therapy

Psychotherapy, East and West

Reading philosophical texts can be daunting- sometimes the terminology and words are dense and sometimes you have to re-read multiple times to understand what the writer means. But reading original sources can be highly enriching too.

Buddhist monk in Phu Soidao Nationalpark, Phu ...

Buddhist monk in Phu Soidao Nationalpark, Phu Soidao Nationalpark Waterfall, Thailand, Uttaradit Province Location: Phu Soidao Nationalpark Thailand. (Photo credit: Wikipedia)

So when I came across an opportunity to read and review ‘Psychotherapy east and west,’ by Alan Watts, I proceeded ahead with some mixed enthusiasm- I like his quote ‘What if money was no object’ very much; but I also knew that I might not have the right expertise to do justice to the book. I am not a participating psychotherapist- the only saving grace is that I am very much familiar with some of the eastern ‘ways of liberation’ like Vedanta and Yoga and somewhat moderately familiar with the other oriental ones like Zen Buddhism and Taoism.

However, there is much that I could not understand, so take what I say with a pinch of salt.

Alan Watts, considers the eastern ways of liberation as something akin to western psychotherapy, with the aim being to bring about a change in individual consciousness.

The main resemblance between these Eastern ways of life and Western psychotherapy is in the concern of both with bringing about changes of consciousness, changes in our ways of feeling our own existence and our relation to human society and the natural world. The psychotherapist has, for the most part, been interested in changing the consciousness of peculiarly disturbed individuals. The disciplines of Buddhism and Taoism are, however, concerned with changing the consciousness of normal, socially adjusted people. But it is increasingly apparent to psychotherapists that the normal state of consciousness in our culture is both the context and the breeding ground of mental disease. A complex of societies of vast material wealthy bent on mutual destruction is anything but a condition of social health.

And thus the importance of context to understand this book- it was first published in the early 60’s a time of cold war as also a time when the, now controversial,  double-bind theory of psychosis was proposed by Gregory Bateson, whose work Alan Watts seems to admire. Watts assumes, and tries to show ,that Eastern ways of liberation also work by making an individual come to see the true nature of the double bind that society / culture imposes. He references the Hindu concept of Maya or ‘world-as-illusion’ and applies it to social institutions and believes that even western psychotherapists are in the game of dispelling Maya for their clients:

For they (psychotherapists) are dealing with people whose distress arises from what may be termed maya, to use the Hindu-Buddhist word whose exact meaning is not merely “illusion” butthe entire world-conception of a culture, considered as illusion in the strict etymological sense of a play (Latin, ludere). The aim of a way of liberation is not the destruction of maya but seeing it for what it is, or seeing through it. Play is not to be taken seriously, or, in other words, ideas of the world and of oneself which are social conventions and institutions are not to be confused with reality.

 

….

Yet very few modern authorities on Buddhism or Vedanta seem to realize that social institutions constitute the maya, the illusion, from which they offer release. It is almost invariably assumed that Nirvana or moksha means release from the physical organism and the physical universe, an accomplishment involving powers of mind over matter that would give their possessor the omnipotence of a god.

Eastern ways of liberation work by dispelling Maya, dissolution of ego and letting Eros or Love/spontaneity reign. But first we have to understand the double-bind to comment on it and to come out of it.

 

And that is just the paradox of the situation: society gives us the idea that the mind, or ego, is inside the skin and that it acts on its own apart from society.
Here, then, is a major contradiction in the rules of then social game. The members of the game are to play as if they were independent agents, but they are not to know that they are just playing as if! It is explicit in the rules that the individual is self-determining, but implicit that he is so only by virtue of the rules. Furthermore, while he is defined as an independent agent, he must not be so independent as not to submit to the rules which define him. Thus he is defined as an agent in order to be held responsible to the group for “his” actions. The rules of the game confer independence and take it away at the same time, without revealing the contradiction.

This is exactly the predicament which Gregory Bateson calls the “double-bind,” in which the individual is called upon to take two mutually exclusive courses of action and at the same time is prevented from being able to comment on the paradox. You are damned if you do and damned if you don’t, and you mustn’t realize it. Bateson has suggested that the individual who finds himself in a family situation which imposes the double-bind upon him in an acute form is liable to schizophrenia. For if he cannot comment on the contradiction, what can he do but withdraw from the field? Yet society does not allow withdrawal; the individual must play the game.

….

But in liberation this comes to pass not through an unconscious compulsion but through insight, through understanding and breaking the double-bind which society imposes. One does not then get into the position of not being able to play the game; one can play it all the better for seeing that it is a game.

But we are getting ahead of ourselves. I will let Watts describe an example of double bind to you , both in philosophy and in practice, so that you get a clearer idea:

If all this is true, it becomes obvious that the ego feeling Is, pure hypnosis. Society is persuading the individual to do what it wants by making it appear that its commands are the individual’s inmost self. What we want is what you want. And this is a double-bind, as when a mother says to her child, who is longing to slush around in a mud puddle, “Now, darling, you don’t want to get into that mud!” This is misinformation, and this — if anything — is the “Great Social Lie.”

The theory of double -bind for psychosis, though largely discredited/ unproven; may still be a useful starting ground to think about how ways of liberation work. Is the purpose of Zen Koans like ‘show me your true self’ a way to put a person in double bind? Watts wanted this book to be provocative and not a summary of what  research had already happened in terms of commonality between eastern and western approaches to psychotherapy- and I believe he succeeds in making one think.

I loved the book and came out richer for having read that- but beware that like all philosophical books it could be a little dense at times. I hope others, including myself,  continue taking ideas from both east and west and keep cross fertilizing them, until we are all ‘liberated’!!

But the book here:

Depression and Mania: The Bipolar thinking style

PsyBlog has recently posted an article on Cognitive Therapy (CBT) and how it is useful in Depression treatment. this therapy has been shown to be equally effective in Depression as is medication, though this woks in a top-down fashion in the brain (revealed by brain scans), while anti-depressants work in a bottom-up fashion.

PsyBlog quotes the following irrational beliefs , as outlined by Beck, that are prominent in Depression.

* Over-generalization. Drawing general conclusions from a single (usually negative) event. E.g. thinking that failing to be promoted at work means a promotion will never come.
* Minimalization and Maximization. Getting things out of perspective: e.g. either grossly underestimating own performance or overestimating the importance of a negative event.
* Dichotomous thinking – Thinking that everything is either very good or very bad so that there are no gray areas. In reality, of course, life is one big gray area.

To me all of these beliefs are equally relevant for Manic thinking, although in the Manic case these beliefs would be about positive events and have a different spin.

  • Over-generalization: a single instance of success at some endeavor disposing one to think that one can achieve anything in unrelated fileds. Also more co-incidence detection and more correlation-is-causation type of thinking that may ultimately lead to the Magical Thinking of full-blown Psychosis.
  • Minimalizations and Maximizations: Here, again, things go out of perspective: Overestimating one’s own performance and underestimating the importance of external happenstances that might have led to success.
  • Dichotomous thinking: thinking that things are mostly good/bad and unfounded optimism/faith/trust – the opposite of the depressive feeling. Although the reverse thinking that things are mostly bad (external environment is bad, I am good) can also kick in. The point is seeing the world in Black/white but not in shades of gray.

PsyBlog also has an earlier post on depressive thinking style in which it elaborates on the internal-locus-of-control predisposition in depressive probands. Thus, the depressive style is marked by the following internal, global and stable attributions: :

* It is my fault that I didn’t get the job. Here I have made an internal attribution.

* I think I am worthless: a thought that is likely to affect all areas of my life. Now I am making this attribution global.

* I see no reason for the fact that I am worthless to ever change. Now the attribution is stable


It is clear that the Manic person too makes the similar attributions: His success (maybe a single, lucky success) is due to his genius(internal attribution). His genius is not limited to one field- he is generally the most valuable, productive and creative genius and is an all-rounder(global attribution). His genius is not a short-lived entity- he will continue to remain a productive genius no matter what external circumstances / reality (stable attribution). He may thus have no drive to learn about external reality as he suspects that the external reality is not relevant and he can predict outcomes (which are bound to be good) based on his skills, expertise, grandiosity alone. An extreme form of this thinking may lead to the loss of reality characteristic of a full blown Psychotic episode.

While the minimalisations and maximizations are explained by the internal locus of control, the over-generalization is explicable by a propensity of jumping-to-conclusions sort of thinking that leads to global, stable over-regularizations. Another feature important in my view would be the mixing of contexts, where things from one context are referenced in another, dissimilar context. One could call this mixing up of metaphorical thinking where wrong analogies are applied and thus wrong (positive or negative) conclusions are arrived at. The third factor of dichotomous thinking is also very important though hard to pin down. Why should everything appear black and white in depressive or manic thinking and why in one case(depressive ), black is the color of self, while in Manic white is the color of self, remains a mystery. Answering how and when the switch from a grayish-world to a black-me-world(I’m a piece of shit) or white-me-world(I’m the next Einstein) happens would go a long way in making the bipolar patient control his moods and if he has to be sick then enable him to go for a manic episode (where the price may be insanity- a psychotic episode) instead of a depressive one (where there is a real risk of life).

Although the other wrong attributions and thinking styles also need to be addressed, the mechanism of the switching of mood/ black-white world view would help the most and should be the first one targeted in CBT/ medications.

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