OTHER-CENTRED THERAPY: A BUDDHIST PARADIGM
SUMMARY
Buddhist psychology offers an analysis of the self as a defensive, illusory structure, constructed in response to an awareness of the omnipresence of affliction. By creating the delusion of a permanent self, humans isolate themselves from one another, and from experience, in a field of perceptual distortions and repeating behavioural patterns, or karmic tendencies. Whilst the creation of self-structures, or identity, is a universal process for ordinary humans, when this process becomes too powerful, or is based on habit patterns which are overly destructive or limiting, it gives rise to difficulties that are generally identified as mental heath problems.
A Buddhist therapeutic approach therefore involves methods which disrupt the rigidity of the mental formations commonly associated with identity and which bring the person into closer relationship with the world and with others. These may be of two kinds: those methods which deconstruct ‘the self’, and those which facilitate better connection with ‘the other’. This presentation offers an exploration of a number of methods, some developed at the Amida Centre, and others drawn from other Buddhist therapeutic approaches such as the Japanese therapies Naikan and Morita, which fall into this latter category.
In its view of the self, Buddhist psychology provides a timely critique of some Western assumptions of mental health and offers a distinctly different paradigm for viewing the therapeutic. Other-centred approaches hold a particular place within this field, transcending the
need for self-focus in therapy and presenting a practical route to therapeutic change.
THE SELF AS AN ILLUSORY STRUCTURE
The key teachings of Buddhism offer a model for understanding the way in which the self is constructed. These teachings are consistent with one another and can be mapped onto each other, providing a model which is complex, insightful and useful. We can see that the core teachings are intended to work together, giving different perspectives on both the process of self-building and the way in which this process can be contained. This ‘one model’ view is supported as follows:
· Teachings can be interpreted in way that are consistent with one another
· The same key elements appear in several different teachings eg vedana,
samskara, vijnana and (nama)rupa all appear in both the teaching of the
skandhas and the teaching of Dependant Origination
· Some teachings are presented in different forms in different sutras, using
elements which are usually found in other teachings, suggesting there is
interchangeability.
Key teachings which we draw on in the basic model which we use at Amida are:
· The Five Skandhas,
· Dependent Origination
· The Four Noble Truths
· The Rare and Common Factors
· Theories of Conditional Relations (particularly object-relation)
In addition we can incorporate the Buddhist understanding of the senses, and manas
and alaya vijnanas.
SELF IS CREATED IN RESPONSE TO AFFLICTION
One basic principle which Buddhism offers is an understanding of Dukkha as a driving force of our psychology. The teaching of the Four Noble Truths begins with Dukkha, which is described in terms of existential life events. This is the reality of the human condition. The description of Dukkha also includes the secondary afflictions which come from attachment to self (the skandhas)
The second Noble Truth, Samudaya, means arising and refers to the arising of reactions in response to dukkha. Samudaya usually involves clinging and is associated with craving and attachment. It is the normal human response to try to escape afflictions through distraction. The attachments which arise are Kama, Bhava, Abhava.
· Kama: sense attachment. The first level of escape from reality is through sensory pleasures or less pleasant sensory distractions.
· Bhava: becoming, or self building. The sensory distractions build into habits which become identified with creating the self.
· Abhava: non-becoming. When self-creation ceases to work, or the self is threatened, theperson seeks oblivion, perhaps through suicide, self-harm, addiction or psychologicaldeadening.
These three elements give a description of the basic progress of a person in withdrawing from engagement with life and offer a typology for understanding levels of mental distress. The third and fourth Noble Truths, Nirodha and Marga, describe a process of unhooking from attachment and containing the energy of ones response to life affliction (nirodha) and re-engaging with life in a more spiritual way (marga).
THE SELF IS CREATED THROUGH A CYCLE OF REACTION
The teachings of Dependent Origination and of the Skandhas both describe the processes of self-creation. The two teachings map onto one another, and show how our perception of the world is conditioned by our mental structures and how our mental structures are conditioned by our perception of things. We are in a state of avidya (not seeing) because of our vijnana (common, or divided, consciousness).
· Our sense of ourselves as a special case creates a barrier between us and the world.
· Our perception of the world is always distorted by self-interest
· Our sense of self is an attempt to achieve a feeling of permanence in the face of uncertainty
To show how this model is portrayed, let us look at the teaching of the skandhas:
Rupa: the perceptual object, or the colouration which we add to the object. Perception iscoloured by self-interest, so that we see the world in ways which support our habitual view and indirectly our identity.
Vedana: our immediate, visceral reaction. This response is pre-cognitive, and either positive, negative or neutral. It is an expression of greed, hate, or delusion reactions.
Samjna: literally ‘with-knowing’ refers to our distorted perception, or, more specifically, a process of association and entrancement in which we draw the object which we have perceived into a familiar story, and start to follow an old script
Samskara: the creation of mental formations through the actions. Samskara is the creation of karma, which we produce as a result of following our old scripts.
Vijnana: The common or divided consciousness which arises as a result of the other skandhas.
This mentality leads us to seek out objects which will continue to confirm our prejudices about life. In other words it leads us back to seeing the world as rupa.
To expand this model, we can integrate the teaching of Dependent Origination which offers confirmation of the basic structure of ideas and the process nature of the cycle. This teaching also elaborates in some detail how our basic state of avidya (avoidance or ignorance) leads us, through the process of putting our stamp on the world (nama-rupa) to the ‘birth’ of the self. This involves a number of steps. Our conditioned senses grasp at the perceptual objects and clinging to them (as supports for our identity), and this process leads to self creation, but ultimately to deadness.
The teaching of the rare and common factors offers other elements which can be added to the model. This teaching shows us more about vijnana. It shows how we approach the world with intentionality (chetana) and selective attention (manaskara). It also gives some indication of how different elements in the cycle might be transformed into a more enlightened relationship with experience, offering what could be an equivalent cycle of enlightened process.
NOTE: Some elements in this interpretation are open to discussion, as not all are taken in the traditional way. Most alternative interpretations have been posited by others as well as by ourselves, however. There is not space in this presentation to elaborate the arguments for each detail, but the translation of terms has been discussed at greater lengths in our writings. In particular the interpretation of the Four Noble Truths is set out in David Brazier’s book, The Feeling Buddha. The other elements are presented in my book Buddhist Psychology. In as much as some details of this integrative interpretation is open to debate, however, the model as a whole does not depend on these details. For example even if one takes a traditional interpretation of samudaya, the teaching is still clearly associated with the problem of craving and the creation of self through kama, bhava and abhava. The following diagram (based on one in Buddhist Psychology) shows how the basic structure of ideas in the teaching of the Four Noble Truths creates a model which becomes a self-replicating cycle of a) identity formation and b) additional layers of affliction.
The diagram also maps onto this teaching elements from the teaching of Dependent Origination. This equates the reaction and craving with the stage of samudaya, and the stages of clinging (upadana), becoming and birth (Bhava and Jati) and decay and death (Jaramarana) with the three stages of samudaya, kama, bhava and abhava.
The diagram also shows the two paths implicit in the teaching – that of self-building compulsion and that of enlightened engagement.
The diagram above, also based on one from Buddhist Psychology, shows how the teaching of the Skandhas can be seen as a cycle. In this diagram, the teaching is extended by the addition of chetana and manaskara in place of vijnana. This diagram also suggests that those parts of the cycle concerned with our relationship with the world involve the six senses, the unruly doors to experience, whilst samskara is connected with the creation of karmic seeds which make up the
alaya or mind store. Manas, the aspect of mind that acts as organiser of the other parts, or which we might equate to the will, sits between the two, driven on the one hand by our reactive natures and on the other by our self-building intentionality.
The cycle is self-replicating; driven by the compulsive search for evidence to support our attachment to self; to support our theories about of our personal permanence and identity. The model can therefore be seen as one of addiction and compulsion.
Buddhism hypothesises that we are addicted to self.
OTHER CENTRED APPROACHES
The Buddhist understanding of mental process suggests that people construct a self as a defensive structure. The model which Buddhism offers of mental process is a cycle which can be seen as having two ‘poles’. One is about our relationship with the world. The other is about the self which we create. Different practices and therapies put different emphases on these, though, since the whole thing is a cycle, all will address the whole at least indirectly. Some methods focus more on the ‘self’ end of the cycle, seeing it as the focus of the problem and the part of the cycle where there is most leverage. They focus on deconstruction. Such practices focus at two levels:
· Gradual Path: The self which is constructed may be dysfunctional and may be improved by creating better karmic propensities (eg practices such as Watering Good Seeds.- Thich NhatHanh)
· Sudden Path: The self is the problem and needs to be dismantled (eg sudden path methods such as Zen)
An Other-Centred approach focuses predominantly on our relationship with the world. Since problems arise from our tendency to impose personal agendas on those whom we encounter and environments which we inhabit, gaining a clearer view of the world, as it really is, takes us out of the cycle. Of course as ordinary people this real perspective is never fully achievable, but other-centred methods help people to make moves in that direction.
CORE SKILLS:
EMPATHY
Empathy is the attempt to see the world ‘as if’ through the eyes of the other. A fundamental principle, then, in an other-centred approach, is to help the client to develop empathy for the ‘others’ in their world. This includes developing understanding of the significant people in their current life and from the past, not just in terms of their impact on the client him or her self, but also as people with their own reasons for being. The basic question which the therapist might ask is not ‘how is it for you’ but rather ‘how is it for them?’
OBJECT RELATED WORK
One of the conditional relations described in the Abhidharma is that of object relation. The mind is dependent on the object to which it gives attention. This principle can be seen, for example, in the practice of meditation, which is described as focusing the mind upon a wholesome object. One key skill which a therapist develops in an other-centred approach is to work object-relatedly. This means holding the client’s attention upon the objects which are significant in the client’s world, rather than bringing the attention back to the client’s self. The attention is outwardly orientated but may be focused in two ways. On the rupa quality of the object: The investigation may focus on the power of the object to hold the clients attention and on the scene that is associated with the
object. These are conditions which give rise to a mental state. The visual characteristics of the scene and object are intensified as the client is encouraged to allow the mind’s eye (mano-vijnana) to make the appearance of the object (often, but not always a person) more vivid. This work may lead to understanding of the pattern of reaction and association and the way that mental formations and identities are conditioned, or it may lead to cathartic insight and a change of heart.
Rupa-based work is useful in:
· Exposing patterns of perception, assumption, reaction, scripts, associations
· Showing how different identities are conditioned by different ‘objects’
· Leading to cathartic expression (focus on the object is more cathartic than focus on feelings)
· Conditioning a change of heart
The real existence of the object: Whilst investigation of the rupa aspects of the object are useful and revealing, other forms of object-related work involve challenging the habitual patterns of perception which the client has. Exploring the ‘reality’ of the object may be achieved through
· Challenging the perception directly. “Is that really so?”
· Developing empathy for the ‘other’
· Investigation, deduction and enquiry into the truth
· Role-reversal work, imaginatively and sometimes dramatically entering the other’s shoes.
The following diagram (which comes from my forthcoming book Other-Centred Therapy) shows some of the directions which an other-centred investigation might take.
THERAPIES COMPATIBLE WITH AN OTHER-CENTRED APPROACH
The other-centred perspective, as the Buddhist model itself, provides a paradigm within which different therapeutic methodologies can be integrated. It lends itself particularly to those approaches which do not draw attention to the self. We have already seen how empathy is a core skill, which therapist and client can develop.
Common to many therapies, in a other-centred work it takes on a different slant, its explicit focus being on the person’s world and not their thoughts or feelings about it.
Other approaches which might be used in an other-centred way include:
GROUNDING AND BODY BASED ACTIVITIES
Unless we are completely of the ‘projection of mind’ school of thought, our physical presence in the world gives us irrefutable evidence of the real nature of things which we come into contact with. Helping clients to develop their awareness of bodily contact with this physical world creates a good foundation for other-centred work.
PSYCHODRAMA
On the Amida programme we use psychodrama within an other-centred model because it offers valuable tools to explore the other-centred perspective. These include scene setting, enactment and role-reversal. Psychodrama provides students with conceptual clarity as well as removing the need to focus therapy in the self position.
NAIKAN THERAPY
Investigating the dependent nature of the person is given form in the practice of Naikan, a Japanese therapy in which the participant works with three questions:
· What have others done for me?
· What have I done I return?
· What trouble has my existence caused?
Traditionally undertaken in a retreat setting, Naikan therapy tends to encourage a deep appreciation of life and others, and may evoke feelings of regret at past events and ways in which one has not seen the needs or interests of others. Adaptations of Naikan can be done as a personal practice, guided by weekly sessions with a therapist or teacher, or through the internet. Todo Institute in Vermont offers regular programmes.
MORITA THERAPY
Another Japanese approach, Morita uses a number of exercises and techniques to break down a person’s attachment to seeing the world in particular ways or to thinking that they can control the feelings which arise in response to it. It suggests that we can choose what we do, but we cannot choose what we feel. It encourages people to be useful and to take an interest in creating a positive social environment.
MINDFULNESS BASED APPROACHES
Mindfulness practices focus on here and now attention. They may be used to develop the client’s awareness of the physical world in which they are living and the physical process of tasks which are being undertaken. Mindfulness also implies remembrance of the spiritual dimension. If taken in this way, the practice of mindfulness not only puts a person in touch with the physical reality of their world, but also its spiritual grounding.
FOUNDATIONAL ATTITUDES:
FAITH
Faith plays a crucial role in the relinquishment of self-attachment. Whilst embedded in the self-world, even the investigation of reality is an act of faith. It takes faith too to let go of protective layers of conditioning and face our existential vulnerability and our grief. Faith and refuge are key concepts in a Buddhist approach and in therapeutic work they are equally important foundations.
A NON-JUDGEMENTAL POSITION
Buddhism offers a paradigm in which judgement is theoretically absent, however, in the West we tend to fall back into concepts which come more from our own Judeo-Christian roots; those of guilt, blame, rights, forgiveness and judgement. An other-centred approach supports and depends upon realism rather than guilt, and catharsis and action rather than stagnation and self-justification.
ORDINARY NATURE
The understanding of our dependently originated nature is particularly developed in the thinking of Pureland Schools of Buddhism. Here the emphasis is on our ordinary or “bombu” nature. Each person is seen as having infinite capacity to accumulate bad karma and yet as being surrounded by love and support in the form of the conditions, or other-power (jiriki), which give rise to life
GRATITUDE AND APPRECIATION
It follows from our understanding of the human qualities of dependence, ordinariness and fallibility that other-centred approaches are grounded in a deep sense of appreciation and gratitude. Of course this should not be something forced or false, but tends to arise naturally when we look sat the reality of our situation.
A COMPARISON
In his book Naikan: grace, gratitude and the Japanese art of self-reflection, Gregg Krech gives the following list of elements contrasting features of a traditional Western approach to therapy with Naikan based methodologies. These features are ones that are very similar to those we would identify in an other-centred approach.
1. Traditional: Focus on Feelings; Naikan: Focus on Facts
2. Traditional: Revisit how you have been hurt and mistreated in the past; Naikan: Revisit how you have been cared for and supported in the past
3. Traditional: The therapist validates the Client’s experiences; Naikan: The therapist helps the client understand the experience of others
4. Traditional: Blame others for your problems; Naikan: Take responsibility for your own conduct and the problems you cause others
5. Traditional: The therapist provides analysis and interpretation of the client’s experience;
Naikan: The therapist provides a structured framework for the client’s self-reflection
6. Traditional: Therapy helps clients increase self-esteem; Naikan: Therapy helps clients increase appreciation of life
END NOTE: It is interesting that a recent report by the UK government think-tank, Foresight, arrived at a five-a-day programme of social and personal activities as a basis for mental health. The activities which it identified were:
· Connecting with Friends and Family,
· Learning Something New,
· Being Active,
· Taking Notice, and
· Helping Friends and Strangers.
All of which, from an other-centred perspective, seem to make perfect sense.
