By now, everyone will have heard of and passed judgement on the recent "Black Friday", which inaugurated the spending season that runs up to Christmas. We all know that retailers offered massive discounts on merchandise in order to kick start their Christmas sales which brought throngs of eager buyers to stores, supermarkets and shopping malls throughout the UK. We also know that some people behaved very badly at these sales, as there were widespread reports of crowds of shoppers shoving, punching and kicking each other in order to advance their position as competitors in a veritable frenzy of consumerism. One shopper in Cardiff. Ross Lewis, told the BBC: "People were biting each other, pinching, punching, kicking--it was just absolutely horrendous, it was so, so bad." Yet, in spite of such unseemly, violent behaviour, retailers counted the day a great success as records were broken for both in-store and on-line sales. In fact, Black Friday exceeded all previous records for on-line sales, even though the websites of several major retailers had crashed because of the high volume of on-line traffic. So, notwithstanding the misery that the day caused, Black Friday must still be regarded as a resounding commercial success.
For those who lament the loss of the spiritual importance of Advent, the term Black Friday may appear strangely appropriate. For it seems like nothing so much as the feast day of Mammon who has long personified wealth and greed in Christianity. I myself was puzzled by how suddenly and deeply the term Black Friday has been taken into public consciousness without any apparent deliberation by anyone. Wikipedia, that indispensable, if not entirely reliable source of information, tells us that the term was first used in Philadelphia, Pennsylvania in the early 1960's to indicate the heavy road and foot traffic that routinely occurred on the day after Thanksgiving which has always kicked off the Christmas sales season for American retailers. Later, the term was used to indicate the most profitable time of the year, when sales would take companies out of "the red" of financial loss and into "the black" of profitability. But finding the meaning of any word is not a matter of tracing its origins. Meaning consists of the way a word is currently used, which may have changed completely from its original usage. As a term, Black Friday may have begun innocently as a morally neutral term of description. But with its more recent associations of violent mobs of frenzied shoppers driven by mindless craving, Black Friday now carries a more disturbing meaning.
There is, of course, a documentable history behind the changing use of the term Black Friday, which surely corresponds to the rise of consumerism in contemporary culture. Indeed, "black" as a sign for profit and hence, a positive value, shows how pervasive commercial values have become for society in general. And witnessing ugly mobs of rapacious shoppers on television and other news media surely accounts for some of the term's more unsavoury connotations. Yet, I suspect there is something deeper that resonates in the term that speaks of a more thoroughgoing corruption. The manifestly spiritual values of good will and generosity that were once celebrated as the essence of the Christmas season have been almost completely supplanted by the unrestrained indulgence of our most avaricious passions. This is hardly a new insight so there would be little point in repeating some trite sermon about how crass commercialism has robbed Christmas of its spiritual importance. We all know that. Yet, most of us feel powerless to resist this joyless season of excess that consumerism has imposed on us. And that, I suspect, is what gives Black Friday its power as a sign of truth.
More than a century ago, the French sociologist, Emile Durkheim, observed that through what he termed a collective consciousness [Fr. conscience collective] a society shares a number of beliefs, attitudes and ideas that are not necessarily explicitly stated. Things are done and known by customs which everybody follows without consideration or reflection. Although people may like to think that their social habits were bequeathed by divine dispensation and have a timeless heritage, in fact they all originated in particular events and out of particular circumstances. Nor are they timeless or static. Customs and beliefs are constantly shifting, sometimes dramatically and cataclysmically, but more often, subtly and imperceptibly, like the face of someone who looks the same for years but then suddenly seems old. We might see this as an example of the law of impermanence in its relentless action. But it doesn't tell us much about how things change. How, for example, did Black Friday eclipse Advent Sunday as the day when the Christmas season is seen to begin? And how did Christmas cease being celebrated as Christ's mass to become the feast of Mammon?
This, I think, can be partly explained by Jung's notion of the collective unconscious, which far from being historically determined, draws on a particular idea of the eternal. According to Jung, behind every psychic phenomenon there is an archetypal energy that gives rise to an archetypal form, which in turn informs psychic activity. Archetypes may disappear for a time, but they never entirely perish. They recur upon circumstances which can arise mysteriously and unpredictably, long after the gods that once represented them have been forgotten. Mammon may no longer live as he once did, but his spirit appears more robust than ever. And although there may be no exact precedent for Black Friday as the inaugural shopping day for consumerism's busiest season, the experience of societies going dangerously adrift on a tide of material greed and moral decadence has been recurrent throughout history. What is eerie now is how the term seems to catch the sense of our collective spiritual decline without anyone intending it to be understood that way. And with the planet being dangerously overheated due to human activities that are directly linked to rising material consumption, the term seems to carry an additional connotation of our self destructive tendencies reaching terminal climax: Black Friday, indeed.
How does Black Friday affect the practice of psychotherapy? Probably very little in most individual cases. But I think Black Friday is symbolic in the Jungian sense in that much of its meaning lies beyond conscious apprehension, yet still affects people's general sense of being. This is to suggest a very vague, perhaps even unverifiable influence in the conflicted lives of clients. After all, if a client's marriage or relationship is in peril, what would a mere shopping day have to do with it? Nothing directly, perhaps. But I suspect that the devil's dance of consumerism plays like background music in the private lives that many people lead. For Buddhist psychotherapy there might be something else at work in the phenomenon of Black Friday. Buddhism asserts that craving or trishna is the source of suffering and that avidya or ignorance prevents us from seeing it as such. Witnessing the eruption of greed, anger and delusion that caused Black Friday, a Buddhist therapist may have some insight as to why people were so eager to participate in it.
Years ago, long before I had thought to become a therapist, I witnessed a rather curious scene on the London Underground. I was going to catch the lift after leaving my train and had come up behind a man who stood by himself, speaking rather loudly and excitedly, seemingly to no one at all. Instinctively, I kept a distance, for though his agitation was obvious, I could see no reason for it. Seeing mentally disturbed people on the Tube is a common enough sight, so I thought he might have been schizophrenic. But when the lift arrived the man turned around, revealing that he had actually been speaking into a mobile phone. Ignoring me, he closed his conversation with a rather theatrical flourish. "This is my life and I don't ever want to speak to you again!", he declared. He then switched off his phone and got into the lift with me and a few other people and stood quietly throughout the ascent before alighting onto Edgeware Road. Perhaps he isn't mad after all, I thought. Still, there seemed something distinctly odd about his phone call which remained in my memory, even though the incident itself was quite trivial.
Years later, when I was training to be a therapist, I found a likely explanation for what I had witnessed long ago on the tube. Caroline Brazier and I attended a talk in Leicester, which featured speakers from a remarkable organization called the Hearing Voices Network, which is an association of self help groups that provide advice and emotional support for people who "hear voices, see visions or experience other unusual perceptions." The organization, which has chapters all over the UK, is part of a world wide movement to help people who suffer from disturbing perceptions find support and fellowship with others who have similar experiences. While HVN is careful not to describe its mission as therapeutic, there is little doubt that it can be profoundly beneficial to people who often find themselves terrifyingly alone in their unusual experiences. Started in 1987 by a Dutch psychiatrist named Marius Romme and his partner, a psychologist named Sondra Escher, the movement began after Romme had been treating a patient who had discovered a way to deal with and make sense of the voices in her head after reading The Origin of Consciousness in the Breakdown of the Bicameral Mind by the American psychologist, Julian Jaynes. Drawing evidence from ancient literature such as the Homeric epics, the book argues that seeing apparitions and hearing disembodied voices were once common in human experience, even quite recently in human history. Romme's patient inferred from this that the private voices she heard needn't be regarded as symptoms of a severe mental illness. They could instead be interpreted as the voices of independent agents--gods or disembodied spirits-- whose influence could either be ignored or heeded by her volition. Her realisation proved so self-empowering that both she and Romme went on Dutch television to discuss her discovery. What followed was an overwhelming public response from thousands of people who had had experiences like her's and led to the formation of the Resonance Foundation, which became the first group in the Hearing Voices Movement.
While HVN does not regard voices and visions as symptoms of mental illness, it does recognise how disturbing such experiences can be. As a self help and support group, it gives members the opportunity to exchange a wealth of practical advice so that they can help each other cope with the difficulties of having unusual perceptions. Hearing the testimony of one member I found a strong clue about the mobile phone conversation that I overheard years ago. He had been advised that whenever the voices in his head became so overwhelming that they demanded a response to pick up a mobile phone and pretend to speak into it, thus transforming his seemingly bizarre behaviour into an apparently normal public act. Everyone in the audience laughed at this and the speaker himself was well aware of how amusing his account was. But there was a horrifying pretext to his using a mobile phone as a prop to hide his conflict with the voices inside his head. It was his childhood of physical and sexual abuse, which included broken bones and hours spent locked up in a dark cupboard. Indeed, he first began to hear voices during such a confinement and at first he found them quite benevolent. Later, though, the voices began to echo the cruel phrases of persecution that he heard throughout his childhood. Those voices are still with him constantly and he could hear them even as he was addressing us. But they no longer dominate his life as they once did.
Given experiences like the speaker's, it may seem curious that HVN does not regard such unusual perceptions as symptoms of a mental illness such as psychosis. Romme himself takes a strong line against pathologising unusual perceptions and the organization in general seems to frown on using the term hallucinations to describe the unusual perceptions that its members experience. Some also argue that hearing voices and seeing visions have provided humanity with some of its greatest mystical and artistic insights, as such phenomena appear to spring from the deepest layers of transpersonal consciousness. Jesus, the Buddha, the Prophet Muhammed and William Blake are a few of the most famous figures whose lives were deeply affected by their unusual--indeed, their extraordinary--perceptions. Without romanticising such experiences, this does raise questions about the phenomenal nature of unusual perceptions. Mainstream psychiatry dismisses them as hallucinations, mere symptoms of pathological conditions. By and large, this appears to be true. But what do we make of those exceptional cases of unusual perceptions that prove to be valuable, perhaps even transcendental or visionary? Could it be that unusual perceptions provide evidence for a faculty of the imagination that becomes roused by a great experiential pressure--either psychological or spiritual in nature--which may, in Blake's famous phrase, "cleanse the doors of perception", revealing a metaphysical depth of experience that ordinary perception does not reveal; or, alternatively, casts the percipient into a hell realm with little hope of escape? We can only speculate. But the speakers we heard that night in Leicester said nothing about Blakean visions of the eternal. It was all about the voices--sometimes menacing, sometimes mocking--addressing them from within a heavy fog of depression that they all said they suffered.
Whatever the ultimate nature of unusual perceptions, HVN provides invaluable assistance to people who must cope with their immediate experience of suffering such perceptions. It also helps sufferers reclaim their dignity as it insists on regarding unusual perceptions as entirely human. Romme likens hearing voices to homosexuality which also once suffered the stigma of psychiatric censure before it was seen as just another variation in human nature. The speaker who told us about the clever use of his mobile phone, shared another incident with us, which seemed to give supportive evidence for Romme's idea. One afternoon when he went to his lounge for his usual afternoon rest he found himself in an unusually pleasant mood. And when he sat down he found something he never thought he would be able to experience: the voices in his head were silent. The caesura did not last long. But it was the first time he was free of his voices since childhood. Strange, he admitted with a laugh, but his brief period of silence was not as blissful as he might have expected. For he actually missed the voices as a normal feature of his internal awareness. But thanks to the support of HVN, that normal feature of his experience is no longer as hellish as it once was.
Let me give a standard dictionary definition of a word that I use often and consider indispensable, yet still find rather indefinite. The word is "experience" which the Merriam Webster on-line dictionary defines as "direct observation of or participation in events as a basis of knowledge". The same webpage gives another similar, but rather more colloquial definition: "the process of doing and seeing things and of having things happen to you." I would suggest another related definition which is "life in the activities and reflections of living". But I am only offering a different way of expressing the idea that experience is both a mode of action as well as a mode of reflection. There is also another, somewhat terser definition of experience which means "know-how" or, expressed more elegantly in French, "savoir faire." But all these are broad, versatile definitions and would seem to lack the specificity needed to be truly illuminating were it not for the implication that the term experience applies uniquely to each of us as individuals.
Indeed, what is intrinsic to the concept of experience is that it implies the existence of a self to whom experience occurs, even though experience sometimes occurs collectively. Moreover, experience applies to virtually every activity or state of consciousness. There are experiences related solely to the five senses of sight, hearing, touch, smell and taste as well as more mental, if not quite disembodied experiences such as counting numbers or drawing on memory in an act of recollection. Examples of other types of experience which are much more complex are those that are related to particular endeavours or domains of activity. Each type of experience will have a unique set of associations, which might involve a related set of skills, that only those who engage in them could ever possess. Sailors experience the sea and pilots experience the sky much more fully than the rest of us do, but neither experience the streets of London like a London taxi driver does. The logic behind these examples leads to an important and irreducible truth. No one can experience your life as you do.
This should not lead us to suppose that experience is entirely subjective or solipsistic. We create and share experiences with others, so much so that we can easily fall into the opposite error of supposing that the truth of our experience can be found only with others, or even worse, that such truth belongs to others alone. That someone else might have a better understanding of aspects of our experience than we have is often true. A dance master, for example, will readily discern the flaws in our clumsy footwork and a physician may be able to tell why we have a fever. Yet the experience of ourselves as individual subjects remains singular and can be known to others only by analogy or empathic attention and even then, only partially. For only we ourselves as individuals are in a position to know our self experience in depth and over an extended period of time. Thus, experience is the primary means of self revelation for each of us, not so much through the thoughts that we think or the views that we hold, but by the sense of self, the embodied sense of being "me" that seems to survive each transition of self understanding. Though the abstract truth of experience may be maddeningly elusive, the sense of experience is always present in conscious awareness and may feel inescapable.
Buddhist psychotherapy, even in proclaiming the doctrine of not-self, must deal with the exigencies of self experience just like any other form of psychotherapy must do. Although not-self is no get-out-of-jail-free card, it does offer a light for examining experience and making sense of it. Mostly, this has to do with making skilful use of impermanence as an ontological principle. But as I have argued before, therapy must work from the reality of self experience that the client presents before it has any hope of facilitating a deeper realisation of not-self. Getting to know the client in the consulting room offers the possibility of understanding the client as embodied subject--the self that the client experiences out in the world beyond the consulting room. Empathic attention is essential for doing this, but as David Black argues, so is sympathy--feeling with the client, particularly in his or her experience of psychological suffering. Important though analytical skills are, this intimate understanding of the client has less to do with "figuring him out" or subjecting her to exacting analytical scrutiny than it does with respecting the client's experience and working sensitively within it.
I began this post by reflecting on the imprecision of experience as a term. But that imprecision is no defect of the concept. For in its wide embrace, experience can be anything that can happen to us as persons.
A quick note on the death of David Smail, a clinical psychologist whose writing I admired very much and whose death in August I have only recently learned about. I came to Smail's work by a fortunate accident years ago, long before I decided to become a therapist. I was at Waterstone's on Picadilly and sat down in an armchair and found a stack of books at my elbow. The book at the top was a dual text edition that contained two titles, Why Therapy Doesn't Work and Taking Care. Intrigued, I began to read the book and was quickly taken by the case he made. Therapy doesn't work, he argued, because it promises certainty based in objective evidence which we as embodied subjects cannot possess. Moreover, by locating the source of people's problems inside their minds, therapy overlooked and tacitly excused the actual living conditions that caused them to suffer psychologically. Indeed, by ignoring the social context of mental illness, psychotherapy was guilty of blaming the victim for their problems and abetting the social forces that were truly to blame. For me, the echo of Laing could be heard loud and clear in Smail's argument. Smail was in fact, an admirer of Laing, but there was much that separated their work. Laing, surely the more adventurous thinker, sought to plumb the depths of the psyche and saw psychotic breakdown as a legitimate means of breaking free of repressive norms. Smail offered a more modest and perhaps more compelling argument. Can't we as a society see that it is socially sanctioned cruelty that is most responsible for making people's lives a misery?
In fact, much of Smail's thinking drew from his work in the 1980's as an NHS psychologist dealing with people who suffered from the emergence of Free Market capitalism as a new social ethic. In a backhanded tribute to Thatcher, he credited her for teaching him the most about the misuse of political power as a source of widespread psychological suffering. But Smail offered something other than a standard leftist critique of the abuses of capitalism. Above all, he insisted on the moral necessity of recognising our common humanity. It was, he thought, the abandonment of compassion as an essential psychological value and the celebration of power as a positive psychological value in its own right that were most responsible for the distress that people suffered. Kindness, he seemed to suggest, was what mentally ill people really needed to find dignity and their well being.
It would seem Smail had little time for exploring the more hidden dynamics of the psyche. Certainly, many people might question raising social criticism above self formation as a concern of psychotherapy. But research (such as that which can be found in Richard Wilkinson and Kate Pickett's excellent The Spirit Level) tends to confirm Smail's conviction that is the gross inequality caused by rampant and unchecked capitalism that lies behind a host of social ills, including mental illness. Smail did not shy away from the political implications of his thinking, and this too may have caused unease among some observers. In fact, therapists do not possess any special insight into politics and their political opinions deserve no particular respect. At the same time, it must be recognised that there are pernicious psychological influences within a society that preserves the interests of the powerful and wealthy and organises a vast industry of deception to do so. In a previous post I cited Smail's remark that consumerism--free market capitalism's cunning master of propaganda--seeks to convince that love is always in short supply and that only the wealthy, the successful and the well- adjusted deserve to get it. We only begin to appreciate the scale of such deception and the cultural corruption that ensues from it when we consider the amount of time people spend watching television and other forms of popular entertainment---amusing ourselves to death, in Neil Postman's memorable phrase. Smail was surely right to point out that there was a relation between the values society promotes and the mental agony that society's "losers" suffer.
For all of my admiration for him, I am not an expert on Smail and I am not competent to discuss his work in any depth. But I credit him as an influence in my own thinking and think back to that day at Waterstone's when I first encountered his books as a pivotal moment towards my decision to become a therapist.
In my last post I considered things from an existential perspective and drew heavily on my reading of existentialism, particularly Heidegger and Sartre, in my understanding of how we encounter the world as individuals. What I called a moment of truth, Heidegger termed the call of conscience, but both refer to the solitary self reckoning that must be involved in any individual's quest for personal truth. I also followed the thinking of virtually every existential thinker--beginning with Kierkegaard and Nietzsche-- in characterising the search for personal truth and meaning as an inherently anxious undertaking. For there appears no possibility of ever finding solid factual ground on which such a search for meaning can be based. "The moment of truth is also a moment of doubt," I wrote. Yet, in closing I wondered if my position could be reconciled with Buddhism which not only confidently asserts the possibility of shedding all doubts and arriving at a final gnosis, but also prescribes a way of making such a realisation. This may seem far removed from the concerns of psychotherapy which of necessity must have more modest aims. But in fact, the nature of the Buddha's realisation either does or does not tell us about the psychic possibilities of being human. So what was the nature of the Buddha's realisation and how is it relevant to psychotherapy?
Let me begin with the second question by speaking personally as a Buddhist psychotherapist. Although I don't flaunt my spiritual colours, I don't conceal them, either, More importantly, I would never try to convert anyone to Buddhism. As I have written before, I believe it would be unethical to use psychotherapy as an opportunity to proselytise, for therapy should try to work within the client's spiritual orientation, whatever it happens to be. Perhaps for this reason most therapists prefer to remain silent about their spiritual convictions, especially as this helps to keep the focus on the client's experience. But many Buddhist therapists are like me and tend to be more open about their spiritual beliefs. This may be justified on the grounds that Buddhist psychology offers a comprehensive theoretical model of human experience which features a penetrating analysis of the dynamics of attachment. But even more important for me is the idea that we all possess a Buddha nature, that is we are already enlightened, yet fail to realise it. This amounts to a kind of faith and makes Buddhism more important for me in my role as therapist than for the client. There is, however, one glaring difficulty with this. I am not enlightened and have had no direct experience of Buddha nature.
Of course, there are all sorts of facile ways of justifying my position. I might, for example, claim that Buddha nature is the inmost ground of being and as such is the most fundamental endowment of human consciousness. This, however, would be more of a theological position and would be scarcely different than the Christian belief in the soul. Besides, in my understanding Buddha nature has an active, if mostly hidden function in the psyche and might be described as awareness prior to self awareness or knowing before any accumulation of knowledge. But any attempt to find an abstract expression for something that I have not directly experienced leaves me open to the charge that I am only speaking speculatively, without the authority of actual insight. Indeed, I am not entirely convinced of these claims, myself. Yet, I still find my orientation as a psychotherapist (to say nothing of my personal, spiritual convictions) through my belief in Buddha nature. Although this belief may be entirely justifiable for my spiritual practice, it may seem somewhat questionable for psychotherapy. After all, shouldn't therapy rely on something more than faith healing?
I would say not and would argue that every therapeutic approach, even the most sceptical, demands at least a modicum of faith in the possibility that psychotherapy can help the client. To be sure, those who hold faith in therapy may see it as determinedly rational and might indignantly deny any association with anything that smacks of spirituality. But every form of therapy must begin with a sense of the latent, unrealised potential that the client has not been able to find by himself. Even Freud, who dismissed spirituality as infantile, believed that psychoanalysis could help patients drop their neurotic defences and become capable of love and work. Moreover, in almost all forms of psychotherapy success is conceived as a kind of emancipation from the self defeating habit patterns that govern the lives of clients. Practically speaking then, faith in therapy may amount to little more than the belief in the possibility of finding such a freedom.
But let me go back to my own faith and what I said before about the dynamic function of Buddha nature. Buddha nature for me as a therapist isn't so much a latent potential as it is the primary, fundamental property of consciousness. Indeed, it is the radiant fact of consciousness itself whose very light makes possible the divagations away from it. I can offer no proof for this belief nor can I bring much in the way of evidence to support any argument I might make for it. I also know it can be easily dismissed as a fantasy or soft headed fabrication. But my belief in Buddha nature is not about demonstrable facts. It is about meaningful wonder based both in the happenstance of the everyday world and in the inherent mystery of being existent at all. In this connection, I always think of the Buddha's own moment of seminal wonder as a boy sitting under a rose apple tree, watching his father's fields being ploughed on a beautiful spring day. What of all the worms and insects that were dislodged and eaten by birds as their habitats were being destroyed? Was this their inevitable fate? he wondered. There could be no factual answer to his question. Facts would only allow the flat observation that this is how the world is. Yet, at this precise moment when he might have turned away from an unfathomable mystery, he fell spontaneously into meditative rapture and kept alive the spark of wonder that might have been extinguished by strict objective reasoning. Later, the memory of this episode inspired him to meditate in his own way which gave rise to the deep insights that made him a Buddha.
I am no Buddha, but as a therapist I do try to be like the boy under the rose apple tree. In a world I cannot imagine being more beautiful, I am amazed by the infinite variety of suffering that I witness in it. In being with a client and attuning myself to his or her experience of suffering, it would be easy to succumb to hopelessness. Yet my faith in therapy which is founded on my faith in Buddha nature, gives me hope when my powers of reasoning fail me.
A friend of mine who often finds himself in rather high powered company through the promotional work he sometimes does told me about a recent experience of his that left him somewhat disquieted. It was during a photo shoot in London for some sort of publicity campaign which brought together an assembly of diverse talents that would assure the final product would meet the highest professional standards in advertising. The mood in the room was friendly and energetic enough, yet my friend found himself unable to share in the cheerful spirit of camaraderie. "It was their talk," he explained. "All they were talking about was the stuff you'd find in the Sun: gossip about celebrities and things like that. But the thing was I couldn't tell if they were actually interested in it or not. I mean who could possibly be interested in rubbish like that? Yet that's all they talked about."
The ubiquity of celebrity culture is one of the vexations of modern life. Even if you try to remain aloof from it, you still know more about celebrities--people who are famous for being famous--than you would ever want to know. Part of this is due to the pervasiveness of various social and mass media, which keep a pipeline of celebrity gossip flowing incessantly into the public arena. But another reason has to do with the question of seriousness that occurred to my friend during the photo shoot that he attended. Were the other people there really interested in the lives of celebrities that they were discussing or were they only joking about matters that they actually felt were beneath them? My friend couldn't tell. So perhaps a third possibility can be suggested. They were not speaking either out of true interest or intentional irony so much as they had adopted tones of playful half interest because it was the easiest, most natural way for them to converse with each other. Besides, everybody regards celebrity gossip as mere fodder for idle conversation, just as everybody knows that the manufactured glamour of celebrity isn't quite real, either. But perhaps this was the cause of my friend's feeling of unease. The empty conversation didn't occur because of any real interest of the participants. They just sort of fell into it because they had no other, real interests to speak of. Their idle chatter filled a void.
A photo shoot is hardly the place for a symposium so perhaps it would be a mistake to be disappointed by the vacuous conversation that took place there. Yet, like my friend I too find that celebrity gossip often becomes the preferred theme of many casual social encounters and thus cancels the possibility of more serious and stimulating conversation. Indeed, I think we both wondered where serious, spontaneous conversations are supposed to take place, even as we conversed freely about psychotherapy, politics and religion in his kitchen in north London. But the seriousness, not to say solemnity of our conversation, violated a certain unspoken protocol of most casual social encounters: don't talk about serious matters as if they seriously matter to you.
Psychotherapy, of course, begins with an entirely different premise as it seeks to discover the hidden, inner truth behind the mask required for social interaction. The idea here is that behind that mask there is a true self that never dares express itself for fear of censure or exclusion. According to this view, psychotherapy creates a safe environment for the client to remove that mask, allowing the true self to emerge. Although it is sometimes useful to think along these lines, we should be careful not to reify any simplistic notion of a self that finds its truth in an act of cathartic self disclosure. It is far better to think of a true self experience based in authentic possibility rather than of a true self. But observing such a fine distinction hardly makes realising the truth of self any less elusive. Still, the idea persists that there is a truth of self that has a pre-existent objective status, even if we ourselves don't know what that truth is. It is just "out there", presumably observed with patient disinterest by psychiatrists and other experts in human behaviour, even though it is supposed to lurk unseen and unknown within us.
Psychotherapy should attempt to see things in a different light. Not because there is no objective factual truth or that such truth is unimportant to psychotherapy, but because a merely objective view of human affairs can never fathom human experience which will always involve factors that will escape prediction and prior understanding. Above all, it will miss the happenstance of the everyday world within which each individual life must make its self discovery and appears predestined only after the fact. This inherently anxious state of affairs is usually easy to ignore by losing oneself in meaningless diversions and the idle supposition that important matters are best left to specialists and experts. But a crisis of self that robs idle pleasures of their diverting power and forces one to distrust second hand certainties taken from experts can bring about a turn towards truth that is anything but consoling. For the truth of self can never be entirely factual, but must rely on a faith that can never be conclusively verified. Such a moment of truth must also be a moment of doubt.
I have no doubt that dealing with a crisis of self is what psychotherapy is all about. And I am also aware that the view I express here owes more to my reading of Heidegger and Sartre than to the Buddha. So how does Buddhism figure into any crisis of self?
In my last blog I talked about two clients--though not mine-- whose childhood experiences created massive emotional deficits which undermined their ability to find love and approval as adults. But I didn't discuss the emotional lives of their parents which might have given the impression that they were simply ogres who abused their children out of the sheer evil delight of doing so. Although I offer no defence for actions which appear to have been deliberately cruel, I think the emotional lives of such parents need to be considered in order to understand the emotional lives of their damaged children. Indeed, I fear much of the popular literature on child abuse tends towards the gothic and favours stereotyped tales of violated innocence. This might satisfy a popular taste for victims and villains, but it tells us little about how children develop their self understanding though their relationships with their parents. Instead, it is assumed that abuse has a simple, predetermined cause and effect relationship to mental illness. No doubt bad parents can and do make their children mad by inflicting terrible and senseless punishments on them. But I think there is another version of this pat formula which is rather more complicated. Parents drive their children mad by demanding that they share in the madness that they themselves suffer.
All of this was suggested by a conversation I had recently with a friend who has battled severe mental illness for most of his adult life. This appears to be a result of having to manage the mental illnesses of both his parents from a very young age. His mother suffered from bouts of deep depression and his father was a paranoid schizophrenic. Nearly everyone, including my friend, believes that these circumstances offer compelling evidence for his strong, perhaps even fatal genetic predisposition towards mental illness. According to a widely believed theory, my friend must have inherited his mental illness much as he has inherited his hair and eye colour. I would reserve judgement on such a claim, though I concede that it merits thorough investigation. I will say more about this later, but one undesirable consequence of adopting a position of genetic determinism is that it inclines us to overlook the force of personal experience in shaping any personality, but particularly for profoundly disturbed personalities who suffer mental illness. Consider, for example, a regular childhood experience that my friend was forced to endure.
My friend was only four on the first occasion in which he was made to participate in one of his father's psychotic episodes which featured terrifying visual hallucinations. His dad had already begun to rely on my friend for almost everything so he was not reluctant to make a bizarre request. "Get rid of it! It's on the walls! Wipe it off!", his father screamed. Not quite certain of what his father was seeing, he followed his instructions in order to placate him and wiped the walls with his hand as if polishing glass with a cloth. He knew that there was no actual danger. But he also knew that his father's madness was a reality that he would always have to live with. "After a while it just became normal," he recalls. In fact, wiping hallucinations became an ordinary occurrence over the next four years. Not that his father found sanity when my friend turned eight. It was just that his terrible visions gave way to other symptoms of madness for which other strategies of compliance had to be devised.
In spite of regarding it as normal as a child, my friend now believes his relationship with his father was actually abusive. He is certainly entitled to feel that way. The burden of providing emotional security for a psychologically disturbed adult should never fall on a young child whose emotional development depends largely on the stability that only a responsible and caring adult can provide. Yet his father was not intentionally abusive, either. My friend never suffered physical violence or sexual exploitation and even the verbal aggression that he heard was seldom directed at him. There was only his father's crushing dependency on my friend which deprived him of emotionally stability. Having had to act as the steward in his father's terrifying voyages into madness as a child, it is little wonder that he still struggles to find stability and direction as an adult.
His dreadful childhood experiences do not, however, rule out the possibility of a strong genetic component in my friend's mental illness. But if genes preordained the emotional dispositions of my friend and his parents, then the agony that he continues to suffer today must have commenced at his conception. The lurid scenes of despair that he was forced to witness as a child almost had to follow from his genetic inheritance. This would seem to lend scientific weight to his occasional, but deeply depressing conviction that he should never have been born at all. Here, though, we should retain some scepticism about genetic determinism and keep in mind that there is no proven causal link between genes and any mental illness. At best, there might be some interaction between genes and environment that would increase the likelihood of someone developing a mental illness. But as Raymond Tallis observes, it is remarkable how little genes tell us about being human. Indeed, it tells us nothing about the experience, that is the felt sense and conscious appreciation, of being human, at all.
This doesn't mean that genes are irrelevant to human experience. Clearly, they provide an essential foundation for it, at least inasmuch as our physicality contributes the embodied form for all our experiences. Yet the formulation "interaction of genes and environment" suggests how limited a genetic perspective actually is. For a human environment is not merely an environment like a pond is for a frog. It is an open, indeterminate field of experience from which an infinite number of unpredictable potential experiences can and do arise. Denying the possibility that experience--the adventitious , unpredictable, perhaps ultimately unknowable possibilities inherent in being human-- could make us what we are seems to be the prevailing consensus these days. Yet appreciating the particularity of what human experience is for each of us may be the only true way to understand each other---even those trapped in the terrifying vortex of madness.
Psychotherapy often deals with cases of fractured love so I will begin this post with a couple of cases in point. They are based loosely on two actual cases, though not on any cases of mine. In fact, I hardly know the people involved at all, but even so I have taken the precaution of changing their names and certain details so that if the subjects of these tales ever happened to read them they would not be able to recognise themselves. Perhaps then these should be regarded more as fictions than factual accounts, though I hope that this entails no loss of their essential truth.
Julie was an only child whose parents divorced when she was five, but nothing was ever explained to her. One day her father simply moved out of her house and her mother had to take a job at the local supermarket. While her mother worked, Julie spent a great deal of time at home alone watching television. Although her dad used to visit once a fortnight, he never mentioned that he had married again or that his second wife had given birth to another daughter. But one day when she was ten, a beautiful five year old girl got out of the car with her dad who explained that this beautiful little girl was actually her little sister. She stared in disbelief and as she watched her half-sister playing contentedly with dolls that she had outgrown, she couldn't quite shake the feeling that this was all a very strange, but rather terrible dream. The feeling intensified as she watched the little girl get back in the car to go back home with her dad--to go to their home, leaving Julie behind. She began to feel angry at her dad and wrote him a letter which said that if he wouldn't see her more often then she didn't want to see him at all. He wrote back and said fine, Julie, you won't see me at all, then. His letter left her with a feeling of nothingness which seemed to engulf her. She felt as if all her feelings had been hollowed out of her, leaving her feeling strangely disembodied. A single mother on benefit now, she has had a succession of relationships with men who invariably mistreat her before leaving in a cold fury. She always feels nullified afterwards, just like she felt when her dad left her. Then she gets together with another man who invariably mistreats her before leaving her, making her feel nullified... and so on.
Everyone agreed that there was no trusting Conor. A small, weedy boy of sixteen, he seemed all too eager to please and appeared annoyingly desperate to make friends. Unfortunately, Conor was a petty thief who had a habit of stealing objects that were practically worthless in themselves, but important to the people who owned them. Rulers, pens and other small items all had a way of winding up in his possession, though he would always deny that he took them. He had found them, he would say, as if the items had simply dropped into his hands by accident. No one believed his ridiculous excuses so his reputation as a thief was fatally coupled with his reputation for being a liar. Eventually, he was caught in the act of stealing a pocket calculator and some of the harder lads who had always hated him anyway, decided they had had enough. They would teach him a lesson that he would never forget. Conor sensed that he was in danger and was agile enough to evade his attackers for a time. But finally he was cornered in a secluded place and beaten savagely. Conor didn't show up to school for a week after that and people thought perhaps he would never come back at all. But he returned later as if nothing had happened. In fact, a beating wasn't unusual for Conor. His father used to beat him regularly, usually for small mistakes, but sometimes for no other reason than his mere physical presence. The actual, underlying reason was that Conor wasn't his real son, but was the offspring of a casual night of sex between his drunken mother and a man she had barely known and could not have remembered if she tried. After giving birth to Conor, his mum was usually too drunk to deal with him. So it was his stepfather who looked after Conor, though in a way that was entirely bereft of affection. "Useless bastard," his dad always used to say after a beating.
For psychotherapists there would be nothing unusual about these two cases. The difficulty would be to see past the massive damage inflicted on the victims to find emotional possibility from the ruins of their childhood experiences. Indeed, these two stories offer textbook examples of childhood abuse, so much so that we must be careful not to suppose that we know more about the victims' suffering than they do. Nevertheless, it is easy to see what they manifestly do not. A pattern of misery which had been laid down at childhood keeps repeating itself through actions that the victims initiate, yet fail to understand. When Julie goes into yet another abusive relationship, it is both new and strangely familiar to her, though seen objectively its novelty might seem to depend on her wilful blindness. And when Conor antagonises those whose approval he craves, the futility of his behaviour is exceeded only by his lack if self insight. Like everybody else, they too, want love and approval. But it as if in their desperation for love and acceptance Julie and Conor set out to demonstrate that they do not deserve it.
The writer and psychotherapist David Smail argues that love is dangerous because people will surrender almost anything to get it. Moreover, a consumerist culture demands that love must always appear to be in short supply and tries to convince us that only the beautiful, the intelligent and the well-adjusted really deserve it. Love and approval can thus appear to be unattainable prizes of a cut-throat competition. In any such competition, people like Julie and Conor would enter the contest condemned to lose. For it is a game they hardly know how to play and whose unspoken rules seem designed to trip them up. Of course, it can be objected that true love is nothing like this and that true love is precisely what they need. But this begs the question: what is true love as distinct from its baser variants in desire and gratification?
Irving Yalom describes himself as love's executioner, meaning that as a psychotherapist he sees it as his task to shatter the illusions on which romantic love thrives. I admire Yalom and agree with him. Yet a therapist must wield the executioner's axe with caution, as illusions, especially about those whom the client claims to love, may offer precious insights into the self experience of the client. Julie, for instance, always feels hesitant before going into another abusive relationship. Her lack of self insight suggests the intensity of her self needs and conversely, the intensity of her self needs thwarts the development of her self insight. All of this might be dismissed as little more than the rat run of a pathological process. Yet Julie's moment of hesitation may hold the key to the self insight that would prevent her from going into yet another bad relationship. To be sure, her hesitation will likely be unarticulated and filled with anxiety. But it is in expressing her anxiety, in giving voice to her dark intuitions about her future, that Julie may discover why her relationships always replicate the pattern of failed love that she first experienced with her father. This, however, may only tell her why desire fails to become realised as love. It gives no clear answer as to how love might actually be found.
Buddhist psychology has very little to say about love and relationships in the modern sense. But it does offer a rich abundance of wisdom on the cultivation of positive emotions by practising equanimity, kindness and compassion. Buddhism also tells us that craving is the primary cause of all suffering, even the craving for love in its most chaste forms. But for people such as Julie and Conor, love does not so much represent the satisfaction of craving as it seems to offer rescue from the emotional isolation that they have suffered from childhood. Psychotherapy can, in fact, offer the possibility of rescue, but an ethical therapist will be careful not to cast himself as a saviour. "Why can't I find love?" is the burning question that takes many people into therapy, often with the belief that the therapist can provide an easy answer. That there are no easy answers, certainly none that the therapist can provide, is the place for therapy to begin. But gradually, as the therapeutic alliance develops, a deeper self awareness may develop in the client which not only makes finding a loving relationship more likely; it also frees love of its compulsive force and its self alienating urgency. Love is no longer seen as a possession. It becomes way of knowing oneself and wanting to know others.
I have had some thoughtful responses to my last post, particularly from Glenn Macauley which can be read by following the "Comments" link to that post. I won't try to paraphrase Glenn's argument here, but he points out some important objections to the argument that I made about the harmful influence of medical terminology on the development of the self insight which allows us to make sense of a painful psychological condition. It is all very well to argue that medical jargon is inadequate for expressing anyone's emotional life. But what if a psychological problem actually is something that can be effectively treated by medication alone? Would there be anything wrong with that? And isn't a blanket disapproval of psycho-pharmaceuticals rather like suggesting that it is bad form to resort to medication? Finally, wouldn't it be positively harmful to insist on psychotherapy if the only true remedy is medication?
I think there are a couple perspectives on this issue that are not easy to separate. Firstly, there is a personal perspective, that is each individual's experience of a particular psychological condition. Then, there is a medical or scientific overview of that condition which provides all sorts of useful information (or data, as scientists prefer to call it) of a more general nature. The first perspective is based on the testimony of the client's experience while the second provides relevant information about some of the factors that often, if not invariably give rise to the experience of a psychological condition. As a psychotherapist, I must focus primarily on the personal, experiential perspective of the client rather than on a more general medical overview of his condition. Nevertheless, I must also be informed by a medical perspective on whatever condition my client happens to be suffering from. So when a client comes in suffering from depression, say, I will listen carefully to what he reports and presents, while keeping in mind that depression often possesses features that he might not be aware of. He may not, for example, be aware of the episodic nature of depression or know that what feels to him like a permanent condition will often remit after six months. I must also keep in mind that medication can be a literal life saver for a client who may be at risk of committing suicide, even while I try to help him deal with his problems which make him feel suicidal.
But if medication rids a client of the symptoms of his depression, why bother with psychotherapy at all? For if a psychological condition is all just a matter of biochemistry, psychotherapy would seem little more than a pointless, if not harmful indulgence. But here we have to be careful about what the medical evidence suggests. While it is true that medication can help people maintain equilibrium for a variety of psychological afflictions, this is not quite the same as getting rid of their symptoms. Perhaps it would be better to say that medication offers relief from symptoms, though such relief, as I said before, can be literally life saving. But does that relief endure over the long term? Here the evidence is inconclusive, but does reveal some undesirable side effects of long term medication. It is not uncommon, for example, for people who take anti-depressants to suffer a loss of libido as a side effect of their medication. And the long term use of anti-psychotic medication can severely disrupt the nervous system, leaving the sufferer with tardive dyskinesia, a condition that both affects his movements and makes him feel like a zombie (this, incidentally, solves the mystery about why schizophrenics often refuse to take their medication). But even in suffering from such unwanted side effects, many people may still prefer to remain on medication. I believe their decisions should be respected, though I would stipulate that they should be fully informed of the pros and cons of medication. But I also believe that, notwithstanding the widespread medical faith in psycho-pharmaceuticals, there is a case to be made for psychotherapy in treating seemingly intractable psychological conditions. Except, of course, when psychotherapy is harmful.
This too, is an issue that I have addressed before in a previous post, but the point deserves to be made again. If a therapist is inept or unethical a client's situation will likely be made much worse by psychotherapy. The point should be obvious, but I have listened to too many arguments in favour of psychotherapy without any consideration of what makes therapy succeed or fail. But even an ethical and skilled therapist may not succeed in helping his client. At some point the client must also accept responsibility for the therapeutic process. So again we come to the single most important factor for the success of psychotherapy, the relationship between therapist and client. In my previous post I talked about how important self expression is for therapy and argued that a medicalised discourse of self experience presents formidable impediments to self understanding (I am well aware that a similar case can and should be made against therapy-speak and psycho-babble). But I neglected to say that a therapeutic relationship involves far more than the self expression of the client. It also demands the effective and meaningful communication of his experience in whatever form of expression feels natural to him. Indeed, the client's self expressive capacity develops though the therapeutic encounter which depends on the therapist's receptive capacity and ability to understand what the client is trying to communicate.
My argument here may seem like an attempt to reinvent the wheel. Isn't it true, after all, that psychotherapists have always known that therapy depends on a therapeutic alliance which is established by its depth of communication? As an article of faith, perhaps. But that faith has to be redeemed in every course of psychotherapy and there will always be cases that will test, if not entirely disprove it. For such faith is not an established fact like the law of gravity. It is a possibility or a promise that may or may not be realised. Once more I come back to Laing's quotation about psychotherapy being a stubborn attempt to communicate the experience of being human by two people through the relationship between them. They discover the truth of being human by communicating it.
I have already talked about the myth of mental illness in a previous post, but there are other aspects to this issue that I failed to address earlier. In fact, I am not sure the issue can ever be settled definitively as there are so many factors to consider. But perhaps at bottom the question is about the nature of psychological suffering , a matter which has vexed the consciousness of humankind as long as people have been reflectively self aware. But what I am interested in here is how the language or discourse of mental illness affects the self understanding of people who experience mental and emotional suffering. This is not merely a question of semantics, but relates to something far more fundamental to our understanding of what it is to be human. But let me begin by restating what I said before about the concept of mental illness. First, if there is a myth of mental illness there is no doubting the reality of the mental agony which is very similar to an illness in the suffering that it causes. Second, the idea of mental illness as an affliction has an extremely ancient heritage. Indeed, the Buddha himself used the trope and he was certainly not the first to use it. Finally, severe mental illness may require medical treatment and can, in the short term at least, be effectively treated, if not cured by the judicious use of psycho-pharmaceuticals. I think all three points are fairly incontestable, though there might be some people who remain adamantly opposed in principle to the use of psycho-pharmaceuticals under any circumstances. But of the three points the first is surely the most important.