Positive Health Online

There is the view, whether or not it is more prevalent now than in the past is arguable, that you have to be able to measure the worth of anything in pounds, shillings and pence, or in scientifically quantifiable amounts. The idea that in order to justify your engagement in any activity it must be seen to be cost-effective, almost, the results known and approved of in advance. Of course, these kind of evaluations are part of the world we live in, to ignore or deny that is not a helpful position, but is it the only one, and is it becoming the most important in many peoples eyes? What about the true value of things? The inestimable value of a life, of love, of joy, of creativity, of great music or painting? I believe one of the functions of psychotherapy is to restore to individuals their sense of self worth and their sense of what is truly valuable and important to them, and to thereby strengthen their resistance to the ethos that says that all must be measured and weighed up. Insofar as it does this, it will also affect the societies, organisations, and structures that those individuals are a part of.

If there is one characteristic shared by people entering psychotherapy, I think it could be said that they don't, indeed they don't know how to, value themselves and their own inner processes enough. Sometimes it is a stated aim of the therapy to address this, but it is always implicit in the material that arises in the first weeks and months of a therapeutic relationship. Paradoxically, the very act of taking the step of seeking help, is already bringing into being the other position. Entering therapy, a person is saying; I need attention, and I deserve it, I have a potential to bring out, however obscured. It is an act of hope. But this message is often not felt by the client themselves. The overwhelming feelings more often are hopelessness, despair, anxiety, fear, grief, rage, confusion, and usually a sense of being stuck, there being no movement, no sense of things changing of their own accord.

Often there is a sense of having reached the bottom and being desperate, hence the impulse to seek help, often despite all sorts of familial, peer, or cultural messages that discourage this step. But, underlying whatever diversity of content may be being presented by clients, there is, as I say, the common ground of a lack of a sense of inner value, both of the self and of other elements of their lives. Sometimes it seems as if a life that could be lived in colour is being lived in black and white.

Now, I first went into therapy nearly twenty years ago, and I have moved on considerably from those early experiences, but I still know in myself vividly the flavour of what it is like to be in such a place, for it was a place in which then I lived pretty much all of the time, and now, I only rarely visit. It is a place in which it is impossible to feel well, impossible to use the title of this magazine, to feel 'positive health'. It may or may not be a place in which someone can cope, can hold down a job or even have a high powered career, look after their children, and indeed themselves to an adequate level, communicate to a degree, and keep their relationship or their marriage functioning. The resilience of the human spirit can be surprising, people without a robust sense of self worth may sustain for years any or all of these things and many others, or they may, understandably, crumble under the various stresses and strains and enter into crisis, but what they certainly cannot do is, very simply, feel well for any length of time.

It has, of course, been said before, but wellness is not simply the absence of symptoms and illnesses. This is a negative view of human health. A convincingly encompassing positive evaluation of health is more difficult to come by, but I would like to put one forward, based on the insights of traditional Buddhism. Buddhism would have it that the whole of phenomena can be described in terms of what are known as the Skandhas, which are form, or body; feeling or sensation; perception; volitional impulses, and consciousness. In the type of psychotherapy that I practice, the Skandhas are used as a model for examining what is happening in the processes of both the client and the therapist, and three qualities are used in the evaluative process; the qualities of spaciousness, clarity, and compassion. Let me give you an example.

I was working with my therapist on excitement, inspiration, energy, which, at the time, I had in abundance having recently worked through much that was blocking me. I was experiencing these qualities very much on the feeling and the perceptual levels; feelings of excitement and bubbliness, images of beautiful sea waves rising, and the idea of things that I could achieve in the creative sphere.

What is the problem you might ask? Apparently none, so why have I been unable to contact these feeling for much of my life, and why, when they do arise, is it so difficult for me to sustain them and channel them productively? My attention was drawn away from my exhilarating mental processes and I was reminded that I am, indeed, embodied, and therefore implicitly reminded that if I do desire to act with this creativity, part of the vehicle through which I must do so is my physical form. But what happened? Drawn back into my body, I immediately experienced fear, and with it the realisation that at some point in my life I had imbibed the message that it's not all right to be so excited, so enthusiastic, that it must be suppressed in order to be acceptable. I cannot overemphasise the point that this information was somehow held more in my physical body, than in my mind or my emotions.

The mind, the perceptions, may have been rich and flowing, but for years I was unable to translate this into action, struggling to achieve what I would have liked to achieve in the world. So in the Skandha or perception there may be great spaciousness, a lot of potential, and there also may be clarity, the ideas form themselves, get very exciting and there may be a lot of joy in the process, I have felt very good towards myself on this level, so compassion is in the picture too. But when I touch into the Skandha of volition, through the Skandha of form what happens, there is a tightening, a freezing, an inability to move, i.e. spaciousness is diminished, the impulses become confused, I no longer have a sense of what is to be done, what is right for me, i.e. clarity is diminished, and on top of all that I begin to berate myself for my inability to act, so compassion has taken a fall, too. Using the twofold model of the Skandhas and clarity, compassion and spaciousness, it is often possible to map what is happening to the individual, to locate the difficulty in relation to the whole person. Of course, discovering these nuggets of understanding in each client is the result of long processes of exploration of both the past and the present, and the relationships across all of the Skandhas. This example is a pivotal theme to my own particular dynamic process which I frequently explore.

Knowledge is powerful, but in itself it is not enough. It has been observed many times in the history of psychotherapy that merely for the client to have gained an understanding of how the problems arise, is not enough to liberate her from them.

What actually heals? This is, of course, an enormous and profound question that goes to the very heart of all therapies. What is healing? What facilitates it? Let us look again at our example. The fundamental change between the state of openness in the mind of myself as the client and the blocked state in the will is in terms of the spaciousness; the mind flows, creates, moves, the will is tight and narrow and unable to move. To bring increased space into a state of disturbance is to open up the potential for change. The other two qualities, clarity and compassion, are allowed to emerge if the space is uncovered into which these two innate qualities can express themselves. How do we make contact with this space when we are in a place of tightness, of spaciousness in the therapist, both towards herself and towards the client, in relation to the issue or process being dealt with, is the primary vehicle that allows healing to take place. Healing in psychotherapy takes place in the relationship itself between the client and the therapist. The original restriction has usually come into being in response to the tightness of a situation around the developing child; disapproval, punishment, lack of love etc. The offering of an alternative responses in the tight places, again and again, can eventually facilitate a softening within the client to whatever the feared and denied process is.

The Psychospiritual psychotherapist as well as having undergone and continuing to undergo therapy for herself, also has a commitment to self reflective practice; usually to a meditation practice that explicitly allows the arising of spaciousness, clarity, and compassion within the context of the Skandhas. My own teacher, Maura Sills of the Karuna Institute, says: 'The power of psychotherapy is very similar to the power of meditation, which is the cultivation of awareness. A psychotherapy which is not involved in the study of consciousness, or does not have awareness practice as central to being human, cannot meet human needs today. Psychotherapy does not only concentrate on the cognitive mind, it also has the potential for a deeper, inner response or healing. The subliminal mind, the wise mind uncovered in our attentive awareness, is the mind we need to be reconnected with.'

The psychotherapist who is bringing this awareness into her own process can then use the same fundamental skills to bear on the dilemmas of the client; she can hold the wise mind whilst the client allows confusion and distress to be expressed, to emerge from the frozen and stuck and shocked places that are suppressed in everyday life, often in fear of judgement or rejection. Eventually the client's own wholeness and wisdom is given the space to emerge from the darkness. This work, which we call joint practice, goes beyond the clinicality of techniques and methods; the therapist must truly struggle to find a place in her heart for the client so that the client's own heart can be touched by her own process; she is supported to move back into the centrality of her own experience and to value what is important to her.

In a world where achievement has displaced relationship, this movement is radical. It does not happen easily and the therapist grows with the client, often in ways that cannot be predicted. As openness to the true depths of another human being grows, the discomfort of reality intrudes into our accustomed defences and demands response on deeper and deeper levels. Who is this person with whom I am sharing this journey into the unknown? Can I allow myself to be touched by their pain and distress? Can I show them that they have touched me, that their communication has been truly heard, not judged, not pushed away? In this relationship the client may begin to receive what they have been unable to receive, for whatever reason, before in their lives: the loving presence and respect for another human being. Neither therapist nor client can remain unchanged if such a meeting takes place. This is the true ground of alchemy: the transformative. It is this that is hoped for when the client takes the first tentative steps to reveal themselves to the therapist, formerly a stranger in their lives, but someone who, in a good therapeutic relationship, takes on a special place in the client's life that is different than that which can be expected from anyone else; the place of exclusive dedication to the growth and well-being of that particular client. It is the client's reception of this care and attention that changes the nature of the place in themselves from which they can then meet the rest of the world.