psychotherapy emotions

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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
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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
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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
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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
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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).
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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.
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