Tag Archives: meditation

The Therapy Turf Wars

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“My therapeutic approach is better than yours!” All too often therapists with one particular approach criticize one – or all – of the others, and I’m sick of it. CBT is frequently involved in these turf wars, partly because it’s the favourite of the NHS. Some CBT therapists imply that their approach is vastly superior to all others, ignoring the evidence that supports the effectiveness of other schools of therapy. Humanistic therapists frequently respond in kind, suggesting that CBT is shallow, simplistic and unable to tackle deep rooted issues.

Ruby Wax is an especially irritating ‘turf war’ critic. Ruby is a passionate advocate of Mindfulness Based Cognitive Therapy, an approach I have a lot of respect for. Sadly Ruby feels it necessary to dismiss several of the most important ‘rival’ schools of therapy with funny parodies. Carl Rogers developed the Person Centred Approach (PCA) that unpins most Counselling in the UK today. According to Ruby the PCA is about repeating “whatever you said back to you like a parrot but with love” (Wax, 2013). She goes on to dismiss Gestalt, Existential and Psychoanalytic approaches. Ruby; it may be funny, but it’s not clever!

Triggering my ire today is a book about the Human Givens Approach, which claims that the PCA, Psychodynamic school and CBT are all “piecemeal approaches” and that none of them “are sufficient on its own” (Griffin and Tyrrell, 2007). Their solution is, of course, the Human Givens Approach! The research evidence suggests that PCA, Psychodynamic and CBT can all be effective in certain circumstances. CBT is backed by a robust research base and a Person Centred Approach is one of only four therapeutic modalities approved for the treatment of depression under the NHS.

All this frustrates and saddens me. The Human Givens Approach has a great deal to offer and I’ve integrated it into my own therapeutic practice. But I’m galled that those who developed it feel the need to dismiss other approaches as inadequate. It sometimes feels like I’m back in the school playground hearing one kid saying “My Dad’s bigger than your Dad!” Viewing all this though a psychodynamic lens, I wonder if some therapists have unresolved childhood issues?

The parable of the blind men and an elephant
We need a wide perspective

Given that the human mind is the most complex system in the known universe, is it really plausible that one school of therapy will have the definitive and complete answer to every individual’s unique mental health problems? Maybe one day, but most certainly not yet. Meanwhile I’m adopting a pluralistic approach, learning as much as I can about as many different paths to healing as possible. I try to take a wide perspective, asking myself the question; for this particular client, at this specific moment, which therapeutic lens is going to be the most helpful? This is usually called having an ‘integrative’ approach, but I think I’m best described as a pragmatic therapist: My only interest is what works?

The moment of now

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Many years ago I saw a talk by the American photographer Duane Michals. Michals rarely works with a single image, preferring to create short sequences of pictures that question our conventional understanding of reality. Michals created a characteristically intense moment in his presentation when he repeated one word about seven times in a way that emphasized its essence: Now! Now! Now! Now! Now! Now! Now!

For those few seconds I was entirely in the moment. It was an unforgettable experience. All this was long before Eckhart Tolle’s book The Power of Now: A Guide to Spiritual Enlightenment, but they highlight the same mode of consciousness.

The Illuminated Man, Duane Michals

I work with that moment of now every morning during my meditation practice. Some days I can truly be in the now for a while – really being with my breath – and it’s an extraordinary experience. There is a timeless calm. But the ‘monkey mind’ doesn’t sit still for long and in the next moment there’s some commentary running again.

I’ve found it very helpful to approach watching my breath with the same attitude of attention as I adopt with a psychotherapy client. When I’m with a client I work to be completely present. What is happening right here right now? If I can be with my breath that way, then I become present to myself, to this moment, to now.

“Breathing in, I calm body and mind. Breathing out, I smile. Dwelling in the present moment I know this is the only moment.”

Thich Nhat Hanh

But sometimes I get caught up in the striving. After my meditation I’ll judge my practice: How much of the time was I present? How persistent was my monkey mind? I might conclude that ‘Today was better/worse than yesterday.’

John Kabat-Zinn defines mindfulness meditation as “the intentional cultivation of nonjudgemental moment-to-moment awareness” (1996). Just such a moment came today, in the midst of an otherwise quite ordinary Wednesday, and it made me realize that meditation isn’t about achieving something – less monkey mind or more ‘timeless calm’. It’s the practice that matters, not the result. Moment-to-moment awareness – being in the now – emerges slowly from practice. The realization that now is all there is comes like a strangers smile, unbidden and unexpected.

Wired to survive?

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According to evolutionary neuroscience we’re not wired to be happy or content but simply to survive. It’s a new science, so such judgements are subject to review, but it certainly seems that our bodymind system easily becomes dysfunctional in modern industrial societies.

Paul Gilbert is a clinical psychologist and developed a new therapeutic approach called ‘compassion focused therapy’ (CFT). Paul has identified three basic bodymind systems; one is focused on potential threats, another on finding resources, and the third on calm contentment & soothing. When the threat system is active our attention becomes like velcro for danger signs and teflon non-stick for anything positive: If you’re on alert for wolves then the fact that the moon looks fabulous is pretty irrelevant! Short-term that’s fine and once danger has passed we naturally shift to either the search and reward mode or the calm contentment system. As long as there’s a cycle between these three systems, we’re fine.

Adapted from Gilbert, 2019

Because the threat system has survival value it can override the other two and it’s activated whenever there’s a perceived danger. The threat system works on a ‘better safe than sorry’ basis so will trigger whenever we feel that a situation isn’t safe. Many people live in situations which don’t feel safe; low income, precarious or stressful work, discrimination, difficult relationships or just keeping abreast of the news. That means that the threat system is often over-active and many people don’t spend enough time in the regenerative contentment & soothing system.

Compassion focused therapy draws heavily on mindfulness to help people learn to rebalance themselves. By becoming mindful of when we’re stuck in the anxiety provoking threat system, we can learn to shift into calm contentment. Self compassion is hugely helpful in this, and though we all have compassion, we may not practice it much. In our culture it can be seen as a sign of weakness or a distraction from the busyness of our lives. But in fact compassion is a form of courage that inspires us to act. With practice we can develop more compassion for ourselves and others, healing within and making the world a better place in the process.

It’s worth noting that mindfulness is the key strategy in CFT. Mindfulness, like so many of the other approaches to alleviating mental distress, is an embodied pathway of connection. If we really are wired to survive, perhaps early humans developed the embodied pathways of connection as a route to a deeper thriving? Practices like mindfulness, ritual, dance, psychedelics and the deliberate use of trance emerged early in human evolution. These same practices are retained by many indigenous groups and have therapeutic value for them. The same is true for all of us: These ancient healing practices can take us beyond mere survival mode to a vibrant, joyful existence.

The Embodied Pathways of Connection

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What links mindfulness, psychedelics, nature connection, ritual and the therapeutic technique of Focusing? They can all help us access to our deepest embodied knowing and awaken us from the illusion of separation. For Thich Nhat Hanh, a Buddhist monk and lifelong peace activist, the purpose of our existence is “to awaken from our illusion of separateness.” But how?

Meditation is one path, and John Danvers wrote that mindfulness is a tool for coming to “fully realise that we are relational beings in a relational universe” (Danvers, 2016). John describes an experience where mindfulness allowed his fixed sense of self to dissolve:

“the egocentric, unitary, ‘I’, wasn’t there. Instead a different state of being was at work (or at play) – as if the edges of myself were dissolved into the surrounding space. It felt like there was no separation between me and the world” (2016).

Gail Bradbrook felt an inner stuckness for years. She was passionate about social change, but none of her campaigning efforts had really taken off. So Gail headed off to Costa Rica to experience the healing power of psychedelics – AKA enthogens – including Ayahuasca. She had heard reports of how “people on psychedelics report a deeply felt sense of peace, oneness and unity with the planet” (Bradbrook, 2019). The experience was transformational and on her return home Gail co-founded Extinction Rebellion.

Throughout the ‘60’s and ‘70’s Robert Greenway led groups on multi-day treks into the wilderness. He found that spending several days in wild nature could have a “profound impact on the psyche”. People typically had “feelings of expansion or reconnection” that he identified as spiritual (Greenway, 1995). I’ve written about this wilderness effect elsewhere, but it’s important to note that spending even a brief time in nature can open our awareness of deep connection. Claire Thompson describes her experience of watching a dramatically beautiful sunrise:

“I didn’t realise until afterwards, but my sense of self was absent. I was simply absorbed by the intrinsic wonder of the view and intimately involved in deep contemplation of the pure grace and delicate beauty of nature. I was an integral part of the scene” (2013).

Loch Voil

Ritual is one of the most ancient, powerful and widespread pathways to connection. In Sacred Ecology I wrote that being “part of a powerful ritual” can enable us to “come to the wisdom of the body; that all things are ultimately one”. A lot depends on the intention of the ritual and the integrity of those who facilitate it, but it’s no accident that members of my local Extinction Rebellion group will lead a Summer Solstice Ceremony this evening to support the movement.

I’ve often written about Focusing and Eugene Gendlin, the philosopher and psychotherapist who developed it. In essence, Focusing is a process of sensing into the body, curiously open to what meaningful sensations might be there. Many people have walked this pathway of connection and Herbert Schroeder is a good example. Herbert was working as an environmental psychologist for the US Department of Agriculture when he began experimenting with Focusing in natural spaces. He experienced “an inward, bodily sense of myself expanding out into space, as though the boundary separating myself from my environment had become relaxed and permeable” (2008).

How can practices as diverse as Focusing, ritual, meditation, taking psychedelics and walking in nature have such dramatic – and similar – effects? Gendlin gave us a key part of the answer when he wrote that the “physically felt body is in fact part of a gigantic system of here and other places, now and other times, you and other people – in fact, the whole universe” (1981). Gendlin, like many other thinkers, recognized that we are not the isolated individuals of our cultural myth.

The quotes above all speak of connection, relationship, expansion and the dissolution of boundaries. Although they’ve taken different pathways, they seems to be arriving at the same place; the wisdom of the body that revels what Thich Nhat Hanh calls the “illusion of separateness”. Mindfulness, psychedelics, nature connection, ritual and Focusing are all pathways that lead us to deeper connection. Crucially, they are all part of our embodied experience. These then are embodied pathways of connection (EPOC). There are other EPOC, some of which I’ve already identified; trance, dance, sex and sensual experience. Others are still to be recognized, so if you think there’s an EPOC I’m missing, I’d love to hear from you.

In my next post I’ll explore the role of the EPOC in therapy.