I. IntroductionToday we live in a scientific age in which almost every aspect of our lives has been affected by science. Since the scientific revolution during the seventeenth century, science has continued to have a vast influence on what we think and do. Modern scientific thought is closer to the ancient beliefs of Buddhism, which holds to an infinite universe, with no beginning and no end. As K. N. Jayatilleke states, the early Buddhists' conception of the cosmos is in essence, similar to the modern conception of the universe.[1] Whenever, we step into a new age or new geographical area we ask ourselves, 'How can we put Buddhist principles of therapy and counseling into practice to face the present situation?' This question is based on the presumption that the Buddhist principles should be changed from place to place and time to time. K. Sri Dhammananda mentioned, religion without science is crippled, while science without religion is blind.[2] To be sure, Buddhism does not deny modern scientific progress, but it tries to describe the truths of the universal phenomenon. The scientific spirit can be found in the Buddha's approach to spiritual truth.
Currently, there are more than fifty types of therapy.[3] Therapy may address specific forms of diagnosable mental illness, or everyday problems in relationships or meeting personal goals. Treatment of everyday problems is more often referred to as counseling, but the term is sometimes used interchangeably with 'psychotherapy'. In most countries, however, psychotherapists must be trained, certified, and licensed, with a range of different certification and licensing requirements enforced internationally. Psychotherapists may be psychologists, social workers, marriage-family therapists, trained nurses, psychiatrists, psychoanalysts, mental health counselors, school counselors or professionals of other mental health disciplines.
In the context of modern psychology the word therapy is often used in the restricted sense of techniques for treating mental illness. But during the last few decades the framework of therapy has widened, the narrow gap between the mentally sick and the healthy has been questioned, whole societies have sometimes been sick and psychologists like Fromm refer to the pathology of normalcy, and increasing numbers fall prey to the milder forms of behavior disorders.[4] Padmasiri De Silva has mentioned the psychology of Buddhism is different from that of any field of psychological enquiry pursued for its own sake, for the Buddha pursued theoretical questions only when they had a bearing on the predicament of the suffering man. The psychology of Buddhism is primarily designed to answer the way out of it. The therapeutic basis of the psychology of Buddhism provides interesting analogies to the philosophy of Buddhism.[5] In this paper I wish to focus on the Ambalatthika-Rahulovadasutta, and make a relationship and point up what is the standpoint of the ideal in Buddhist therapy and counseling, and compare it with Western therapy and counseling.
II. A Story of the Ambalatthika-Rahulovadasutta
The story below is quoted from the Ambalatthika-Rahulovadasutta in the Majjhima Nikaya.
What do you think about this, Rahula? What is the purpose of a mirror?
Its purpose is reflection, revered sir.
Even so, Rahula, a deed is to be done with the body after repeated reflection; a deed is to be done with speech…with the mind after repeated reflection.
If you, Rahula, are desirous of doing a deed with the body, you should reflect on that deed of your body, thus: 'That deed which I am desirous of doing with the body is a deed of my body that might conduce to the harm of self and that might conduce to the harm of others and that might conduce to the harm of both; this deed of body is unskilled, its yield is anguish, its result is anguish.'
If you, Rahula, reflecting thus, should find, 'That deed which I am desirous of doing with the body that would conduce to the harm of self and to the harm of others and to the harm of both; this deed of body is unskilled, its yield is anguish, its result is anguish' – a deed of body like this, Rahula, is certainly not to be done by you.
But if you, Rahula, while reflecting thus, should find, 'That deed which I am desirous of doing with the body is a deed of my body that would conduce neither to the harm of self nor to the harm of others nor to the harm of both; this deed of body is skilled, its yield is happy, its result is happy' – a deed of body like this, Rahula, may be by you.[6]
III. Evaluation of the events of story in psychological perspective
In the story above, and to imply the Buddhist view, 'mirror' is not only used to look at oneself but it is used to reflect our outward and inward form. The mirror of Buddhism, however, reveals the aspect of our lives. Mirrors, which function by virtue of the laws of light and reflection, are a product of human wisdom. Even though people may make up their faces, they tend to neglect to polish their lives. While they quickly wash off a stain from their faces, they remain unconcerned about stains in their behaviors. And Buddhism recognizes that human beings have two types of diseases, those of the body and those of the mind. In the Roga Sutta of the Anggutara Nikaya, Buddha has mentioned:
There are two types of illnesses. What are they? Bodily illness and mental illnesses, one can enjoy freedom from physical illness for a year or two, or even a hundred years or more. But, rare in this world are those who enjoy freedom from mental illness even for a moment, except those who are free from mental defilements.
Recently, our society seems to view therapy as a matter of fixing what's broken. We know it instead as a process that enhances our strengths. Therapy can uncover what's been hidden, rebalancing the psyche by paying attention to areas we normally ignore. In presence-oriented psychotherapy we practice comprising whatever arises within, with calm awareness and clear intention. In the process, we experience joy, grief, anger, delight, pain, and/or energy – the full emotional spectrum. And we find a deeper strength, the strength of a steady presence that allows the emotions to flow according to their own ever-changing nature. Learning to trust this flow, understanding that our experience will continue for as long as we're in this body, we learn to trust ourselves, and our own ability to stay with ourselves fully through whatever arises. Now we have to ask ourselves, how we can see our self in the mirror. What are the treatments, given in the Buddhist point of view to relate our lives?
Buddha's approach was, from the beginning, therapeutic in nature. Thus the central teachings known as the Four Noble Truths were structured in a way which paralleled the medical practice in the Buddha's day: (I) identify a disease (dukkha), (II) specify its cause (dukkha samudaya), (III) determine if the disease is curable (dukkha nirodha), (IV) outline the method of cure (dukkha nirodha gamini patipada).
I. Dukkha – suffering and unsatisfactoriness – is a pervasive feature of life;
II. But it has identifiable causes, such as demanding desires, based on a misperception of the nature of reality;
III. It can be overcome – in the experience of nirvana, by finally destroying these causes;
IV. This can be accomplished by following the Noble Eightfold Path: the 'middle way' which systematically develops moral virtue (right speech, action and livelihood), meditative calming (right effort, mindfulness and concentration) and insight based on this (right understanding and thought). The three aspects of the path work, respectively, on three aspects of one's character:
1. Moral virtue works on bodily and verbal conduct, so as to act in a more morally wholesome, virtuous way; avoiding intentional harm to any being, and practicing generosity.
2. Meditative calming acts on the way one's citta (mind) or heart-works.
3. Insight works on one's understand of the nature of reality.
It seems that what can be called the discovery of a Buddha is just these Four Noble Truths. This is the typical teaching of the Buddha's of all ages, peculiar to them and no one else. In Samyutta Nikaya Buddha addressed the monks:
What do you think, monks, which are the more numerous, just this handful of simsapa[7] leaves I have here, or those in the grove overhead?
Very few in number, lord, are the leaves in the handful gathered up by the exalted one; much more in number are those in the grove overhead.
Just so, monks, much more in number are those I have found out, but not revealed; and why, monks, have I not revealed them?
Because they are not concerned with profit, they are not rudiments of the holy life; they conduce not to revulsion, to dispassion, to cessation, to tranquility, to full understanding, to the perfect wisdom, to Nibbana. That is why I have not revealed them.
And what is it, monks that I have revealed?
Just that this is ill.
This is the arising of ill.
This is the ceasing of ill.
This is the practice that leads to the ceasing of ill, and why so?
Because, monks, this is concerned with profit. It is the rudiments of the holy life. It does conduce to revulsion, to dispassion, to cessation, to tranquility, to full understanding, to the perfect wisdom,[and] it does conduce to Nibbana. Therefore have I revealed it?[8]
Actually, the Buddha's statement is a very accurate, precise teaching. It is the perfect teaching, but people cannot understand it. They tend to misunderstand and to think it comes from an egoism, materialism, nihilism, atheism, and 'world-renunciation'. Because of this, people are always interpreting everything from their egos. Anywhere, according to Buddhism we can see three levels of the definition of suffering:
1. Birth is suffering, ageing is suffering, illness is suffering, death is suffering, sorrow and lamentation, pain, grief and despair are suffering.
2. Association with the unpleasant is suffering, dissociation from the pleasant is suffering, not to get what one wants is suffering.
3. The five aggregates of grasping are suffering. I. Material form as an aggregate of grasping. II. Feeling as an aggregate of grasping. III. Perception as an aggregate of grasping. IV. Volitional activity as an aggregate of grasping. V. Consciousness as an aggregate of grasping.[9]
According to the above mentioned, we know that the Four Noble Truths are the most fundamental Buddhist teachings; they appear many times throughout the most ancient Buddhist texts, the Pali Canon and even in Mahayana texts. They are the truths the Buddha realized during his enlightenment experience. The Four Noble Truths are also very practical. They have everything to do with the present moment, and how we relate to it. I have provided several ideals of skills, and show how the Four Noble Truths are connected with Buddhist therapy, and compared with Western therapy, as follows:
Buddhist Treatment:
Four Noble Truth = Therapy / Counseling
Suffering = See the problem
Aarising of suffering = How the problem arose
Cessation of suffering = Solution to the problem
Path to cessation to suffering = Path to the solution
Nevertheless, in Western therapies treatment is mostly by using medicine. For instance, in the 1950s antidepressant drugs were discovered and used to combat depression. It became the main treatment for clinical depression by 1980s. By this time, side by side with drug treatment, psychological treatment was also attempted by adopting behavioral approaches, cognitive therapy and interpersonal therapy. The biggest problem about depression is its tendency to recur with increasing frequency.[10] Somatic therapy has been interpreted by R. K. R. Salokangas. The past three decades of treatment for psychotic patients on first admission is in three phases:
1. 1949～1958, the period of emphasis on shock therapies;
2. 1959～1968, the era of neuroleptices;
3. 1969 to the present, intensive out patient treatment.[11]
However, R. M. Fraser and I. B. Glass's use of electroshock on elderly patients has stirred controversy not only about this use, but also about unilateral versus bilateral electrode placement, which is a controversy, as well, in the treatment of younger patients. They studied the problem because depression and suicide increase with age.[12] Nevertheless, in Buddhism, as I mentioned above, using a mirror is to reflect our own behavior, good conduct, and not do harm to each other. Using the Four Noble Truths to see our problem, and how the problem arose, then, the solution, and finally the path to the solution ensures the ideal person. Unlike the Western view of therapy to build up the self simply does not do justice to what we actually seek from the therapeutic process?[13]
Now, we can see what are the differences between Buddhist and Western therapy treatment. It is not hard to see that the emphasis in Buddhism, however, is on the nature of our experience. Buddhism is very much concerned with both mind and body (good behaviors) analysis because Buddhism is an empirical phenomenon. All of the Four Noble Truths are equally valuable and noble. It is not the suffering that is noble but the truth. The truth, however, is not a metaphysical entity but an empirical process. Just like a doctor should understand an illness before recommending any treatment one should understand suffering. The illness, the Buddha refers to, is a particular kind of suffering, and there is nothing metaphysical about it. We all experience it. However, Buddhism does not teach that life is a wretched experience, just that the pleasures we do get from objects or people are impermanent and thus the end of pleasure is suffering. This is considered to be such a fundamental truth in Buddhism that it is the first of the Four Noble Truths of Buddhism. Suffering in life includes birth, aging, illness, death, separation from loved ones, association with unpleasant persons, the frustration of one's desires, and the suffering caused by the five aggregates.
IV. Conclusion
Finally, it is unquestionably the value and utility of techniques and approaches found in religious and spiritual traditions, in the context of therapy and counseling, which are recognized by many present-day in practitioners. Buddhism has been used particularly and widely in this way. In light of this point, several present-day therapy settings have used Buddhist techniques and ideas, and the reports available suggest a positive and fruitful outcome. For example, Kishimoto has reported on the use of Zen Buddhist techniques for neurotic patients in Japan, and there are reports on the use of Early Buddhist techniques with groups of alcoholics and drug addicts in Kandy, Sri Lanka.[14] On the other hand, in recent times, there are several Western psychiatrists and researchers who have put the four foundations of mindfulness into practice, such as:
1. Christopher K. Germer. "Mindfulness and Psychotherapy."
2. Georg H. Eifert. "Acceptance & Commitment Therapy for Anxiety Disorders: A Practitioner's Treatment Guide to Using Mindfulness, Acceptance, and Values-Based Behavior Change Strategies."
3. Jan Kabat Zinn. "Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness"; "Coming to Our Senses: Healing Ourselves and the World Through Mindfulness"; "Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life."
4. Jeffrey Brantley. "Calming Your Anxious Mind: How Mindfulness and Compassion Can Free You from Anxiety, Fear, and Panic."
5. John R. McQuaid. "Peaceful Mind: Using Mindfulness and Cognitive Behavioral Psychology to Overcome Depression."
6. M. D. Mark Epstein. "Going to Pieces without Falling Apart a Buddhist Perspective on Wholeness."
7. Olaf G. Deatherage. "Mindfulness Meditation as Psychotherapy."
8. Ruth A. Baer. "Mindfulness-Based Treatment Approaches: Clinician's Guide to Evidence Base and Applications (Practical Resources for the Mental Health Professional)."
9. Steven C. Hayes. "Mindfulness and Acceptance: Expanding the Cognitive-Behavioral Tradition."
10. Zindel V. Segal, J. Mark G. Williams, and John D. Teasdale. "Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse", and so on.
As a result, with the above mentioned, Buddhist treatment techniques are widespread propagation and used in Western counties in the present-day and with no hesitation, I suppose that it will be practiced in the future.
References:
- "Buddhism and counseling." British Journal of Guidance & Counselling Vol. 21, No.1 Jan.1993, pp. 30～34.
- Corsini, J. Raymond. (ed) (1994) Encyclopedia of Psychology. New York: John Wiley & Sons.
- de Silva, Padmasiri. (1991) An Introduction to Buddhism Psychology. London: Macmillan Academic and Professional Ltd.
- Horner, I. B. (2004) The Collection of the Middle Length Saying (Majjhima-Nikaya). Vol. II. New Delhi: Motilal Banarsidass Publishers Private Limited. (First Indian Edition)
- Jayatilleke, K. N. (2000) The Message of the Buddha. Kandy: Buddhist Publication Society.
- Mark Epstein, M. D. (1999) "Going to Pieces without Falling Apart a Buddhist Perspective on Wholeness." New York: Broadway Books.
- Premasiri, P. D. (2007) "Disease and Therapy from the Buddhist Perspective." Buddhist Studies in Honour of Venerable Kirindigalle Dhammaratana. Colombo: Sridevi Printers (Pvt.) Ltd. pp. 177～189.
- Ratnayaka, Sumana. (2003) "An introduction to Buddhist psychology and psychotherapy" Symposium on Buddhist studies. UK: Thames Meditation Society. pp. 82～111.
- Ven. K. Sri Dhammananda. (1998) What Buddhists Believe. Malaysia: Buddhist Missionary Society.
- Woodward, F. L. (2005) The Book of the Kindred sayings (Samyutta-Nikaya). Vol. V. New Delhi: Motilal Banarsidass Publishers Private Limited. (First Indian Edition)
Notes:
[1] The Message of the Buddha. pp.90～98.
[2] What Buddhists Believe. p.269.
[3] For details see Wikipedia, the free encyclopedia.
[4] An Introduction to Buddhism Psychology. p.9
[5] Ibid. p.8
[6] Majjhima Nikaya. Vol. II, pp. 88～89
[7] Leaves from the tree Dalbergia Sisu or the Asoka tree.
[8] Samyutta Nikaya. Vol. V, p.370
[9] Samyutta Nikaya. Vol. V, p.357
[10] Disease and Therapy from the Buddhist Perspective. pp. 182～183
[11] Encyclopedia of Psychology. p. 529
[12] Ibid.
[13] Going to Pieces Without Falling Apart a Buddhist Perspective on Wholeness. p. xix
[14] Buddhism and Counseling. p.30
