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org & Click above on “More from this Publisher” In the last 30 years Buddhism has increasingly influenced a new generation of American psychotherapists. The basic Buddhist concepts of Buddha nature, the dharma, attachment and meditation have opened up new ways of thinking about the self, psychopathology, therapeutic process, the goal of therapy, the affective focus of therapy, the super-ego and therapeutic technique. Using a Buddhist approach to group therapy we can maintain adherence to the traditional principles of group therapeutic leadership technique, while exploring the possibilities for changing group structure through meditation, increasing insight and empathy in both leader and group members, and deepening access to repressed material. This approach does not create “a new form of therapy or group therapy,” but rather might enable us to do better what it is that we already know how to do. It is interesting that the history of Buddhism in America, and the history of psychoanalysis, begin at almost the same moment. Although Thoreau in the 1840’s, and the spiritual movement of the Theosophists and certain Boston scholars after the 1870’s, had all been interested in Buddhism, its entrance into the United States is often dated from the arrival of the Zen teacher Soyen Shaku in 1905 – only four years before Freud’s famous Clark University lectures of 1909. Since then both movements have permeated American society. But it was in the 1950’s that Buddhism began to enter the American mainstream. The writers Jack Kerouac, Gary Snyder and Allen Ginsberg embraced Zen Buddhism with a fervor. With his easy and brilliant writing style, the transplanted Englishman Alan Watts began to make Buddhism accessible to a wider audience. And at Columbia University the esteemed (and aged – he was then in his late 80’s) Zen scholar D.T. Suzuki began to teach the famous seminar that introduced Buddhism to psychoanalysis. Attended by Erich Fromm and Karen Horney (as well as the musician John Cage and others), this class led to the seminal 1957 Cuernavaca conference on Zen Buddhism and Psychoanalysis and to the book of the same name. This was the first attempt to bring these two powerful movements together in a scholarly fashion (Suzuki, Fromm and De Martino, 1960). In the 60’s and 70’s Buddhism grew in popularity. Starting in 1959 another Zen master named Suzuki (Shunryu Suzuki Roshi) began to teach in San Francisco, and his collected dharma talks, later published under the title Zen Mind, Beginner’s Mind, (Suzuki, 1972) became a classic. In the 70’s two Tibetan Buddhism teachers, Chogyam Trungpa Rinpoche and Tarthang Tulku, also began to teach in the United States, and three young Americans, Joseph
Goldstein, Jack Kornfield and Sharon Salzberg brought back from Asia the form of Buddhism called Insight Meditation and founded the Insight Meditation Society in Massachusetts. Starting in the 1980’s came pioneering work in the integration of Buddhism and psychotherapy – especially the books of Diane Shainberg (Shainberg, 1983, 1993, 2000), John Welwood (1983, 2000), and Mark Epstein (Epstein, 1995, 1998, 2001), among many others. It has often been noted that among many spiritual traditions Buddhism seems to hold a particular appeal for psychotherapists. This has been attributed to two causes. First, compared to the other great spiritual traditions, Buddhism contains a particularly sophisticated understanding of human psychology (the Buddha having jokingly been referred to as the world’s first cognitive psychotherapist). Second, the powerful emphasis on love and compassion that permeates all of Buddhist teaching is sometimes contrasted with what is said to be the harshness of the Jewish conception of divinity, and with the Christian emphasis on original sin and guilt, and is said to be in harmony with psychotherapeutic concepts of healing. Basic Concepts of Buddhism For the purposes of this paper we will focus on four basic concepts of Buddhism: Buddha nature, the dharma, attachment, and meditation. 1. The Nature of the Self and Buddha Nature. The most fundamental idea in Buddhism is that all human beings are, at their core, healthy, wise and loving – brilliantly sane, as one Buddhist teacher put it. This is referred to as Buddha nature. At the same time, Buddhism famously teaches that “there is no self.” By this Buddhism does not mean to deny the obvious fact that we all experience ourselves as having a continuous identity, and that this concept is useful in living our daily lives. The idea is rather that this everyday idea of identity is not the deepest, most real experience that we can have of ourselves. We might say that our identity, as we usually experience it, is composed of a set of mental constructs, self-representations or self-images, which are actually simply ideas. Buddhism teaches that on a deep level we may sometimes experience ourselves in such a way as to reveal this ordinary concept of the self to be not completely real. Instead, we could experience ourselves as deeply aware, peaceful, wise, and caring, as not a static object but a process, as interdependent with others – “inter-being,” as one teacher put it – rather than as independent of others. Putting these ideas together, we might say that there are fundamentally two different ways to experience the self – somewhat analogous to, although not identical with, Winnicott’s well-known concept of the true self and false self. In one mode, which we could call the social self or the false self, we experience ourselves as a static set of self-representations, independent of others, in which deficiency and psychodynamic conflict reside. In the other mode – Buddha nature – we may experience ourselves as a fundamentally healthy, loving, wise
interdependent process. It is an interesting and crucial fact, for most of us, that the capacity to experience ourselves in the mode of our Buddha nature may be a capacity that is even more deeply repressed than the thoughts, feelings and impulses of what we normally think of as the unconscious. 2. The Journey of our Lives – the Dharma. The word dharma has many meanings in Buddhism, but the most fundamental of these is that the universe and our lives are characterized by order, and that we can live our lives with the most happiness if we align ourselves with this order. A corollary is that the most useful way to approach any situation in our lives, especially a difficult one, is not to consider it as a problem to be solved, but rather to see it as an opportunity to learn something new about this order and about how to align with it. 3. The Cause of Unhappiness: Attachment. Buddhism teaches that our unhappiness in life springs from our not understanding how to be happy. In order to be happy we focus on achieving goals that are basically unstable, such as wealth, power, beauty, health, prestige, pleasure, or the enhancement of certain self-images. Buddhism refers to the need for these goals as “attachment.” The idea here is not that it is wrong or immature to pursue such goals – they are obviously of value – but that it is a mistake to make them our primary focus, to base our happiness on them. (Because for us as therapists, educated by object relations theorists, the word “attachment” has another meaning; it is sometimes clearer to refer to “attachment” in everyday language as “expectation” or “need” or “mental addiction.”) Instead of focusing on attachments or addictions for our happiness, however, we might make our primary focus a more satisfying and stable goal – for instance, developing the capacity to experience our Buddha nature through fully feeling and accepting what we are experiencing at each moment of our lives. 4. Meditation: A Technology for Happiness - Re-training the Psyche. In his famous initial teaching the Buddha suggested eight different techniques which could lead to a well-lived life (“the eight-fold path.”) For our purposes the most relevant of these might be meditation. The most basic form of Buddhist meditation, mindfulness meditation, is done by focusing our attention on our breathing, and gently bringing our attention back to our breathing when our attention wanders. The theory of meditation is as follows. The potential exists in all of us for our consciousness to be in contact with the deepest level of who we are. What interferes are the habits of our brain, our habits of thinking and feeling which tend to focus our attention on our attachments, our addictions. Meditation is simply a matter of re-training our brains to focus away from these attachments – the places to which our minds wander during meditation – to leave the brain free to contact something deeper and more satisfying. Focusing on our breathing is a technique to pull our minds away from our mental addictions.
Principles of Buddhist Psychotherapy In the application of Buddhism to psychotherapy we need to be aware of a number of caveats. First, for the purposes of this article, I am simplifying Buddhism to a considerable degree. Second, like all the world’s great spiritual traditions, Buddhism is not monolithic. Just as there are many traditions within each of Christianity, Judaism, and Islam, for example, so too there are at least five major traditions within Buddhism that are currently practiced in the United States. These are Insight (Vipassana) Meditation, Zen Buddhism, Tibetan Buddhism, Pure Land Buddhism, and Nichiren (Soka Gakkai) Buddhism. However, within this diversity there is a core of shared beliefs that can allow us to speak of a common Buddhist approach to psychotherapy. Third and most crucial, an approach to therapy informed by Buddhist principles does not constitute a radically new form of therapy. A conscious fly on the wall in the office of a therapist who might think of herself as Buddhist might not, most of the time, observe very much that seems different from traditional psychotherapy. At times different techniques might be introduced, it is true, and a Buddhist understanding might be translated into different ways of intervening. But the main difference would probably be in how the therapist is understanding and experiencing what is transpiring in the session. A Buddhist approach to therapy will not necessarily yield “a new form of therapy.” The primary effect of Buddhism on the practice of group therapy is in the way Buddhist practice changes the consciousness of the therapist. In my experience this is in the direction of a greater capacity on the part of therapists to be fully present in the here-and-now with the patient, to be compassionate, and to be flexible and creative with their responses – in other words, to do more effectively what we already know how to do. This effect of Buddhist practice on the consciousness of the therapist is illustrated in the recent book Psychoanalysis and Buddhism (Safran, 2003). In this compilation of articles and dialogues a number of senior psychoanalysts with decades of experience with Buddhist practice explore in detail the ways in which their years of Buddhist meditation has refined their capacity to be present with their patients with greater delicacy, creativity, caring and presence. This idea – that Buddhist practice can help us as psychotherapists do more effectively what we already know how to do – extends also to a cognitive understanding of what we might call certain basic Buddhist principles of psychotherapy. A rough outline of these different principles of therapy is presented below. 1 .The Self. According to Buddhist thinking, there is fundamentally no pathology in human beings. What we refer to as psychopathology certainly does exist, of course, as part of the organization of the social self. But this is a consequence of our consciousness being cut off from contact with who we truly are on a deeper level. When we are in fact in the mode of the true self we may
experience ourselves as without pathology. These are the experiences we may have while looking at a beautiful sunset, or listening to music, or being engaged in artistic creativity, or making love, or being engaged in a particularly meaningful therapy session, or participating in a special moment of athletics. These experiences, which have been referred to a “flow,” (Csikszentmihayli, 1990), or are spoken of by world-class athletes as “being in the zone,” are characterized by feelings of utter calm, of effortless spontaneity, of a sense of oneness with the world, and a sense of beauty and rightness. Such experiences of Buddha nature, in a Buddhist conception of psychotherapy, are considered to be the birthright of all humans. We might think of it in this way that our experience is like a kaleidoscope. Whether we are experiencing ourselves as the social self or as the true self, the same components of our psyches are present. But in the two states the organization of the psyche is radically different. It could be the aim of psychotherapy to teach us how to spin our internal kaleidoscopes in such a way that we have increased access to our Buddha nature. 2. Psychopathology. In the Buddhist view what is usually considered to be psychopathology is not thought to be caused by the usual suspects – intrapsychic conflict (in the structural or ego-psychological models of the psyche), deficient self and self-object experience (in the self-psychological model), or pathological internalized object relations (in the object relations model). Rather, psychological dysfunction is considered to be a result of lack of contact with Buddha nature. In line with the Buddhist conception of dharma, psychopathology is in fact not considered to be “pathology” at all, but rather “path,” a distinction first made, to the best of my knowledge, by John Welwood (Welwood, 1986). That is, symptoms and dysfunction are not fundamentally considered to be problems, but rather to be opportunities to learn on the journey of life. To quote the dolphin researcher and neuroscientist John Lilly, “in life there are no mistakes, only experiments.” 3. Therapeutic Process. We may best approach the Buddhist understanding of therapeutic process by contrasting it with the models of therapeutic process that characterize traditional models of psychotherapy. In traditional terms, healing occurs either through making the unconscious conscious, or through the provision of an appropriately empathic self-object response, or through the correction of dysfunctional relational patterns. In Buddhist therapy, on the other hand, healing occurs through opening a channel between the conscious mind and the deepest level of who we are. 4. The Goal of Therapy. Traditionally the goal of therapy is considered to be satisfying relationships and productive work. In a Buddhist approach to therapy we might add the capacity to be and to play. “Play” is used here in the highest sense of the word, as used by the historian Huizinga in his classic Homo Ludens (Huizinga, 1950) or by Winnicott (Playing and Reality, 1989). The idea is
similar to that expressed by the German playwright Friedrich Schiller when he wrote, “ we only play when in the full meaning of the word we are human, and we are only completely human when we play.” 5. The Affective Focus of Therapy. In Buddhist therapy there is an overt focus on cultivating certain positive emotions – for example, compassion, empathy and forgiveness. This is not done to the exclusion of bringing unconscious feelings of lust, hurt, grief, anger and hatred into consciousness, but as an additional deliberate focus. It follows the meditative principle of re-training the brain so it is more able to contact the deeper level of who we are. 6. The Role of the Super-ego. A Buddhist point of view would be open to the possibility that the super-ego might ultimately be an antiquated internal structure. This is not to deny the crucial importance of morality in life, which is heavily emphasized in Buddhism. (In fact traditional Buddhist practice begins with an emphasis on ethics rather than meditation.) The idea rather is that the deepest source of morality might lie not in a psychic structure derived from internalized parental object representations, but rather in a profound sense of being in touch with our essence, which might automatically include a sense of deep caring and respect for others. According to this approach the super-ego could be viewed as a structure that can be outlived rather than modified and softened. Of course it could be argued that what a Buddhist considers to be morality derived from Buddha nature is really just another way of talking about an unconscious mature super-ego, but from the Buddhist point of view even a mature super-ego could be considered simply a mental object, and therefore a potential interference with contact with what could be an even stronger source of morality. General Principles of Technique in a Buddhist Approach to Therapy 1. The Practice of Psychotherapy as a Maturational Path for the Therapist. One of the great secrets of our profession, which we all know but do not talk much about, is that the quality of our clinical work depends heavily on the quality of our own personal maturity. So the first principle of Buddhist therapeutic technique has to be for us to do our own inner maturational work, in whatever way seems right to us. Ultimately this takes precedence over all else. 2. Presence. Next it must be said that talking about a Buddhist, or for that matter, any spiritual technique for psychotherapy is to immediately engage in a massive paradox. For the essence of a Buddhist approach to technique is that there is no technique at all. That is, in a Buddhist approach to therapy, the essence of the technique of doing therapy is not to try to “do” anything at all – that is, not to try to “fix” the patient or “make something better.” Rather the idea is to “be” with the patient or the group, to be present, without
trying to fix anyone or anything. This is essentially what the existential analysts meant by “presence,” what Sullivan meant by “the syntactic mode,” what the Jewish mystic Buber meant by “an I-Thou relationship,” and what Bion meant by jettisoning “memory, understanding and desire.” In other words, the technique is simply to be fully present with the patient or group, which means allowing oneself as a therapist to fully experience and accept the patient’s and one’s own experience without the need to do anything. Or as the psychologist and spiritual teacher Ram Dass (Richard Alpert) said when talking of his own approach to doing psychotherapy, “the gift you offer another person is just your being.” 3. Cultivating Communion and Catalyzing the Patient’s Contact with her True Self. In spite of all this, we might still want to know something more about technique than the simple admonition to be mature and present. What actually is supposed to happen, we might ask. From a Buddhist perspective we might think of it this way. The ultimate healing for our patients consists in our helping them to spin their internal kaleidoscopes, to shift from a false self to a true self mode, to contact the essence of who they really are, to contact their Buddha nature. The psychotherapist who is in contact with her own true self, her own Buddha nature, establishes a sense of authentic contact with her patient, establishes an I-Thou relationship or what we might call a sense of communion. She then is operating in a sense as a midwife, and can catalyze her patient’s capacity to contact her own Buddha nature. We might think of it as the therapist blowing on the spark of Buddha nature in the patient to allow it to become a flame. This might be considered the fundamental healing process in the Buddhist approach to psychotherapy. 4. Emphasizing the Healthy Growth Edge. It is critical, in this approach to therapy, to always emphasize the aspect of the patient that is growing, rather than to focus primarily on what we usually call pathology. This does not mean that as therapists we will not point out and interpret dysfunctional emotional, cognitive or behavioral patterns, but only that the emphasis is always placed on health. This also suggests an emphasis in psychotherapy on compassion and empathy, though not to the exclusion of dealing with conflict and aggression. This approach is familiar to many of us through the principles of self-psychology (or in family therapy through the concept of “re-framing”), and we may often at times include it in our therapeutic armamentarium. What characterizes the Buddhist approach, and can be deeply transformative, is a commitment on the part of the therapist to make identifying healthy motivation the priority, no matter how “pathological” the presenting clinical material may appear to be. (Of course therapeutic judgment may dictate departing from this injunction when clinically indicated, as in the case of dealing with sociopathy or severe acting-out.) 5. Being Willing to Rest Peacefully in Not Knowing. According to the Buddhist approach, the greatest source of our ability to help our patients will originate in our Buddha nature, our deepest source of wisdom and compassion.
Over-attending to the conscious mind only interferes with our access to this knowledge – hence Theodor Reik’s famous advice to listen with the third ear (Reik, 1964). What is required is a capacity to be comfortable with confusion, what the poet John Keats famously referred to as “negative capability” – “when a man is capable of being in uncertainties, mysteries, doubts, without any irritable reaching after fact and reason” (Keats,1959). 6. Being as Flexible as Possible in the Practice of Therapy. This requires trusting our intuition, taking chances, always being willing to change our minds, always being willing to not know how psychotherapy works. We could be like Michelangelo (at age 87!): “I am still learning.” This also means being able to admit mistakes without considering them to be problems (Dogen, considered one of the greatest Buddhist teachers, stated: “my life has been a continuous series of mistakes.”) 7. Using Active Techniques to Facilitate Contact with Deeper Experience and Letting Go of the False Self. These might include introducing meditation, emphasizing breathing, and the use of special techniques such as gestalt work or Eugene Gendlin’s focusing technique (Gendlin, 1996). The idea here is that the barriers to directly experiencing the true self may be so habitual and rigid that active intervention on the part of the therapist may be needed and welcomed by the patient. It goes almost without saying that all such active interventions are freighted with transference implications which must be carefully attended to by the clinician. A Buddhist Approach to Group Psychotherapy First it is important to note again that a Buddhist-oriented group therapeutic approach may not differ in fundamental ways from a traditional psychodynamic or interpersonal approach (Rutan and Stone,1984, Yalom,1985). The theory, content, process and technique may not differ radically from what we are used to. Buddhist group therapy, therefore, to the extent that such a thing has been in the process of being invented by a number of therapists in the last decade, is not “a new form of group therapy.” In this sense it differs from certain innovations that have appeared on the group therapy scene in recent decades, such as gestalt group therapy, transactional analysis, redecision group therapy, and cognitivebehavioral group therapy, to name just a few, all of which do seem to constitute fundamentally new (and often, quite powerful and helpful) approaches to our clinical work. So at least in our present state of knowledge, a Buddhist approach to group therapy does not necessarily lead to a radically new approach to group process or group dynamics. Good group therapy is good group therapy, and the basis of a Buddhist approach to running groups is to be a good group therapist. Along these lines, no therapy group, no matter what its orientation, can be successful
unless its leader adheres to the basic principles of good group therapy leadership. These are, to review (Porter, 1994): 1. Attending to individual needs by giving primacy to the here-and-now, interpreting the unconscious, and encouraging the expression of feelings in words in a way that is useful for both the individual and the group. 2. Attending to group needs by maintaining the therapeutic frame, always making the group the agent of change as much as possible, stimulating group interaction, and educating the group to the therapeutic process. 3. Balancing individual and group needs appropriately. 4. Dealing with resistance by according it priority, recognizing its often unconscious nature, allowing anxiety to be optimal rather than maximal or minimal, and dealing with resistances in order of severity. 5. Dealing with transference by using the group as an instrument, using optimal timing, and recognizing the need to deal with transference using a variety of approaches (insight, supportive, self-psychological, relational) according to the needs of the patient at any given moment. 6. Dealing with counter-transference by allowing it to be conscious and deciding when to simply use it as data and when and how to selectively express it. 7. Dealing with primitive group processes, such as scapegoating, regression, and projective identification. This being said, where a Buddhist group therapy may differ is in the more subtle, but nonetheless critical aspects of the work: the structure of the group, the overall approach of the therapist to clinical material, the effect of the approach on the consciousness of the therapist, the effect on the atmosphere of the group, and the effect on the level of clinical material available for productive therapeutic work. In 2001 I started two “meditation training groups” for psychotherapists, intended to explore the possibilities for integrating meditation, spirituality, and group process. I called the groups “training groups” and the interaction “group process,” and I further called the approach “spiritual” in a general way, as it incorporated understanding and study from years of spiritual practice that I had done in many different spiritual traditions. Nonetheless, much of what I did was highly informed by my own 15 years of specifically Buddhist study and meditation practice, and the groups can serve as a model for what may happen when a traditionallytrained psychotherapist introduces a spiritual perspective into the practice of group therapy.
The model I used evolved over time, largely in response to input from the members of the groups. The present model is 15- 20 minutes of meditation at the start of the group, 5 minutes to discuss technical issues of meditation, and about an hour of group process. The groups end with one to two minutes of closing meditation. At the present time there are 4-5 members in each group. After about a year both groups spontaneously (and independently – within about 4 months of each other) decided to change their contract and become formal therapy groups – a development which had not been consciously in my mind when I started the groups. This seemed to be the result of a sense of depth and emotional connection that had developed among the members of each group. The clinical examples in this paper are drawn from these two groups. Here are some ways in which a therapy group run according to Buddhist principles might differ from what we have come to know as traditional group therapy, based on my experience with these two groups. 1. Structure of the Group. As I mentioned, groups might begin with a period of meditation. It seems important that this not be so short as to be meaningless, but not so long as to substantially interfere with group process during the remainder of the session. An initial period of 15-25 minutes seems best, at this stage of my experience. 2. Leadership Technique. In leading these two groups I tried to adhere as much as possible to the basic principles of Buddhist psychotherapy technique outlined above: being present, cultivating communion, emphasizing the healthy growth edge, resting in not knowing, trusting intuition, focusing on positive affect, questioning the super-ego, and being willing to use active techniques. This seemed to affect both my own consciousness and the atmosphere of the group. 3. The Consciousness of the Leader: Increased Empathy and Insight. Much of the effect of bringing a Buddhist approach to group therapy seemed to spring from the effect of the spiritual perspective on my own consciousness. In the groups which I have led from this perspective, I have found, without particularly trying, that I tend to have a greater degree of empathy and intuitive understanding than usual. This seems to take the form of a greater ability to spontaneously “get” where a person is, a deeper degree of compassion, and greater access to creative responses. I attribute this to the effect on me of the “mental set” with which I approach the group, the effect on me of the initial period of meditation, and also the effect on me of years of practice of Buddhist meditation. Clinical example #1 (All clinical examples have been discussed with and approved by members of the relevant groups in so far as this was clinically possible.)
One group was initially characterized for about 6 months by seemingly relentless attacks on me as the leader. With the exception of one time when I responded angrily to provocation, I was surprised to notice in myself a more flexible than usual capacity to maintain a sense of equanimity and empathy in the face of a very high level of aggression. Although it was of course not the point of the experience, I noticed that the capacity to hold aggression without acting it out became a maturational experience for me as a leader, and ultimately set a tone that allowed the group to transform into a deeper and stronger container. From my point of view, my Buddhist training seemed to have deepened my own capacity for compassion and non-judgmental presence. 4. The Atmosphere of the Group: Increased Honesty and Compassion. Similarly in my experience the groups themselves have seemed characterized by an increased dimension of giving and receiving difficult feedback with empathy and compassion. This has also been true in most of the one-day or two-day training groups I have run at the Eastern Group Psychotherapy Society or the American Group Psychotherapy Association annual meetings using this approach. Clinical example #2 By their second year both groups contained four women and one man. Each man seemed, for a period of time, to be experiencing an angry and unsatisfying stance toward a woman in his life. Although in each case it was abundantly clear that the woman in question was contributing in major ways to the relationship difficulty, it was also clear to both groups that the man, without fully realizing it, was caught in a behavior pattern that was making things worse for him. The women in each group were able to give very direct feedback to the men, relating it in some instances to here-and-now interactions in the group. In both situations what was striking to me was the exceptional capacity of the group to be both direct and empathic, and the striking ability of the men to receive the feedback totally non-defensively, and to rapidly integrate it into their daily lives. Here too the group atmosphere allowed for a striking degree of compassion and empathy that seemed related to the Buddhist principles of psychotherapy technique with which I had attempted to lead the groups. 5. Increased Depth of Material. What has been striking in both groups has been the rapid access to very deep, sometimes primitive material, that seems at times to be emerging from the first year of life, and that has included transferential interactions with me. This has had very positive (and at times challenging) effects. Clinical example #3.
The group referred to in the first clinical example was at first one of the most difficult I have ever led in 32 years of leading groups, and then evolved into one of the most successful. It started as a group of ten women and myself that met for the first time the week before September 11, 2001. The weeks following 9/11 many members were not able to attend. As members began to trickle back, a hostile and mistrustful attitude toward the group and toward me began to evolve. Several women developed intense, angry and painfully suspicious relationships with me, which ultimately led to their leaving the group. I had the fascinating (and frustrating) experience as a leader that whatever I said or didn’t say was wrong. I seemed never to be able to help the group come together as a safe, trustworthy environment. In retrospect I realized a number of things. First, of course, the presence of ten women and one male leader certainly made for a very challenging transference situation. Second, as I learned from both this and the other similar group which I ran, ten members turned out to be too many once the groups unexpectedly turned into therapy groups. But probably most important, the combination of September 11 and the meditation ignited a regressive firestorm that took months to burn out. When the dust settled, what I came to understand was that the environment of New York City merged with the environment of the group in the experience of the group members. As we have come to know (Scheidlinger, 1974), the group is often, and especially in times of crisis, experienced as the mother of early life, as is society as a whole. On September 11 a massive attack of male aggression tore apart the containing (maternal) fabric of society in New York City. Hence the City itself, as well as the fragmented therapy group (which was unable to fully reconstitute itself for weeks) was experienced as unsafe. I, on the other hand, was experienced primarily as either the castrated father who was unable to protect the integrity of the group, or as the aggressive male who was identified with the attackers. In line with this, many women in the group began to experience me as a replica of a traumatizing father. Eventually a number of women dropped out of the group, which then gradually settled into a productive work mode. With the addition of a new male member, the group continued working on very deep material, as members began to deal with profound feelings of anger and hatred toward their mothers. I supported this, pointing out the enormous maturational value of being able to experience intense hatred without self-judgment, repression, projection or acting-out. One woman successfully freed herself from a lifelong and crippling dependency on her mother by using her hatred as an engine of separation, and then eventually began to develop feelings of compassion and forgiveness for her. A second woman went through an analogous process embodied in a painful separation from a beloved but disappointing analyst, and then went on to explore the corresponding psychodynamics with her actual mother. In summary, in this group it seemed that the spiritual orientation of the group and the practice of meditation allowed the group to move to a very primitive
regressed level very quickly. Specifically, the meditation seemed to give patients quicker and deeper access to unconscious material, and my own background in Buddhism seemed to allow for greater empathy and attunement of therapeutic process than I had experienced in the past. When external events deepened the process more rapidly than the container of the group could hold, the process did become unstable. But the pressure of the traumatic events seemed to allow the group eventually to become a cauldron for transformation into a new and stronger container. What was quite fascinating was to see that once the group became more stable, it evolved from one of the most difficult to one of the most profoundly successfully groups which I have ever encountered, able to work on a surprisingly deep level with very productive results. Summary and Conclusions We have reviewed the history of Buddhism in America in the last 100 years, some basic concepts of Buddhism (Buddha nature, dharma, attachment and meditation), and some basic principles of Buddhist psychotherapy regarding the self, psychopathology, therapeutic process, the goal of therapy, the affective focus of therapy and the super-ego. We discussed the basic principles of Buddhist therapeutic technique, which include the need for the therapist to do her own maturational work, be present, cultivate communion, emphasize the healthy growth edge, be comfortable with not knowing, be open and flexible, focus on positive affect, question the super-ego, and be open to the use of active techniques. We explored the application of all this to group therapy, reviewing the basic principles of traditional group therapeutic leadership technique, and then, using examples from two Buddhist-oriented therapy groups which I have led, reviewed how bringing a Buddhist orientation to group therapy might change the structure (by adding meditation), change the overall technical approach of the leader, change the consciousness of the leader (in the direction of greater insight and empathy), shift the atmosphere in the group (toward more honesty and compassion), and deepen group members’ access to repressed material. Overall what I have emphasized is that a Buddhist approach to group therapy does not create a radically new “form of group therapy,” but may substantially enhance our capability to do better what we already know how to do as group therapists. A final word needs to be added. I have described how a Buddhist approach to group therapy might enhance the effectiveness of our usual clinical work. This has emphasized certain aspects of the Buddhist tradition that make it especially helpful to the practice of psychotherapy. Meditation and Buddhist practice develops the therapist’s capacity to be present in the here-and-now, to be compassionate, to be attuned to healthy potential, to question the super-ego, to be flexible and intuitive, and to contact, and encourage contact with, the true self.
But there is nothing exclusive in the Buddhist tradition that uniquely qualifies it, among other spiritual traditions, to be privileged in enhancing our therapeutic effectiveness. One could write an equally compelling paper, for example, on “A Christian Approach to Group Therapy,” which might emphasize the usefulness of prayer, purging, mercy and forgiveness; or a “Jewish/Kabbalistic Approach to Group Therapy,” enumerating techniques to contact and activate the sephirot; or a Hindu/Yoga approach, focusing on the use of asanas and pranayama, the activation of kundalini shakti, the opening of chakras, and the path of service and union with the Divine; or a Moslem/Sufi approach, a Taoist approach, or a Shamanistic approach, to pick just a few of the many intriguing possibilities from among the world’s great spiritual traditions. Indeed, I believe that in the conduct of the therapy groups which I described, I never once mentioned the word “Buddhism,” and that the members of those groups, should they happen to read this paper, would be a bit surprised to know that they had been participating in a “Buddhist-oriented psychotherapy group.” In part this is because, as I mentioned earlier, the groups were not run exclusively according to Buddhist principles, but also incorporated many other spiritual traditions which I had happened to study. It may also be in part because psychotherapeutic technique does not require (and in fact may even eschew) making glaringly explicit the theoretical framework with which one approaches the clinical work. Be that as it may, my point is that Buddhism is just one of the many great spiritual traditions which our species has developed, and hopefully it may serve to facilitate, along with many other influences, the development of an ever more wise and compassionate twenty-first century philosophy and practice of group psychotherapy. REFERENCES Csikszentmihayli, M. (1990). Flow: The psychology of optimal experience. New York: Harper and Row. Epstein, M. (1995). Thoughts without a thinker: Psychotherapy from a Buddhist perspective. New York: Basic Books. Epstein, M. (1998) Going to pieces without falling apart: A Buddhist perspective on wholeness – lessons from meditation and psychotherapy. New York: Broadway Books. Epstein, M. (2001). Going on being: Buddhism and the way of change. New York: Broadway Books. Gendlin, E.T. (1996). Focusing-oriented psychotherapy: A manual of the experiential method. New York: Guilford. Huizinga, J. (1950) Homo ludens: A study of the play element in culture. Boston: Beacon. Keats, J. (1959). To George and Thomas Keats, Dec. 21, 1817. In Major British writers (p. 361). New York: Harcourt Brace and Co.
Porter, K.(1994). Principles of group therapeutic technique. In H.S. Bernard and K.R. Mackenzie, Basics of group psychotherapy (pp. 100-122). New York: Guilford. Reik, T. (1964). Listening with the third ear. New York: Pyramid Books. Rutan, J.S. & Stone, W.N. (1984). Psychodynamic group psychotherapy. Lexington, MA: D.C. Heath. Safran, J.D. (2003), ed. Psychoanalysis and Buddhism: An unfolding dialogue. Boston: Wisdom Publications. Shainberg, D. (1983). Healing in psychotherapy: The process of holistic change. Langhorne, PA: Gordon and Breach. Shainberg, D. (1993). Healing in psychotherapy: The path and process of inner change, 2nd ed. Langhorne, PA: Gordon and Breach. Shainberg, D. (2000). Chasing elephants: Healing psychologically with Buddhist wisdom. New York: Asti-Rahman Books. Suzuki, D.T., Fromm, E., & DeMartino, R. (1960). Zen Buddhism and psychoanalysis. New York: Grove Press. Suzuki, S. ( 1970). Zen mind, beginner’s mind. New York: Weatherhill. Welwood, J. ( 1983), ed. Awakening the heart: East/West approaches to psychotherapy and the healing relationship. Boston: Shambhala. Welwood, J. ( 1986). Class at Omega Institute, Rhinebeck, New York Welwood, J. (2000). Toward a psychology of awakening: Buddhism, psychotherapy, and the path of personal and spiritual transformation. Boston: Shambhala. Winnicott, D.W. (1989). Playing and reality. New York: Routledge. Yalom, I. (1985). The theory and practice of group psychotherapy, 3rd ed. New York: Basic Books. ________________________________________ *This article was published in Group, Journal of the Eastern Group Psychotherapy Society, vol. 28:4, pp. 53-70, Dec. 2004, and is reprinted here with permission of the author. ** Kenneth Porter, M.D., is a spiritually-oriented psychiatrist and psychotherapist practicing individual, couples, and group psychotherapy in New York City. He is a teacher of Buddhist meditation at the New York Insight Meditation Center, PastPresident of the Association for Spirituality and Psychotherapy, and long-term student of Kundalini Science and of the Diamond Approach of A.H. Almaas. He can be contacted at email@example.com. My thanks to Ken Porter for submitting this essay for publication on the www.desmoinesmeditation.org website. Contact Charlie Day at (515) 255-8398 or firstname.lastname@example.org to submit material or discuss meditation, Buddhism, sitting groups, retreats, or meditation experiences.
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