We enter psychotherapy because we are suffering. Suffering can take many forms: may it be feeling low, reoccurring headaches, or overwhelming anxiety to name a few examples. The suffering, however strange this may sound, is a perfect manifestation of what is going on, a clue to the past, and a doorway to the future. How can the manifestation be understood in terms of causality and how would it be worked with in psychotherapy?
Feeling low can for instance be the result of reoccurring self-attacks to protect a loved one from anger (“I direct the feeling of anger toward myself instead of you whom I’m angry with to protect our relationship” – “the gift of love”). Here, the therapist’s role would be to help make space for the feeling of anger and stop the self-attack – no wonder that one starts to feel low when it’s like someone is hitting you from the inside (or from above so you feel low?) all the time!
Reoccurring headaches could be anxiety that is discharged in the voluntary muscles, like the neck muscles; here a therapist could help to see that the anxiety causes the problematic symptom and help the patient explore what the anxiety signals (usually when we are anxious there are feelings we struggle to bear).
Overwhelming anxiety might cause dissociation (be physically here but not present), nausea (due to anxiety being discharged in smooth, involuntary muscles), or different degrees of hallucinations (for instance, that “normal” situations and “normal-acting” people seem very hostile and thus creating great fear) – here a therapist could help to tolerate and understand anxiety in a step by step manner, to learn where the threshold for too much anxiety is and what triggers for the patient problematic responses (again, usually feelings).
This way of understanding symptoms focuses on the relationship between feelings, anxiety, and defense mechanisms (basically what we do in an attempt to avoid the pain in our lives). In psychotherapy, this presents itself in the patient’s current relationships with others and with the therapist – as an enactment of past, important relationships with attachment figures.
This affect-focused style of therapy goes very well together with Buddhism. Life is full of suffering and the origin of that suffering is aversion, craving, and delusion (also known as the three poisons). We suffer when we can’t face or tolerate what is – reality. When we dislike the way that we feel (aversion) – we suffer (“I don’t want to be angry with you because I love you and I don’t want my anger causing you to leave!). When we want to feel something else (craving) – we suffer (“I just wish I didn’t have these headaches!”). When we believe we should feel a certain way (delusion) – we suffer (“I should be able to handle my own feelings”). Defense mechanisms, as I said, are what we take to when we suffer – because we don’t want to suffer! But often, defense mechanism also hinders us from living a full life. They protect AND hinder us.
In Buddhism, the number of Dharma gates (ways to enlightenment; enlightenment could be described as “liberated from the suffering of the world”) is said to be 84000, or more accurately: the ways to “freedom from suffering” are numberless. But freedom might not be what we think it is. Freedom in this regard is when we can see and tolerate reality for what it is: we feel what we feel in relation to reality, so that we can see through and beyond our own delusions and defense mechanisms. Becoming free of suffering has little to do with getting rid of and everything to do with integration. Freedom is bearing whatever goes on, on the inside and the outside. (And please note, this is an everlasting journey because we can only face what is in this moment.) There is nothing we can achieve in that sense, we can only show up to the next moment. Thus, we have endless opportunities for enlightenment, because THIS moment is always fresh.
That things are as they are we can do little about (of course we can try to change things but then again, things are as they are), but what we certainly can do to help ourselves is separate fantasy from reality. We can help ourselves to see and understand what makes us avoid reality – to help us tolerate (not meaning liking necessarily) reality. The work of both psychotherapy and zen buddhist practice have a lot in common: we come because we suffer, we learn to see the cause of the suffering, we find that there is another way to life and then we practice the embodiment of that way.
“Reality triggers emotions. If we cannot tolerate them, we avoid the reality that triggers them” – Jon Frederickson, Co-creating safety