Questions for our Mental Health Professionals: Dark Thoughts

[Jundo]

Hi,

I have a question or two for all our mental health professionals at Treeleaf.

I was listening to an episode of a new science podcast on the subject of "Dark Thoughts" (be warned, if others will want to listen and are sensitive, that some of descriptions during the episode are very very dark and violent).

http://www.radiolab.org/story/invisibilia/

During the first 30 minutes of the program, they discuss 3 schools of therapy:

-1- Analysis seeking for the meaning of thoughts, usually Freudian. Thoughts have meaning, often hidden in the subconscious.

-2- Dr. Beck's Cognitive Behavioral Therapy "don't take one's 'automatic negative thoughts' seriously, challenge them and don't buy in", which has come to largely replace analysis for most therapists.

-3- "Third Wave" or "Mindfulness" Therapy which, without seeking to contradict thoughts as in CBT, just "lets them go without engaging" in meditation, not buying in. This kind of therapy is experiencing a boom.

I am wondering how you feel about all this.

Also, it is my impression that 3 (and aspects of 2 too) have the flavor of Shikantaza. There are differences too from Shikantaza, which emphasizes much more. Based on your experience in our Community and with Shikantaza, how do you find Shikantaza to be similar or different from 2 and 3?

It would be very helpful to hear from all our professionals.

Gassho, Jundo

PS - Do you agree that the therapist allowing these patients to hold a knife to his throat is perhaps taking some chances?

[alan.r]

Looking forward to what the professionals here have to say about this.

Gassho,
Alan
sattoday

[Meishin]

Hi,

using CBT and variants of mindfulness for a long time, I was attracted to Shikantaza because of the easy fit. There is a flavor and there are differences. When I use mindfulness with a client I am stealing happily from Jundo's videos. Clients for the most part seem to benefit.

So so far as the P.S. is concerned, yes a therapist who allows a patient to hold a knife to his/her throat is taking some chances. In my opinion.

Gassho
Meishin
sat today

[Jishin]

Hi,

using CBT and variants of mindfulness for a long time, I was attracted to Shikantaza because of the easy fit. There is a flavor and there are differences. When I use mindfulness with a client I am stealing happily from Jundo's videos. Clients for the most part seem to benefit.

So so far as the P.S. is concerned, yes a therapist who allows a patient to hold a knife to his/her throat is taking some chances. In my opinion.

Gassho
Meishin
sat today

Hi,

Psychiatrists of my generation focus on psychotropic medications to manage psychiatric illness. I defer to Meishin and others that do therapy routinely on this subject.

Gassho, Jishin, _/st\_

[Lowell]

I can see shikantaza in the free associations of Freud's patients as they focused on reporting, moment-from-moment, what was going through their mind. I can see shikantaza in the automatic thoughts that the patient undergoing CBT scribbles down on their worksheets. I can see shikantaza, obviously, in the new mindfulness therapies. I can see shikantaza in the often given advice to panic attack patients: "Do not fight it. Do not think about it. Just float through it." There are those aspects in therapy where one just follows the mind, observes, and is instructed by what one sees. More often, however, in my opinion, thoughts, along with the "self," are reified and the view of "me" becomes more solidified. What all therepies do, however, share with the Buddha, is a desire to understand and alleviate suffering. I just find the Four Noble Truths and the Eightfold Path more substantive than the unconscious, reformulated cognitions, etc.

Gassho,
Lowell

Sat Today

[Jinyo]

Hi there,

interesting programme.

I can see that 2 and 3 have a flavour of shikantaza but as the focus of the programme is on case studies of OCD - specifically - I guess we're mainly comparing an overlap in positions
as to how we regard the reality of thoughts?

I think when we sit shikantaza we do become more aware of the obsessive nature of our thoughts - and gradually learn to change our relationship to our thoughts - so
it may well have a therapeutic effect.

However - if we broaden out (which the programme didn't do) - some intrusive, troubling thoughts may require a more psychoanalytic route. Psychoanalysis has really moved on
since Freud and some therapists work within a number of modalities - choosing which is the best intervention for the client. It's quite possible to synthesize all 3 of the approaches discussed.

I'd say the therapist with an arsenal of knives, poisens, etc is pretty confident in his approach !!

The thing is he knows that the clients coming to him are tormented by their thoughts because they have a conscience - and would never act on what they fear. They are not psychopaths or sociopaths - hopefully!

I think the mindfulness therapies are really helpful - and yes - there is some element of shikantaza within them - but perhaps something has been 'lost' in the borrowing/extracting
from Buddhism.

Personally - I'd like to see a re-integration of Buddhist psychology/ teachings into some mindfulness based therapies - and a synthesis with other approaches as well. We have so much knowledge now to help people.



Willow

sat today

[Tiwala]

Hi all,

I'm not a mental health professional, but I've recently taken a major leap in my college education and decided to change my major to B.S. Psychology.

Psychoanalysis has moved away from Freudian theories to other theories and they still have a place in today's therapies. As Willow mentioned, some thoughts really do need some analysis. It's called the psychodynamic approach nowadays, which includes Freudian psychoanalysis. Some events in one's childhood, which may or may not have been repressed, may be the model from which someone's pathological behavior is based on. For example, someone who seems to have ended up in a series of abusive relationships in adulthood may have had an experience of domestic abuse as a child and is actually searching for love in the same way that he or she was treated in childhood, whether consciously done or not.

Here is a nicely animated video giving an overview of various forms of therapy that professionals use. In it, it's stated that therapists usually use a combination of various forms of therapy in treating patients. https://www.youtube.com/watch?v=6nEL44QkL9w

P.S. There seems to be a concern about prescription of medication for various disorders. I am not entirely aware of the situation in the United States, but medication does help alleviate symptoms, but more often than not, there is always therapy involved to correct unhelpful thoughts and behaviors learned from being ill all that time. Depression, for example, is seen to be a complex disorder arising from an intricate play of social, psychological, and physiological factors, all of which must be addressed.

Gassho,
Ben
Sat today.

[Kokuu]

Dear all

I am not a mental health proferssional but have had conversations about this subject with both my ex wife (a Theravadin buddhist and clinical psychologist) and someone who attended my sitting group, a clinical psychologist who teaches and researches mindfulness based stress reduction.

The way they have both explained it to me is that both CBT and mindfulness-based therapy such as ACT (Acceptance Commitment Therapy which has in some ways taken over from CBT in a new wave of therapists in the UK) are ways of dealing with thoughts and feelings as they arise. ACT/mindfulness is more akin to the meditation technique of just letting things be as they are and not engaging with them whereas CBT tends to challenge the accuracy of thoughts that arise. Psychotherapy, in contrast, is used to tackle more deep-seated problems in which tackling the symptom thoughts is insufficient and there is a need to understand the deeper basis of where the thoughts come from.

Anyway, this is my lay-person's understanding. I have also personally found CBT a very helpful method for dealing with negtive thoughts that can arise as a result of physical illness.

Gassho
Kokuu
#sattoday

[Jinyo]

Good luck with your course Ben - it feels like you have a good grasp/overview of this fascinating subject area.



Willow

sat today

[RichardH]

By coincidence I just asked the following question on reddit (under my reddit name Objectalone) and have received responses that seem relevant to our teacher's post, and may be of interest to mental health professionals. 800 responses since yesterday.

"Have you ever been disturbed by an aspect of your character revealed by a stressful or threatening situation"

http://www.reddit.com/r/AskReddit/comments/30fgpq/serious_have_you_ever_been_disturbed_by_an_aspect/

Edit: question was removed from reddit after 1600 responses for being of a yes/no survey nature according to the mods. Cest la vie. The linked page is still readable.


Gassho
Daizan

sat today

[Nameless]

Shikantaza seems very prevalent in the Third Wave (the humanistic perspective). Like others have said, therapeutic mindfulness can be a bit watered down though. It's like they take the Buddhism out of Zen. Shikantaza can be a bit like CBT at times, but the approach tends to be a bit different. CBT involves actively reshaping our thought patterns by seeing that negative thoughts, self-concepts and phobias are unfounded. A degree of reconditioning occurs, in which triggers become associated with new, more wholesome, states of mind.As for psychoanalysis goes... There may be a degree of unconscious stuff coming to the surface in Zen practice, but I don't buy any of Freud or his counterparts' theories behind them. And letting a client hold a knife to you sounds like a very experimental form of therapy Haha. Mind you, I'm not a professional, just a psych student. Gassho, John Sat Today

[Ugrok]

Hi !

I've been in "traditional" psychoanalysis for the last five years (meaning, not having a face to face conversation but lying on a couch talking while the analyst listens and - rarely - notices stuff to talk about), and i started practicing zazen during the first. I don't know which did what, but this took me from an anxious wreck, unable to do stuff on his own and to be responsible, to a quite normal guy who can lead his life more or less as he wants to and without too much harming others. I found that it was a very good combination to be in psychoanalysis while practicing zazen and vice versa.

During those years i found that there was a lot in common between psychoanalysis and zen. I recently discovered that (and it did not suprise me at all) in Lacan's first book of his seminars, the very first paragraph is about... zen. I'm not a professional, but i can write about it if you are interested. There are a few books about the links between zen and psychoanalysis, the most well known was written by Erich Fromm ("Bouddhisme zen et psychanalyse" in French, I suppose it's "Zen Buddhism and psychoanalysis" in English), and is a great read.

Gassho,

Ugrok

Sat Today

[Entai]

Hi everyone!
I'm not a professional, but have quite a bit of experience as a patient. For me there's the medical or chemical element, treated with meds. Then the therapy aspect. For years the only "therapy" I was taught was breathing exercises and relaxation techniques. Over the past few years I've been with a good therapist doing CBT. I find it very helpful.

All of the methods discussed (including #3) have the goal of a therapeutic result. Shikantaza doesn't look for a goal. I try to view my therapy and sitting separately. I analyze enough as it is! So for me, there's a time for the couch and a time for the cushion.

Just some thoughts.
Gassho, Entai

#SatToday

[Jishin]

Hi,

A psychiatrist once told me talk therapy can work well in augmenting medication treatment of certain conditions such as schizophrenia and bipolar type one.

Gassho, Jishin, _/st\_

[Shinzan]

First, I am not a psychotherapist or similar professional.

Second, this is an important topic. It is important to know the difference between the purposes of psychotherapy and the process of zen/shikantaza. Altho related, they are very different. Perhaps I am putting it too simplistically, but for me "therapy is about growing up, zen is about waking up." Therapy is about bringing into awareness and easing the maladaptive strategies from our conditioning and history; zen is about seeing thru the whole process of making up strategies, to be present in what is here-now.

Just my perspective. Glad to hear others' views.
_/st\_ Shinzan