The 3rd World Conference on Buddhism and Science (WCBS) The Rationale for Developing a Mindfulness-Based, Emotion-Focused Therapy Padmasiri de Silva, Monash University “A meditative approach is an alternative to avoidance; it involves paying attention to emotions in a particular way. A meditative process involves teaching clients the skills of describing their experiences to themselves in an objective manner as if they were an outside observer talking to another person”. “Once people are able to distance themselves from the actual emotion, they will no longer feel overwhelmed by their anger, sadness, fear or shame. The meaning of their thoughts that kept adding fuel to their emotional fires will no longer absorb them” (Greenberg, EmotionFocused Therapy, 2008, 206-207). PRELUDE While mindfulness-based cognitive therapy with the focus on ‘thoughts’ has entered the main stream of western therapeutic traditions, there is a need for developing a mindfulness-based emotion-focused therapy within the Buddhist tradition. From the perspectives of the nature of emotions found in the Buddhist suttas, an emotion is more complex than a thought: an emotion involves a blend of the cognitive (sanna, citta), the affective (vedana), motivational (chanda, raga) and volitional (sankhara) factors and the body (rupa). The impact of cognitive sciences on emotion studies indicate that ‘understanding emotions is central to understanding intelligent systems’. Though many decades back, in the psychologist’s landscape of consciousness and behaviour, emotion was a poor cousin, recent work in neurology (Emotional Brain, Joseph Ledoux, 1996), the biology and physiology of facial expression (Paul Ekman, 1973), Healing Emotions, (Goleman ed, 1997), the neuroplasticity thesis of the brain by Richard Davidson (2003), and the theory of the body as a second brain (Candace Pert, 1997)—all this indicate a veritable revolution in emotion studies. Against this background, the Canadian psychologist, Leslie Greenberg has developed an emotion-focused therapy. There is a framework for developing an emotion focused therapy 1 drawing resources from Buddhism. While there are certain differences between Greenberg’s approach and the mindfulness-based Buddhist approach, the similarities in terms of the nature of emotions and emotion regulation are of great interest. Also, there have been other therapeutic approaches with some focus on emotions: the classical psychoanalytical view, where emotions are seen as drive related and needing to be discharged or tamed; interpersonal approaches seen as socially adaptive orienting tendencies; behavioural theory focused on de-conditioning and exposure; cognitive-behavioural approaches see emotions as post-cognitive phenomena, to be changed by rationally challenging beliefs. There is current evidence to the fact that in the psychoanalytic, behavioural and cognitive therapies, as well as the later humanistic and experiential therapies, there have been attempts to integrate mindfulness techniques. Mindfulness-Based cognitive therapy has over the last two decades come to stay as a dominant therapeutic tradition. In my own practice, over four years, some attempt has been made to develop a mindfulness-based emotion focused therapy. But my exposure to Greenberg’s work has given me a context to develop a conceptual framework for a more sophisticated emotion-focused therapy within the Buddhist tradition. Though working primarily within the early Buddhist tradition, I have also gained from my acquaintance with the Mahayana and the Tibetan Buddhist traditions Joseph Ledoux, the neurologist working on the emotion of fear was struck by the speed of the affective process, that the emotional meaning of a stimulus might be appraised by the brain before the perceptual systems have fully processed the stimulus. He says that there are two paths producing emotions: a lower road, when the amygdala senses danger (sensing a snake) and sounds the emergency signals (run); the high road, when the same information goes through the thalamus to the neocortex. In taking the lower road, there is a kind of ‘emotional hijacking’. In taking the upper road, one has time to discern false signals; the dry-wig that snapped under the weight of your boot was not that of a rattlesnake shaking its tail. This discovery reveals why some times negative emotions invade us in a quick and mechanical way. This context confirms the Buddhist analysis that certain emotions—‘the alarm bells of fight or flight’, may stir the subliminal level of our consciousness (anusaya-bhumi); emerge as thoughts (pariyutthana-bhumi), and express in action (vitikkamma-bhumi). Another important discovery by Antonio Damasio was that by studying brain injuries, he found that the emotional brain enhances decision making, and more recently, Richard Davidson in developing the neuroplasticity thesis, demonstrated that the brain changes as a result of meditative experience. The notion that the brain, immune system and emotions are interconnected provides a veritable background for developing EFT and one which provides a background for Greenberg’s work on emotion regulation. Four important features of emotions common to Greenberg’s and the Buddhist analysis are the following: emotions are related to issues of ‘meaning’ with a strong cognitive strand; emotions are motivators, directed towards goals, with a conative or volitional strand; emotions have strong affective component; managing emotions well involve an attentional dimension—to transform and regulate emotional change. Differences between the two approaches are related to the moral and spiritual facets of Buddhism, a facet often neglected in mindfulness-based therapies. Both systems attempt to replace unhealthy emotions by those that contribute to mental and physical health, stability, balance and harmony. But, there are differences between 2 Greenberg’s distinction between primary adaptive and primary maladaptive emotions, and the Buddhist distinction between ‘negative’ and ‘positive emotions’ : greed is the root of heedlessness, hate is the root of turbulance and delusion is the root of misery. But in terms of a psychological analysis, the roots of suffering in addictions (lobha), reactivity (dosa), identity confusion (moha) and its techniques of alleviation from suffering have a clear therapeutic quality, dealing with anger, addictions and emotions of self-assessment (pride, shame, jealousy and guilt, see, Taylor, 1985). PRINCIPLES OF EMOTIONAL CHANGE In EFT the central mechanism of the change in psychotherapy is emotional processing and the emergent meaning-making processes. (i) Awareness of emotion is the most basic principle. Once we know what we feel, we reconnect to the needs that are being signalled by an emotion, and are motivated to meet our needs. The therapist according to Greenberg, “works with clients to help the client approach, tolerate and regulate, as well as accept their emotions”(Greenberg2010, 22). Acceptance of emotions as opposed to avoidance is an important step in emotional change. (ii) Emotional expression: The clients must also be in live contact with their emotions, and thus develop effective exposure to previously avoided feelings. While arousal and tolerance of emotions is necessary, optimum emotional processing involves the integration of cognition and affect. (iii) Emotion Regulation. When emotions such as shame, fear and powerlessness overwhelm people, there is a need to help people regulate their emotions by getting them some ‘distance’ from them. Any attempt to regulate emotions by preventing themselves from feeling the disturbing emotions, withdrawing, avoiding, use distraction strategies or the worst transform disturbing emotions to psychosomatic complaints, and even seeking stimulusseeking enjoyment to drown them are all counter-productive. At this point Greenberg observes: Important means of regulating emotion include regulating breathing and mindfulness—the nonjudgmental observation and description of one’s emotional states. Basic emotion regulation skills also include naming the emotion, describing the emotion in one’s body, clarifying the event that evoked the emotion, and understanding one’s interpretation of the situation and the actions prompted by the emotion (Greenberg, 2008, 206). iv. Reflection on emotional experience at the level of deep experiential level is recommended, as a way of consolidation. V Transformation of one emotion by another is the final method mentioned. He quotes Spinoza’s celebrated saying, “an emotion cannot be restrained nor removed unless by an opposed and a stronger emotion” (Ethics,iv, p195). Buddhist Perspectives on Emotion Regulation The Pali term vedana (feeling, hedonic tone) has to be distinguished from the term ‘emotion’ as used in the English language, as there is no generic term for emotion, though specific 3 emotions like fear, anger and sadness are mentioned along with how to deal with them. Feeling is one of the following five aggregates: body (rupa), feelings (vedana), perceptions (sanna), volitional/intentional activity (sankhara) and consciousness (vinnana). An emotion may be described as an interactive complex or construction emerging from these five factors blending the cognitive, motivational, affective and physiological arousal and within this network of sensory contact, feelings, desires, thoughts, appraisals and bodily sensations and intentional/volitional activity we see the emergence of emotions. Negative emotions are fed by the roots of addictions, reactivity and identity confusions. This structural and ‘componential’ view of emotions helps the therapist to use the four frames of reference in the Satipatthana: body, feelings/sensations, thought patterns and phenomena. There is a second perspective emerging from Buddhist psycho-dynamics of the causal setting: Sensory contact conditions feeling, feeling conditions craving and craving conditions clinging. Pleasant feelings are fed by the subliminal proclivity for lust (raga anusaya),painful feelings stir the proclivity for aversion (patigha anusaya), cognitive distortions (ditthi anusaya) and conceits ( mana anusaya) are related to pleasant/neutral feelings. The most important for mindfulness in everyday life which takes a preventive stance instead of doing ‘damage control’ are the fourfold techniques of dealing with defilements and negative emotions: through restraint (samvara), abandoning once they have emerged (pahana), developing positive emotional skills (bhavana) and stabilising once the skills have emerged (anurakkhana). The Buddha used a number of graphic metaphors to describe these methods: the watchfulness of a doorkeeper, instilling discipline like a horse trainer, the persistence of an army defending a fortress; exercising balance and the right pitch between restlessness and laziness, like a welltuned musical instrument and the skills of an acrobat. Similar to Greenberg’s method, remedying negative emotions by antidotes is recommended: for lust, unattractive and even repulsive facets of the body through decay; for ill-will, looking at the good qualities of a person, patience and forgiveness, loving kindness and equanimity; for grief, respect, honour and gratitude to the lost person, and re-work her good qualities in your own life and kamma is a good shock absorber. Transforming instead of demonizing is a classic method in Buddhism, embracing suffering and converting it to a noble truth—accept, tolerate, learn and develop insight to suffering. This is what Carl Jung called ‘emotional alchemy’, converting brass into gold. Nyanaponika Thera observes, instead of throwing out negativities, “with a little magic they can be converted into just the opposite of what they were..” The concept of impermanence helps us to look at anger or lust as a thought which emerges, stays for a while and passes away and as Matthieu Ricard says, if you have a hard look, they are empty and evaporate. This is the last method—liberating from the spell of an emotion. A significant difference between Buddhism and Greenberg is that negativities like the five hindrances (nivarana), lust, ill-will, sluggishness, restlessness and doubt are obstacles to be cleared on the liberation path and not a therapeutic issue, though similar emotions may emerge in a secular setting. The Body in Emotional Experience “Bhikkhus, just as various winds blow in the sky: winds from the east, winds from the west, winds from the north, winds from the south, dusty winds and dustless winds, cold winds and 4 hot winds, mild winds and strong winds; so too various feelings arise in the body: pleasant feeling arises, painful feeling arises, neither-painful-nor-pleasurable feeling arises” (S iv, 218). “People need to attend to whether the emotional experience is felt in their bodies as hot or cold, a big ball or a small knot.....Thus, if you begin to notice and label the quality and location of your feeling as “hot sensation in my chest”, to notice its intensity as “moderate” and its shape as “a round ball”, then the torrents of emotion will subside” (Greenberg, 2008, 206). While cognitive theories of emotions capture a central facet of emotions, there has been a great revival of interest in the body-based physiological theories of emotions. The human nervous system has two parts, the central and the peripheral, and the peripheral in turn is divided into the somatic and autonomous nervous system. The ANS is again subdivided into the sympathetic and the parasympathetic facets, and it is the sympathetic that is active in negative emotions like fear and anger resulting in increased heart and respiration rates , sweat secretions, adrenalin secretion etc. The parasympathetic section moderates sympathetic arousal. In meditation, the calming effects are greatly achieved by a feedback from the body, to the mind, especially rhythmic breathing and muscle relaxation. It was William James who described the body as the mind’s sounding board, allowing emotional signals to resonate as the sound of a guitar amplifies the sound of the strings, and this means that by suppressing some automatic bodily changes, and consciously making others, we gain emotional control. A philosopher, Jesse Prinz has developed on the Jamesinian theory, describing emotions as ‘embodied appraisals’ in his book, Gut Reactions ( Prinz, 2004). While Greenberg (2008, 134) has an important focus on the body in emotions, the mindfulness practice on the body (kayanupassana) offers the entry into systematic meditation practice. Buddhism has an interactionist theory of the mind-body relation, so that in emotional experience body can influence the mind, and the mind acts on the body, thus bridging the chasm between cognitive and physiological arousal theories of emotions. In the higher reaches of meditation, the seven links of awakening (bojjhanga), the fifth link is non-agitation, calming of the body and mind (kaya-citta passaddhi). CONCLUDING THOUGHTS: I have left out Greenberg’s work on couples, on issues of identity and attachment, and focused mainly on the work on nature of emotions and emotion regulation. As I conclude this analysis, it must be mentioned that there is a very deep and profound concern about the ‘self’ in therapy. Greenberg following Carl Rogers considers transparency of internal experience (congruence) as well as the communication component crucial for therapy, but there are issues concerning the fragility of the self, as well as restructuring a sense of the self. According to Jack Engler, discussing the perils and promises of the spiritual path, “You have to be somebody before you can be nobody”(see, Epstein, 1417). If so is psychotherapy a prelude to the spiritual path? I feel that a preliminary level of personal organization is useful for meditation. But in a more profound sense, as Mark Epstein says, “Narcissistic residues reverberates throughout the life circle” till their cessation (nissarana) in nibbana (Epstein, 2007, 74). 5 SELECTED REFERENCES Epstein, Mark, 2007, Psychotherapy Without the Self, Yale University Press, New Haven, London. Greenberg, Leslie, 2010, February, Emotion Focused Therapy, Workshop Handbook, IEFT, Sydney. Greenberg, Leslie, 2008, Emotion-Focused Therapy, American Psychological association, Washington, DC. Greenberg, Leslie and Safran, J.D, 1987, Emotion in Psychotherapy: Affect, Cognition and the Process of Change, Guilford Press, New York. Hayes, Adele and Feldman, Greg, 2004, “Clarifying the Construct of Mindfulness in the Context of Emotion Regulation and the Process of Change in Therapy”, American Psychological Association D12, 2004. Ricard, Matthieu, 2006, Happiness, Atlantic Books, London. Nyanaponika, Thero, 1986, The power of Mindfulness, B.P.S, Kandy. Prinz, Jesse, J. 2004, Gut Reactions, Oxford University Press, Oxford Taylor, Gabriele,1985, Pride, Shame and Guilt: Emotions of Self-Assessment, Claendon Press, Oxford. The Dalailama and Ekman, Paul, 2008, Emotional Awareness, Henry Holt, New York. Sutta Literature Anguttara Nikaya/Gradual Sayings Digha Nikaya/Dialogues of the Buddha Majjhima Nikaya/Middle Length Sayings Samyuta Nikaya/Kindred Sayings Specific Suttas as Background Readings: Bahuvedaniya Sutta, Culavedalla Sutta, Salayatanavibhanga Sutta, Vitatakka Santana Sutta, Vatthupama sutta, Sabbasava Sutta, Satipatthana sutta, Anapanasati Sutta, Kayagatasati Sutta. 6