band of radicals. Nevertheless, his argument that to confuse the emotional difficulties that people face (which he called "problems in living") with any sort of real medical condition was a grave category error which carried great critical force for the radicals of the Sixties. It would seem it still does so today. But, needless to say, mainstream psychiatry has never had any patience with this line of argument. Ever since the 1970's and the publication of the third edition of the DSM, psychiatry has become increasingly committed to strictly biological models of mental illness which make few, if any concessions to the subjectivity of psychiatric patients. Indeed, Emil Kraeplin, the father of modern psychiatry, declared that psychiatrists should have no more empathy for their patients than surgeons should have for theirs. Unfortunately, psychiatry's attempt to treat mental illnesses as pathologies like any other has been a tremendous failure as the dramatic rise in the incidence of mental illness since the 1970's clearly shows.
But if what we call mental illness is no such thing, what exactly is this form of suffering whose reality can hardly be doubted? Here I think the new critics of psychiatry have much more insightful things to say than the old anti-psychiatrists who were often intemperate, if not fanatical in attacking psychiatric and societal norms. When Cooper, for example, called for the death of the family, you had the feeling that he wanted the gallows to be prepared for Mum and Dad. By contrast, the new critics offer a careful appraisal of medical evidence to demonstrate that the current psychiatric models of mental illness simply do not work and often lead to treatments that make patients much worse than they were before. Bentall, a clinical psychologist, offers a fairly good, if provisional, alternative model of mental illness in his book, Madness Explained. But if anything, I am more impressed by Greenberg's frank admission of being baffled by mental illness, especially in some of its more florid manifestations. I think the inference to be drawn here is that though madness is certainly like an illness in the suffering it causes, it is not an actual illness in either its causes or its treatment.
The Buddha, it should be noted, held no Szaszian doubts about the reality of mental illness. But unlike Kraeplin and his descendants in modern psychiatry, he did not think its cause was any physical disorder, either. Moreover, of the two types of illness, physical and mental, he regarded mental illness as much worse. For the worst that can ensue from any physical illness is death, whereas any mental illness is certain to lead to an unfavourable rebirth, most likely in a hell or animal realm. But at this point we may be tempted to regard the Buddha's use of the term mental illness as little more than a metaphysical conceit. But was it? According to Buddhism, the roots of any mental illness are the three passions of aversion, greed and delusion, which are referred to as either fires or poisons. These three passions are almost always active in some way or another in the mentality of virtually all living beings. Indeed, these passions drive the round of rebirth as they perpetuate craving. Seen from a Buddhist perspective, then, we are almost all mentally ill, at least some of the time. But then it may be hard to see how such an idea of mental illness, which appears all too inclusive, could be relevant to any modern concept of mental illness, especially when the only cure for rebirth is nirvana.
Yet, aversion, greed and delusion almost always lie behind the complaints that bring people into psychotherapy. Aversion and greed feed psychological frustrations like wood on a fire. And delusion is universally regarded as a symptom of mental illness, though Buddhism would not confine its understanding of delusion to any clinical definition. According to Buddhism, we are all deluded to some extent, which means that we all misapprehend reality because of the distorted perceptions that our cravings impose on our view of things. Personally, I have always preferred to view the passions of aversion, greed and delusion as poisons, even though the original metaphor used in the Pali Canon referred to them as fires. But as a therapist I often reflect on how apt it is to see them as real poisons whose effects can be literally poisonous. Anybody who has ever worked as a counsellor or therapist probably has had clients who suffered their aversive anger in waves of bile that may have caused actual nausea. And greed often expresses itself as muscular tension that feels like a compressed spring of unfulfilled yearning. The poisonous effects of delusion, however, are seldom so apparent, which makes it the hardest passion to detect, as well as the most insidious poison to treat. Indeed, once identified, anger and greed can usually be dealt with. But aversion and greed usually lie concealed beneath a veil of delusion which is experienced as self. Anyway, the point I am making is that we have something here that is far more practical in dealing with mental illness than a mere metaphysical conceit.
When Buddhism states that everyone is mentally ill, it also goes on to assert that the Eight Fold path is the course of treatment that each individual must undertake in order to be cured. But mental illness as it is more commonly understood may present greater hazards on the Buddhist path that most other people don't have to face. This is where psychotherapy can help those who suffer mental illness acquire the resources to live more purposively, perhaps even to embark on the Buddhist path. Does this mean that Buddhist psychotherapy is better than any other forms of psychotherapy? Not necessarily. For success in therapy is largely the result of a good therapeutic alliance in which the theoretical orientation of the therapist seems to count for comparatively little. But perhaps even more importantly, a psychotherapist is not a confessor or spiritual guide. For a spiritual guide works within a particular spiritual paradigm to bring an aspirant to spiritual truth; a therapist works from a therapeutic orientation to reach the client in his or her life situation, but without imposing any spiritual agenda.
But to get back to the original question of this blog: is mental illness just a myth? Maybe; maybe not. The debate is far from settled. But aversion, greed and delusion are not myths at all. They make the world go around. And sometimes they move people to take up psychotherapy.
There was a good op-ed piece in the Guardian recently [06/08/2014] by Suzanne Moore on mindfulness which raises some important questions about the current mindfulness craze. Moore complains that mindfulness has been taken away from its original religious context and turned into just another device in consumerism's panoply of diversions. She is surely on to something here. Robbed of any spiritual purpose, mindfulness is now being made to serve just about any secular interest. Bankers do it, soldiers do it and in Japan, even gangsters, the dreaded Yakuza, have always done it. So what is going on here?
I have a number of friends, committed Buddhists all, who look upon the popularisation of mindfulness as a highly positive development. And I once had occasion to ask Ajahn Amaro, the abbot of Amaravati Buddhist monastery, what he thought of the spread of secular mindfulness. "Stealth Buddhism", he replied with a broad smile. I greatly admire Amaro as a teacher and authority on Buddhism, but I tend to side with Moore on this matter. While it is likely that some people will take their introduction to mindfulness as a good first step towards a more committed spiritual practice, our cultural experience suggests that secular mindfulness could be a short-lived affair. Indeed, if you are of a certain age you may have the feeling that you have seen this sort of thing before. You might remember when Transcendental Meditation was widely promoted as a panacea for every imaginable ill. I have nothing against TM and suspect that its benefits in stress reduction are quite similar to those of secular mindfulness. But what the hype surrounding any sort of approach to meditation tends to overlook is the importance of maintaining a regular, disciplined practice. The Buddha, however, taught that the single most important factor needed for meditation is patient endurance. Unfortunately, consumerism thrives on novelty and as soon as something is seen as tedious it quickly loses its appeal. This is hardly auspicious for developing any sort of serious meditation practice. Nevertheless, TM is still widely practised and taught and many people no doubt continue to benefit from it. So it is quite possible that secular mindfulness will find a similar market niche for itself.
It is easy to see how mindfulness appeals to people these days. It is, after all, sold as a technique that improves concentration by inducing calm and reducing stress. Efficiency tends to be the watchword here, as if the practice can be justified only by referring to performance tables indicating such things as increased productivity in the work place and higher grades on test scores, to say nothing of the physiological and psychological benefits that have been confirmed in clinical tests. But while such benefits may indeed be demonstrable, they can also be regarded as mere side effects of a practice whose greatest benefit might actually be its ability to afford a clear view of the self making propensity of the mind. This is what most intrigues me about mindfulness, both as a psychotherapist and as a practitioner of mindfulness. I hope to discuss this theme at greater length in a later blog.
There are a couple of books I would like to recommend now. The first is Selling Spirituality by Jeremy Carrette and Richard King,. which argues that the marketing of a variety of disparate spiritual practices relies on the selection of such practices (cherry picking, as it were) for their commercial appeal. Taking things such as yoga, mindfulness and other forms of spiritual practice away from the religious traditions in which they originated can be likened to the corporate strategy of asset stripping used in predatory capitalism. The book deserves attention for it offers a carefully argued and well researched analysis which documents and describes the present commercial climate of spirituality very well. The other book is a recent collection of articles called After Mindfulness,which was edited by Manu Bazzano. My highly favourable review of this book, which has been recently published in Self & Society, can be found soon on the "Publications" page on this website. I think this is a terrific book which explores in greater depth some of the issues that Moore addressed in her article. So for anyone who is interested in secular mindfulness, it is certainly well worth reading.
Finally, fairness obliges me to mention two of my friends, Andy Paice and Richard Burnett, who are strong advocates of secular mindfulness. Richard has a prominent role in the Mindfulness in Schools Project [mindfulnessinschools.org] and is enthusiastic about what mindfulness can do for pupils. His enthusiasm can be quite infectious as I know, for I credit him for reviving my interest in mindfulness several years ago when it had begun to flag. Andy is a former Karma Kagyu monk who spent three years on a meditation retreat in a Tibetan monastery in France before disrobing and returning to the UK. He now works as a life coach specialising in mindfulness [www.naturalinsight.com] and includes bankers and other business people in his list of clients. But you don't have to be a rich City of London type to enjoy his services. Andy holds weekly meditation services in Finsbury Park which can be attended by anyone for a small donation. Although I continue to have reservations about how secular mindfulness is being marketed these days, I have nothing but respect for the ways Richard and Andy try to spread their knowledge of mindfulness.
I was talking recently with Jeff Harrison, my friend and fellow psychotherapist, about some of the difficulties and challenges involved in translating Buddhist ideas about human experience for psychotherapy. Although Jeff is not actually a Buddhist, he is very knowledgeable about Buddhism as he wrote his doctoral thesis at the University of Kent comparing Madhyamaka Buddhist philosophy with contemporary post-structuralism and now serves on the teaching staff of the Tariki Buddhist Psychotherapy training programme where I train. So he brings a great deal of practical experience, as well as theoretical understanding to Buddhist psychology. Perhaps Jeff might be described a critical fellow traveller of Buddhism, in that he respects and employs many Buddhist ideas for psychotherapy, but remains sceptical about Buddhism' s metaphysical claims. Our recent discussion revolved around that perennial issue for psychotherapy, the nature of the unconscious.
Our discussion was prompted by a book I recently read about Yogacara Buddhism, called Living Yogacara by Tagawa Shun'ei, which provides a good, accessible introduction to a highly complex subject. Yogacara was a development within Mahayana Buddhism and spread throughout northern and eastern Asia where it continues to influence Buddhist thought and practice, especially in Tibetan Buddhism. Although I can't claim an extensive understanding of Yogacara , as a Buddhist therapist I am deeply intrigued by its model of human consciousness which seems to anticipate some of the ideas found in psychoanalysis about complexes. As always, a great deal of caution has to be observed in making any such comparisons. It is necessary to note, for instance, the differences in historical context, as well observe that psychoanalysis has a much a different understanding of the human condition than any form of Buddhism has. But even so, the similarities between Yogacara and psychoanalysis are striking, especially for me, a Buddhist therapist with a strong interest in psychodynamic thinking.
In order to appreciate the similarities, we might first briefly consider the concept of complexes which emerged as a key idea of depth psychology at the turn of the last century. The idea has its roots in experimental psychology from more than a century ago when people such as William James, Hermann Rorschach and even Jung observed that clusters of associated ideas could be found in subjects who were not entirely aware of them. A Rorschach test, for example, presents a variety of inkblots which depict no real objects to subjects who were asked to say what these various shapes reminded them of. The test would then reveal something about the character of the person being tested. Of course, such projective tests can be meaningful only according to the the interpretive scheme being used. But the early psychoanalysts were quick to cite projective tests as objective evidence for their ideas of psychological complexes. Psychoanalysis argued that the proven reality of complexes revealed a dynamic unconscious which ruled the thoughts and emotions of all people, not just psychoanalytic patients. But complexes are hardly solid entities with easily discerned objective properties. They are better thought of as heuristic devices used by psychoanalysis to understand the unconscious processes of patients. Moreover, the great differences of opinion which emerged between Freud and Jung about the nature of complexes may have undermined the claim that the evidence for them was entirely empirical. But this is taking me away from the topic at hand.
Let's now go back more than 1600 years in India when Buddhism was still flourishing and Mahayana was developing rapidly. I confess I lack sufficient understanding of this period of Buddhist history to present any informed picture of it, but it was clearly a time of extraordinary spiritual exploration. It was here at this time that Yogacara was developed by two Buddhist monks, Vasubandhu and Asanga, who presented a model of consciousness that added two new faculties that were not included in Buddhism's previous model of consciousness. According to the model that had been taught since the Buddha's time several centuries before Yogacara, consciousness was comprised of the five sense modalities of sight, hearing, smell, touch and taste, as well as an additional faculty, the mano vijnana, or the mind as a sense faculty aware of its own contents. Yogacara claimed that two additional faculties of consciousness were needed to give a complete picture of consciousness. First, there was the alaya or storehouse consciousness which contained the karmic seeds of past actions that would be germinated whenever the conditions were favourable for them to do so. Then there was the manas which identified with the contents of the alaya in a perpetual quest to secure a lasting self. Clearly, these two added faculties of consciousness present a picture of the mind that has much in common with psychoanalytic ideas of the unconscious. But, as I said before, the differences between these two ways of looking at consciousness should not be overlooked. It is worth noting in this regard that the discovery of the alaya and the manas did not come about through any clinical investigations of human psychopathology similar in any way to psychoanalysis's discovery of complexes. According to legend, Asanga was transported to Tushita heaven where he was given tutorials on the mind by the Maitreya Bodhisattva and then returned to the material plane where he shared this unique teaching. But perhaps Jung had something similar happen to him when he came up with his idea of the collective unconscious.
As I say, Yogacara continues to influence Buddhist thought and practice, but I am not sure quite how it does so. Presumably it informs the practice of meditation, perhaps by teaching practitioners how to deal with the personal contents of the unconscious that inevitably arise in meditation. If that is the case, then its affinity with psychotherapy would seem even stronger. But is the similarity of Yogacara to psychotherapy a mere curiosity or does psychotherapy have something to learn by becoming acquainted with Yogacara? As a Buddhist therapist, I am inclined to think so, but at the same time I would be suspicious of drawing any superficial conclusions. And when Yogacara talks about bijas or karmic seeds originating from countless lifetimes in the past lying dormant in the alaya, I can't help but be baffled by the claim. It is not that I doubt the possibility of rebirth. But nothing in my experience permits me to see it as anything other than fantastical. If, for example, a client came in and claimed a vivid memory of a trauma that occurred to her in a previous life in some place like ancient Egypt, I would listen respectfully, but would suspect that her complaint disguised a more immediate difficulty.
Jeff, no doubt, would have even stronger reservations about accepting any claims about rebirth, but that didn't really figure into our conversation. But he did ask me what relevance I thought any Buddhist ideas concerning the unconscious could have for psychotherapy "All samskaras [compunded things] are inherently empty," I replied. That is to say that the unconscious, which often secretes its darkest contents into consciousness by the devious means of complexes, can be seen through if they are brought to the light of awareness. But this has always been the aim of psychotherapy, which is what Freud must have had in mind when he wrote: "Where id was, there ego shall be." But the further claim of Buddhism, which goes beyond Freud's therapeutic ambition of enabling patients to be capable of love and work, is that by seeing the inherent emptiness of all phenomena a more complete and final realisation can be attained. Having said that, even Buddhist therapists should be satisfied with hitting the Freudian marker for success.
Speaking of rebirth, I want to briefly recount a story I once heard about the late Jungian psychotherapist Roger Woolger who specialised in past life regression. I never met Woolger myself, but a mutual friend once asked him if he believed that his clients were actually retrieving memories from previous lifetimes. "Three days out of the week I do; three days out of the week I don't and on the seventh I just don't know.," he replied. I approve of this answer as it balances belief and scepticism and then takes a day off.
In my last blog I questioned whether realising the truth of anatman or no-self should ever be a value for psychotherapy. This is a question that therapists with a Buddhist orientation have had to confront ever since Buddhist psychology was discovered as a source of insight for psychotherapy. More than twenty years ago the well known Buddhist psychotherapist, Jack Engler, came up with a a marvellously pithy expression for how the self development which psychotherapy seeks could be reconciled with the ultimate truth of no-self. "You have to be somebody before you can be nobody," Engler wrote. His dictum became quite popular among Buddhist therapists, but non-Buddhists may be forgiven for being puzzled by it. After all, who would want to become a nobody? And should being a nobody really be held out as any sort of spiritual or psychological ideal?
Perhaps the first thing that should be said here is that being no-self-- or being nobody in Engler's sense of the term-- does not mean depersonalisation, that dreadful state in which someone does not experience himself as human, but feels like a mere object or thing. This occurs either as a precursor to psychosis or features prominently in psychotic breakdown [a brilliant description of this phenomenon can be found in RD Laing's The Divided Self]. By contrast, realising no-self entails no impairment to human feeling and actually enhances the capacity for feeling sympathy towards others. Indeed, it frees one of obsessive egoic concern and allows one to encounter others in a spirit of free generosity. Perhaps another way of putting this is that when the self is no longer an issue a person becomes free to encounter others in an unobtrusive way that encourages and shares in the well being of others. Yet, it must be observed that this lofty ideal may seldom seem to occur in therapy where the selves of both client and therapist often lie coiled and hidden in unconscious processes that work insidiously to thwart any deep realisation of no-self. So is it possible that no-self has little true relevance to psychotherapy which typically deals with the low, base, often shameful passions of human nature?
Actually, no-self can apply very well in psychotherapy, though a crucial feature must be borne in mind when considering the idea. No-self doesn't so much refer to a thing or even a state of mind or state of being, as much as it indicates a fundamental and inherent characteristic of all things. No-self is better understood as an underlying feature of reality which is only made at all evident by the apparent effects of impermanence. Moreover, it is the craving for permanence which gives rise to the illusion of self which produces suffering. All of this is very basic Buddhist psychology and my brief sketch of it here hardly does justice to the detailed vision and exhaustive analysis that support the Buddhist idea of no-self. But if we were to make a rough and ready translation of a core principle of Buddhist psychology for easy assimilation for psychotherapy it could be that attachment to any phenomena---objects, pleasures, aversions, views, but above all, ideas of self--is the principle cause of psychological distress. Clearly, this principle has a great deal in common with similar ideas about attachment in secular psychology. But the Buddhist analysis based upon the key idea of no-self is surely the most thorough deconstruction of attachment to be found. Arguably, it is that very thoroughness which may pose a problem for psychotherapy.
Now I don't think for a moment that Buddhism is an exclusively monastic practice, but there is no doubt that the monastic life has always been upheld as the most conducive for attaining enlightenment. We might go on to observe that few environments could be better suited for realising the truth of no-self than in a monastery where distractions are kept at a minimum and the conditions for developing the concentration that are necessary for realising no-self are highly propitious. Psychotherapy, by contrast, must labour in the everyday world of money, sex, war and karma (this wonderful phrase comes from the title of David Loy's excellent collection of essays) and thus finding equilibrium in the turmoil of the everyday world must be one of the foremost concerns of any form of psychotherapy. Moreover, psychotherapy is not usually about seeing into the ultimate nature of things. It is about functioning in the world where relationships break down, untimely and tragic deaths occur and where failures and disappointments abound. Here clients seldom, if ever strive for ultimate release, but will usually settle settle for immediate relief from their woes. Yet, having said all this, I don't think the notion of no-self and the higher promise of ultimate release are entirely out of place in the consulting room. Certainly for me, my faith in Buddhist principles is vital for my work as a therapist, even though I am hardly enlightened and would never cast myself as an exemplar of the Buddhdaharma. Still, I am convinced that Buddhism is fundamentally right about all the essential questions regarding the human condition. But this is only my faith and therapy must never rely on faith alone.
Earlier, I referred to the coiled and hidden selves of both client and therapist that are brought to bear on psychotherapy. What I was alluding to was transference and counter-transference, the complex and largely unconscious exchange of feelings that client and therapist inevitably develop for each other during a long course of psychotherapy. Dealing with such feelings can be tricky and dangerous business, but as Freud maintained, it is essential for psychoanalysis and performs an important function for other forms of long term psychotherapy, as well. The reality of transference and counter-transference present convincing evidence of the self processes of both therapist and client and would seem to undermine any possibility of finding the more elusive presence of no-self. Yet, occasionally both parties may experience a moment of clarity when the anxiety that infiltrates therapy unexpectedly lifts and the sense of oppression that governs the life of the client temporarily dissolves. "Find the space between your thoughts," is an instruction sometimes used for meditation. It often comes as a surprise that there is such a space and that in its very emptiness it can be astonishingly luminous. Any such experience, however brief, holds an intimation of what consciousness might actually be once it is freed of mindless habit. Psychotherapy is about exploring mindless habits and bringing them to the light of consciousness. But Buddhism shows a way to locate that light.