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Buddhism and psychotherapy

Nearly every week one of my clients asks me something about Buddhism so I thought I’d briefly say what Buddhism means in my work as a ‘Buddhist-inclined’ therapist. If you are reading this you’ve probably looked at my website and seen the pictures of Buddha and you’ll know that I am a Buddhist. Firstly, let me by very clear, I do not try to persuade anyone to become a Buddhist, I do not preach, and Buddhism is not a proselytising religion or faith. Indeed, I see it as a way of life, a way of practice, and a philosophy rather than a religion. Buddha simply means ‘one who is awake’ or ‘enlightened’. Enlightenment is simply lifting the veils of ego or self so that we can see the world as it is and from a Buddhist perspective, this level of awareness is possible to all people. We develop an ego or sense of ‘I’ when we are children; this is the sense of self as a thinking, feeling, and willing individual and distinguishes itself from the selves of others and from objects of its thought. The ego offers us protection and a sense of self but as we mature, we can learn through meditation and mindfulness practice to relax those structures. ‘Fully perceiving the nature of the self’ is one way to define enlightenment, we can connect to ourselves, the world and to nature in a more authentic, meaningful way.

“The goal in psychotherapy is exactly the same as in Buddhism.” – Carl Jung

Buddhism and psychology generally follow a similar goal structure; in simple words, the aim is for greater self-knowledge and to discover relief from suffering – distress, unease etc. Buddhist psychology asks us to begin looking at our ‘suffering’ or the things about ourselves or our experiences that we wish we could change. One of the things I do in therapy is encourage clients to begin to be more comfortable with experiencing our discomfort, to accept thoughts, feelings, body sensations just as they are without getting hooked into them and without pushing them away.

In this experience, we find the things that once used to cause intense distress to become opportunities to disengage and observe our internal workings. We learn to see where our reactions stem from through this mindfulness practice, and we can begin to find compassion for ourselves. Where we once may have believed that there was something deeply wrong with us or that we are ‘bad’ for having feelings of anger or jealousy or other societally negatively viewed emotions, we can see these feelings as part of an internal emotional weather system. Storms and clouds just passing by don’t need to be interacted with- acknowledged and allowed to pass through. Of course, this is not an instant response, it does take practice and commitment.

Mindfulness is an attitude to life that can be used in any (or no) spiritual tradition, these days statues and pictures of the Buddha are as likely to be a garden ornament or in a bar as they are in a temple.  He represents peace, calm and harmony yet, he himself only attained enlightenment after a long and personal struggle with his Self and his inner demons. So, Buddha is a very useful reminder that change in life requires commitment and takes practice. He shows clients that we need to change attitudes and let down defences which are holding us back. Both Buddhism and psychotherapy encourage reflexivity or curiosity about ourselves.

Is there a paradox though? Most clients do not come to me to ‘accept’ what is happening, they want to change. Can there be common ground between these perspectives of ‘change’ versus ‘acceptance’?

Recently some approaches to psychotherapy are beginning to understand, address, and even incorporate the reality of this paradox into their therapeutic approach. Recently there has been a radical shift in approach by many schools of thought in Western psychology, and two modalities which I integrate into my practice, Acceptance and Commitment Therapy (ACT) and Dialectical Behaviour Therapy (DBT), acknowledge this paradox. In DBT, the most central dialect is the relationship between acceptance and change. Clients are encouraged to accept themselves, their histories, and their current situations exactly as they are, while working intensively to change their behaviours and environments to build a better life. The synthesis of this apparent contradiction is a central goal of DBT.

Suffering cannot be changed by simply wishing it away. Denial, avoidance and all the other control strategies we use, the ‘problems we have about problems’ are the real cause of ongoing misery. In Acceptance and Commitment Therapy, the terms used to highlight this are “clean discomfort” and “dirty discomfort.” Clean discomfort is the natural pain of life, while dirty discomfort is the desperation, fear, guilt, and misery that accompany the urge to escape or control those experiences. Buddha explains it in the story where he describes suffering as like being hit by two arrows; the first is painful, but the second we fire at ourselves as we try to rationalise, escape, minimise, blame ourselves or feel guilty for the reality of the pain of the first arrow, hurts even more.

In Buddhist terms it is not the world that causes suffering but rather what we demand of it. There is no ‘rule’ that says that life, the world, or the universe should be free from suffering and yet we tend to want a life free from distress, illness, old age and death – but we will not find it in real life, such a quest is a fool’s errand. As we go through life, we will experience ups and downs, we get ill, get old, suffer pain, see loved ones die and eventually face death ourselves. We cannot change the first of Buddha’s arrows – we will experience things we would rather avoid – but through acceptance we can avoid the more problematic second arrow, the ‘dirty discomfort’, the ‘problem with the problem.’ Such is the nature of the paradox of ‘change’ versus ‘acceptance’.

My initial training was in humanistic therapy, and I undertook further training in existential therapy, DBT and ACT. All of them see acceptance as being crucial to change – the ‘paradoxical theory of change’. Briefly stated, it is this: that change occurs when one becomes what he or she is, not when he or she tries to become what he is not. In other words, before we change, we must first accept where, who and what we are, change cannot be forced, it happens naturally when it is ripe to happen. However, change must begin from life as it is, not from the illusions we create or desires we have to make life seem as we would like it to be. We must be fully engaged in the reality of our present to be able to step into our future. 

And EMDR? I think that EMDR fundamentally is a mindfulness therapy; they go hand in hand. If you’ve read any of my previous posts, you’ll know that mindfulness is broadly defined as non-judgmental awareness of whatever comes up, ideally with curiosity, openness, non-judgment, compassion, and acceptance. AS an EMDR therapist I hold a mindful posture to all traumatic and related material clients report; it all arises as phenomena to be witnessed, which depersonalises the traumatic events targeted for processing.

Likewise, both EMDR and mindfulness-based therapies are present-oriented, helping clients notice what they are currently experiencing and feeling as transitory events in consciousness, not fixed traits, without judgment or self-criticism. Both can be briefly summarised into essentially present-time, non-judgmental awareness that can lead to transformative healing. Both involve trusting the process as it organically unfolds, what Alan Watts called the ‘wisdom of insecurity’ – that a constant striving for something that is fixed and permanence in a world that is always changing, is fruitless.

Existential therapists talk about existential anxiety or ‘angst’, the realisation that we cannot be sure about anything other than this present moment and the need to accept the uncertain nature of the future and take responsibility for what we might do with it. This is not the same as ‘normal’ anxiety, existential anxiety is more about issues like the meaning of life, the inevitability of your death, and how you can make the time you have left on this planet matter.

Buddhism and existentialism do overlap quite a lot and this is something I will return to in other blog.

“Our sorrows and wounds are healed only when we touch them with compassion.” – Jack Kornfield, Buddha’s Little Instruction Book, page 31