Charles T. Tart
Institute of Transpersonal Psychology and University of California, Davis
Arthur J. Deikman
University of California, San Francisco

(1991, Mindfulness, spiritual seeking and psychotherapy. Journal of Transpersonal Psychology, 23, 29-52, 1991 (Tart, C. & Deikman, A.).)

Author's Notes

Charles T. Tart, Ph.D. , is Professor of Psychology at the University of California, Davis. He is the author of many articles on transpersonal topics (see JTP 1970, 1971, 1976, 1979, 1986, 1990) and numerous books, including Transpersonal Psychologies, States of Consciousness, Waking Up, and Open Mind, Discriminating Mind.

Arthur J. Deikman, M.D., a psychiatrist, has done extensive research on meditation, the mystical experience, the relationship of mysticism to psychotherapy, and the cult behavior of everyday life. He has published numerous papers in thee areas plus three books: Personal freedom; The observing self: Mysticism and psychotherapy; and The wrong way home: Uncovering the patterns of cult behavior in American society. Dr. Deikman is in private practice in Mill Valley and San Francisco, where he is clinical Professor at the University of California.

Abstract

Abstract: Many people seeking growth and maturity have explored both Western psychotherapy and Eastern mindfulness methods and often find neither approach as effective as they would like. What can mindfulness methods contribute to more effective psychotherapy and vice versa? This discussion explores these questions, as well as such issues as psychodynamically based resistance to knowing and mindfulness, the importance of relationship in therapy and its lack in classical mindfulness training, shortcomings of mindfulness work in isolation, ethical standards for spiritual teachers, and some similarities and differences between the goals of psychotherapy and spiritual growth.

Article

In Eastern spiritual traditions we have specific techniques for developing mindfulness, usually formal meditation practices of some sort, such as Vipassana mindfulness meditation. These Eastern practices consider the development of mindfulness as an ultimate goal, leading to enlightenment.

In the West we have many kinds of psychotherapy which is our kind of recognition that peoples' experience and behavior are often determined by unconscious reasons. That is, people often do not fully know what they are doing, why they are doing it, or have a really accurate grasp of the situation they are in. Consequently there is a lot of unnecessary suffering. There are many techniques whereby you can train people in psychotherapy to become more mindful and insightful, and, as a consequence, lead to a happier and more effective life.

Now the question I am particularly interested in and that I would like us to discuss is this. Consider our Western mindfulness traditions -- our psychological, psychiatric, and humanistic growth traditions, to give them a very broad name -- what can they accomplish that probably is either not done at all or not done efficiently in the traditional Eastern mindfulness approaches? What do you do as a psychotherapist to help your clients to become mindful that probably would not happen if they sat on their cushions by themselves practicing Vipassana or other traditional Eastern forms of meditation?

Does the Mind That Looks Inside Really Want to Know?

Arthur J. Deikman: One of the basic ideas behind Western psychotherapy is that our minds have endeavored to protect us by shielding us from things that would make us too unhappy or frightened. Thus, if a person consciously decides to look inside and see what may be motivating certain actions, the same mind that is looking inside is also trying to make sure that he or she does not see something inside that his or her mind classified as too stressful to bear in the past. This factor sets certain limits on what the person himself can see.

On the other hand, an outside observer, the therapist, does not usually have the same blocks on seeing certain things that the client may have. So by virtue of the fact that the therapist is on the outside looking at the client's behavior, he or she is in a position to say, "Hey, this area here is pretty covered up; what is going on there?" The therapist can put pressure on the client's psychological systems in a way that the person themselves would find hard or impossible to do. Thus the client, the person seeking greater mindfulness, has a blind spot; they do not see certain areas of mental and emotional functioning, especially if they are problematic areas. Much of the training of a therapist in Western psychotherapy has to do with learning to detect those places of restricted functioning and begin to open them up, so the underlying problems they conceal can be dealt with. Psychotherapy training is fairly systematic; it is directed specifically to that.

CTT: I would like you to elaborate on the training. Any intelligent person, for instance, can see that somebody else is behaving stupidly and give them advice on how to behave in a way that would be generally accepted as a more sensible (given cultural norms) way to behave. What is different about the therapist?

AJD: A therapist might say, "You must have received lots of advice by now on what you obviously should be doing, but you are not doing it. So clearly there is something else going on. What are your own thoughts upon the fact that this comes up? How do you react inside when someone tells you that you should do such and such?" You direct the client's attention to the fact that he or she is making choices. The client may not know why he or she is making those particular choices, but there is an emotionally important basis for it. Instead of mistakenly seeing the maladaptive behavior as a lack of will power, you help the client see that the symptoms represent strategic choices, ways of apparently solving a problem. Then you can try to help the client become more mindful, to discover the unconscious assumption(s) on which the presenting problems and solutions are based.

Isn't Mindfulness Enough?

CTT: Let me push this deeper. Suppose I am viewing this same situation of a client's maladaptive behavior from the perspective of an Eastern mindfulness tradition. I would agree that your analysis is right: if the person keeps doing something stupid, there must be a reason. But in terms of what to do, I would instruct the client that he or she should take up mindfulness meditation. "You must look inside and understand your mind by systematically focusing attention on it. Then you will understand what causes your problems and resolve them."

AJD: Well, I would say that is naive. Because the same mind that is looking inside is, as I said before, also determined to protect the person by not getting into any areas that are dangerous. So some kind of outside assistance is needed, directed specifically to the problem areas, the areas that the client's mind does not want to look at.

CTT: How does the therapist get around this problem of resistance?

AJD: Basically the therapist has to be aware of what aspect the client is resisting and the nature of the resistance: to skillfully point it out to the client. The symptom serves a function. The therapist needs to clarify that function. This skillful pointing out must be based on an attitude that combines a certain firmness and intent to break through the resistance, with a genuine respect for the client's nature and symptoms.

It may not be easy to see the defenses or the resistances and not be caught yourself by them. But an easy thing, one you learn relatively early in your training, is to begin to notice places in which there is a tiny gap, a gap in logic or a gap in emotional affect. The client may be talking about something, for example, but the affect, the emotional tone, does not quite match. You find it profitable to direct the client's attention to such gaps: "I notice you were saying such and such, but you did not seem very happy while you were talking about it." You pick up one of these places where the defenses are imperfect.

It is as if the mind tried to put everything under the rug, but it cannot get every-thing under the rug at the same time.

The free association technique, for example, is often used as a way of bypassing that controlled, hiding self. The more a person just allows their thoughts and emotions to flow, the more the underlying issue will manifest itself in the content. Then the client may begin to see connections where there was isolation before, as well as the therapist seeing connections that may be helpful in guiding therapy. Working with these gaps is a major dimension of Western psychotherapy. Freud was important in pointing out the usefulness of working with inconsistencies, although he certainly was not the only contributor in this area.

The Importance of the Therapeutic Relationship

Freud also was important in highlighting another important dimension of psychotherapy. This is based on the observation that the client's strategic solutions will manifest in therapy in the relationship with the therapist -- the transference -- as well as in relationships with other important people. So in psychotherapy you can make use of that relationship manifestation, be aware of it, be alert for it, point it out, and explore it. This analysis or focus on the transference is very useful and important because it is a here and now situation.

If you look at the literature on the Eastern traditions, indeed on the mystical traditions in general, you can see in the anecdotes examples of where a master, if he is skilled, is using some daily interaction to reflect information back to the person about what he or she is actually doing, regardless of what he or she says or believes they are doing. They make use of everyday behavior to show students what they are actually doing.

Sometimes such teaching by reflection can involve transference responses, too. But apparently the use of transference is sporadic and we have to infer it from anecdotes. In the psychotherapeutic tradition you can do much more focused work with it, particularly in dealing with dependency and idealization of the therapist.

In the Eastern traditions veneration of the Master, the Teacher, the guru, the lama, or someone else like that, is usually built into the system as a central feature. The teacher is represented as vastly superior to the student or even as fully enlightened. While there is a sense in which this superiority is true, there is another sense in which it is not. Unfortunately the student may use that belief in the great superiority of the teacher as an excuse to avoid necessary self-confrontation. "Of course the Master can do that apparently unspiritual or negative action because he is enlightened and special, etc., and I am just down here, an ordinary sinner, so I cannot expect to understand what is happening, much less criticize it...especially since I need the Master's blessing and guidance if I am to have any chance of spiritual progress." There are all kinds of evasions of growth that can take place in that framework of veneration of the teacher. The knowledge of human psychology gained from Western psychotherapy has shown us that analysis of dependency fantasies is extremely helpful for maturation.

Active Focus on Relationships

CTT: Let me play devil's advocate here. A master might respond by agreeing that students have projections about the master, but since the students are supposed to be mindful of what they are doing, you can see this simply as an opportunity for them to observe what they are doing. What is different in the psychotherapeutic approach to bringing about mindfulness about projections?

AJD: Our Western psychotherapeutic approach might say not only is there an opportunity, but we are going to be active in making sure that opportunity is realized. The fact that the opportunity is there does not mean the person is going see it or use it. Western psychotherapy has to do with attempting to make sure the person sees it by using the technical approach of the psychotherapy situation.

CTT: Could you give me examples of the sort of techniques that would be used in an active way to make the person use the opportunity?

AJD: For instance, suppose a client might be rather embarrassed to talk about something or is afraid of bringing in some area of his or her life, When this area is touched on you notice this embarrassment or fear. You might then inquire as to what they were expecting from you and it might turn out they were expecting a very critical, denigrating kind of response. So you might inquire further, "Why does that seem plausible to you?"

We assume, of course, that you are not the type of person the client expects to be dealing with, that you have not actually been behaving that way in the therapy sessions. Then, as you explore in depth the details of the fantasy the client has towards you, the underlying bias becomes more clear. You and your client can become aware of the specific images and tendencies that are distorting perception.

What I have described is an example of transference, responses to the therapist that are out of proportion. Usually these responses are revealed only over time in certain behaviors. For example it might come out in the form that the client never presents his or her critical thoughts of the therapist, or the client is always presenting himself or herself as weak. Suppose your client is a therapist herself, for example. At some point you might say, "We have worked together for two years, you are a therapist, you are very bright, but apparently, I do everything right. Isn't it a little odd that you have never commented on a single mistake of mine or a single failing?"

CTT: So we have an interesting note here. The therapist admits weakness, admits his or her humanity, instead of being perfect. This is very different from working with a Teacher who claims to be or is seen as perfect.

AJD: I would not use the word "admit." The position would be: "Of course I make errors and mistakes, of course you have some awareness of this. So the fact that it is never voiced does not reflect either that I am perfect or that you are oblivious to it. It means you have certain concerns about what would happen if you were to voice them. It would be valuable -- increase your mindfulness -- to find out what those concerns are."

CTT: Let us go back a little more to direction of the activity of therapy. Insofar as I understand them correctly, the Eastern traditions would generally argue that a person can not observe himself or herself very well when they first begin to practice meditative mindfulness. This is because there are "obscurations," blocks to clear perception, in the mind. But the really important thing people need to develop is the power of observation per se. In classical Vipassana mindfulness meditation you are supposed to watch what is happening now. You get distracted, but the instruction is to come back to the focus of attention as soon as you know that you have become distracted. Quite aside from specific insights you may have while doing this, what you train is the ability to observe per se. You build up general purpose "observation muscles" by keeping up the practice, always bringing your mind back to the task.

I have no doubt that with this kind of practice many people do develop a greatly increased capacity to observe internal events in general. Why do you feel this is not enough from the therapeutic point of view? Elaborate on why active assistance from the therapist is an improvement over pure mindfulness cultivation.

Why Isn't Pure Mindfulness Enough?

AJD: It does not seem to be enough, judging by my own scattered observations of people who practice only meditative disciplines. From a theoretical point of view, it comes back to what I said earlier, that such training of the mind may be to observe more clearly what it sees, but there can be a dynamic there, an activity in the person to make sure that certain things are not seen. That dynamic is not necessarily taken care of by meditation exercises per se. (I will add, though, as I discussed in The Observing Self (Deikman, 1982), that I think this heightening and focus on the observing self is an important activity in both meditation and psychotherapy, and an important link between them.) So developing skill in self-observation is helpful, but Western psychotherapy is a more dynamic process. An important component of the Western view of the mind is that we are continually trying to resolve conflicting wishes, needs, hopes, and aspirations. The importance and subtlety of resolving conflicts is not dealt with sufficiently in the Eastern traditions, insofar as I understand them.

To elaborate on this, conflicts arise not so much because reality is so inherently conflictual, although it is complex enough, but because each of us grows up in a world comprised primarily of one or two vitally important people, our parents, and they represented the world to us in a particular way. So we took in their distortions, produced by their own conflicts and adapted to their distortions as if they were an accurate representation of the world. These early, distorted adaptations then become forgotten or are repressed or otherwise shut off from conscious awareness. In our present life we react to the general world on the basis of what we learned earlier, that is we systematically distort our perceptions of the world and our relationships with other people through this early, distorted learning and its subsequent projection on to current reality. The projection of this early learning on to one's spiritual teacher can be quite an obstacle.

CTT: So you would agree with the position I have advanced (Tart, 1986) that it is possible that someone might practice some kind of insight meditation and in general get very good at observing more and more precisely what is happening, get relatively enlightened, but still have certain areas of personal functioning that they never looked at because of defenses that deflect attention?

AJD: Absolutely.

Meditative Insightfulness and Psychotherapy

CTT: Now there is something implicit in what we have discussed earlier, and I would like to see if you will agree with this. A person who became skilled at insight meditation or other forms of self-observation, such as Gurdjieffian self-observation, will probably have an advantage at being able to pick up things quickly if they go into psychotherapy. Yes?

AJD: What does "skilled" at insight meditation mean?

CTT: Suppose we start with a model of a person who is relatively insensitive to their inner feelings and the subtleties of their experience. Psychologically sophisticated outside observers might independently agree, for instance, that this person is fairly agitated in a given situation, but the person honestly reports that he feels calm. Or outside observers might independently agree that the person's behavior suggests a mixture of fear and jealousy, but the person reports, to the best of his or her ability to sense their experience, only that they are feeling jealous. After successful training in traditional insight meditation or other self observation techniques, the person is now able to sense agitation in a similar situation where he could not sense it before. If he now can report a mixture of feelings of both fear and jealousy, I would say that person is becoming better at self observation, "skilled" at it. As Shinzen Young expressed it, gross experiences become more articulated into subtler components of experience (Young, in Tart, 1989).

AJD: I generally find that people's styles do not change all that much. There are people who are very well tuned in on inner processes and they sensitively pick up cues about situations, and there are people for whom that sensitivity is almost like a foreign process. These latter kind of people can make some progress in the direction of more sensitivity, but a therapist might have to work differently with them than with the other clients. So I do not know if you can take various personality styles, have them do insight meditation and get the result that someone who was relatively obtuse in that respect becomes sensitive. If that happened, I would think that would be an advantage for someone undergoing psychotherapy, but I do not know enough about the empirical data of what happens to those who practice meditation to say much about it.

CTT: So you are saying people might maintain their habits of sensitivity or lack thereof.

AJD: It might be a cognitive habit, a personality style or a genetic predisposition.

CTT: S o for an insensitive person, for them to recognize anger they might simply have to learn to observe that their fists are clenched and infer anger, even if they have not internally "felt" it yet. For another person they might get a subtle little tight feeling in their chest long before anything manifests in their observable behavior, but immediately know they were feeling angry.

AJD: There are some people who, when you ask them to free associate, or to "tune in" on their feelings just go right to it. There are others who just do not seem to get it and you have to work differently.

Using Psychotherapy to Aid Meditative Development

CTT: Suppose a person sincerely seeking personal and spiritual growth was planning to spend a considerable amount of time doing insight meditation in one of the classical Eastern modes. Let us assume you were hired as a consultant, with the idea of adding some aspects of psychotherapy to the meditation practice or retreat to make it more "efficient." What would you do? What would you suggest? Assume for the moment that you have great resources available for this project, rather than worrying about practicalities.

AJD: Let us think about the kind of concentrated practice you would have in a retreat. What length of time are we considering?

CTT: Let us assume one to three months.

AJD: It would go something like this. Each person would have the opportunity, two or three times a week, to meet individually with a therapist to explore whatever issues were coming up in the context of their meditative practice. It should be the same therapist for each session for a given person.

Ideally psychotherapy should be long term, as this allows the rhythms of a client's life to bring up a variety of important material. On the other hand, here the therapeutic work would take advantage of the time frame of the retreat. If you have, say, a month, and you know that you are going to meet with someone eight to twelve times, you might work in a more focused way than if you felt it was a more open-ended situation.

CTT: In practical terms, you are calling for about one full-time therapist for every ten people or so. Suppose we have less ideal conditions, where, for example, you only had one therapist for every hundred people or so. How could a therapist delegate some of the work of therapy so that people could do various things themselves or in groups that do not require the presence of a therapist?

AJD: You can do a lot in group therapies, but then that addresses a different level of phenomenon, how people behave in groups. This can be quite useful for people, but it would take a fairly long time for the group process to begin to reveal the individuals' psychological processes, unless it was one of these quasi-groups in which the therapist worked individually with a person in the group while the other people just watched, or something similar.

But I do not think there is a substitute for the one to one relationship with the therapist. Therapy does not really consist of a bunch of separate techniques that you can farm out. There is a lot of art and a lot of mystery to the process. Books can tell you what to do, but not when to do it. This issue of timing and finding a way of working that meets the client's personality takes a while to develop. The answer to your question could be that one therapist cannot do it.

Using Meditation to Aid Traditional Psychotherapy

CTT: Let us look at this issue from the opposite approach. Suppose you had a number of clients who were scheduled for psychotherapy, and I said, "What could you ask them to learn from a meditative tradition that you think could facilitate their psychotherapy?" You could have meditation teachers as consultants if you want or teach aspects of meditation, but what would you ask people to learn, to practice?

AJD: I am not sure. I have had a little experience with clients who were practicing meditation, and also with clients who, in the course of therapy, raised a question about taking up meditation. In the latter case, I referred them to meditation teachers. I did not find that meditating was a significant help for my clients' psychotherapeutic issues. My own feeling is that the main power of meditation is in terms of spiritual development; however the knowledge of how to use such meditation and for which people and under what circumstances is not really within my ken. So I would not want to fool around in an area for which I am not really trained and for which I do not have the specific knowledge. I might even jeopardize or interfere with the potential use of the meditation for its intended spiritual purpose. If a client thought it might be useful, if they wanted to try it, I would refer them to a meditation teacher, but generally I would not "prescribe" meditation.

Goals of Psychotherapy and Spiritual Development

CTT: How are you distinguishing growth in psychotherapy from spiritual development here?

AJD: I could characterize them both as having the goal of increased realism, but the realism with which psychotherapy is concerned is at a different level than the realism which the mystical techniques address.

I think it is important that therapists have an appreciation of the reality that the spiritual disciplines reflect because that will inform what the therapist does in an overall sense. It will affect how he or she views a human being and what outcomes the therapist can see as possible.

In psychotherapy, you are basically working to help the client clarify the motivations that underlie behavior that is frustrating and restricting him or her at the level of interpersonal relationships and also with regards to their work efficiency and creativity. Such limiting behaviors and experiences might include anxiety and depression, restrictions on intimacy, self-defeating behavior, and the like. Now all kinds of behaviors might be improved in the course of spiritual development, but only as a secondary byproduct of something that really has a different focus. Indeed, spiritual development may require a certain degree of health to have things go well. Thus I could see psychotherapy as providing a very important foundation from which someone might gain access to larger dimensions of reality. But psychotherapy is not a spiritual discipline per se.

CTT: One of the ways I have compared Eastern and Western approaches to growth is that both agree that increasing mindfulness is good, but they have a different set of beliefs of what human beings ultimately are and what their possibilities are. In this sense, Western psychotherapy has a very limited view of what a person can be, compared to the mystical traditions (both Eastern and Western).

AJD: Yes, absolutely. I think that limited view is a largely unrecognized problem in Western psychotherapy.

CTT: I recall that Freud said something to the effect that the best we can hope for as a result of growth is ordinary suffering, without added neurotic suffering, or something cheerful like that!

AJD: In my experience, most people can deal with ordinary suffering. It is the added neurotic suffering that breaks our back. Maybe that is what Freud meant.

Faith and Skepticism

CTT: You mentioned skepticism. Let us follow this up. Obviously science is, in a sense, institutionalized doubt, and it is gotten us a long way.....

AJD: Institutionalized doubt? I do not know what you mean.

CTT: In my understanding of the basic process of science (Tart, 1972; Tart, 1975; pp. 11-58) you do not simply accept things as they are, you ask why they are that way, you want to look behind the obvious. Someone may give you a plausible sounding explanation, but it is your job as a scientist to doubt it because we know that just because something sounds plausible and rational does not guarantee that it really explains the state of affairs. The plausible explanations you create as a scientist -- the theories -- are always subject to test as we can always rationalize any pattern of events in front of us. Your theory has to make verifiable predictions to be a good scientific theory and you have to test those predictions to see if they actually work out.

AJD: You really think that is what science is about?

CTT: That is an important aspect.

AJD: An aspect of it, yes.

CTT: A very important aspect of it. Now most spiritual traditions, in contrast, talk continuously about faith, not doubt, they advocate respecting and venerating the tradition and the teacher. Do you see a place for doubt in spiritual growth?

AJD: Yes. I think you frequently get distortions of the mystical tradition in which this veneration and faith are misunderstood. If you believe that sincerity is extremely important in the spiritual quest, then for a person to pretend to a faith, to pretend that he or she has complete faith when actually they have real questions or doubts, is a forced position of the mind that is not very sound. In Sufism and in Zen Buddhism, as well, if you look carefully at the talks or teaching materials per se, you will see that they take a dim view of someone who never has any doubts. Faith in the mystical sense probably has a much more profound meaning than we are accustomed to assign to it, so I do not know that doubt is at all incompatible with deep faith.

CTT: Let me press you a little on this. Take for instance, the Sufi teaching story (Shah, 1970b; pp. 84-85) about the learned Dervish who heard these hermits out on an island mispronouncing their sacred chant. He corrected them and told them the right way, then sailed away. As his ship drew away he could hear them saying it correctly but then they fumbled and went back to their old, incorrect way

References

Anonymous (1975). A course in miracles. Tiburon, California: Foundation for Inner Peace.

Deikman, A. J. (1963). Experimental meditation. Journal of Nervous and Mental Diseases, 136, 329-373. Reprinted in C. Tart (Ed.), Altered States of Consciousness. San Francisco: Harper & Row, 1990. Pp. 241-264.

Deikman, A. J. (1966). Deautomatization and the mystic experience. Psychiatry, 29, 324-338. Reprinted in C. Tart (Ed.), Altered States of Consciousness. San Francisco: Harper & Row, 1990. Pp. 34-57.

Deikman, A. (1976). Personal Freedom: On Finding Your Way to the Real World. New York: Grossman Publishers.

Deikman, A. (1982). The Observing Self: Mysticism and Psychotherapy. Boston: Beacon.

Deikman, A. (1983). Evaluating spiritual and utopian groups. Journal of Humanistic Psychology, 23, 8-19.

Deikman, A. (1990). The Wrong Way Home: Uncovering the Patterns of Cult Behavior in American Society. Boston: Beacon.

Shah, I. (1970). Tales of the Dervishes: Teaching Stores of the Sufi Masters Over the Past Thousand Years. New York: E. P. Dutton & Company, Inc.

Tart, C. (1972). States of consciousness and state-specific sciences. Science, 176, 1203-1210.

Tart, C (Editor) (1975). Transpersonal Psychologies. New York: Harper & Row.

Tart, C. (1986). Waking Up: Overcoming the Obstacles to Human Potential. Boston: New Science Library.

Tart, C. (1989). Open Mind, Discriminating Mind: Reflections on Human Possibilities. San Francisco: Harper & Row.

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