Peace Corps service in Jamaica

I only met one Jamaican psychologist during my two years living in Kingston, serving as a Peace Corps Volunteer. She told me that there were only a few psychologists on the island. The University of the West Indies, on the outskirts of Kingston, didn’t have a psychology department. When Maria and I applied for Peace Corps service after our marriage in 1990, I never dreamed that I’d be employed as a psychologist in whatever developing country invited us to serve. (The more open an applicant is to serving wherever his/her services are needed, the higher the likelihood of acceptance.) With a bachelors degree in English, I thought I’d end up teaching English somewhere near where Maria worked. Maria was a psychiatric nurse – easy to place – and our Peace Corps recruiter initially referred to me as her “ball and chain” – not so easy to place. Maria was selected by Jamaica to serve as an instructor at the University Hospital of the West Indies (UHWI) School of Nursing. It just so happened that UHWI had just opened Jamaica’s first detox/rehab ward (mainly for alcoholics and crack cocaine addicts) and was in need of a ward psychologist. So from 1991-93 I wound up being one of Jamaica’s few practicing clinical psychologists.

The ward was initially run by a young psychiatrist who had just finished his residency at Johns Hopkins, and the staff consisted mostly of nurses, none of whom had experience working exclusively with substance abusers. When I reported for duty I discovered that the 8-bed ward had no treatment model (other than the medical model) and I had no job description. The only thing resembling treatment was several Twelve Step meetings  a week.

So I told the staff what I was qualified to do and they encouraged me to write my own job description: I would interview each new patient, review his/her medical record, and write a clinical assessment, with recommendations for the treatment plan. I would serve as a member of the treatment team. I would conduct group therapy sessions (psycho-educational and process  groups), and do individual and family therapy as needed.

I knew the program really needed to be based on a valid treatment model if it was to be effective. Other than the ward psychiatrist, I was the only treatment team member to have had training in substance abuse treatment. I knew that my first task as a Peace Corps Volunteer (PCV) was to listen and observe and learn, and to win the trust and confidence of the rest of the treatment team before I started making suggestions. However, I also started to work on a relapse prevention model that I’d introduce once I’d earned my place on the treatment team. I wanted to co-lead my groups with staff nurses, but they repeatedly declined. They were content to monitor the sessions from the nursing station.

I initially felt somewhat anxious at the prospect of leading groups. I was confident that group dynamics would be the same in Jamaica as in the U.S., but I knew that I had things to learn about Jamaican cultural norms, and I hadn’t yet developed an ear for Jamaican patois. English is the official language and all educated Jamaicans speak it clearly, with that unmistakable accent. But all Jamaicans also speak patois, and “deep patois” is initially unintelligible to English speakers. An effective group leader has to stay on top of not only everything that’s said in group, but also the non-verbal communication within the group. My initial test came early-on.

In a group session with all males, after a heated exchange between “Clarence” and “Desmond,” I thought, Did I just hear a death threat? Indeed I had, and I did an immediate intervention: “Threats of violence are not allowed in group, gentlemen. I know it’s almost lunch time, but we’re not leaving this room until Clarence not only takes back his threat, but means  what he says.” Before the end of the session, Clarence had retracted his threat, and shook hands with Desmond. Jamaican men tend to be macho, and it took all of my group leadership skills to stay in control during some contentious sessions.

The nurses were relieved to learn that I could stand up to angry Jamaican addicts. They never had to call Security, no matter how heated things got in group. More than once I had to break up fights. Most of the addicts I worked with came to respect me, and most seemed to like me. Some requested that I work with them individually. My psycho-educational group sessions focused on the relapse prevention skills that I was incorporating into my treatment model.

I soon “earned my spurs” with the ward staff, and began to feel like a valued member of the team. Everyone seemed pleased with the quality of the clinical services I provided, and in my second year of service I introduced my relapse prevention model. I’d written a relapse prevention manual with workbook exercises such as “Identifying your triggers for relapse.” I printed and assembled it at the Peace Corps office, and provided copies to all staff and patients. The model and the manual were approved by the treatment team and adopted into practice. When I left, after Maria and I had completed our two years of service, I felt a sense of accomplishment. A fellow Returned Peace Corps Volunteer (“Once a PCV, always a PCV”) later told me that when he’d served at UHWI, a few years after my service, the manual was still in use.

Peace Corps service can be very challenging, and many PCVs aren’t able to accomplish what they set out to do in their assignments, due to circumstances beyond their control.  The Country Director said to our training group, “If you feel like you’re ‘giving up’ two years of your life to serve in the Peace Corps, Jamaica doesn’t need you. You’re here to live two years of your life among the people of Jamaica.” The Peace Corps Mantra is “I got more than I gave.” Our lives were enriched by our two years in Jamaica. You can read the whole story in my first book, Two Years in Kingston Town: A Peace Corps Memoir, available online at Amazon and Barnes & Noble. For those with an interest in cross-cultural therapy, the book contains vivid descriptions of some of my clinical interventions in therapy groups. But it also describes places on the island that tourists seldom see, daily life in Kingston, and encounters with all sorts of interesting people.

 

 

 

 

 

 

 

 

 

 

Attributions and the blame game

Part of the human condition is that we tell ourselves stories that help us to make sense of our lives. Making sense of things is a subjective process, but in our stories, we objectify. We often make ourselves the Good Guy, and others the Bad Guy(s) in our personal mythologies. I ran into Good Guy versus Bad Guy interpersonal conflicts innumerable times in my career as a psychotherapist. Of course there are bad situations that are entirely attributable to other people or to some external factor, but it’s often easier to blame some person or some external thing than  to examine your own co-responsibility for finding yourself in an undesirable situation. Instead of working on ourselves, we can attribute our problems to external factors.

I’ve written  previously about avoiding the “monofactorial hypothesis” that A caused B. (“He became an alcoholic because he stopped going to church.”) The monofactorial hypotheses is simplistic, whereas human behaviors and relationship dynamics can be very complex and multifactorial. I’ve also written about the way people give away their own power when they blame other people for their emotional state or their behavior. (“I wouldn’t have hit him if he hadn’t dissed me!” or “She ruined my life when she ________.”) In another post I wrote about Dr. Erik Berne’s book The Games People Play, in which he identifies interpersonal “games” such as Wooden Leg. This game involves statements like “But for my ‘wooden leg’ (i.e. family history, shyness, unpopularity, bad luck, etc.) I would/would have _________.” There may be an element of truth in a stated belief such as this, but there are likely other factors at play.

Many people come to therapy because they feel out of control in some area of their lives. Frequently they have pat explanations of how people and circumstances are making their lives difficult or intolerable, without factoring their own contributions to the problem into the equation. But before I go on I want to be very clear that I’m not blaming anxious or depressed people for their symptoms, especially people suffering from clinical anxiety and depression. However, even people with these chronic conditions can worsen their symptoms by the way they think. Some people attribute their anxiety and depression entirely to external factors, but to some degree they’re unconsciously “doing” anxiety and/or depression.

Many people with anxiety disorders and phobias come up with unique behaviors or rituals that subjectively help them to cope with their symptoms. These behaviors can affect relationships in minor or major ways. The only explanation for the symptom-relief is the person’s belief in their efficacy. I worked with one highly anxious woman who’d “discovered” that crunching on shaved ice cubes temporarily relieved her anxiety. That meant that her lifestyle was restricted to situations where she had constant access to ice, every waking hour. Most people in her life found her persistent ice crunching very annoying. In therapy I got her to see how she was, to some degree, “doing anxiety,” by convincing herself that she had to constantly crunch ice, and worked with her to find better ways to cope with her anxiety. Eventually we got past her exclusive focus on symptoms, and examined the root causes of her anxiety.

Some depressed people “do depression,” or exacerbate their clinical depression, by the way they think. The deep sadness we feel when we experience a significant loss is a natural response. But we can block the natural healing/recovery response to a tragic loss by our thinking, i.e. “I’ll never get over this.” or “I deserve this suffering because I ______.” It’s only human to attribute blame or responsibility onto externals, and sometimes there are  external factors – things we can’t control – that are understandably heartbreaking or discouraging or infuriating. But attributing blame and responsibility can be an excuse, or a distraction from choosing to change yourself in positive ways.

We are, by our very nature, subjective in the way we convert our perceptions – our experience – into cognitions. Some people are more objective than others, because they strive to be fair and objective, and to pay attention to the role of their own thought processes in their experiences. Having witnessed and dealt with countless interpersonal conflicts as a psychotherapist, I’m quite aware of the tendency of people to think of things in in Good Guy/Bad Guy terms. I try to practice what I preach when I’m having a relationship conflict. I ask myself, “How much of this is him/her/them, and how much is me?” This has helped me to resolve conflicts, so it’s become a reflex.

Often there’s a third important factor in the equation – the situation or context. Sometimes that situation or context is a major determinant in what’s going on, and has to be taken into account and given due weight as a relevant factor. In such situations the analysis can be two-sided (“How much is me and how much is IT?), or when others are involved, three-sided (“How much is me, how much is him/her/them, and how much is IT?”) Both as a therapist and in personal relationships, I’ve found this way of thinking to be helpful in coming to terms with problems in my life, without creating new ones by the way I think.

If I blame external factors as the only things holding me back, I have to wait for them to change before I take action. If I take my share of the responsibility for being in an undesirable situation, I can start working to change it immediately. In situations that are entirely attributable to externals, all we can do is work on our attitudes and coping skills.

 

 

 

The mystery of consciousness

In this post I’m going to depart from my usual subject matter to explore something related to psychology, but belonging more to the study of philosophy. Somewhere down the road in this blog I intend to explore topics not directly related to psychotherapy, such as the effects of language on consciousness, the traps of language, and even what “is” is.

Psychology is a relatively young science. Some of the earliest psychologists thought that consciousness should be the primary focus of psychology; but it can’t be observed and measured. Behavior can, so psychology is now understood as the study of human behavior. Consciousness clearly exists in the universe, or I wouldn’t have written this and you wouldn’t be reading it.

Although consciousness is self-evident, science can’t account for it, and it’s relegated to the realm of metaphysics. American psychologist and philosopher William James (who had experimented with the effects of nitrous oxide and ether on consciousness) had this observation: “Our normal waking consciousness . . . is but one special type of  consciousness, whilst all about it, parted from it by the filmiest of screens, there lie potential forms of consciousness entirely different . . . . No account of the universe in its totality can be final which leaves these other forms of consciousness quite disregarded. How to regard them is the question . . . . At any rate, they forbid a premature closing of our accounts with reality.”

James clearly believed that the mystery of consciousness is a vital piece of the cosmic puzzle. But I need to comment on his phrase, “Our normal waking consciousness.” The whole notion of the term “altered states of consciousness” rests on the assumption that there’s a standard, or normal, state of waking consciousness – which I don’t think is the case. To my way of thinking there’s a spectrum of  “normal” states of consciousness (SOCs). I’m in one SOC when I’m engaged in a debate, another when I’m solving a math problem, another when I’m absorbed in a story, and yet another when I’m dancing. All of these are normal states of waking consciousness. This range of normal experiences can be altered in profound ways by drugs, meditative practices, symptoms of mental illness, and other life experiences.

I’ve already written about ways to change your experiences by changing the way you think. But before I expand on non-drug consciousness alteration, I need to be candid about my own psychedelic experiences. (I actually met both Dr. Humphrey Osmond, who coined the term “psychedelic,” and Dr. Timothy Leary, the high priest of LSD.) It’s not my intention to promote the use of psychedelic substances to anyone, but I do think more research needs to be done on their therapeutic use. There are many factors to be considered before taking a psychedelic drug, including the possibility of mental illness, dosage and purity of the substance, as well as one’s mental set and the setting in which the drug is taken.

I haven’t taken a psychedelic drug in years, but in my hippie days I “tripped” many times – mostly on LSD, but also on peyote and psilocybin mushrooms. I’ve never had a “bad trip,” and I believe that my philosophy has benefitted from having experienced SOCs so discontinuous with my “normal” experience that I can’t find words to do them justice. In psychedelic consciousness both perception and cognition are altered in a way that’s unimaginable without experiencing it first-hand. Almost all of my trips had a strong spiritual element, unattached to any specific religious tradition. Especially on high dosages, I felt a oneness-with-the-universe that’s beyond description.

I may never get answers to all of my questions about consciousness, but it’s my Grail Quest. Some books have helped me along the way. After reading William James’ Varieties of Religious Experience, I went on to read Daniel Goleman’s Varieties of Meditative Experience and Masters and Houston’s Varieties of Psychedelic Experience. I’ve also read much of Varieties of Anomalous Experience, published by the American Psychological Association, which explores the scientific literature on such purported phenomena as near-death experiences, out-of-body experiences, hallucinations, lucid dreams, mysticism, “psychic abilities,” and reincarnation. All of these books explore aspects of consciousness, and I recommend them all to any readers who share my fascination with the topic. The best book I’ve ever read on the psychedelic experience was Alan Watts’ The Joyous Cosmology.

What consciousness “is” depends on who you ask. Some philosophers have a materialist frame of reference and view consciousness as a byproduct, or epiphenomenon, of biological existence. From an evolutionary perspective, consciousness arose in complex organisms, allowing them to detect and avoid threats in their environments, enhancing their odds of survival. Science favors a materialist viewpoint. Philosophers with an idealist frame of reference view consciousness as a (or the) fundamental underpinning of the cosmos, or as the cosmic glue that holds everything together – much like The Force in the Star Wars movies. Many religions have an idealist frame. For instance, Hinduism holds that the material world is an illusion – the veil of maya that hides the true, non-dual reality of Brahman.

This post will serve as a point of departure for some future posts about the mystery of consciousness. I won’t be blogging next week, as I need to focus on another writing project. I wish you Godspeed and good fortune in the New Year!

 

 

Metaphor and storytelling in therapy, Part 2

Throughout most of my mental health career I was blessed with good supervision. My first clinical supervisor was a PhD licensed psychologist, Dr. Robert Klein. He taught me a lot, including a procedure for helping enuretic children – bedwetters – to “keep a dry bed” when their families were trying to force them to “stop wetting the bed.” Using this procedure I was able to help several enuretic children to overcome their problem quickly. In one instance, it only took one session for a boy to immediately start keeping a dry bed. The procedure uses storytelling in two different ways, to role-model the desired outcome – as well as a family systems intervention.

This is the sequence I’d learned: After establishing some degree of rapport with the anxious and humiliated child, I’d tell him – in front of his parent(s) – a very brief generic story about “a boy your age” with the same problem, who’d gotten over the problem as quickly as it had started, after seeing a counselor. This provided a ray of hope for a child who desperately wanted to stop wetting his bed, but was clueless as to how to do it.

Then I’d do a family systems intervention, to change the family’s response to the problem, and to get the family to start promoting success, rather than punishing failure. I’d explain that the problem was caused by anxiety ( or “nerves”), and when the boy stopped worrying about bedwetting, it would stop. I’d instruct the parent(s) to stop shaming and punishing the child for “wetting the bed,” and encourage them to talk instead about “keeping a dry bed.” Any siblings should be instructed not to tease their brother. Once I felt confident that the parent(s) understood the plan and that the family would stop blaming and punishing their child, I’d speak to him individually.

By this time, the boy saw me as an ally, one who’d asked his family to stop shaming and punishing him, and who’d predicted quick success. I’d tell him, “There’s a part of your brain that never sleeps” (it’s called the reticular formation), and predicted that when his bladder got full when he was asleep, that part of his brain would wake him up, so he could go pee in the toilet. Then I’d ask him to name his favorite hero, so I could craft a story especially for him. If he said Spider-Man, I’d make up a story on the spot about Spider-Man defeating some supervillain, then going home. There Peter Parker would eat supper, pee, and go to bed. When his bladder got full in the middle of the night, he got up and peed in the toilet, and woke up after sunrise in a dry bed.

Somehow this simple story that models the desired behavior, using a role-model chosen by the child, helps him to be less anxious and to wake up when he needs to pee. In the case of my “one-session enuresis cure,” when I saw the boy’s mother weeks later, I asked her how he was doing and she told me he’d kept a dry bed since the day we met. I asked her how she understood what had worked for him, and she replied, “He said you’d told him that there’s a part of his brain that never sleeps.” Using metaphors and stories that predict success, and give the  client reasons to expect it, can be very effective in therapy.

Therapists who are good at storytelling can craft stories on the spot, or collect teaching stories and select the right one for the right client and situation. The following story, slightly modified, comes from therapist and author Bill O’Hanlon. It’s a good story to tell people whose lives are affected by phobias and irrational fears: The abbot of  a monastery had to go to town for the day, but he hesitated because every time he went away, the monks got into some kind of trouble. The monks urged him to go, promising to stay out of trouble, and not leave the monastery until he returned. So the abbot set out the next morning. Not long after he left, the monks heard a loud knock on the heavy oaken door to the great hall. One of them went and opened the door. He found himself facing a hideous, slimy demon, with a mouthful of fangs and claws like razors. The monk screamed and jumped back, and the demon entered. Other monks heard the screams and ran to the great hall, where they saw the demon menacing their brother and growing larger before their eyes.  They started screaming, too, and the demon grew even faster, towering above their heads.

When the abbot returned, he knew right away that the monks were in trouble again, because the door to the great hall was open, and he heard screaming inside. He entered, closing the door behind him. He saw the huge demon growling and menacing the monks, who cowered in a corner, trembling and screaming. Calmly, the abbot walked over to them, saying “Hi, demon” offhandedly as he passed him.  “Look” he said to the monks, “This demon eats your fear and it makes him grow, but he can’t hurt you. Ignore him.” Comforted by their abbot’s calm presence, the monks stopped screaming and stood up; and the demon started to shrink. Then, to their surprise, the abbot started laughing and telling jokes. Soon all the monks were laughing, and the demon continued to shrink until it was the size of a mouse – its actual size. It couldn’t leave because the door was closed, and the monks decided to keep it as a reminder not to let themselves be ruled by their fears. The abbot told them, “Fear cannot grow where there is heart and humor and laughter.”

If you’re a therapist or are studying to be one, I recommend Bill O’Hanlon’s website <billohanlon.com> as a gateway to a treasure trove of resources. He studied under Dr. Milton Erickson, one of the giants of psychotherapy, whom I’ll be writing about in future posts. Bill has written over 30 published books, and has written about how you can write and publish your book. I got the fear demon story from his CD of stories, “Keep Your Feet Moving: Favorite Teaching and Healing Tales.”

Metaphor and storytelling in therapy, Part 1

Partly because I was an undergraduate English major before I got a psychology graduate degree, I was very language-oriented as a therapist. Carefully listening to my clients’ metaphors and linguistic formulations  (as well as noticing non-verbal cues) was my best key to understanding their unique experiences of being-in-the-world. I tried to use their own language and metaphors in my tailored communications with each client, and often crafted strategic metaphors that I hoped would reach them where they lived. Sometimes I presented the metaphor concisely: “It’s like you always wear a suit of armor around people, and you’ve been wearing it for so long you don’t know when it’s okay to take it off, or even how to do it if you wanted to.” When a strategic metaphor hits the nail on the head, it’s immediately validated by the client, and helps to establish trust in the relationship. (“She understands me!”) If it doesn’t, the client will often use the metaphor as a starting point for clarification: “It’s more like a wall I build around me than a suit of armor.” This provides the therapist with a better understanding of the client’s worldview, and a better metaphor to use with him.

Sometimes I extended my metaphor into a story: Once upon a time there was a knight named Val who survived every battle he fought in, and was a renowned warrior. He was known for his bravery and for his impressive suit of armor, crafted by the best armorer in the kingdom. Sir Val took great care to maintain the steel armor and oil the leather straps, and never went into battle without a careful inspection, to make sure everything was in place. In time, he became known as the most formidable knight in the kingdom. But then there came a time of peace. With no battles to be fought, the king declared an outdoor feast on Midsummer’s Day. It was hot, and the knights and ladies wore their light summer finery. But Sir Val showed up wearing his full suit of armor. He was sweating bullets, it was almost impossible to eat or drink wearing gauntlets and a helmet with a visor, and romancing the ladies with a lute and a song was out of the question; so he left shortly after he arrived. It didn’t hurt his reputation as a brave and formidable knight, but nobody could understand why he thought he needed to wear his armor to a picnic.

Sometimes a story is more effective than an explanation or an interpretation or a speech. I still remember what I learned as a boy from the “Story of the Boy Who Called Wolf” : if you develop a reputation as a liar, people won’t believe you even when you tell the truth. It gave me a practical reason to lie, not a lecture on truthfulness. Teaching stories abound in Buddhism, Sufism, and other religious traditions. Jesus used parables to illustrate religious truths.

One of my favorite Buddhist teaching stories, which I told many times in therapy, is about a Western scholar, an expert on Oriental religions, who was visiting Japan. He had the good fortune to be invited to a Buddhist monastery for a formal tea ceremony with the abbot, or roshi. He was escorted to a serene rock garden, where the roshi awaited him, sitting on a mat. The scholar knew something about tea ceremonies, and sat opposite the roshi, who bowed to him and set about preparing the tea in silence. Impatient, uncomfortable with the silence, the scholar began babbling about Confucianism and Taoism and Buddhism, wishing to impress his host with his broad knowledge. The roshi kept silence until the tea was ready, and nodded to indicate that his guest should hold out his teacup to be filled. The scholar did so, still talking. When the cup was filled, the roshi kept on pouring. The tea overflowed the cup, at which point the scholar shut up, watching the tea drip onto the mat. “Your mind is like that teacup,” the roshi observed. “It’s already so full that it can’t hold anything new. If you want to learn new things, first you have to empty your cup.”

Another Buddhist story I told many times in therapy was about a senior monk and a novice who are journeying on foot through the countryside. They belong to an order that generally observes silence and forbids physical contact with women. One rainy morning they come to a rain-swollen stream. An old woman is weeping, unable to cross and return to her family on the other side. The older monk lifts her up and carries her across the torrent. Then the two monks continue on their journey, in silence. When they set up camp that night, the novice asks for permission to speak. “Our order clearly prohibits physical contact with women, and yet you took this woman in your arms this morning.” “Yes,” the older monk replied. “But I put her down on the far bank of the stream. You’ve been carrying her all day.”

Do you know anyone who might benefit from hearing any of these stories? I’ve collected teaching stories for years, and will share more of my favorites in future posts. An extended metaphor is an analogy, and a story is a kind of extended analogy. A good story can lodge itself in your long-term memory, and affect your behavior.

Motivation, perception and memory

We rely on our perception – our senses – to keep us aware of what’s going on around us. What we perceive through our senses is the raw data for our cognition, which is the sense we make of that raw data. Cognition is an individual thing. Two or more people may witness the same event and come away with different versions of what happened.

Memory isn’t like a tape recorder that accurately records all the events we witness or experience. It’s affected by many factors, one of which is your motivations (if any) regarding the event.  When I studied perceptual psychology in grad school, I learned the principle “motivation affects perception.” What you want – if only at that moment – affects what you see and hear. What we’re motivated to think or believe, for whatever reasons, unconsciously affects our perceptions. This determines what we subsequently think or believe about the event or situation, shaping our memory of it. For example, if a foul is called on your team at a sporting event, you’re more likely to perceive that it was a bad call than if you were rooting for the other team. If you witnessed a car crash in which friends were injured or killed, you’re more likely to perceive – and recall – that the driver of the other car was at fault. It’s human nature.

In grad school I audited a perceptual psychology course taught by a husband and wife team (Dr.s Fred and Anne Richards) who had co-authored with another psychologist an authoritative textbook on the subject. They were excellent teachers, but free expression by students was encouraged in the psychology department, and some of the students took exception to our professors’ habit of responding to questions about perceptual phenomena with “according to the book _____.” Fred and Anne didn’t seem to “get” the objection, and continued to refer to their book in response to questions.

So, one day before class a student I’ll call Steve asked if he could have the last fifteen minutes of the session, and Fred and Anne graciously agreed. At the appointed time, Steve led us outside, where a friend had been tending a hibachi grill filled with burning charcoal. Steve asked for silence until we returned to the classroom, and proceeded to burn a copy of the textbook before our startled  eyes. I recall a wide variety of reactions, from shocked looks and gasps, to laughter. We returned to the classroom and had the best discussion I remember in the whole course. What we learned was that no two of us who’d witnessed the book-burning had had the same experience! Some had responded viscerally (“I can’t believe I’m WATCHING A BOOK-BURNING!”), some had appreciated Steve’s statement in different ways, and others felt concerned about Fred and Anne’s feelings, as they conjectured about what those might be. I think it’s fair to say that our teachers were stunned, but they handled the event with grace, and we all learned something from it.

Motivation affects both our cognitions and our subsequent recall. Juries in criminal courts tend to be impressed by eye-witness testimony, but trial  lawyers know well how unreliable it can be. Whether one’s motivations come from underlying attitudes, beliefs, and personal values relevant to the issues at hand, or conscious bias, or personal relationships involved, they affect perception and all that follows. The emotions that may be attached to events and situations also affect our memories at an unconscious level. Jerzy Kosinski put it this way: “What we remember lacks the hard edge of fact. To help us along, we create little fictions, highly subtle and elaborate scenarios which clarify and shape our experience. The remembered event becomes a fiction, a structure made to accommodate certain feelings.”

In prior posts I’ve written about cognitive and cognitive behavioral therapy, and will be writing more as I continue to review theories and therapies. Our cognitions aggregate into beliefs, whether or not those  cognitions were logical or rational. These therapies help people to become more aware of their thoughts and beliefs, and to distinguish between those that are rational and those that aren’t. To understand human behavior, it’s important to grasp that what we see and hear is affected by what we want. I submit that a baker, a painter, and a starving man, seeing the same loaf of bread, see different things. What we bring to a situation partly determines what we take from it.

James Taylor wrote: “Painters use their eyes to show us what they see/ But when that canvas dries, we all see it differently.”

Mindfulness and meditation

Mindfulness has become a buzzword, not only in psychotherapy, but in the mass media. Mindfulness is when you “stop and smell the roses.” Some people are making a lot of money marketing mindfulness training, but learning to practice it costs nothing beyond an investment of your time. An age-old Asian aphorism is that the mind is like a drunken monkey bitten by a scorpion. One of the benefits of this time investment is learning to tame your monkey mind.

Fritz Perls said that past and future are fictions: our lives are spent exclusively in the here-and-now. Buddhism teaches that all suffering arises from attachments, and in that regard it correlates to cognitive behavioral therapy. Self-talk is like a constant mental radio broadcast that most people don’t know how to turn off, as much as they might wish to sometimes. In my career I’ve had many clients who lived their lives in thrall to their frequent or constant irrational thoughts. Learning meditation gives you a way to turn off the mental radio at will.

Mindfulness is a kind of meditation that’s always available to us. It doesn’t require silence, or sitting in the lotus position, or chanting, or concentrating on a mandala, or doing yoga breathing – although all of these practices are valid methods  for learning to meditate.  Mindfulness simply means getting out of your head and being fully present in the here-and-now, the only time there is, without letting your mind wander and without making judgments.

Before I specifically get into mindfulness further, I’ll first share my understanding of meditation in general. I learned to meditate in grad school, and found that there are many methods for learning to stay in a meditative state of consciousness, some of which I listed above. I’ve experienced two distinct levels of meditation. I started out with what I call single-pointed meditation, which means learning to focus on a single thing – a candle flame in a darkened room, a mantra (chant), focusing on your breathing to the exclusion of all other thought. Unrelated thoughts will inevitably intrude, but with practice you can learn to ignore them, let them go, and return your focus to the single point. At first it’s a balancing act, like walking a mental tightrope. When you first realize that you’ve achieved a meditative state, you think “I’m meditating!”, but the instant you think that, you’re not – you’re thinking again. With sufficient practice you can lengthen the time you stay in the meditative state, and develop confidence in your ability to meditate whenever you choose to.

Once I’d learned to stay focused on one thing exclusively, without letting my mind wander to other things, I was able to move on to a new level of meditation – pure awareness. I learned that it’s possible to be awake and aware, without being aware of any thing. Learning to suspend object-consciousness and judgement is a liberation. You can tame your monkey mind, turn off the mental radio. The silence is golden. It’s a distinct state of consciousness that teaches you what thinking cannot teach. It calms the body and the mind.

Mindfulness is a kind of single-pointed meditative state. You can be mindful while performing a task, taking a walk, taking a bath, having a conversation, doing Tai Chi, or standing in a crowd. You can be mindful of your self-talk. Mindfulness means staying focused on your here-and-now experience, to the exclusion of extraneous thoughts and without making judgments like good/bad, beautiful/ugly, or right/wrong.

Many times in public I’ve played a mindful game with myself, a game that teaches me things about my ordinary (non-mindful) consciousness and my monkey  mind. Normally when I’m in public, people-watching, I’m constantly categorizing and judging and speculating about all the people I see: whether or not I find them attractive, whether they’re fat or thin, graceful or clumsy, whether  they seem smart or dumb, likeable or unlikeable, etc.  Sometimes when I catch myself making these instant evaluations, I decide to play “the Buddha game.” I mindfully suspend my monkey mind and imagine that everybody I see is a Buddha – perfect, God in disguise. Just as I believe that meditation has changed my ordinary consciousness over time, I believe that playing the Buddha game has helped me to be less judgmental and more compassionate.

Mindfulness training is at the core of Dialectical Behavior Therapy (DBT), a highly effective therapy developed by Dr. Marsha Linehan to treat people who meet the diagnostic criteria for Borderline Personality Disorder. While she was devising the core strategies of DBT, Dr. Linehan studied meditation with a Catholic priest in a contemplative order and with a zen master. The people for whom DBT was designed tend to be extremely judgmental (of themselves and others) and emotionally volatile. Dr. Linehan became convinced that practicing mindfulness would help them to find balance in their deeply conflicted lives. Having co-led DBT skills training groups and seeing first-hand the effectiveness of mindfulness training, I believe that it’s beneficial for mentally ill people with other diagnoses, too. But as I’ve said many times, you don’t have to be sick to get better. Mindfulness is a learnable practice that can improve your life, if you invest some time in it.