One of the most fascinating, as well as necessary controversies in contemporary Western Buddhism concerns rebirth. Historically, all Buddhist traditions have regarded rebirth--which should not be confused with reincarnation--as fundamental to Buddhist doctrine. The Buddha himself taught that rebirth was part of the cosmic order and he claimed to possess direct knowledge not only of his own previous lives, but also those of all sentient beings. His testimony appears in the Pali Canon, the oldest, as well as the most authoritative scriptures in Buddhism. Until recently, unquestioning belief in rebirth has amounted to virtual orthodoxy. But as Buddhism has begun to find its way in Western culture, it has encountered a well established Western world view that opposes belief in an afterlife of any kind as a matter of epistemological principle. In this sceptical and empirical world view, to credit the possibility of rebirth without the possibility of empirical verification is simply impermissible. Rebirth must be rejected just as summarily as the Christian belief in heaven and hell. Yet, there a few people who subscribe to this view and still call themselves Buddhists, in spite of their entrenched scepticism. In his wonderful memoir, Confessions of a Buddhist Atheist, Stephen Batchelor recounts his experiences as a Buddhist monk and scholar who, though he sincerely tried to believe in rebirth, was unable to shed his doubts. Although his lack of conviction led him to disrobe after years of being first a Tibetan monk and then a Zen monk in Korea, he still regards himself as a Buddhist because he believes that the Buddha's message of spiritual liberation remains valid within the limits of human finitude. Batchelor refers to his position as "Buddhism without belief" and he used this memorable phrase as the title of his best known book. However, not all Western Buddhists agree with him or share his scepticism. The British born Theravada monk Ajahn Brahm, for example, describes Batchelor's views as beliefs without Buddhism. And many other Western Buddhists appear drawn to the religion precisely because it affirms rebirth.
The question of what happens to us after death is unlikely ever to be settled by examination of the empirical evidence, for what little evidence there is, is highly questionable, to say the least. Still, the want of evidence won't make either the question or the belief in rebirth go away. As a Western Buddhist myself, I sit on the fence in this matter. I don't find the evidential case for rebirth convincing and regard most personal testimony about past lives as doubtful, if not fraudulent. Yet, unlike Batchelor, I don't believe Buddhism carries much moral force without rebirth, for without that belief it loses its essential moral imperative. To paraphrase Doestoyevsky, without karma anything is permitted. It also seems to me that Batchelor doesn't believe so much in the Buddhist ideal of enlightenment as he does in ataraxia, the state of deep tranquillity that was extolled by the Stoic philosophers as a way of achieving harmony with the universe. And unlike Buddhism, personal rebirth doesn't figure into Stoic metaphysics, at all. But Buddhism, as I understand it, offers far more than an antidote to the stress and anxiety that is inherent in our mortal condition. It also promises the possibility of finding permanent release from samsara, the wheel of life and death. From the Buddhist perspective, death as a finality would not constitute a metaphysical problem. Oblivion at death would mean the end of suffering, which would make it tantamount to nirvana. But this is a view that the Buddha explicitly rejected as annihilationism. What he taught is that it is birth and death as an inseparable sequence that makes suffering inescapable. And that is the problem: to be born is be fated to die; to die is to be fated to be reborn, only to die and be reborn again and again in an infinite series. It is easy to grasp the first of these propositions, but the second is too obscure for most of us to see. Though we witness the reality of both birth and death all the time, the idea of rebirth may seem to be mere speculation.
Religions claim to know what science cannot disprove and so there is a vast array of ideas about what happens to us after death. The Hindu Vedas speak of reincarnation and of an atman, an eternal soul that is reborn in accordance with its karma. Buddhism differs from this view, chiefly in its rejection of the idea of atman, claiming instead that there is anatman, or not-self that is better thought of as a karmic process than a psychic entity. What we take to be a self is actually a collection of elements that has been brought into being by prior karma without there ever being a soul or self to direct or oversee this process. It is a blind, vacant urge to be, rather than a sempiternal self that turns the wheel of life and death. Yet, Buddhism also claims that it is possible to be aware of that urge--even, strange to say, to be self aware of it. As the great Japanese Zen Master Dogen expressed it, to study the self is to lose the self. Or, to put it in another way, to become deeply self aware is to realise the truth of not-self. But in order to do this it is necessary to have insight into the blind urge that perpetuates being. And it is in observing this urge in action that we may also reach some understanding of rebirth.
In the Buddhist doctrine of dependent origination, which describes birth and death as a twelve stage cycle, birth [jati] follows from craving [trishna] and clinging [upadanna] only to be succeeded by death [jaro maranam] in inevitable progression. Death itself is a transitional state of deep ignorance or unconsciousness in which all our latent urges germinate before giving rise to the same sequence all over again. The description of the cycle is necessarily abstract and schematic, but for that very reason it can appear deceptively simple. The Buddha himself reproved his close disciple, Ananda, when he exclaimed how easy it was to comprehend. But it is within each stage of the cycle that things become complicated, perhaps most of all in the samskaras, a term that means both volitional action and karmic formation. One way of thinking of a samskara is as a habit pattern that springs to mind whenever the conditions for its emergence are propitious. And each time we act on that habit, it becomes more deeply ingrained in our mentality. Samskaras then function like karmic capital that only increases every time it is invested in being as voluntary action. Not all samskaras are harmful or inauspicious and Buddhism has always advocated the cultivation of benign karma both to lead to a better life and make an advance towards ultimate liberation. But even the most sublime samskara cannot offer liberation, for when the conditions that sustain it disintegrate as all compound things do, the samskara vanishes as if into the air. And here, perhaps, we may catch a small glimpse of what it is like to die and be reborn.
Almost everyone knows what it is to experience a loss that amounts to a kind of death, when everything we thought we had been living for felt torn from our grasp. Yet such losses may not have been as dire as we had first thought. As children, for example, we may have mourned the loss of a cherished toy with inconsolable grief. And for some people, even as adults, losing something as inconsequential as a football match or a beauty contest could provoke a feeling approaching self negation. Of course, there are other losses that may strike us as worthier of sorrow, such as the end of a relationship or marriage, and, above all, the death of someone we love. But no matter how important or trivial a particular loss might be deemed, it is our reaction to it that indicates how death could condition rebirth. We might experience a feeling of numbed bewilderment in which nothing--no hope or desire, perhaps not even a feeling of distress--seems to impinge on our sense of self. We would simply feel cut off from the people or things that once seemed to sustain us. But then, something remarkable would likely happen, usually without much conscious effort: we would become ourselves again. And though this might feel like rejuvenation, it could just as well feel like a return to a dreary round of familiar need. Though it might seem to be a rebirth of some kind, our coming back to life would still be led by the same self needs that had always ruled us.
Of course, none of this provides any argument for rebirth after physical death. No matter how much we might feel reborn within one lifetime death would still appear as the irreversible exit it always has been and will always be. But if there is an afterlife our present lives might offer some clues about what we should expect.
What brings people to psychotherapy? Ideally, this is a question that would never be answered in general terms for each person is unique and therapy only becomes meaningful once the client begins to come to terms with his or her uniqueness. The better, indeed essential question is always: "What brings you to therapy?" For only by eliciting reflections based on the actual experience of the client can a strong foundation for therapy be built. As a psychotherapist, then, I avoid making any medical sounding diagnoses precisely because it discourages the development of the self awareness that therapy depends on. Moreover, I don't believe that a medical diagnosis--derived from the Greek, meaning seeing through-- for purely psychological conditions is actually possible. Although I believe that fixed patterns of mental suffering are a reality beyond dispute, the idea that there are discrete disease entities that can account for them has little, if any merit in my view. Still, because there are typical patterns of thought and behaviour for a great range of psychological complaints, having some theoretical understanding of what people commonly experience when they are depressed, anxious or deeply confused is a resource that no therapist can do without. But helping the client to look beyond the symptoms of her particular condition and find the intentional actions that keep that condition in place is what therapy is all about. This almost always involves recalling painful experiences from the past, as well as looking at difficulties and frustrations in the present. And what is often discovered is that at the heart of those frustrations there is often a terrible privation that can be be both mysterious and obvious at the same time. The lack is love.
The idea that getting love is the answer for all the pains and frustrations to the which the self is subject is practically a cliche and every therapist should regard it with deep suspicion. Alas, not all therapists do and many err seriously by seeing themselves as the guardians of their clients' affections. It is common to hear, for instance, of therapists projecting their own material into the client's discontents, imposing their sense of narrative into the living story of their clients. This may be done more or less innocently, but it is almost always done blindly and can only work against the client's need to develop self insight. Perhaps even worse is when therapists explicitly advertise themselves as love doctors who can dispense wisdom and advice for obtaining love and sex. There are certainly good, ethical therapists who deal responsibly with issues relating to sex and relationships. Unfortunately, there are also others who are only too happy to exploit the insecurity of their clients by promising success in love. As we might suspect, this is largely an American phenomenon, but the practice of promising to deliver romantic success happens here, too. The late David Smail, a brilliant psychologist, used to argue that it was a strategy of advanced capitalism to present love as a scarce commodity by convincing people that only the wealthy, famous, intelligent or beautiful are worthy of it. His argument finds validation in psychotherapists who pander to the desperate hopes of the lovelorn by playing on the logic of feeling that a capitalist society promotes. Yet, surely, feeling unworthy of love is nothing new or modern. The complaint of the world has always been that there is never enough love to go around. If some therapists find the shortage of love an opportunity for selling it like snake oil, the problem that therapy will always face is the absence of love. "Why doesn't love happen to me?"; or, even more poignantly, "why didn't love happen in my childhood, when I needed it the most?" are questions that always come up in therapy.
Of course, seeing love from a position of deprivation is almost certainly to form a distorted idea of it. It's like trying to imagine life on a planet in a distant galaxy. The possibilities may appear endless, but none are open to direct experience. Fortunately, most of us have experienced love in some form or another. And usually those experiences provide essential guidance for our emotional lives. Yet, although almost any form of love does have a transcendent quality, confining our notions of love to our personal experience of it may be misleading, especially if we think that love obtains only in the people or things that stimulate our affections or arouse our desires. Though we may find security in knowing whom and what we love and the reasons why we love them, we may still be mistaken in closing the circle of our love around them. We forget that love begins as an opening and a discovery that enables us to know others--and ourselves--in a way that no other form of knowledge permits. Consumerism does a booming trade by persuading us that love appears only in erotic or sentimental guises and convincing us to dread the possibility of never getting it. But love depends less on objects that provide reliable satisfactions than it does on keeping the heart open to the experience of others.
Those who are advanced on a spiritual path--people we might regard as enlightened--appear almost indiscriminate in the expression of their love. It seems to radiate from them like sunlight. They also seem to know something that the rest of us don't. Their love doesn't need to be gratified--it is already gratified, or rather, perhaps, their love is realised beyond any need to find gratification. Certainly they seem able to give love without receiving it in turn; nor do they seem aggrieved by the lack of reciprocation. But for most of us, love is far more conditional. We are cautious and selective in offering it and we usually offer it only in order to get it. But then, it may be that we really don't see what the enlightened seem to know so clearly. Almost everyone wants love--to give and receive it--but the conditions we impose on it impair our understanding of what love is. And because love leaves us vulnerable to disappointment, we are understandably protective of our affections. So we cling to love as we have experienced it, even when the conditions of that experience may have vanished.
So how does therapy help with the lack of love? Certainly not by preaching the virtues of universal love, no more than by shilling the benefits of romantic love. But because love is essential to human experience, it must remain open to personal enquiry. This may not only involve examining the client's personal history of sadness and disappointment; it also involves an imaginative exploration of how love can be meaningful in the terms that her life experience furnishes. Love really is the answer for so many of the pains that people suffer. But sometimes therapy is the place to begin to address the question.
I have tried to be cautious about making pronouncements concerning events in the news, but the recent mass murder in Oregon deserves attention because of the proclaimed linkage of this atrocity with the apparent mental illness of the killer. The gunman, whom the authorities are reluctant to name for fear of giving him a sort warped celebrity, appears to have been a disaffected loner whose inner life was dominated by visions of wanton slaughter before he decided to act out his fantasy. Authorities, journalists and even Presidential candidates have been quick to identify mental illness as a contributing cause of the rampage, as only a madman would ever dream of committing such a horrible crime. It does seem obvious that the murderer was seriously disturbed, for his crime was as senseless as it was dreadful. Even so, it is impossible to say exactly what mental illness he was he suffering from, as no one, not even the members of his family, knew what he was feeling and thinking before he went out on his spree of murder. Still, although any diagnosis can only be speculative, I suspect we will be hearing many opinions from experts who will lend scientific authority to the widespread belief that the killer was indeed suffering from a mental illness. Such discussions will hardly be constructive or enlightening, however, if they only address the mental condition of the killer and say nothing about the legal and social contexts which made the crime possible. But only by looking at the atrocity from these perspectives can there be any hope of understanding it and preventing other such incidents in the future. By demanding consideration of these factors, I am not attempting to excuse the murderer or suggest that he was not seriously disturbed. But a society that continues to make guns easily available to anyone after repeated incidents of mass murder can hardly pretend to bear no responsibility for the slaughter. Unfortunately, it is also easy to foresee that those deemed mentally ill will suffer unfair suspicion because of the actions of a few individuals with whom they may have nothing in common except for a psychiatric diagnosis. Because a psychiatric label might seem to offer insight into the mind of the killer, entirely innocent people may become scapegoats for crimes for which society itself deserves much of the blame. Meanwhile, a far greater psychopathology escapes the scrutiny it deserves.
The madness begins with laws that allow dangerous firearms to be so widely available. The US enshrines the right to own and bear arms in the Second Amendment of the Constitution. This provision was originally intended to give citizens a measure of protection against the possibility of state tyranny. Since then, however, the idea that guns are basic and necessary instruments for protecting individual liberty has become one of the unchallengeable convictions of the American Right. There is also a certain shameless defiance in this belief in the sanctity of gun ownership which was exemplified by Governor Rick Perry of Texas who, after the Sandy Hook Primary School massacre in Connecticut, invited gun manufacturers from that state to relocate to Texas where they would be more warmly welcomed. Of course, gun makers themselves do all they can to further their interests by pushing a fanatically extreme interpretation of Second Amendment rights, chiefly through the National Rifle Association, a powerful lobbying group that categorically opposes any restrictions on the right to own firearms. In some states such as Texas, every adult, no matter what his background or criminal history, is free to buy a gun with no questions asked. Readers who are not American may not fully appreciate the number of homicides that occur in the US, even excluding the wholesale murders that are committed by mass murderers on rampages (in fact, these count for a very small percentage of total gun deaths). But comparisons help to throw light on the matter. In 2013, there were 537 murders committed in the UK, which may seem an appallingly high number. But in the same year in the US there were over 14,000 murders. Texas alone contributed 1133 murders to the total count (California, however, came first among US states with 1745). Appalling as these numbers are, no less sickening are some of the individual circumstances of deaths caused by guns. In this week's news, for example, there is a report out of Tennessee about the killing of an eight year old girl by an eleven year old boy. He is alleged to have shot her because she refused to show him her puppies. Yet in spite of many such incidents and the staggeringly high number of homicides in the country, the NRA continues to maintain that gun ownership is the best defence against crime. In truth, the NRA's influence in Congress should be regarded as a crime in itself.
Fortunately, Great Britain does not suffer the infatuation with guns that America does. But even without easy access to firearms, horrifying rampages such as the massacre in Dunblane still happen here, even if they are not nearly as frequent as on the other side of the Atlantic. So why do some people act out their violent fantasies? This raises psychological and social questions, rather than legal and political ones. But as I said before, getting into the mind of a mass murderer without knowing much about him strikes me as a dubious undertaking. What is more open to general consideration is how violence and murder as represented in such popular entertainments as television, movies and video games might contribute to the fantasy life of a killer. This is an old debate that still divides opinion among social scientists, but from a Buddhist perspective there really is no argument. The law of karma asserts that the cultivation of any attitude, be it harmful or benign, produces consequences that will follow accordingly, if not entirely predictably. This does not, of course, mean that every kid who plays Grand Theft Auto will go on to become a violent criminal, as other factors will usually counteract the urge to violence that such entertainments foment. Much the same dynamic can be observed in violent pornography. Although most men who view violent porn do not become sex offenders, a susceptible minority of them find it a powerful stimulus to sexual assault. But even when an unskilful intention does not lead to an actual crime, Buddhism would still insist that intentionally arousing any harmful passion in order to take pleasure in it is to perpetuate a chain of negative karma, even if the agent has no awareness of being enchained and suffers no immediate consequences from his actions. Moreover, this is not a solitary matter that only affects the person who carries a particular karmic disposition. Karma can spread to others like shared good fortune or a contagious disease. And though it depends on causes and conditions that are not easily analysed, karma presents experience as an apparent destiny beyond which we struggle to see. For karma creates the world and assigns a place in it to each of us; or rather, it appears to, for karma is the fabric from of which all our illusions are woven.
The idea of shared karma may be particularly illuminating for a crime such as mass murder. While a mass killer is probably acting out of blind hatred for people he might not know at all, beneath that emotion there is almost certainly a great deal of fear. Moreover, it may not be particularly personal fear, but may have more to do with a social climate in which fear predominates. I remember once going to a sporting goods store in Texas to buy some camping equipment. I was astonished to see how many customers there were at the gun counter, all looking to purchase powerful handguns. These were not guns made for sport; they were made to kill people. So just who did these gun buyers expect to shoot? Governor Perry is worth quoting here. "When a criminal breaks into your home, I'll let the liberals call the lawyer. I'm going to call [the American gun maker] Smith and Wesson." Perry, then, has more faith in guns as a source of security than in the rule of law. Nor is he alone among American politicians in holding such a view. Recently, the billionaire Republican candidate for president, Donald Trump, expressed his views on the mass murder in Oregon. Noting that "there are a lot of sick people out there", Trump suggested that if the teachers at the community college where the massacre occurred had been armed "[they] would have been a helluva lot better off." Another Republican candidate, Ben Carson, said that he wouldn't have stood by idly when the gunman was going on his rampage. Presumably, he would have been packing his Smith and Wesson. At present, Carson and Trump are the leading contenders for the Republican nomination. Although Trump, Carson and Perry would not be diagnosed as mentally ill (though perhaps Trump would score high on a test for narcissistic personality disorder), they are seriously deluded in believing that the unrestricted use of fire arms will make people safer. And for people who are desperately insecure to begin with, the wildly irrational beliefs of powerful public figures who make laws and influence public attitudes will have a particularly toxic effect. When powerful people proclaim that having a gun and being ready to use it should be regarded as responsible citizenship, especially in a popular culture which celebrates violence as a means of resolving conflict, small wonder that both murder and mass murder have become routine occurrences. The idea then that horrors such as the Oregon massacre are due solely to the individual pathologies of a few "sick people out there"is to overlook the social context of the massacre. Seen from that perspective, it was far more normal than people realise.
I am happy to report that I recently passed the BACP competency test. But because the test has a pass rate of around 93% my achievement can hardly be called exceptional. Still, it is noteworthy in that it helps to secure my status as a member of the largest body of counsellors and psychotherapists in the UK. I have actually been a BACP member ever since I began training as a counsellor and therapist and perhaps like most people who have joined, I see membership as a useful credential in plying my trade. But I also believe in the BACP's mission to uphold ethical standards for our profession. For counselling and psychotherapy depend on the therapist's ethical commitment to the psychological welfare of clients; any practitioner who violates that trust by exploiting the vulnerability of clients for his own personal gratification should not be practising at all. But the BACP does more than try to uphold ethical standards for the profession. It also attempts to inculcate methods of good practice for which the competency test serves as a standard. There are some essential tasks such as record keeping, therapeutic contracts, and above all, client confidentiality, which all practitioners should understand and manage responsibly and the BACP is right to insist on their importance. But beyond these things, I wonder what constitutes good practice and wonder even more how it can be tested. I don't doubt the possibility of learning to be a good therapist. Indeed, learning to be a therapist is a necessity, though I believe it can only be learned through experience, not by didactic teaching methods that are more likely to inhibit the intuitiveness and spontaneity which I believe are essential for therapy. But if these essential skills can only be learned and not really taught, how can they be tested?
My family history was never meant to feature so much in this blog, but once again I turn to a memory that involves my father. Actually, my recollection involves both my parents and goes back to when he died of a heart attack in 1989. I happened to be visiting them on the night of his death and I will always retain the vivid memory of being awakened from a deep sleep by my mother as she burst into my room and cried, "Wake up! Come quickly! Dad is having a heart attack!" It took me a moment to come to awareness and realise what was happening. But once I did I quickly followed her into their bedroom where I found my father gasping loudly and rapidly, with a curiously blank and impassive expression on his face. Immediately, I phoned EMS which said that a crew would be with us within a half hour, which seemed far too long to save him. Unfortunately, neither my mother nor I had CPR training, but I knew that standing by helplessly watching him die would be almost as agonising for us as dying was for him. So I made a pretence of exercising a skill that I didn't actually possess and urged my mother to join me in trying to save my father. It didn't work. By the time the ambulance arrived my father had crossed a threshold into irreversible brain damage as the medics sensitively explained to me soon after they tried to revive him. They could save him, they advised me away from my mother, but if they did he would be brain dead and on life support for the rest of his life. My decision, I am tempted to joke, was a no-brainer. But in truth I knew that my father would have dreaded the thought that he would spend the rest of his life languishing in a non-conscious state, his body sustained artificially by technology. Sparing my mother any part in the decision that I knew she would later approve, I told them to let him die.
The story does not end there, however. My mother was devastated by my father's entirely unexpected death, especially as they both had been looking forward to their fiftieth wedding anniversary which was just two years away. Their marriage was as close as it was enduring and neither could have imagined living without the other. But my mother was forced to confront the unthinkable reality of living alone as soon as the ambulance crew left my parents' home. Suddenly looking like a lost little girl, she asked me "How can I possibly live without him?". In fact, life did become very difficult for her, especially in the immediate aftermath of my father's death. Staying at her house a few weeks after his funeral, I woke up in the middle of the night to hear her sobbing and crying out my father's name. I wanted to go into her bedroom and console her, but something told me that she didn't want that. As much as I loved my mother and father, I knew I couldn't be with her in the depths of her sorrow. I also knew that her sorrow was something that she needed to feel, no matter how painful her experience of it was. So I lay in bed listening to her weep, staying awake in case she wanted me to be with her. But her call for me never came.
Later, though, I heard an extraordinary story from my sister about what my mother had experienced sometime in the period of her deep mourning. She had been alone one night--perhaps she had been calling out my father's name just as she had done on the night that I heard her--when an apparent miracle happened. My father actually appeared in their bedroom. Sitting down on the bed he had shared with her when he was alive, he assured her that he was fine and told her not to worry about him. He also told her that she too was going to be fine, for he knew that she would be well taken care of in his absence. My mother was not particularly superstitious, but nor did she possess a notably sceptical mind. In fact, it occurred to me that in her grief she might have been highly suggestible as sleight of hand artists refer to people who are easily tricked. Yet, in my sister's account of what my mother had told her, the exchange between my mother and deceased father was exactly what he would have said, for he had always been the wise and protective husband to her. Moreover, the vividness of her experience seemed to be far beyond what she might have simply imagined. I myself never questioned my mother about the visitation, mostly because I didn't want to cast doubt on an experience that had consoled her in a way that I never could. But I have always wondered if the spirit of my father actually did make a posthumous appearance to her.
In his book on hallucinations, Oliver Sacks (who himself recently died) wrote that hallucinating the presence of a recently deceased loved one--especially a parent, child or spouse--is actually quite common among people who are in bereavement. Losing someone who is very close can actually feel like losing a part of oneself, just as the well worn cliche claims. Sacks even goes so far as to compare such a loss to losing a body part and experiencing a so called phantom limb from which physical sensations arise from an apparently absent source. It as if the brain feels forced to conjure what is assumed to be essential to self experience. Sacks does not, however, consider the idea that such hallucinations could be the means by which a disembodied spirit becomes manifest. But then neuroscience must regard hallucinations as neurological events and not as potential vehicles for spiritual presences. Hallucinating the spirit of a dead loved one can be seen as nothing more than emotion overriding an intolerable objective reality. Its only mystery to neuroscience is how such wish fulfilment manages to be so convincing.
Being free of any physicalist bias, Buddhism has no difficulty in accepting paranormal events. And in the Buddhist cultures of Asia, the idea that my father actually did appear to my mother would provoke little disbelief. Even many Western Buddhists would find it easy to accept that my father made a brief detour in what Tibetans refer to as the sidpa bardo, an intermediate realm between one life and another, before migrating to his next birth. Whether he did or not, there is a danger of romanticising what my mother experienced. Romantics may be tempted to believe that my father's post-death appearance to her meant that he was waiting patiently on the other side of death for them to spend eternity together. Certainly, this is what my mother (who was Catholic, not Buddhist, but also somewhat romantic) would have wanted to believe. So perhaps her ardent wish to be reunited with my father was the cause of her hallucination, just as neuroscience would aver. If so, the power of her attachment and belief in romantic love had succeeded in creating her own reality, however temporary and illusory it was. Although Buddhism is more inclined to credit the veridicality of my mother's experience, it would not agree with any romantic ideas about eternity, either. For samsara is a an eternal tribulation that never ends happily ever after. This doesn't mean that my parents love for each other was false or illusory; it was just fleeting, as all things are. I also like to think that their love brought them closer to awakening and helped me along my path, too.
Everyone by now has seen and been moved by the images of the refugee crisis in the Middle East. Hundreds of thousands of people have been driven out of Syria and in their frantic diaspora are trying to find safety wherever they can. The photograph of Aylan Kurdi, the drowned three year old boy whose body washed up on a Turkish shore might remind us of a child sleeping peacefully, except for the fact that we know he is dead. Another photograph makes it easy to imagine the circumstances of his perishing. This is the almost equally famous picture of a Syrian man holding a child in his arms as his anguished facial expression tells of the overwhelming terrors that he must deal with in order for his family to survive. Such images are shocking and poignant, yet also necessary, for they evoke compassion and motivate people to act to alleviate the suffering of innocent victims of war. Here in Britain, it was gratifying to watch the haste with which David Cameron was forced to reverse his decision not to allow any more Syrian refugees into the country following the public outcry against his refusal to grant asylum to people who so clearly need it. The British people showed the compassion that he once claimed would be the hallmark of his government. Yet the events that caused this crisis are complex and the region in general is so highly volatile that there is little realistic hope of finding immediate peace there. The situation can be likened to a terrible blaze that shows no sign of ever being extinguished. While most people would like a counsel of peace to prevail so that civic order can be restored, the raging fire of enmity and strife almost assures that any such counsel would go unheeded.
The horror that we now witness in the Middle East is, of course, nothing new. War and its dreadful consequences seem to be what history is made of, though we tend to forget this in times of peace. Or perhaps, rather, we repress the horror of war in order to escape the dreadful memory of it. My father fought in World War ii and participated in a number of battles that were legendary for their savagery. But he didn't like to talk about those experiences or remember the carnage that he witnessed on the battlefield. "You just don't want to think about it," he told me. My father, however, was fortunate in being able to set those terrible memories aside. Others who may be more psychologically vulnerable or suffer losses such as my father never had to endure, find it impossible to free themselves of the oppressive memory of their suffering. Abdullah Kurdi, Aylan's father, lost his wife and another son at the same time that his youngest child was drowned. He now says that his soul was buried along with his family and just by seeing the picture of the corpse of his youngest son we know that he is not exaggerating. Moreover, it is difficult to imagine that he won't always feel this way. But the fallout of war is not confined to the people who have had direct experience of it. The after-effects may be felt, if not actually remembered, later in life by those around them. Although my father suffered no lasting trauma from his experience of war, he frankly admitted that it was the closest thing to hell that he had ever witnessed. Fortunately, as children, my brothers, sisters and I had little inkling of what he had suffered as a combatant. As a therapist, however, I have often heard stories of some older clients about their parents who, as children, suffered from traumas inflicted on them during WW II. As adults, their parents could become inexplicably moody or given to sudden outbursts of anger which left their children--who would later become my clients--feeling frightened and confused. A child's small gesture of defiance could provoke a towering rage that was way out of proportion to the act that had provoked it. At other times, a gloomy silence could fill the house like a noxious cloud. Perhaps worst of all, my client's parents were emotionally unable to provide the love and support that all children need. The wartime traumas of their parents were thus contributing factors to the post-war suffering that brought my clients to therapy years later, long after their parents had died. The trauma of war survived those who actually experienced it.
The idea of transgenerational trauma may seem too vague to be truly insightful. And if history is a recurrent nightmare of war punctuated by peace, who hasn't been affected by it? It might also be reasoned that if the nightmare of history is inevitable, what can be done about it except arm ourselves for the next conflict? Although psychotherapy may try to tend to the psychic wounds of individuals affected by war, the underlying cause is much greater than psychotherapy can ever hope to address. The endless round of violence and retribution appears to be the way the world continually reorders itself. There will, it seems, always be a fire next time. The phrase "the nightmare of history" comes from James Joyce's Ulysses, and is spoken by Stephen Daedalus in mild resistance to an anti-semitic tirade by a man who blames the Jews for the decline of England. The novel was written more than a century ago and though history has since raced forward through events that nobody in the early 20th century could have predicted, the hostilities that were alive then are no less and perhaps even more virulent now. The nightmare of history from which Stephen Daedalus wanted to escape is flourishing as strongly as ever.
But what could waking up from the nightmare of history actually mean? Many people seem to think it would mean making the world a more peaceful place in which mindless conflicts don't send millions of people into exile or expose children and other innocents to the murderous ravages of war. Although this would certainly improve the world, the unconscious urge to violence and war would still remain within us. An important goal of politics should be to keep those destructive urges safely dormant and far removed from the social sphere. Yet, a nightmare born of some festering frustration could still erupt into an unexpected crisis at any time. Buddhism, of course, advocates awakening in a more thoroughgoing sense that goes to the very roots of our dangerous, unconscious urges. Waking up would mean facing up to and letting go of all the bogus needs that give rise to our conflicted interests. Ultimately, it would mean escaping samsara, the round of birth and death, but more immediately it would mean becoming aware of the fact that the nightmare of history is our own creation.
In my last post I discussed psychiatry and anti-psychiatry and argued that the latter term has been used by institutional psychiatry to defend its inordinate reliance on psychopharmaceuticals. By favouring psychopharmocology--the use of medication in treating mental illness--over psychotherapy--aptly described by Freud as the "talking cure"-- psychiatry has neglected perhaps the most important feature of psychological healing. Still it is true that the cautious and judicious use of psychopharmaceuticals may not only be life saving, it can also complement psychotherapy. But having just recently finished reading Kay Redfield Jamison's brilliant and eloquent memoir An Unquiet Mind, which recounts her lifelong battle with manic-depression (she prefers this old term for her disease to the current one, bi-polar disorder), I now have a somewhat different perspective on how medication may work as a treatment. Jamison is uniquely qualified to discuss the matter, for not only has she suffered the illness herself, but as a clinical psychologist and professor of psychiatry she possesses a deep scientific understanding of mood disorders. Fortunately, her credentials do not prevent her from being strongly in favour of psychotherapy and she expresses her view of therapy in lyrical passages of praise. But it must be noted that her psychotherapist was also a psychiatrist who, from the first, had always insisted that medication was essential for her to maintain equilibrium. For her part, Jamison is clear that lithium was the only thing that could have saved her from madness or death. For her, at least, psychotherapy was not the primary means of her life saving treatment, it was secondary. So does Jamison's case have implications for the treatment of severe mental illness in general?
I address this question without pretending to have any definite answers or even having the means of arriving at one. As a therapist I have no medical training and couldn't prescribe aspirin, let alone anti-psychotic medication. But both my reading and experience as a therapist incline me to be sceptical of the more extravagant claims of psychopharmacology. The evidence is both abundant and clear that the benefits of drugs therapy have been wildly oversold, in part, it seems, because medications need to be sold. It is also clear that the medical approach to mental illness has progressively moved away from trying to understand the experience of psychological distress as a means of gaining insight into madness and instead has tried to pin down symptoms in behaviour for discrete disease entities that never quite materialise. My own experience confirms what my reading has documented. Many of my clients have gone to their GP's or psychiatrists complaining of anxiety and depression and with scarcely an attempt to find out why they might be feeling that way, are given prescriptions for anti-depressants. While this has sometimes brought them short-term relief, it also had the effect of making them feel more helpless and confused about their emotional lives. The experience of such frustration is often what prompts people to turn to psychotherapy. They want to make sense of their experience, which is something that psychopharamaceuticals alone fails to do for them. But making sense has two rather different meanings which should not be conflated. Many, if not most of my clients come to therapy in order to make sense of what may be called a crisis of personal meaning. But for someone who is suffering from a severe psychosis as Jamison did, making sense of one's self experience in the throes of a psychotic breakdown means nothing less than trying to find enough emotional stability for ordinary living. In cases like hers, medication would seem indispensable for making any kind of sense at all. Yet not everybody would agree with her.
R.D. Laing once argued that by resorting to medication (usually without the patient's consent) psychiatry halted the potential for self healing that could occur naturally in psychotic breakdown. Breakdown can lead to breakthrough, as he put it. This does sometimes happen, but instances of it are surpassingly rare, even without any interference from psychiatry. Moreover, Laing made his argument in reference to schizophrenic breakdown, which though also classified as a psychosis, has much different characteristics than manic-depression (I follow Jamison's recommendation and use this term instead of bi-polar disorder). According to Laing, the schizophrenic could be regarded as almost a frustrated mystic and psychosis could be seen as a way of dealing with his frustration. Although Jamison, a psychologist who firmly believes in the biological origins of madness, has no tolerance for this line of thinking, when writing about manic-depression she makes a somewhat similar case. The manic depressive often possesses great intellectual and imaginative powers which can lead to great artistic, literary or scientific achievement. Indeed, in another book, Touched with Fire, she discusses how manic depression affected such great artists as Lord Byron, Vincent Van Gough and Virginia Woolf, both in the expression of their genius and in the torment of their emotional lives. But perhaps it is her own personal testimony that conveys even more strongly the sense of creative exaltation that arises out of a charged hypomanic state. In these high moods, she felt more intensely alive and open to the creative possibilities of being in the world. But she is equally clear about how dreadful and self nullifying her depressions felt, as well as how terrifying it was to feel possessed by wild, manic energy while feeling hopelessly doomed (it is this latter feeling that to her makes manic-depression the perfect term for the condition). Jamison admits that there are times when she misses the inspiration that her illness brought her. But she is also keenly aware that without lithium she would be either dead or insane. Unlike Laing, she finds no self healing potential in madness at all.
So who is right? Psychiatry or anti-psychiatry? The question is too misleading to be answered. Firstly, the term anti-psychiatry no longer possesses the radical, oppositional force that it once did and it now functions as an easy smear for any critic of institutional psychiatry (Jamison, to her credit, does not invoke the term). And the fact that the medical treatment of madness dates back to the earliest days of medicine tells us not only that it has always dealt with mental illness, but also that it always will. Even so, institutional psychiatry has lost trust by neglecting the human, experiential dimension of madness, perhaps the most uniquely human affliction there is, by becoming so consumed by the biology of mental illness. In treating the disease, it has lost interest in the experience of the people who suffer it. As an author of a definitive textbook on manic-depressive illness, Jamison knows all the available science on the disease. But as a non-scientist I am more impressed by her personal testimony about why she needs lithium in order to survive. I wonder who but the most rabid anti-psychiatrist would want to deny someone like her the medication? But by handing out medication indiscriminately, without concern for the experience of the patient, psychiatry is guilty of a similar dereliction of care.
As a psychotherapist I can only observe the debate about the merits and dangers of medication without being able to participate in it. But I would still criticise any practitioner, medical or not, whose putative expertise sanctions ignoring the personal experience of the patient. Contrary to what Kraeplin said and institutional psychiatry believes, psychiatrists are not surgeons and they do need empathy in order to treat their patients. Perhaps reading An Unquiet Mind would be instructive for them.
After losing the copy that I was reading a year ago, I finally got another one and have now read Gary Greenberg's The Book of Woe, which is an account of how the latest edition of the Diagnostic Statistical Manual, the DSM-5, was written. As probably everyone who reads this blog is aware, the DSM is a handbook published by the American Psychiatric Association which presents a comprehensive list of all mental disorders, as well as a clinical description of the symptoms for each disorder. But at just under 1000 pages, the latest edition is way too bulky to be called handy and is not nearly as scientific or authoritative as the APA would have people believe. Greenberg gives an amusing account of the the politics and feuds that led up to the publication of the manual, which makes their efforts seem less like medical science and more like psychiatric follies. But he is careful not to present the DSM committee as a cabal of evil shrinks intent on diagnosing us all as mentally ill in order to sell drugs and enrich both themselves and pharmaceutical companies. They are, rather, mostly concerned, if somewhat clueless professionals who want to relieve people of their mental suffering. But since the publication of the DSM-3 some forty odd years ago, psychiatry made a fateful turn and has adhered to a disease model of mental illness that has continuously tried to eliminate any nebulous mental or experiential factors from its understanding of mental illness. Unfortunately, as the incidence of mental illness has soared over the past forty years, the attempt to ground psychiatric treatments in the diagnosis of some identifiable physical pathogen has proven entirely fruitless. This approach has, however, led to vastly increased sales of psychopharmaceuticals which have enriched both psychiatrists and pharmaceutical companies. It may also account for the reluctance of psychiatry to admit to its failure and try another tack. For it is never easy to admit to failure, but it is much more difficult to do so if it means losing such great lucrative rewards. Given its potential for scientific, as well as financial corruption, the close alliance between psychiatry and Big Pharma deserves the closest scrutiny and Greenberg's book offers yet another persuasive case about its dangers. But if psychiatry--which has always been the branch of medicine that deals with mental illness--has failed so signally in finding either cause or remedy for madness, does this mean that the bio-medical approach should be abandoned altogether? The question deserves serious consideration.
To mainstream psychiatry, however, even to entertain such a question is to fall into the camp of anti-psychiatry. We might recall that the term anti-psychiatry was first coined more than forty years ago by R.D. Laing's colleague David Cooper, a radical psychiatrist from South Africa who did indeed want to see the profession destroyed (Laing himself detested the term and never took such an incendiary position). But nowadays anybody outside of the psychiatric consensus who dares to express criticism of it is likely to be branded an anti-psychiatrist. This includes serious critics like Robert Whitaker and Richard Bentall, as well as less reputable ones from Scientology. It almost goes without saying that Greenberg has been slapped with the label because of The Book of Woe. But by dismissing him so automatically psychiatry is refusing to engage in the serious argument that lies at the heart of the book. What is the role that medicine should play in the treatment of mental and emotional suffering? A true anti-psychiatrist (though like Laing, he, too, hated the term), Thomas Szasz, argued that mental illness is a myth that is based on a category error and that what psychiatry called mental illnesses were actually "problems in living". But that is not what Greenberg believes. As a practising psychotherapist, he knows that when people feel depressed, confused, agitated and bewildered, they feel sick and want to be free of their suffering. But the question remains: are they suffering from some biologically based malady?
Unfortunately, there is no simple answer to this question. As Greenberg points out, unlike other, more diagnosable physical ailments, the symptoms of a mental disease constitute the disease itself and do not point to an underlying pathogen or physical condition that gives rise to them. The symptoms of depression, for example, merely indicate that a person suffering them is depressed. Although the dream of psychiatry has always been to devise something like a simple blood test that would detect clear bio-chemical markers for mental illness, researchers have been unable to devise any such test and have found no markers and no magic bullets for madness. But psychopharmaceutical drugs do have effects, sometimes positive, even life saving ones. Every therapist has encountered someone who has been rescued from the maelstrom of a suicidal depression by the timely administration of anti-depressant medication. And sometimes medication can stabilise a client so that psychotherapy can take place or become more effective. But medication can also have terribly negative side-effects and if psychiatry is to be condemned for anything, it is for minimising them and overselling the benefits of drugs. Its error appears to spring from a dogmatic belief that the only effective treatment of mental illness can be medical and any other approach can be safely ignored. A consequence of this belief is that it will always keep the self experience of the patient at arm's length from the psychiatrist. As Emil Kraeplin, the father of psychiatry once decreed, psychiatrists should have no more empathy for their patients than surgeons have for theirs. Ever since the publication of the DSM-3, psychiatry has been all too faithful to his tenet of heartlessness.
Of course, not all psychiatrists feel this way and many of the greatest psychotherapists and psychological theorists have also been psychiatrists. No less a figure than Freud--the father of psychotherapy, as well as a psychiatrist-- believed that medical training could actually act as an impediment to becoming a good psychotherapist. His reasoning was diametrically opposed to Kraeplin's as he believed that the detached objectivity that the physician should cultivate would prevent the development of the empathic understanding that is so essential to psychotherapy. But Greenberg notes that medicine has always been at least as much an art as it is a science and that much of its effectiveness depends on the intuitive skills of the physician, as well as the medical knowledge that he draws on. A good doctor not only has a sound grasp of medical practice; he also knows how to apply it to the individual needs and particular circumstances of each of his patients. If this principle applies in medicine, it applies even more strongly in psychotherapy where theoretical knowledge is provisional at best and the empathic bond between therapist and client is perhaps the single most important factor in the success of therapy. How ironic that by increasingly focussing on the physical factors of mental distress, psychiatry has turned its attention away from the relationship between doctor and patient where the best prospect of healing lies.
None of this, however, presents an argument for the claim that medicine has no place in the treatment of mental illness. And as research into the brain and neurological functioning progresses, it is reasonable to suppose that better treatments will be found for dealing with the distress of mental illness. But perhaps psychiatry stands to gain even more by regaining its interest in the experiences of its patients and putting more emphasis on the therapeutic relationship.
My friend Leon Schlamm died suddenly a couple of weeks ago. He had just come through a rather long, difficult period of poor health, but after quitting smoking on his doctor's advice he seemed to be doing quite well. A mutual friend had spoken to him a few of days before he died and they made tentative plans for a meeting. But then, just as he was about to pin down the appointment, he received news that Leon had been rushed into hospital. I don't know the details of Leon's final hours, but I understand that death came fairly quickly after he was hospitalised. At sixty seven, he was really too young to die, especially as he was enjoying his retirement as a lecturer in Religious Studies at the University of Kent. I first met Leon at Kent nine years ago when, as a mature student, I applied for a place in the MA programme in the Study of Mysticism and Religious Experience that he and Peter Moore had convened. The MA programme--which is now in younger hands--emphasises the psychology of religious experience over more theological or sociological concerns, which suited my interests perfectly. Leon and I also hit it off immediately as we had read many of the same books and found we usually shared the same opinions about them. But there was another, deeper reason for our friendship. Leon's academic speciality was C.G. Jung. In fact, Leon didn't just study Jung; he was a passionate Jungian (he was spending his retirement in close reading of Jung's Red Book, Liber Novis, for personal, rather than academic interests). As much as anything else, it was our great admiration for Jung that revealed our affinity for each other.
Because I have no formal training as a psychotherapist in analytical psychology, I am not able to call myself a Jungian. Even so, apart from Buddhism, no other school of psychology influences my thought and practice quite so deeply. So I call myself a crypto-Jungian to acknowledge my debt to Jung without claiming any credentials as a member of that elite guild. Yet, in spite of its great influence and wide renown, Jung himself remains a controversial figure who does not command universal respect. Many Freudian psychoanalysts, especially of earlier generations, could never forgive his break from Freud. But even to critics of other orientations, he is often regarded as little more than a crank whose spiritualistic views spoiled his claim to be a reputable psychological scientist. In fact, the early Jung was a ground breaking clinical psychologist whose research into psychological types is still used in such standard psychological tests as the Myers-Briggs. But after his split from Freud and suffering his creative illness (which was, in fact, nothing less than a psychotic breakdown) Jung seemed less the clinician and more of a visionary. This altered his reputation irrevocably and made him into the figure who still divides opinion so sharply. It isn't just that his ideas about archetypes and the collective unconscious took him into places that clinical psychology could not and dared not go. Nor is it his often unclear, sometimes even cryptic style of writing. It is also that his approach to the psychology of religion, which did take religion seriously, did not do so in terms that pleased many theologians or religious believers. Indeed, even in Religious Studies at Kent there were some members of the department who regarded Jung with scorn that matched any Freudian's. But none of this made Leon question Jung's genius. Like all Jungians I have known (my two psychotherapists were both Jungians), Leon was well apprised of Jung's faults and shortcomings.
It is now widely recognised that Jung was very much a man of his culture and times and his wide learning and sometimes narrow prejudices contributed to his world view. After nearly a century of critical scholarship, Jung's personal and professional shortcomings have been well documented. As a scholar and student of mythology, his science and anthropology now seem dated, as well as Eurocentric. Even worse, his questionable association with the Nazis before WW II showed his alarming willingness to dance with the devil. The idea, however, that Jung himself was a Nazi or that he had any admiration for Hitler or his movement is simply false (in an interview conducted in the 1930's, for example, he said that Hitler was a vacant personality who was leading Germany into the abyss). In fact, notwithstanding his somewhat racialist, if not racist views (the collective unconscious was, after all, first called the racial unconscious) Jung could be described as something of semitophile who, from the first, always had many Jewish admirers and followers (in fact, Leon himself was Jewish). There is also the troubling matter of Jung's rather complicated relationships with women, particularly his female patients, most notably Toni Woolf (who was involved in a menage a trois with Jung and his wife, Emma) and Sabina Spielrein. Having had affairs with both women, Jung claimed that they each matched his ideal anima and exerted an attraction that was as much spiritual, as it was romantic. In fact, both women possessed formidable intellects that Jung truly admired and Wolff in particular was an important collaborator in the development of many of his ideas. But Jung took liberties with his female patients that was no more acceptable then than it would be now. Yet, at least to his admirers, his achievements remain indisputable, no matter what his transgressions.
As a scholar, Leon had a somewhat different view of Jung than mine as a therapist. He was more interested in Jung's ideas about spiritual experience, whereas it is Jung's approach to psychotherapy and his understanding of individuation that has made him so important for me. The idea of individuation can be summarised easily enough. It is coming to terms with the unconscious forces and influences in one's life in an ongoing process of becoming oneself. But note that slippery word "unconscious" and the unfathomable depth that it conceals. One of my favourite quotes by Jung begins to suggest its depth of meaning: "The unconscious really is unconscious", he said in a famous interview with the BBC. What I think he meant by this is that unlike the Freudian idea of the unconscious, which regards it as a hidden mechanism of desire that has been made comprehensible by psychoanalytic theory, Jung saw the unconscious as progressively more unknowable the more deeply it is plumbed. At root, the unconscious connects to nothing less than the infinite mystery of being. But in the course of ordinary living we are scarcely aware of it and most of us may have little inkling that it influences us at all. Yet on the force of certain, usually traumatic experiences anyone can be plunged into an unconscious depth that reveals the provisional and constructed nature of conventional reality. Although this can be psychologically destabilising as well as terrifying, it also holds a potential for higher self development. Individuation, as Jung conceived it, must involve both psychological conflict and the discovery of the inner resources to deal with it. Discovering and developing such inner resources is much of what Jungian psychotherapy is all about.
In our last meeting together, I was trying to persuade Leon to start up a discussion group on Jung. "Let me think about it," he replied. Although he was enjoying the freedom his retirement was giving him, I thought that the prospect of having regular discussions on the subject to which he had devoted so much of his life would be irresistible to him. Moreover, it was in small groups of like-minded people where he seemed to express himself most freely. And I would have benefited from the stimulation that his conversation always gave me. When I first met Leon I had the feeling that he had been a friend long before I knew him. Now that he is gone, I will miss the deeper friendship that might have developed.
Years ago, I was walking through the streets of Kathmandu and turned a corner onto a fairly empty side street where I found a ragged beggar who just then happened to be waving to a friend of his across the street from him. The beggar greeted his friend cheerfully and clearly took pleasure at seeing him, but his mood changed instantly once he noticed me, a Western traveller and hence, obviously rich. He seemed to experience a brief moment of identity crisis, as if he had been unmasked by his moment of unguarded happiness. But then, like an actor resuming his role after stumbling out of character, he immediately dropped the happy attitude he had been showing and turned to me with a look of abject misery and held out his hands imploringly for some baksheesh. No doubt his pains were real enough. Being a beggar in Nepal, one of the poorest countries in the world, must surely offer little more than a life of deprivation with few satisfactions. Yet the sudden transition from spontaneous, unrehearsed joy to the stereotyped expression of suffering was undeniably comic and when I smiled at him he seemed to accept that there was no point in carrying on with his act. In fact, in Nepal, as in so many poor countries, beggary is a way of life, virtually an occupation. And just as there are customs for every other station in life, there are customs that govern that occupation, too. By letting me catch him in a moment of undisguised happiness, the beggar seemed to violate a rule of presentation. A beggar must never appear less than miserable lest the pretext for provoking pity in others becomes open to doubt, for it is the spectacle of his suffering that is the means by which he earns his living. Given their living conditions, beggars can hardly be blamed for having to present themselves in such a demeaning fashion. We should also observe that the economic conditions which force them to become beggars add evidence to a serious argument that has long been made against a global economic system which casts untold millions into such hopeless poverty. But a sophisticated argument about the inequities of capitalism may overlook the more immediate, psychological transaction between beggars and potential donors. What is it about their respective roles that reveals something about the human condition?
Pity, as I have noted, is the crucial bond that unites beggar and donor, as the suffering of the one elicits charity from the other. But to be the recipient of such pity requires not just poverty, but also a visible demonstration of the pain and helplessness that poverty causes. The donor, of course, is in a much more favourable position in this transaction, yet he may still feel uneasy about the nature of the exchange. Although he might see himself as a benefactor whose act of charity helps provide the beggar with his daily bread, he might also recognise how his paltry offering does little more than sustain the beggar in his wretched condition. In a better world, both donor and beggar might hope that something more could be done to reduce the beggar's misery and perhaps even rescue him from it. But there are always limits to what anybody can do in any given situation and sometimes a small act of charity may be the best that can be done. If, however, the intention behind pity never sees beyond the small objective of offering temporary relief to someone in chronic suffering, pity remains trivial and somehow demeaning. It is no more than a ritual gesture, a mere nod to the fact of suffering without any interest in becoming fully cognizant of the experience of suffering. It is little more than Compassion Lite.
Traditionally, Buddhism has always observed the necessity of linking compassion to wisdom, if only to observe the limits of what compassion can do to alleviate suffering in any particular case. When, for example, someone is suffering a fatal disease we should do what we can to ameliorate the pain without losing sight of the fact that death is inevitable--that death is in fact an existential inevitability. Similarly, in regarding some unexpected disaster, we should offer help in the aftermath, while recognising that it may not be in our power to do anything to rectify the loss. But wisdom about suffering means much more than recognising the limits of compassion. It also means recognising the experience, as well as the fact of suffering, so that compassion leads both to the sensitive expression of that recognition, as well as to effective action. For compassion may be as much an act of communication as it is an act of charity. It is also what distinguishes compassion from mere pity. Although compassion might first arise as a feeling of pity, it requires a certain attentive interest for it to become a deeper, more considered response. This does not mean that the expression of compassion must be verbal. But it must be sensitive and considered as an expression of care.
It should be obvious then that while compassion must have an essential role in psychotherapy, pity should have no place in it at all. Yet, anybody who has worked as a counsellor or psychotherapist will have had the experience of encountering clients who have come into therapy after experiencing some terrible misfortune which seemed to provoke a feeling of helplessness in both himself and the client. Facing some serious illness or impending death or some other seemingly total loss can make a client feel utterly bereft of hope; moreover, such hopelessness may appear to be an entirely appropriate response even to the therapist. The temptation of the therapist then might be to offer pity as a salve to the suffering the client presents. But this would only encourage the client to indulge in self pity, which is certainly among the worst ways of dealing with tragedy or loss. It would be as if both client and therapist agreed to share in the fellow feeling of despair, which might alleviate the feeling of emotional isolation in the client, but would do nothing to develop self insight or find better possibilities for his actual situation. To be sure, false optimism or blind faith in positive thinking can, in the long run, be just as self defeating. But finding true hope and authentic possibility in the darkest, most hopeless of circumstances is one of the great benefits that psychotherapy can offer. But it takes time and effort, as well as a willingness to experience the pain of loss.
Living in a world without pity would be to live in a heartless, uncaring world. But finding compassion in a world in which suffering is certain is a way of enduring, as well as making sense of it.