The Compassionate Practice of Psychotherapy

Edward M. Podvoll, M.D.

1. Foundations of Clinical Recovery
2. A Design for Treatment: Mind and Environment
3. ntensive !syc"ot"era#y: ntimacy and E$c"ange
4. T"e %ature of Courage in !syc"ot"era#y
T"is is a transcri#t of an intensive training seminar given &y Ed'ard M. !odvoll( M.D. at t"e )arme C"oling meditation
center on contem#lative #syc"ot"era#y and t"e *ind"orse !ro+ect( ,cto&er 1-.( 1/02.
1ig"tly edited &y 2effrey Fortuna( 2330( 4oulder( Colorado.
Talk No. 2: October 1, 1982

1. Foundations of Clinical Recovery
*elcome to t"is training session in contem#lative #syc"ot"era#y. *"at 'e 'ould li5e to do t"is 'ee5end is tal5 a&out
'or5ing 'it" #eo#le from a #oint of vie' t"at is some'"at different t"en t"e 'ay many of us "ave &een trained. T"at is
al'ays a &it of a s"oc5. t certainly 'as to me( to &egin 'or5ing 'it" #eo#le from t"e #oint of vie' of first 'or5ing 'it"
one6s o'n &ody( s#eec" and mind. Many #eo#le "ere are #rofessional #syc"ot"era#ists( &ut #rofessional or not(
every&ody is 'or5ing 'it" #eo#le. T"ose '"o "ave constituted t"emselves as 7#rofessionals7 in t"is area of 'or5ing 'it"
#eo#le "ave a #articular &urden and at t"e same time a #articular res#onsi&ility. As #rofessionals( 'e gat"er u#on
ourselves a social accreditation( a socio-#olitical #rivilege. T"at it "as al'ays &een so from time immemorial( t"at #eo#le
'ere granted t"at 5ind of status in t"eir culture '"ic" stated t"at t"ey "ad ac8uired a certain degree of training and
ca#a&ility( a degree of maturity t"at allo'ed t"em to fully( t"oroug"ly enter t"e lives of ot"ers and &e useful.
!syc"ot"era#y( alt"oug" it is 8uite a ne' term in our culture( 902 years old:( "as ac8uired a similar
res#onsi&ility to 'or5 'it" #eo#le and t"at is a statement t"at #syc"ot"era#ists e$em#lify t"e #ossi&ilities of
"ealt" and of recovery. ;ealers "ave al'ays ta5en on t"emselves. At t"e same time( '"en 'e loo5 around
and see '"at t"e 'orld of #rofessional #syc"ot"era#y is( 'e find a t"ree-ring circus. *e go to any
convention of t"e American '"atever and 'e find a circus of #ossi&ilities and tec"ni8ues. *e find all 5inds of
statements and "o#es a&out '"at #eo#le are doing and '"at is #ossi&le to do 'it" one<s life= '"at "ealt" is
to &egin 'it". And certainly 'e "ave seen t"at among t"e 'ide variety( t"ere is very little t"at 'e ourselves
'ould #arta5e in. f 'e 'ere in e$treme states of mind( if 'e 'ere in a lot of trou&le( '"at 'ould 'e do.
t is an interesting event to loo5 at: "o' 'e ourselves 'ould go a&out loo5ing for( evaluating( anot"er #erson
'"om 'e 'ould trust( to #ut our life on t"e line 'it"( so to s#ea5. *"ere is it t"at someone goes to t"ese
days> A 8uic5 #erusal of Time Maga?ine and ot"er #eriodicals demonstrates a com#lete disaffection 'it"
7t"era#y7 and 'it" t"ose '"o claim to &e t"e #syc"ot"era#ists at all. And so 'e "ave &ecome very
sus#icious of #syc"ot"era#y in general. *e "ave gotten very sus#icious of #eo#le '"o "ave #resented
t"emselves as t"ose '"o mig"t &e useful to us( es#ecially t"ose '"o are #rofessionals and are ma5ing 8uite
good livings out of doing suc" t"ings. *"at do t"ey 5no' a&out "ealt" and '"at do t"ey 5no' a&out
recovery and '"at do t"ey 5no' t"at 'e do not 5no' or t"at 'e cannot get from &oo5s and so on> *e loo5
at t"ese #eo#le. *e mig"t go from one to anot"er. *e mig"t actually intervie' t"em. T"ey t"in5 t"ey are
intervie'ing us &ut 'e 5no' 'e are intervie'ing t"em. *e are loo5ing at t"em. *"enever 'e go to a
t"era#ist 'e are 'ondering( 7*"at 5ind of #erson is t"is> *"at do t"ey "ave> *"at do t"ey 5no' and '"o
are t"ey> ;o' are t"ey living t"eir lives>@ T"ese are generally t"e same 8uestions t"at #atients( ot"er'ise
5no'n as #eo#le in #ain( are as5ing '"en t"ey enter an intervie' or consulting office. T"ey are saying( A*"o
are t"ese #eo#le>@ And t"ey do not 8uite "ave t"e courage to as5 t"at 8uestion &ut t"ey are loo5ing( ma5ing
u# t"eir minds in any case.
T"e variety of credentials a&out '"o suc" a #erson mig"t &e( does not "old muc" 'ater. !atients loo5 and
see "o' 'e &e"ave( "o' 'e interact 'it" t"em( and t"ey continually 'onder a&out '"at our lives are li5e.
And if t"ey as5 suc" a #ointed 8uestion 'e t"in5 t"ey are &eing intrusive. n any case t"at is t"e usual( t"e
most conventional of conventional attitudes to'ard a #atient6s 'ondering a&out '"o 'e are and '"o t"ey are
#utting t"emselves in t"e "ands of - an intrusion.
T"e various t"era#eutic sc"ools "ave s#eculated a&out '"at it means '"en a #atient 'onders a&out us as
t"era#ists( a&out "o' 'e are living( and "o' trust'ort"y 'e are. Bome sc"ools "ave ela&orate t"eories
a&out t"e notion of trust( as if anot"er "uman &eing s"ould &e a&le to trust us on t"e s#ot. As if trust 'ere not
an earned #"enomena( a situation '"ic" gat"ers and develo#s. T"is is not necessarily meant to &e a criti8ue
of #syc"ot"era#y suc" as 'e 5no' it( or "ave e$#erienced( or as it "as a##eared in t"eories a&out
inter#ersonal interaction &ut it is +ust t"e common e$#erience- '"en 'e go to anot"er for "el# 'e 'onder
'"o t"ey are. T"at moment of in8uisitiveness a&out ot"er mig"t &e a s#ar5 of "ealt" itself.
*e 'onder '"at 5ind of training t"at t"era#ist "as "ad and '"en t"is a##ears- as it must at some #oint in
t"era#y- t"e t"era#ist &egins to 'onder( A*"at e$actly am doing( '"at 5ind of training "ave "ad to enter
so intimately into anot"er #erson6s life>@ *e #resent ourselves as t"e #ossi&ility( t"e lin5( of a relations"i#
t"at mig"t &e useful to anot"er. *e as #rofessional #syc"ot"era#ists "ave ta5en on t"is credential of "el#ing
#eo#le. T"ey 8uestion us. *e 8uestion ourselves.
For t"e most #art( t"at 8uestion is t"e ground of '"at 'e call 7contem#lative #syc"ot"era#y7( t"at t"ere is a
#ossi&ility of training ourselves in suc" a 'ay as to "ave some confidence a&out t"e e$#erience of +ust '"at
recovery is. T"ere is no 'ay to tal5 to anot"er #erson from an attitude of &eing useful to "er 'it"out "aving
e$#erienced some degree of recovery in our o'n lives( 'it"out "aving actually 'or5ed to'ard recovery in
our o'n state of &eing. T"ere is a continual 5ind of oscillation t"at ta5es #lace in a #syc"ot"era#eutic
encounter: every 'ord 'e say is met 'it" t"e res#onse( more or less( 7Does "e really 5no' '"at "e are
tal5ing a&out>@ And t"e more intimate 'e get 'it" #eo#le( t"e more s"ar# t"at res#onse &ecomes. Bo 'e
"ave to 5no' '"at recovery is( '"at "ealt" is at all( if 'e are going to acce#t t"is &urden and a##eal from
anot"er #erson to "el# "im recover. ,ur o'n e$#erience of t"is #"enomena( of recovery( is crucial( and it is
crucial to '"et"er "e trusts us or not( '"ic" means '"et"er 'e earn anot"er #erson6s trust or not.
*e mig"t 'onder '"at t"is t"ing called Arecovery@ is. t "as a variety of c"aracteristics for different #eo#le.
am sure t"at everyone "as "ad an illness of some 5ind( suc" as a #rolonged influen?a. *"at is it li5e to
&egin to come out of t"at( sometimes after a 'ee5 or t'o( after feeling ill( losing a##etite( losing any 5ind of
+oyfulness( or energy( not 'anting to 'or5( feeling ugly( &loated( not even 'anting to loo5 into t"e mirror.
T"en t"ere is a moment '"en you are coming do'n t"e stairs of your "ouse. T"ere is a moment '"ere
t"ings are suddenly all rig"t and you 5no' you are coming out of it. T"ere is an instant of connection 'it" t"e
'ay t"ings used to &e( e$ce#t t"ey are com#letely different. t is li5e t"e first s#ar5 of s#ring in Cermont. Dou
5no' it is going to come eventually &ut it is t"ere and it is different t"en you "ave ever seen it &efore at t"e
same time. T"e moment you try to "ang onto t"at( and say( 7*ell no' everyt"ing is fine7( t"ere is a 5ind of
rela#se and it is not so good. Recovery seems to &e a strangely +oyful( almost ins#iring( #"enomena and
e$tremely evanescent at t"e same time. t could &e someone li5e 4eet"oven '"o 'rote t"e /t" Bym#"ony(
9t"e last movement '"ic" "e called 72oy to t"e *orld@:( '"ic" "e 'rote rig"t during "is recovery from
catastro#"ic #neumonia. T"e &asic c"aracteristic of recovery &eing ins#iration( a##reciation( curiosity( and
desire for contact( '"at 'e generally call Aoutgoingness@.
T"at outgoingness and a##reciation of sense #erce#tions and contact 'it" #eo#le( of "aving 7come &ac57(
recovered( is a moment of "ealt". T"is is a moment of "ealt" t"at all of us long for. t is essentially a recovery
from t"e continuous #reoccu#ation 'it" illness. T"at is t"e meta#"or of '"at 'e are tal5ing a&out. T"e
meta#"or is t"at 'e recover from self-#reoccu#ation 'it" illness and #ain. 4ut t"at 5ind of recovery is only
t"e e$aggeration( t"e "ig"lig"t( of '"at 'e "ad &een trying to do all along. llness is t"e closet( t"e closed
room( t"e stuffiness t"at 'e are trying to &urst out of. llness is an intensification of everyt"ing t"at 'e "ave
&een trying to get a'ay from. Bo t"at '"en 'e fall ill( in t"e vast varieties of #ossi&ilities of #syc"ological
illness( t"ose are +ust t"e intensification of '"at 'e 5ne' "ad to &e dealt 'it" t"roug"out our lives. *"en
someone &ecomes #syc"ologically ill( 'e could say t"at fundamentally( s"e is e$aggerating a situation of
self-#reoccu#ation. T"e illness is a distorted attem#t to leave t"at( to go &eyond a constricted sense of
#ersonality( to &ring t"ings to a "ead. *e desire to go &eyond ourselves( to "ave t"ese moments of
recovery( to recogni?e a B#ringtime of #ossi&ilities. *"en 'e come to a #rofessional #syc"ot"era#ist 'e
'onder "o' muc" t"at #erson can recogni?e '"at 'e long for( and "o' muc" t"at #erson "as recogni?ed
and accom#lis"ed t"at 5ind of recovery in "er o'n life.
T"ere is a #ro&lem t"at comes u# at t"at #oint in terms of #syc"ot"era#y. *e mig"t( in some 'ay or anot"er(
desire anot"er #erson6s "ealt". T"is "as( from t"e very &eginning of t"e "istory of #syc"ot"era#y( &een an
issue: of '"et"er it constitutes an un"oly desire or not. T"roug"out t"e literature( and t"roug"out t"e
su#ervision e$#erience of #eo#le '"o "ave trained in Freudian( 2ungian( Eestalt 'or5( or '"atever( t"e
issue comes u#: '"et"er or not our desiring anot"er #erson6s "ealt" is an ego en"ancement on our #art. f
t"ere is anyt"ing t"at ties toget"er t"e varieties of sc"ools of #syc"ot"era#y( it is t"is issue. *"oever your
su#ervisor is( '"atever t"eir training mig"t &e( t"ey are sus#icious of your desire for anot"er #erson6s "ealt".
T"at sus#iciousness "as an interesting source. t "as to do 'it" '"et"er 'e are using anot"er #erson in "is
attem#t at recovery for our o'n #ur#oses. At t"e same time( it seems odd t"at in t"e ordinary course of
t"ings 'e s"ould not desire( 'is" for anot"er #erson6s 'ell-&eing( for "is e$#erience of recovery.
t is somet"ing of a dilemma t"at #syc"ot"era#y is facing. ,n t"e one "and( t"ere is some 5ind of #urity of
intention or motive( t"at one could a##roac" anot"er #erson( 'or5 'it" anot"er #erson( 'it"out desire for
t"eir 'ell-&eing &ecause it mig"t &e an interference. Det "o' could one do suc" 'or5( '"ic" is sometimes
8uite intensive and grueling( 'it"out t"at desire to &egin 'it"> t is a 5ind of catc" 22. t seems to &oil do'n
to +ust '"at t"e self-gratification of t"e t"era#ist mig"t &e. T"e notion of t"e t"era#ist6s ego is at sta5e. t
comes do'n to t"is: if suc" a t"era#ist could 'or5 'it" a #atient and "o#e for t"e #atient6s recovery 'it"out
ego &eing involved( t"at is fine. And everyt"ing else is sus#icious. Bo( "o' could 'e actually "o#e for
anot"er #erson6s recovery 'it"out ego &eing involved> *"ic" means( "o' 'e could 'or5 'it" our o'n ego-
as#iration as #rofessionals. T"at is t"e '"ole idea( and '"ere t"e '"ole training in contem#lative
#syc"ot"era#y comes in. From t"e &eginning( illness is a distorted( #erverted attem#t to get out of a
claustro#"o&ic( stifling sense of "aving &een conditioned in a 'ay t"at one is &eginning to re+ect. n any
case( 'anting to &e someone different( 'anting to &e #er"a#s t"e #romise of '"at one felt one could &e.
T"en one meets( in t"e t"era#eutic situation( t"e dilemma t"at t"e #erson you are in a relations"i# 'it"
cannot "o#e for t"e same t"ing. !er"a#s t"is is getting a little muddy -- a muddy e$c"ange -- at t"is #oint.
*"at am trying to address is t"e dilemma of #syc"ot"era#ists '"o are 'or5ing 'it" #eo#le and '"o are
&eing #resented 'it" t"e same #ro&lem: t"at t"ey( t"e t"era#ists( "ave faced and are facing continuously in
t"eir o'n life( and t"at is t"e #ro&lem of t"eir o'n attem#t to &e someone more com#assionate t"an '"o
t"ey are. T"e t"era#ist6s continual concern( most dee#-rooted issue( is '"et"er t"ey are com#assionate or
not( of '"et"er t"eir a&ility to &e dee#ly com#assionate #eo#le "as &een cultivated enoug"( or '"et"er t"ey
are +ust fa5ing it. T"at is t"e issue t"at t"e #atient a##roac"es us 'it" and it is t"e issue t"at al'ays comes
u# in our o'n lives and in our 'or5: of '"et"er 'e really "ave t"e stuff to deliver '"at our credentials and
our social status give us t"e #ermission to deliver.
T"era#ists "ave nig"tmares a&out t"at. %o matter '"at sc"ool of t"oug"t( no matter '"at t"e training is(
t"ere are nig"tmares of '"et"er t"ey can so com#letely ta5e on t"at res#onsi&ility and '"et"er t"e c"allenge
of intimacy 'it" anot"er #erson is somet"ing '"ic" t"ey are ca#a&le of acce#ting. T"at is t"e central issue of
a t"era#ist6s life: dou&t a&out t"e de#t" of t"eir "umanness. T"at "as "a##ened across all of t"e sc"ools.
*"at 'e "ave done t"is 'ee5end( is create a situation '"ere t"ere is #ossi&ility of loo5ing at t"is in a slig"tly
different 'ay: to loo5 at '"o 'e are( to loo5 at t"e nature of our o'n state of &eing( as t"era#ists( as #eo#le
'"o are ma5ing t"is #resum#tion( and to see '"at 'e can learn from t"at. T"at involves a fe' t"ings: it
involves listening to some of t"ese ideas and discussing t"em. t involves t"e #ractice of meditation: of
+oining loo5ing at ourselves and loo5ing at our relations"i#s toget"er at t"e same time= of loo5ing at "o' our
mind 'or5s a&out relations"i#s and loo5ing at "o' our s#eec" 'or5s a&out relations"i#s toget"er. Bo t"at
#er"a#s 'e do not "ave to go t"roug" t"at nig"tmare of dou&t com#letely alone. *e could at least s"are
some of t"e de#t" of our o'n concern a&out 'or5ing 'it" #eo#le and #er"a#s 'e could come u# 'it"
somet"ing t"at could &e useful. 4asically( '"at 'e 'ant to do is &e useful to #eo#le in #ain and '"o "ave no
#at" '"atsoever. *e are t"ere in our agency( mental "ealt" office( '"atever( and 'e are +ust sitting t"ere
any'ay. *e can &e t"ere and actually cultivate a disci#line of relating 'it" our o'n e$#eriences of recovery
'"ile 'e tal5 to #eo#le '"o are yearning for +ust t"at.
Discussion
udience !uestion "!.#: Bir( you 'ere saying t"at illness 'as a distortion( a 'ay of &rea5ing out of t"e
conditioned e$istence t"at one did not li5e "aving im#osed on one( to reconnect 'it" t"e #romise of '"at
one could &e( an effort to reconnect to t"at. And t"en you said t"e t"era#ist cannot "o#e for t"e same t"ing
and 'as not sure '"at you 'ere referring to.
Edward Podvoll "EP#: mean t"e t"era#ist "as not muc" c"oice in t"e situation e$ce#t to 'is" 'ell for
anot"er #erson. 4ut no' in our trainingF'"at is your training>
!: Art t"era#istF#ainting...
EP: t mig"t de#end on t"e sc"ool of art t"era#y. 4ut( for t"e most #art( t"e caring concern for a #atient6s
recovery could &e o&stacle to t"eir recovery. T"at is &asically one of t"e fundamental tenets of su#ervision
t"at t"in5 cuts t"roug" every conceiva&le sc"ool in #syc"ot"era#y no'. ,ur desire and concern mig"t &e
an im#ediment to anot"er #erson6s recovery. 4ut( 'e 5no' t"ey "ave e$#eriences of recovery( using t"e
meta#"or of t"e flu and o&viously more t"an t"at. *e 5no' t"at 'e "ave e$#eriences of recovery and 'e
5no' t"at ot"er #eo#le long for t"at: vividness( a##reciation( "a##iness to &e alive again( and free( at least
momentarily( from #ain and com#laint. Bo 'e 5no' t"at is going on. *e 5no' t"at #eo#le devise incredi&ly
com#licated means of trying to ac"ieve t"ose very sim#le moments. T"ey e$#erience moments of goodness
a&out t"eir lives and t"ey "ave every rig"t to long for t"em. Bo 'e "ave to 5no' a lot a&out t"at. *e "ave to
5no' a lot a&out "o' t"ose moments occur( '"at t"e te$ture of t"em are li5e( and "o' t"ey disa##ear. *e
"ave to 5no' somet"ing a&out t"e grotes8ue 'ays t"at some #eo#le try in order to manufacture t"em.
!: "ave some #ro&lems 'it" seeing recovery in t"e 'ay you #ut it. guess &ecause my o'n e$#erience of
recovery( of recovering myself( is more a #rocess of unlayering( more in #rocess terms t"en suddenly feeling
t"at am. Alt"oug" can see t"at #oint of seeing moments of "ealt" and 'a5ing u#( and may&e more in
retros#ect( 5no'ing t"at "ave come t"roug" a layer. Do you 5no' '"at mean>
EP: T"e layer &eing '"at>
!: May&e t"e raising of a veil or somet"ing t"at 'as 5ee#ing me im#risoned &ut not t"e sense ofF
EP: Could you descri&e a moment li5e t"at>
!: can see '"at you meanF"aving some sense of clarity. 4ut 'onder 'it" #eo#le in t"era#y( and am
loo5ing at my o'n #rocess too( and 'onder if it isn6t more of a #rocess t"at ta5es #lace over time( and t"at
sometimes 'e don6t even 5no' 'e are coming out of somet"ing. n retros#ect 'e feel it is not t"ere any
more.
EP: *ell( '"at 'e are trying to do is not necessarily tal5 a&out t"e actual structure of recovery at t"is #oint(
t"e #rocess of recovery( &ut rat"er to earmar5 t"e e$#erience( t"e delig"tfulness of t"at e$#erience( &ecause
it is a moment. t is moment of every e$#erience t"at 'e "ave of recovery. And 'e "ave to 5no' more a&out.
T"at if 'e are selling t"e #rocess of recovery( 'e s"ould 5no' '"at t"e #roduct is. And t"en( 'e mig"t &e
a&le to ma5e a &etter #roduct. *e are trying to get a&ove( lift our "ead a&ove( t"e notion of a &andaid
mentality. *e are trying to get &eyond t"e conce#t of #utting t"ings &ac5 to t"e 'ay t"ey 'ere. *e are trying
to get out of t"e conce#t of "ealt" as a car and a television set and ma5ing it. As if t"ere 'as no more to do.
*e are trying to get &eyond t"e conce#t of t"e 8uic5 turnover model of treatment '"ic" is( 'e found out(
as5ing for trou&le. *e are trying to get out of t"e notion of +ust getting t"e #ain over 'it". 4ecause 'e 5no'
t"at at t"e &ottom of t"at #eo#le 'ant more and t"ey 'ill reconstitute t"eir #ain and t"eir variety of attem#ts
to ac"ieve states of recovery. Bo( it is a matter of trying to learn more and more a&out t"is t"ing 'e call
recovery. *e are not tal5ing a&out remission. *e are not tal5ing a&out maintenance care. *e are tal5ing
a&out '"at #eo#le 'ant to &egin 'it" and in t"eir failing to get it( "o' t"ey fall ill. !eo#le6s illnesses are so
often an attem#t to manufacture( "o'ever fleetingly( t"ese states of recovery or states of e$#eriences of
vividness and intensity and a##reciation &eyond t"emselvesGs#ringtime. t seems to &e on t"e surface of
t"ings and 'e s"ould &e e$#erts at t"at.
!: s it #ro&a&ly a 8uestion of maintaining> For instance( may&e t"ere is no state of enlig"tenment to &e
soug"t( may&e t"ere is a constant see5ing( or constant #rocess( or maintaining of some effort t"at #roduces
recovery in t"e case of illness.
EP: T"at is getting close to t"e notion of recovery itself. f someone felt t"at "e 'as actually( genuinely
'or5ing to'ard t"at( t"en t"e e$#erience of recovery is already ta5ing #lace. *e are not tal5ing a&out t"e
&ig( final 7live-at-ease-ever-after7 notion &ut 'e are tal5ing a&out actually 'or5ing 'it" states of mind( our life(
and our relations"i#s in suc" a 'ay t"at 'e feel t"at recovery is constantly #ossi&le. t does not mean t"at if
one is in a state of c"ronic de#ression( recovery means only t"at it is gone and one "as to feel "a##y. 4ut
rat"er( t"at one is learning a lot( for e$am#le( from de#ression and t"ere are moments '"en de#ression is
vital and t"ere is ric"ness to it and t"en t"ere is contact out of t"at 'it" t"e tenderness of ot"er #eo#le. ,ne
could 'or5 'it" severely de#ressed #eo#le in terms of t"ese #rofound #ossi&ilities of t"eir understanding
tenderness and sadness in ot"er #eo#le( and &ecause of t"at t"ere is a moment &eyond de#ression and
self-#ain. Bo t"e illness itself is ric" and #rovides t"em 'it" a lot of 5no'ledge and insig"t a&out "o' ot"er
#eo#le 'or5 and '"ere one mig"t actually &e useful to ot"er #eo#le. *e are not tal5ing a&out getting rid of
illness. *e are tal5ing a&out actually using it. And t"at is a long #rocess( a continuous #rocess.
H: *"at you said +ust no' a&out not getting rid of illness( t"en you mentioned &efore a&out manufacturing
recovery and t"ose s#ringtime momentsFcan you give some e$am#les of '"at t"at 'ould &e> E!:
Tomorro' 'e 'ill give a long e$am#le. *e are going to #resent a case tomorro' a&out someone '"o tries
to manufacture s#ringtime( moments of 'ell-&eing( '"ic" are actually e$#erienced as &liss. 4ut su##ose
t"e easiest e$am#le 'ould &e someone in a state of mania( e$cited mania. At t"e &eginning 'e see a lot of
energy coming. A little after t"at 'e see t"at s"e is feeling very +oyful and 'e mig"t even notice our sense of
envy of "er +oyfulness. T"en t"e ne$t moment 'e see t"ere is somet"ing forced a&out t"e '"ole t"ing. %ot
only is s"e trying to convince us( s"e is trying to convince "erself t"at everyt"ing is fantastic. T"ere is a
dramaFa forcing it for'ard. At every moment '"ere t"ere is a flagging of t"at energy( s"e "as to #us" it
furt"er. T"en( 'e notice s"e is #laying a c"aracter. Bo t"ere is a sus#icion t"at s"e is manufacturing
somet"ing. B"e "as gotten our attention( and may&e a flas" of our envy( and s"e is going furt"er. t is
&ecoming &uffoonery( t"at s"e "as to 5ee# going( forcing t"e issue.
!: Bo( if it is not forcing t"e issue( manufacturing( forcing itF 'ould li5e you to say more '"at t"is "ealt" is(
or '"at you are tal5ing a&out t"at is not forced.
EP: am saying t"at it is an intrinsic #ossi&ility arising out of self-#reoccu#ation. T"e e$aggerated caricature
of recovering from illness is '"at #eo#le are longing for. T"at is al'ays going on. 4ut in t"e cases of #eo#le
t"at 'e 'or5 for as #rofessionals( t"ey are trying to manufacture moments of recovery( and t"ey are not
doing it 'ell( and it is ma5ing t"em sic5er. t is leading t"em very muc" into side roads and distorted attem#ts
to ac"ieve some 5ind of e$#erience( an en+oyment of t"eir 'orld &eyond t"emselves( t"e As#ringtime@. T"ey
"ave no idea of "o' to do t"ings differently.
!: T"ere seems to &e some'"at of a #arado$ a&out your s#ea5ing of illness as a #reoccu#ation 'it" self.
am t"in5ing a&out &ot" myself and #eo#le( #articularly one #erson am 'or5ing 'it" at t"e moment( '"o is
so muc" more #reoccu#ied 'it" t"e ot"ers t"at s"e can6t t"in5 of "erself as "aving any #o'er or a&ility to do
anyt"ing for "erself( and so 'it"out t"at s"e cannot &e sufficiently occu#ied 'it" "erself to "ave any strengt"
to see "erself as overcoming t"e enemy '"ic" is destroying "erself. Bo a certain amount of #reoccu#ation
'it" self is "ealt"y.
EP: *ell( t"at is &ecause 'e are tal5ing a&out #reoccu#ation 'it" one6s o'n #ain( t"e #ain of one6s self as
&eing a #o'erless #erson: 7 am a #o'erless #erson7 at t"e mercy of family or '"atever. T"at is already a
definition of self.
!: Dou6re tal5ing a&out #reoccu#ation 'it" #ain rat"er t"an #reoccu#ation 'it" one6s o'n self and doing>
EP: ,ne6s self &ecomes #ain. ,ne6s self &ecomes defined &y inade8uacies "ere( inca#acities t"ere( and
&ecomes a '"ole &oundary of #ain. 4ut 'e find t"at '"en #eo#le recover t"ey &ecome more concerned 'it"
ot"er #eo#le6s #ain t"an t"eir o'n. T"ese are t"e most im#ortant moments of recovery. Even in t"e midst of
a c"ronic #syc"iatric 'ard( #atients may come out of t"eir catatonia to attend to someone else. T"ey feel
very good a&out t"at. T"ey feel relief. And t"en fear.
!: ;o' does a t"era#ist "el# someone to do t"at> ;o' to &e less #reoccu#ied 'it" "er o'n #ain in t"e 'ay
t"at you t"in5 and 'or5 as a t"era#ist>
EP: First to 5no' '"at t"is fascination 'it" oneself is( t"e fascination and into$ication 'it" one6s o'n #ain.
;o' one could &e so ca#tured &y t"at. t"in5 one "as to 5no' a lot a&out t"at. t"in5 t"at is a lot of '"at
sitting #ractice of meditation gives us "ints a&out: t"e mec"anics( t"e actual mec"anics of "o' 'e get
"oo5ed on self-#reoccu#ation.
!: su##ose it can 5ee# one from t"in5ing a&out one6s feelingF&eing #reoccu#ied 'it" t"e #ain.
EP: *ell( t"e #ain is +ust one of one6s feelings and "o' to get out of t"at #ain is anot"er. t could &e endless
feelings. T"at 5ind of into$ication is '"at could lead one to &e tra##ed in a self-definition of #ain. *e "ave to
5no' a lot a&out t"at( as muc" as 'e "ave to 5no' a&out moments of recovery( and t"in5 'e 'ill tal5 more
a&out t"at t"roug" t"is 'ee5end.

Talk $2: October 2, 1982
2. A Design for Treatment: ind and !nvironment
,ur discussion of recovery continues 'it" "o' 'e 5no' it( "o' 'e can a##ly it( and "o' ot"er #eo#le can
recover along 'it" us. *e 'ant to tal5 a&out t"e actual a##lication of '"at 'e understand a&out recovery
and '"at 'e e$#erience a&out it.
,ne of t"e a##lications is a treatment #rogram( a #ossi&le model( t"at 'e "ave &een 'or5ing 'it" in 4oulder(
Colorado designed to 'or5 'it" "ig"ly distur&ed #eo#le using some of t"e #rinci#les a&out t"e nature and
e$#erience of recovery. *e "ave said t"at recovery &egins 'it" mind. ;o' 'e relate to mind &ecomes t"e
#ossi&ility of recovery from illness. ,ne could a'a5e from t"e intermina&le self-#reoccu#ation of illness.
,f course( 'e are tal5ing a&out t"e seeds of illness( inci#ient illness= t"e continuous #otentiality of illness(
'"ic" &egins 'it" self-#reoccu#ation. (2ust li5e severe alco"olism &egins 'it" ta5ing a drin5( t"e desire for a
drin5( a social drin5 'it" t"e desire to &e more social. n t"e same 'ay( 'e mean t"at illness &orn from self-
#reoccu#ation( &ecomes a fascination and t"en into$icates one. Recovery is #ossi&le( in terms of 'a5ing u#
out of t"at into$ication( 'it" t"e e$#erience of a moment of vividness. Recovery "as its o'n natural "istory. t
arises and decays( +ust li5e everyt"ing else. 4ut nevert"eless it can &e recogni?ed( and t"e recognition of t"e
s#ace of a'a5ening during moments of recovery ta5es #lace t"roug" relations"i#.
Relations"i#s "ave a #o'er to ac5no'ledge and #ossi&ly enric" suc" moments of recovery. T"at #uts
#syc"ot"era#y in a uni8ue #osition. A relations"i# could &e t"e &ridge for recovery to &ecome a #rocess t"at
is continuously related to. T"at seems to &e our little s#ecialty in t"is culture: #eo#le '"o loo5 carefully at t"e
nature of "uman intimacy and '"o are a&le to a##ly '"at t"ey 5no' a&out recovery in t"e service of ot"er
#eo#le. T"at is all 'e are saying at t"is #oint t"at a #syc"ot"era#ist is.
4eyond t"at 'e find t"at 'e can relate to t"e enormity and intensity of anot"er #erson6s illness and see
'"ere t"e connection can &e made 'it"in t"e com#le$ity of illness to e$#eriences of a'a5ening and
recovery. *it" t"at #rinci#le in mind( 'e 'ould li5e to discuss an actual #erson and t"e #ossi&ility of t"at
#erson6s recovery. T"at #erson is in a treatment situation( '"ic" s#ecifies an environment and relations"i#s(
'"ic" 'e &elieve can &ring a&out and foster recovery.
am sure everyone 5no's( t"at #resenting a case in a s"ort time and in #u&lic( mig"t involve us in endless
#ossi&ilities and com#le$ities of detail( es#ecially '"en it is a&out suc" an interesting #erson. Bo 'e 'ill
"ave to do +ust a 8uic5 s5etc" and not linger too muc" on "istory and origin( &ut +ust '"o t"is #erson is. *e
could ma5e it &rief &ecause '"o "e is( is already t"e total manifestation of '"ere "e came from and "o' "e
got to &e t"at 'ay. *e 'ill call "im AMr. California@( for reasons t"at 'ill &ecome clear.
;e is a t'enty nine year old young man and "e is tra##ed in a delusion. T"e delusion "as endless
intricacies( and if 'e loo5ed at t"e delusion in more and more de#t" 'e 'ould see "o' t"e delusion reveals
and e$#oses t"e ste#-'ise function of "is falling ill. Bo it is necessary to give a summary of t"e delusion
'"ic" "as made "im nonfunctional and needing ot"ers to survive. ;e 'ould &e offended &y my using t"e
term 7delusion7( &ecause t"at ma5es "im sound insane. 4ut "ave no ot"er c"oice for t"e #ur#ose of
communication. f #resented "is dilemma as somet"ing ot"er t"an a delusion( 'ould sound insane. t is a
#rinci#le of t"is 5ind of 'or5 t"at one can &e deluded and sane at t"e same time.
t is a case of #ossession. T"is man is #ossessed &y a 'oman '"o manifests to "im t"roug" t"e 7astral
#lane@. B"e "as &een 'it" "im for almost t"ree years( never leaving "im( al'ays 'atc"ing "im. B"e controls
"is &ody( "is t"oug"t #rocesses( "is energy level( "is communication( and t"e 'ay "e t"in5s a&out t"e 'orld.
;e defines "imself in terms of t"is delusion. Everyt"ing t"at ta5es #lace in "is &ody or in "is relations"i# to
"is mind( "e says is Anot me@. ;e is almost saying( 7 am not-me. am under control. am #ossessed &y "er.
"ave no 'ill-#o'er. cannot e$ert my o'n 'ill@. And interestingly enoug"( t"is #erson under '"ose control
"e is continuously in( "e calls 7*illo'7.
;e gre' u# in California and is a #roduct of a #articularly e$aggerated form of ne'-age s#irituality( '"ic" 'e
sometimes associate 'it" t"e su#ermar5et variety of s#irituality. ;e "as &een involved in every conceiva&le
s#iritual adventure t"at could ta5e #lace on t"e 'est coast. For t"e #ast 13 years or more "e "as &een
com#letely immersed in a variety of #ractices of almost every religious movement or offs"oot. 4ut it is *illo'
t"at "e sees as "is final religious movement. T"e delusion &eing t"at "er #ossession of "im is for t"e sole
#ur#ose of "is &ending "is 'ill to'ards "er( surrendering to'ards t"e demands s"e ma5es on "im in t"e
form of voices( and visual and somatic manifestations. T"ey demand surrender( su&mission. ,ne demand on
"im is to stri# "imself na5ed in t"e middle of t"e street. Bometimes t"e command mig"t come in terms of "is
"urting "imself #"ysically and #er"a#s even 5illing "imself in "er service. AEat( don6t eat@. T"ey are often
contradictory. T"e #ur#ose of all t"at is for "is li&eration( "is freedom from t"e &ondage of "is o'n ego-
ridden 'ill. f "e comes t"roug"( #erforms t"e acts of surrender and su&mission t"at are re8uired of "im( "e
'ill clean t"e slate of "is 'rongdoings and t"e sense of guilt t"at "e "as carried 'it" "im for eons. *"en "e
accom#lis"es suc" a t"ing &y t"e #ro#er #erformance of self-surrender( and actually cleanses "imself in
suc" a 'ay( "e 'ill ac"ieve a sense of #urity and li&eration '"ic" 'ill &e a model and some"o' useful to all
"uman &eings. ;e feels t"is to &e somet"ing of a #ersonal &urden t"at "e carries. n t"is lifetime "e can &e
of enormous service to t"e s#ecies. ;e cannot fat"om '"y "e 'as t"e one c"osen for t"is #resum#tuous
tas5 &ut nevert"eless( "e is t"e one '"o "as &een given t"e o##ortunity and t"e #rivilege to #erform t"ese
actions. f "e fails( a #recious event in "uman "istory 'ill &e lost for all of us.
;is &ig #ro&lem in life is t"at "e 7#rocrastinates7. ,n t"e edge of self-surrender "e "olds &ac5( "e "esitates
and is una&le to follo' t"roug" 'it" t"e actions re8uired of "im. And t"en "e sin5s into de#ression and self-
loat"ing for not "aving used t"is o##ortunity. T"e guilt of ingratitude is added to "is #ro&lems. ;e is a very
lovea&le #erson. ;e is e$tremely gentle( almost e$aggeratedly so. %ot in t"e sense of &eing a non-entity( &ut
in "is firm &elief t"at "e is gentle( &eyond aggression( and cannot do anyt"ing to "urt anot"er &eing. 4ut it is
actually more t"an t"at. Ever since "e 'as a little &oy( #eo#le noticed "o' gentle "e 'as and even as a 3-
year-old c"ild "e 'as careful not to ste# on insects. T"at #rinci#le of not "arming t"ings "as suffused "is
#ersonality &ut at t"e same time it "as &ecome a "indrance to "is #at" of self-surrender &ecause true
su&mission re8uires "im to #erform violent acts. %ot to su&mit is also violent. t "as &ecome "is catc" 22(
"o' to #erform t"is ty#e of su&mission and not &e violent at t"e same time.
*e &egan 'or5ing 'it" "im a&out seven mont"s ago using a &asic reci#e. t is a sim#le reci#e and t"e
essence of t"e '"ole treatment a##roac" "as &een one of sim#licity. t involves a&out a do?en #eo#le
'or5ing 'it" "im. %o' t"at sounds li5e a lot F a do?en #eo#le 'or5ing 'it" one #erson. t sounds almost
un-American( so many 'or5ing 'it" so fe'( rat"er t"an t"e ot"er 'ay around. 4ut nevert"eless( it is not so
time-consuming as it sounds. *e are tal5ing of roug"ly I or 0 "ours a 'ee5 of anyone6s time. And &ecause
of t"at t"e same team can 'or5 'it" several #eo#le at once.
*e &egan "im in t"is treatment #rogram '"ic" consists of( first esta&lis"ing "im in an ordinary "ouse"old
situation: a sim#le one &ut 8uite decent and dignified 'it"out &eing too &rilliant and t"us frig"ten "im. t 'as
essentially a student situation( an a#artment 'it" t'o &edrooms. ;e lives 'it" a roommate '"o is a mem&er
of t"e treatment team also. *e t"in5 of t"e roommate in terms of &eing a 7foster-friend7( a com#anion(
"el#er( and at times( a &asic administrator of t"e needs of t"e #atient.
A sc"edule is esta&lis"ed for t"e #atient( 'it" t"e #atient( t"at involves giving a structure of time( a sense of
orderliness to t"e day. T"at involves everyt"ing from slee#ing( 'a5ing( food( and e$ercise( to t"e structure of
relations"i#s. t is not very rigid &ut it is very clear. And t"e &oundaries of activity are 8uite clear. T"e
#rinci#le &e"ind t"at is t"at t"e &oundaries( t"e demarcations of action during t"e day( &ecome models of
"o' to discriminate t"e &oundaries &et'een delusion and non-delusion( &et'een &eing a'a5e and &eing
aslee#( &et'een &eing in a daydream and relating to reality. *"at demarcate t"at sc"edule most vividly are
t"e relations"i#s: t"e #atient is involved 'it" several #eo#le t"roug"out a single day. T"e grou# t"at 'or5s
'it" "im s#end &loc5s of time 9t"ree "ours eac": 'it" "im( and "e mig"t see #eo#le a minimum of 2 or 3
&loc5s of time eac" day. ,t"er times( "e is 'it" "is roommate or s#ends some time alone. 4ut it amounts to
a great deal of time 'it" ot"er #eo#le. ,n to# of t"at is "is involvement in intensive #syc"ot"era#y 'it" me(
'"ic" is . times a 'ee5. Bo it is 8uite active inter#ersonally.
T"e 8uality of t"ese relations"i#s is somet"ing t"at 'e 'ant to tal5 more a&out later= t"at is( '"at it means to
do t"e 5inds of t"ings 'e do 'it" t"is #atient '"ic" seem to &e some'"at different from '"at one ordinarily
finds and yet it is not so o&vious on t"e surface. ,n t"e surface '"at 'e do are "ouse"old activities: 'e go
s"o##ing 'it" t"e #atient( 'e ta5e "i5es 'it" t"e #atient( 'e sit and tal5 over a lot of coffee 'it" t"e #atient(
go to movies( concerts( &e 'it" "im( ta5e occasional classes 9"e is a musician:( and so on. T"ese are 8uite
ordinary( #ractical t"ings. 4ut '"at ta5es #lace in t"ose relations"i#s is somet"ing very intimate and very
sane. T"e function( for t"e most #art( of t"ese relations"i#s is a sense of introduction( a connection from t"e
'orld of delusion into t"e vivid real 'orld. T"ere is a sense of mediation &et'een t"ose t'o 'orlds( t"e 'orld
of fascination and into$ication 'it" t"e 'orld of vividness and also of sadness( at t"e same time. ;o' one
#rovides t"at sense of introduction and &ridge 'e 'ill descri&e later( &ut 'e call it t"e nature of &eing a
7t"era#ist-friend7( and t"e action is one 7&asic attendance7.
*"at 'e are doing is 'or5ing 'it" t"e #ossi&ilities of &ody and mind &eing tuned toget"er. *e recogni?e t"at
t"e &asis of "is illness is t"e continuous attem#t to un"inge( or desync"roni?e( "is &ody and mind and live
'it"in t"e s#ace and #ossi&ilities of t"at disconnection. t is t"ere t"at "e ela&orates "is delusional 'orld. T"e
more t"at 'e &ring &ody and mind toget"er( t"e more clearly "e sees t"ings( "is environment( relations"i#s(
and 8ualities of "is mind. T"e more clearly "e sees t"ings( t"e more "e &egins to recogni?e some t"ings. ;e
recogni?es t"at t"e voices t"at tal5 to "im are remar5a&ly unrelia&le. T"ey never come t"roug" 'it" t"eir
#romises. *"en "e sees t"at clearly( dou&t arises. T"e dou&t is &asically '"et"er "e is dreaming or a'a5e.
T"en a dou&t a&out everyt"ing "e "as lived t"roug". t is an instant of a'a5ening( of recognition( and
curiosity( and it "as a great deal of #ain in it at t"e same time. ;e "as devoted "imself &ody and soul to "is
#eculiar s#iritual #at" and every moment of dou&t is a moment not only of clarity &ut of intense #ain and
e$cruciating "umiliation. 4ecause of t"at( "is #rogress J or mig"t &e &etter called "is A+ourney@ J in "is
relations"i#s 'it" us is one of continuous oscillation. T"is fact also seems to tell us somet"ing a&out t"e
nature of recovery. T"at is( recovery is "a##ening in &its and #ieces. T"ere is a'a5ening and t"ere is #ain
and t"ere is desire to fall aslee# and dream again. t is an unending cycle and #rogression. Recovery is not a
linear #"enomenon.
*"at 'e "ave seen in t"e #ast I mont"s are #articular #"ases t"at 'e t"in5 are 7#"ases of recovery7. *e
can say t"at &ecause t"e #atient does seem to &e moving( '"ic" for us means t"e s"ifting of allegiance from
a 'orld of intense imagination and deat"( to an allegiance and yearning for t"e intensity of "uman contact=
actual #assionate relations"i#s 'it" t"e #eo#le t"at "e 'or5s 'it". T"at s"ift is "aving conse8uences on t"e
nature of "is delusion and "o' "e is living "is life. *e can identify some #"ases of "o' t"at seems to &e
"a##ening. *e "ave some confidence t"at it is #art of t"e #rocess of recovery from severe delusion &ecause
'e "ave seen e$actly t"e same t"ing "a##en 'it" ot"ers &efore '"o "ave &een in t"e treatment situation
"ave &een descri&ing.
T"e reci#e continues. First( an ordinary "ouse"old situation 'it" a roommate( t"en a sc"edule( and intimacy
and intensity of relations"i#s are esta&lis"ed. 4eyond t"at( t"e grou# itself "as met in grou# su#ervision to
tal5 a&out t"e #atient and our reactions to "im( and to discuss '"ere t"e o&stacles are to t"e #atient6s
recovery suc" as 'e understand t"e #rinci#les of recovery. At a certain #oint( t"e #atient is invited into t"is
grou# and &ecomes a #art of t"e grou# itself. T"at usually "a##ens from 2 to . mont"s into our 'or5 'it"
#eo#le. At t"at #oint( t"e team &ecomes less of a t"ing im#osed on a #atient and "as a lot of t"e
c"aracteristics of an e$tended family. *e &egin to "ave #icnics toget"er. *e &egin to actually "ost t"e
#arents '"en t"ey visit. And '"en t"e #arents do visit and "ave meetings 'it" t"e team( t"ey meet 'it" t"e
team t"at includes t"e #atient. t "as a #eculiar effect on t"e family situation( '"ic" at t"is #oint is not easy to
descri&e. Essentially t"e effect is t"is: '"en t"e family mem&ers enter t"e team environment( t"ey seem to
&egin to a##reciate eac" ot"er more t"an t"ey "ad for a long time. t &ecomes a meeting #lace for a family to
gat"er as if in a family reunion. Alt"oug" on t"e surface t"e meeting is around t"e focal #oint of t"e #atient<s
illness( it actually ta5es #lace on t"e &asis of a sense of en+oyment of t"e #atient<s recovery. Even #eri#"eral
mem&ers of t"e family seem to #arta5e and en+oy eac" ot"er( '"ic" mig"t not "ave "a##ened since
c"ild"ood.
*e see #"ases develo#ing out of t"is 5ind of situation( 'it"in t"is 5ind of environment. *e t"in5 of it as a
Asane environment@. Bane in t"e sense t"at t"e #atient is surrounded &y sane #eo#le( #eo#le '"o are
'or5ing on t"eir o'n intelligence and t"eir o'n #rocess of recovery t"roug" meditation #ractices. 4eing in
t"e midst of suc" #eo#le t"ere is not muc" c"oice: eit"er one goes dee#er into madness to esca#e suc"
t"ings or c"anges one<s allegiance. t is an old story &ut to us in t"is culture it seems ne'. T"e old story is
t"at '"en you #ut an insane #erson toget"er 'it" ot"er insane #eo#le "e gets less "ealt"y. *"en you #ut an
insane #erson toget"er 'it" "ealt"y #eo#le "e &ecomes "ealt"ier. t is a sim#le formula( '"ic" our "os#ital
system "as not 8uite seemed to discover yet.
91: T"e first #"ase seems to &e a 5ind of infectiousness of sanity. T"at means t"at mind and environment
etc" eac" ot"er( &ecause of t"e sim#licity of sc"edule( and of action( and of doing t"ings( and t"e &oundary
&et'een activities. T"en mind 8uiets do'n. T"e #syc"otic confusion and s#eed seems to &e almost
immediately effected &y an atmos#"ere of sim#licity and some 5ind of soft disci#line at t"e same time. First(
some 8uietness a##ears 'it"in t"e delusion itself. *"at seems to "a##en( '"en t"e relations"i#s &egin( is a
5ind of dra'ing of fire from t"e #atient. !assion &egins to develo#. T"e #atient( even in s#ite of "imself(
&egins to li5e t"ese #eo#le and is attracted to t"eir "ealt". As t"is "a##ens( "e &egins to recogni?e moments
of interest and curiosity and &eyond t"at( moments of concern dra' "im out( almost drag "im out of "imself.
92: *"en t"is a##ears( t"e ne$t #"ase seems to &e a cleavage of t"e delusion. Cleavage in t"e sense t"at
as t"e relations"i#s develo# 'it" team mem&ers( t"ey seem to "ave a life of t"eir o'n( inde#endent of t"e
delusion. T"e #atient &egins to discover t"at "e is living a dou&le life and "e "as to maintain a lot of energy
to live( as if in t'o 'orlds at t"e same time. *"at "a##ens so often in ot"er 5inds of treatment environments(
is t"at t"e outer 'orld gets covered &y t"e delusion: AMy doctor is so and so@ in t"e delusion( and t"e nurse
and '"omever &ecome engulfed in t"e delusion. 4ut t"at does not seem to &e t"e case 'it" t"e #eo#le 'e
"ave 'or5ed 'it". *"at seems to "a##en is t"at a dou&le life gets im#osed on t"e #atient.
93: T"e effect of t"at is t"at t"e delusion does not seem to #ro#agate itself. T"e delusion sto#s at a certain
&oundary and it does not invade t"e relations"i#. 4eyond t"at( t"e delusion itself does not gro' muc" furt"er(
even t"oug" it seems to "ave a su&terranean life of its o'n. t is li5e t"e delusion does not "ave muc"
o$ygen.
9.: T"en( from 'it"in t"is s#lit life( t"e islands of "ealt"y relations"i#s t"at develo# 'it" a 'ide variety of
#eo#le( also "ave an inde#endent life. T"ey are relatively free from delusion and &egin to ma5e t"e #atient
very curious a&out "o' t"ese #eo#le live( "o' t"ey 'or5 'it" t"eir o'n lives( "o' t"ey "ave relations"i#s to
#eo#le in t"eir lives. And t"e #atient is not s"ielded from any of t"is. T"e #atient sees as muc" as "e 'ants
to see.
9K: T"ere occurs a 5ind of occasional flic5er( a s"ift of allegiance into 'anting to live t"at 'ay. Eac" desire in
t"at direction leads to t"e #ro&lem mentioned earlier. First( t"ere is an a'a5ening( &eing dra'n to live li5e
anot"er( and t"en fear( guilt and self-aggression. t is a crucial #art of t"e 'or5 itself( to recogni?e t"e '"ole
natural "istory of t"ese moments of recovery and t"e deterioration of recovery. t is necessary to include all
of t"at: to &e a&le to accommodate t"e '"ole cycle of events in our relations"i# 'it" t"e #atient. ,ur desire
for t"e #atient6s "ealt" is recogni?ed to include t"e same cycle of events. 4ecause of our accommodation t"e
#atient can accommodate t"e a'a5ening of "is curiosity and also "is fear of "umiliation.
*"at 'e mean &y a "ealing environment t"en( is not only t"e structure( &ut t"e #otentiality of including all of
t"e events of t"e #atient<s #syc"ology: t"e moments of recovery and t"e moments of illness( as 'ell as t"e
#ossi&ilities of furt"er illness. n t"e same 'ay( 'e include our o'n #rocess of not clinging to t"e #atient<s
moments of recovery( not &eing dra'n into any re'ard system( and not &ecoming discouraged as 'e see
t"e unfolding natural "istory of t"ose moments( '"ic" could lead to #ain and de#ression. All of t"at is #art of
t"is environment( and it is used and related to #recisely. *e &elieve t"at t"is #atient is in t"e #rocess of
recovery( '"ic" "as t"is oscillating and vulnera&le c"aracter.
Discussion
H: 'onder if your commitment to t"is man is to stay 'it" "im as long as "is allegiance flic5ers &ac5 and
fort"( eventually going more and more going recovery. *ill you 'or5 'it" "im around "is c"oice to go &ac5
into t"e delusion( and to stay 'it" t"at and ma5e t"at more com#lete in a 'ay. *"at need to 5no' is if your
commitment is to stay 'it" "im as long as "e is oscillating until "e ma5es t"e c"oice clear>
E!: t is more of a sense of t"e gat"ering and accumulation of t"e flic5erings. ,ne image 'e mig"t use is of
islands of sanity t"at coagulate so t"at "e s#ends longer times in it and less time in delusion. 4ut muc" more
t"an t"at( is "o' "e mig"t learn to come out of t"e delusion. T"at is a furt"er sense of +ourney( &eyond "is
relations"i# to us. T"e sense of commitment is seeing "im t"roug" "is oscillations 5no'ing all t"e time t"at
"is oscillations are our oscillations( and our commitment is to relate to our oscillations of 7,"( "e6s getting
&etter. ,"( "e6s getting 'orse7. t is going on all t"e timeF"o#e and disa##ointment. ;o' do 'e relate to "is
oscillations> T"at seems to &e a large #art of our 'or5( &ot" individually '"en 'e are 'it" "im( and
collectively as a grou#. ,ur commitment is to 'or5 'it" ourselves and to 'or5 'it" "im. *e &egin to learn
more a&out t"e details of t"e #rocess of "o' 'e mig"t come out of t"e delusion or at least sto# it. T"at
means "is learning more a&out '"at t"is issue is of "is 7#rocrastination and "esitation7.
H: s t"ere a sense t"en of "is &ecoming sane in t"e delusion>
E!: E$actly. t is in t"e #"enomenon of #rocrastination t"at 'e find t"e intricacies of little #ractices. T"ere is
not"ing to call t"em &ut Alittle #ractices@( &ecause t"ey are very "eavy( intense disci#lines of giving in(
surrender( not e$erting "is 'ill. T"ere "as develo#ed a tremendous #recision over t"e years in accurately
seeing '"en and '"ere "e could not do t"em( '"en and '"ere "e #rocrastinates( and '"en "e does not.
;e is do'n to micro-moments of mind6s e$istence( '"ic" "as &ecome a very accurate field of o&servation.
T"e #in#oint of accuracy of "is '"ole e$istence is s"ar#ened in "is delusion and so 'e "ave to 'or5 'it"
'"ere "e is most accurate in "is life. T"is seems to &e t"e only #lace '"ere "e is truly accurate. t 'ould &e
nice to +ust s'ee# a'ay t"e delusion &ut 'e cannot. %or can "e. 4ecause t"at is '"ere "is intelligence is
actually manifesting as "is greatest #recision and "is #ride.
H: 6m t"in5ing a&out t"e treatment model and t"e old issue t"at 'e used to call 7secondary gains7 and
'onder if an ideal 'orld is not &eing created for "im t"at 'ill &e lost if "e regains sanity. And 'onder if "e
manifests concerns a&out t"at>
E!: T"e ideal 'orld &eing t"e treatment environment itself>
H: ,f course. t is 'onderful. t is lovely. And 'onder if t"at is &eing &uilt into "is delusion in t"e sense of
feeding t"e #rocrastination.
E!: Bure. T"is is one of t"e reasons '"y "e is #rocrastinating. ;e does not 'ant to leave us. ;e 5no's t"at
if "e "arms "imself in any serious 'ay "e endangers our &eing toget"er. ;e occasionally "e &urns "imself
'it" cigarettes( or s"aves "is "ead in an attem#t to surrender( &ut t"ese t"ings are not 8uite 'or5ing li5e t"ey
are su##osed to. ;e is "esitating at t"e edge of more drastic acts( li5e ta5ing "is clot"es off in t"e middle of
Main Btreet( &ecause first t"e #olice #ic5 "im u#. T"ey ta5e "im to +ail( t"en t"e "os#ital( and at &est "e gets
out in si$ mont"s at 'orst 2 years. ;e 5no's t"e actual facts of "is s#iritual #at". ;e 5no's all of t"at. 4ut "e
does not 'ant to leave us. ;e li5es "is little life. 4ut it "as a lot of irritations at t"e same time. *e ma5e "im
clean u# t"e "ouse 9'e do it 'it" "im: and c"ange "is clot"es. T"ere is a constant interru#tion 'it" "is love
of television. ;e li5es t"e #eo#le and "e does not 'ant to do anyt"ing to "urt us. Bo t"at is #romoting t"e
#rocrastination. *e are a mon5ey 'renc".
%o' t"e ne$t 8uestion 'ould o&viously &e: since 'e t"ro' a mon5ey 'renc" into "is fully entering t"e 'orld
of delusions( 'e may also &e a mon5ey 'renc" to "is entering a more com#le$ 'orld t"at does not involve
so many friends all t"e time. *e "ave actually lived t"roug" t"at 'it" anot"er #atient( t"e 'oman 'e tal5ed
a&out last 2anuary. B"e 'as very concerned a&out losing "er friends as s"e &ecame "ealt"y &ut t"at turned
out to &e 8uite a good t"ing to 'orry a&out( a "ealt"y t"ing to 'orry a&out. *"en any of us &ecome "ealt"ier
and more inde#endent( t"ere is a concern a&out losing #eo#le. ,r t"at t"eir only attraction to us "as &een
&ecause of our need for t"em. T"ere is a lot to learn from t"at. *e did not 5no' '"at 'as going to "a##en(
"o' it 'as going to turn out. As it turned out( s"e "as not lost us. *e see "er socially 'it"out any real
de#endence ta5ing #lace and losing t"e team "as not &een a dramatic event. At some #oint it 'as "er desire
to say( 7Bto#( 'ant to see '"at "a##ens7. *"at s"e 'anted to do 'as not only live more inde#endently and
feel li5e a #erson '"o could actually live and 'or5 'it"out t"e constant com#anions"i# '"ic" s"e "ad for
almost a year( &ut s"e 'anted to 5no' "o' s"e 'ould relate to t"ese #eo#le '"en t"ey 'ere no longer in
"er service. *e also 'anted to see. *e did not 5no'. *ould 'e +ust dro# "er and say s"e6s gone> %o.
nstead t"ere "as &een a continuing contact t"at "as &een very friendly. And 'e see t"at it mig"t never end.
t mig"t go on for a long time...t"e continuing social contact no matter '"ere s"e lives. T"at seems fine.
H: ;o' did t"is man get in treatment 'it" you( find out a&out you and come into t"e #rogram>
E!: T"at seems to "ave &een an accident 'it" &ot" #atients 'e 'or5ed 'it".
H: Did t"e #atient &ring "imself in>
E!: T"at seems to &e so in any case( no matter '"o first discovers Maitri !syc"ological Bervices Lt"e
*ind"orse service in 4oulder( C,( 1/01-1/0IM( '"et"er it &e a family mem&er or t"e #atient "imself( t"e
final common denominator is t"at t"e #atient "as to say ADes( t"at is t"e 'ay 'ant to do itFnot in a
"os#ital( or a "alf-'ay "ouse( or 'it" lots of drugs.@ T"e #atient "as to say( AT"at sounds rig"t.@
H: 6d li5e to 5no' at '"at #oint you discontinue t"e round t"e cloc5 #rogram. Do you gradually #"ase out>
E!: From everyt"ing 'e are saying( it is gradually #"asing out so t"at even a #atient t"at 'e sto##ed
'or5ing 'it" last Marc" is still in some 5ind of contact 'it" us and t"at is going t"roug" certain #"ases. t
means t"at if 'e are tal5ing a&out a sane "ealing relations"i#( it may never end.
H: 4ut do you ma5e a conscious effort to eliminate &loc5s of time t"at #erson s#ends 'it" t"era#ists>
E!: To ma5e it more efficient>
H: %o( +ust to #"ase out t"e contact "e "as 'it" t"e t"era#ist>
E!: *"at are t"e signs> 6m not sure. A lot of it comes from t"e #atients of '"ere t"ey 'ant to "ave more
free time( more time to do t"ings on t"eir o'n. t"in5 t"e edge of it is t"at t"ey 'ant to test t"e reality of t"is
friends"i#( '"et"er it is #aid for or not. t"in5 t"is &ecomes an intriguing #oint of '"ere t"ey 'ant to cut
do'n. 7T"is #erson '"o says s"e is my friend( and acts li5e my friend( and does everyt"ing a friend is
su##osed to do( and ma5es me feel t"at 'ay to'ards t"em: if t"ere is no money involved( '"at is t"at going
to &e li5e>7 t"in5 t"ey are intrigued 'it" t"e #ossi&ility of testing t"at out. And t"en t"ey 'ant to "ave some
room and see '"at is going to "a##en.
H: Could you say somet"ing more a&out "o' t"e staff 'or5s 'it" t"eir o'n oscillations of "o#e and
disa##ointment. ;o' does t"at relate to t"e #atient doing t"e same t"ing. 'onder if it involves( if not
common disci#line( at least #arallel disci#lines. can see "o' t"e staff 'ould &e 'or5ing 'it" e$#erience in
meditation and 5no'ledge of t"e nature of mind oscillations in general. ;o' 'ould t"e #atient find a 'ay of
'or5ing 'it" "is o'n oscillations and '"at t"e connections 'ould &e>
E!: Meditation #ractice alone is not 8uite enoug" to 'or5 'it" t"e clinging to t"e "o#es and disa##ointments
of anot"er #erson6s "ealt"( a&out anot"er #erson6s recovery. t seems t"at meditation e$#erience "as to &e
turned on &y relations"i#s( "as to &e furt"er enric"ed or cataly?ed &y t"e intensity of relations"i#. T"at is one
of t"e reasons 'e &ring t"e #atient into t"e grou#( into t"e e$tended family situation( so t"at 'e can tal5
e$actly a&out t"is: t"at 'e are 'or5ing 'it" our o'n disa##ointments and our o'n tendency to re'ard "ealt"
in an attem#t to sta&ili?e it and solidify it. *e o#enly discuss t"at: "o' to not get caug"t u# in eac" ot"er6s
moods( "o' our "ealt" and our functioning is not de#endent on our moods. T"e #atient actually 'atc"es us
#rocessing t"is and #er"a#s is internali?ing t"at( &ut no&ody 5no's '"at t"at means. At least( t"ere is a
model of "o' it could &e done in an inter#ersonal conte$t t"at "e actually 'itnesses. t is in front of "is eyes(
of "o' 'e relate to "im and relate to ot"er team mem&ers and "o' 'e relate to our c"ildren. ;e sees us in
'ide variety of life circumstances. ;e goes to dinner 'it" team mem&ers. ;e &a&y-sits. ;e sees us in not
+ust a #rofessional( #ro#erly disci#lined role in an office. ;e sees us on t"e line( on t"e s#ot( all t"e time. Bo(
"o#efully t"e saner 'e are t"e &etter t"e model is.
H: t sounds li5e a mutual commitment for 'or5ing 'it" ot"ers. Dou descri&ed t"is seminar in t"e &roc"ure as
'or5ing 'it" Ma"ayana vision and it seems t"e #atient could &ecome infected in a sense 'it" t"is 'ay of
going &eyond t"e continual momentary o&stacles t"at seem to come u#( to'ards dedication to someone else
and longing to not undermine t"at.
E!: t goes &ot" 'ays. Even in t"e crudest sense of our 'or5ing 'it" #eo#le as #rofessionals -- '"ic" ta5es
a lot of unlearning( a lot of recovery to do t"at -- 'e are de#ending on "im. ;e is t"e cutting edge for us to &e
a&le to #ractice. ,ur recovery and our develo#ment as "ealers are totally loc5ed into our relations"i# 'it"
"im. Bo it is interde#endent recovery.
H: 6m 'ondering a&out your intensive #syc"ot"era#y 'it" "im and "o' it fits in. Moments of recovery are
fleeting and it seems t"at #art of '"at any recovery #rocess 'ould involve 'ould &e lessening t"e contrast or
t"e distance 'it" '"at "e identifies as "is e$#erience and t"e moments of recovery "e 'is"es for. Do you try
and decrease t"at 5ind of contrast and '"et"er t"at "a##ens> T"at is traditionally '"at "a##ens in a
transference relations"i# 'it" an analyst li5e your self.
E!: 6ll attem#t to discuss some of t"at later in a tal5 a&out t"e more intimate 8ualities of relations"i#. 4ut as
you said( "is idea of recovery is 7li&eration7 and 7enlig"tenment7( '"ic" means "is conce#t of t"at. ,ur idea
of recovery is t"at "e mig"t &egin to reevaluate '"at li&eration is and '"at "is life mig"t &e li5e. t is true. *e
are at odds a&out t"at. *e "ave gone t"roug" some 8uite intense e#isodes a&out t"at. *e don6t understand
"im and certainly 'e can6t understand "im( not "aving "is uni8ue and s#ectacular &odily and #erce#tual
e$#eriences. %evert"eless( 'e seem to come to some 5ind of reconciliation( t"at "e "as "is #at" and 'e
"ave our #at" and t"ey are &ot" 8uite valid. ;e 5no's all a&out our meditation #ractice. ,ccasionally "is
roommate does a retreat and comes &ac5. ;e 5no's all a&out t"at. And "e "as met teac"ers of t"e )agyu
lineage..."e "as &een 8uite fortunate to "ave done t"at actually. 4ut 'e "ave lived t"roug" a mutual res#ect
for t"e essence of t"e s#irituality t"at seems to &e involved. T"at is( to transcend ego.
,ne mig"t say( A;o' can you res#ect suc" a 'eirdo system as "is>@ *ell( '"at 'e are res#ecting is "is
desire to free "imself from t"e &ondage of ego( '"ic" is e$cruciatingly #ainful to "im. n some 'ays it is more
#ainful to "im t"an to a lot of us more ordinary fol5. ;e "as a recognition of constriction( of t"e #ainfulness of
ego( and "e is doing &attle 'it" it even unto deat". *illiam 2ames tal5ed a&out suc" #eo#le and said t"at
&asically t"e reason '"y t"ey go so "eadlong( maniacally involved 'it" suc" s#iritual #at"s( is t"at t"ey felt
t"e #ain of ego more t"an most of us do. *e could say t"at a&out "im. *e6ve seen t"ings li5e t"at a&out "im
and 'e res#ect t"at. *e 5no' t"at from time immemorial #eo#le "ave tried to deal 'it" t"eir lives and
attem#ted to transcend t"e limitations of conditioned #ersonality &y t"ro'ing t"emselves into a do-or-die
s#iritual #at". t must &ring t"em to t"e edge of insanity. t is an old story. *e "ave tal5ed a&out t"at 'it"
"im. ;e is one of t"ose #eo#le '"o mig"t cross into total lunacy or "e mig"t "ave some 5ind of s#iritual
develo#ment. 4ut if "e does it totally on "is o'n 'it"out guidance or com#anions"i#( t"en most li5ely "e 'ill
go cra?y and "e seems to understand t"at. Bo( it is a 5ind of mutual res#ect. T"at is '"at allo'ed us to #ut
an end to t"e 'arfare of '"ose 'ay 'as &etter( or '"o 'as doing t"e rig"t t"ing( and '"o 'as doing t"e
'rong t"ing( or '"o understood and '"o did not.
H. Could you say more a&out "is family> 'as struc5 &y t"e fact t"at of t"e #ositive #rocesses t"at came
a&out t"roug" t"e most dysfunctional family mem&er in "is contact 'it" #eo#le so different as com#ared to
'"at usually "a##ens.
E!: Family 'or5F#eo#le "ave tal5ed for a long time a&out t"e family involvement( es#ecially in #syc"osis(
and t"e sense of 7sacrifice7. T"at is( #atients #resent t"emselves as a ritual sacrifice to a family t"at seems
a&solutely cri##led to t"e #atient. t is said t"at in t"is 'ay t"e #atient6s distorted and sometimes grotes8ue
'ays are attem#ts to "eal t"e family. t"in5 you could say t"ere is a touc" of t"at "ere &ut for t"e most #art it
is not a very distur&ed family. T"ey "ave al'ays loved t"is &oy and "is gentleness( in s#ite of t"e fact t"at
t"ey could not understand it. ;is fat"er is diametrically o##osed to "im( or to #ut it t"e ot"er 'ay around( "e
is diametrically o##osed to "is fat"er in terms of tem#erament. For e$am#le( t"is &oy( '"o 'ould not ste# on
an ant at t"e age of t"ree( "as a fat"er '"o is a mountain of a man and a c"am#ion arm-'restler. t is an
interesting +u$ta#osition. T"ey are actually 8uite friendly. T"e fat"er loves t"is &oy dearly even t"oug" "e
al'ays 'anted "im to &e more aggressive( and t"e &oy recogni?es t"e very soft 8uality of "is fat"er at t"e
same time. 4ut occasionally t"ere are struggles a&out '"o is rig"t. t is "ard to fit it into any neat category.
T"e family continues to visit more and t"ey en+oy &eing around t"e team mem&ers.
,ur general attitude to t"e family can &e descri&ed &y t"e e$am#le of our relations"i# to "is sister( '"om 'e
"ave never met. T"e #atient6s younger sister is distur&ed &y '"at "a##ened to "er &rot"er. T"ey "ad &een
very close until t"e time "e 'ent furt"er and furt"er into esoteric s#irituality( '"en s"e lost contact 'it" "im.
*"en "e entered a 'orld of delusion s"e felt angry at "im and 'as frig"tened &y contact 'it" "im. Bo 'e
"ave invited "er to visit. ,ur attitude is t"at 'e advise t"e #arents t"at s"e s"ould come "ere and ma5e
friends 'it" "im. ;e is not so difficult to &e 'it" and 'e can "el# "er do t"is. For "er &enefit( "e could
actually &e 8uite sane for a #eriod of time. t 'ould &e very im#ortant for "er to e$#erience t"at and im#ortant
for "im to &e a&le to do t"at for "er. Bo fundamentally( our attitude to a family is t"e same as in any ot"er
"ealing environment: to #rovide o##ortunities for com#assionate action to ta5e #lace.
H: Do you t"in5 t"e staff 'ill feel successful if t"e #atient does c"oose to &e insane>
E!: !ro&a&ly not. ,ur 'or5 'it" "im could &e descri&ed as ma5ing "im more conscious or a'are and
#recise a&out '"at t"at c"oice is= to go furt"er into "is imagination or come out of it( to ma5e "im more
res#onsi&le for t"at c"oice. 4ut t"at means t"at not ma5ing a c"oice is actually #art of t"e #rocess. T"e more
"e is a'are of t"e minute details of t"e #syc"ological #"enomena of ma5ing suc" a c"oice( t"e less li5ely "e
is to ma5e it. ;e &ecomes stuc5 of t"e edge of dou&t.
6ve 'ondered '"at it 'ould &e li5e if one of our #atients committed suicide. *e are 'or5ing 'it" distur&ed
#eo#le and sometimes t"ey 'a5e u#( loo5 around( and see '"at t"ey "ave done 'it" t"eir lives. t is a
#oignant time. t could lead to 'ild des#air. *ill t"e grou# com#letely colla#se or 'ill it 5ee# on going>
H: Actually your ans'er reveals an assum#tion in &eing t"era#eutic: t"at "el#ing t"is #atient to &e more
a'are of "is o'n situation is t"e forecast t"at "e 'ill ma5e t"e c"oice to &e sane.
E!: T"at is t"e assum#tion. T"e assum#tion is t"at t"e +oyfulness of ordinary life 'ill &e more attractive to
"im t"an t"e torment( &liss( and "ell of "is imagination. Do you t"in5 t"at is a good assum#tion>
H: t"in5 so> E!: *ell( sometimes 'e 'onder( &ecause #syc"otic ecstasy and sense of #o'er is never
forgotten. T"ere is no 'ay it is ever +ust #ut aside. Even t"ose '"o recover most vigorously never forget( are
"aunted &y t"e #ossi&ility of t"at 5ind of &liss. t is a constant magnetic dra' and t"e c"oice "as to &e made
over and over and over again. t is t"e issue of continuing effort &eyond "esitation.

Talk $ %: October %, 1982
". #ntensive Psychotherapy: #ntimacy and !$change
t "as al'ays &een o&vious to us t"at some 5ind of training is re8uired to actually #ut t"is treatment #rogram
into effect and 'or5 'it"in it. 4ecause 'it"out t"at( t"e su##osed sim#licity &ecomes enormously
com#licated. ,ne time '"en 'e 'ere descri&ing t"is situation to ot"er "ealt" #rofessionals t"ey said( A*e
could do t"at. t sounds li5e t"e rig"t 'ay to do t"ings.@ 4ut t"ey could not ma5e t"e-first ste# in t"at
direction.
At some #oint( 'e mig"t &egin to sound +ust li5e t"e #atient t"at 'e "ave &een discussing. ;e said one time(
A don6t understand '"y can6t +ust do t"is t"ing and get it over 'it". *"y 6m "esitating>@ ;e said( A 5no'
e$actly '"at "ave to do and it ma5es #erfect common sense to me. s"ould +ust do it and get it over 'it"
and start living my life.@ T"ere are some t"ings t"at are so straig"tfor'ard and commonsensical t"at are
arduous to do. n fact( sim#licity is given &irt" to from a great deal of training. T"at is '"at 'e 'ant to tal5
a&out no'. T"e #atient is confronted 'it" a mirror image of "imself. Everyt"ing 'e "ave descri&ed as "is
7#at"ology7( or "is distortion of "is 'orld( and "is attem#t to ma5e some sense of it( are actually t"e same
5ind of issues t"at 'e as a team are involved in and it is sometimes 8uite "umorous. *"at "e is involved
'it" are acts of self-surrender and attem#ts to transcend a constricted #ersonal sense of self( '"ic" is +ust
'"at everyone 'or5ing 'it" "im is trying to do in t"eir o'n lives as 'ell. t is a #eculiar #arado$. And
alt"oug" t"is #articular case #uts t"is #arado$ in e$aggerated form( t"in5 'e need to as5 if t"is is not
al'ays going on to some degree or anot"er 'it" everyone '"om 'e 'or5 'it".
*"at 'e "ave o&served so far in 'or5ing 'it" #eo#le from t"is #oint of vie' of #ractice -- our #ersonal
#ractice and our attem#t to mine t"e intelligence of ot"er #eo#le6s #ractices -- is t"at t"e #rimary as#ect of
t"e ot"er6s develo#ment is t"e same as our o'n. T"at is t"e a'a5ening( unfree?ing( or unloc5ing of
com#assionate im#ulses. t "as &een difficult at times to tal5 a&out 'or5ing 'it" distur&ed #eo#le in terms of
t"eir com#assionate im#ulses. Bometimes #eo#le say( A "ave never seen suc" a t"ing. 6ve never seen a
#syc"otic #erson &e involved 'it" anyt"ing &ut "is o'n misera&le self.@ 4ut '"en 'e 'or5 intimately 'it"
"ig"ly distur&ed #eo#le( 'e see t"em d'elling on t"e edge of t"e &loc5ages and "o#es to &e more
com#assionate. n fact( every'"ere 'e loo5 among t"e #syc"o#at"ologies of eit"er #syc"osis or neurosis(
'e find t"e origin of distur&ance to &e t"e varieties of in"i&ition of im#ulses to &e com#assionate and useful
to ot"er #eo#le.
f and '"en 'e recogni?e t"e origin of illness to &e suc" a state of affairs( it means t"at 'e "ave to &ecome
some'"at e$#ert and accurate in discriminating t"ose im#ulses in ot"ers J '"at t"e o&stacles are and "o'
'e mig"t "el# t"em overcome suc" o&stacles. 4ut &efore t"at can "a##en( 'e "ave to 5no' all t"e
c"aracteristic and landmar5s of inci#ient com#assionate im#ulses in ourselves. t is t"e same formula t"at
'e "ave used t"roug"out( t"at 'e cannot recogni?e anyt"ing in anot"er #erson until 'e "ave e$#erienced
t"at and 5no' it t"oroug"ly in terms of its origin( its maintenance( and its natural "istory in our o'n life.
T"is 5ind of sim#listic 'or5 t"at 'e "ave &een descri&ing re8uires more t"an mindfulness disci#lines in order
to ma5e t"e recognition t"at t"e recovery of "ealt" is an ongoing( continuous( fleeting moment t"at is
#ossi&le for us to &e a'are of and ac5no'ledge in our &ody and mind. *e "ave to go furt"er t"an t"at. t is
t"e issue of surrender. ;ere 'e mig"t &egin to sound e$actly li5e Mr. California( in saying t"at t"e com#lete
t"era#eutic environment re8uires #ersonal disci#line of self-surrender. f 'e descri&ed t"is to Mr. California
"e mig"t understand to some degree &ut t"in5 'e 'ere off t"e trac5. ;e mig"t t"in5 'e 'ere mista5en in
s#ite of t"e fact "e does not see anyt"ing 'rong 'it" "is o'n #ersonal disci#line of su&mission( self-
surrender and devotion to a 'oman '"o lives on t"e astral #lane. ;e mig"t t"in5 'e are deluded in training
ourselves to surrender to anot"er #erson6s #ain. %ot "is autocratic '"im( &ut "is #ain. For us( it is t"e furt"er
develo#ment in contem#lative #syc"ot"era#y( t"e ne$t ste# &eyond a meditation disci#line( its fullest
develo#ment. t "as &een said to &e t"e com#letion of t"e meditation disci#line. *ell( 'e are not necessarily
going for &ro5e li5e Mr. California is &ecause 'e find t"at doing t"e #rocess itself is already 8uite useful.
Actually attem#ting t"e #rocess "as conse8uences t"at are valua&le and "el#ful to ot"er #eo#le. *e are
some'"at less am&itious t"an t"e #atient &ut 'e are &asically going in t"e same direction. ;e says t"e #at"
to enlig"tenment is total su&mission and 'e are saying somet"ing similar to t"at. *e are saying t"at ot"er
#eo#le are more im#ortant t"an ourselves. ;e is saying t"at s"e( *illo'( t"e 8ueen of t"e gala$y( t"e mover
of stars( and t"e controller of all "uman &eings is t"e one to &e su&mitted to and #rostrated to. ;is
#rostrations to "er cause us endless an$iety '"en 'e go for a 'al5 and "e suddenly starts #rostrating. 4ut at
t"e same time( t"ere is a slig"t a##reciation for '"at "e is involved in( a #erverted attem#t at recovery( of
going &eyond "is sense of self '"ic" "as gotten to &e so "ateful. *e are saying t"at in order to 'or5 'it"
"im and #eo#le li5e "im( and #er"a#s everyone( t"at somet"ing of t"is a##reciation "as to "a##en. *e as
#rofessional #syc"ot"era#ists "ave to &e in some 5ind of #rocess of surrender. *"en 'e 'or5 'it" #eo#le6s
#ain( t"eir #ain is our ma+or connection. T"ey are in #ain and t"ey some"o' 'ind u# in front of us( in t"e
same room 'it" us. 4ecause of t"eir #ain( 'e "ave an o##ortunity to 'or5 'it" t"em( an o##ortunity at t"e
same time( to 'or5 'it" our o'n lives.
*e mig"t feel uneasy a&out t"e notion of #syc"ot"era#eutic 'or5 &eing inse#ara&le from develo#ing
ourselves &ut it "as al'ays &een said in t"e 4udd"ist tradition t"at 'or5ing 'it" #eo#le in e$treme states of
mind is 8uic5 #at". t means ris5ing our sanity. !utting ourselves on t"at 5ind of edge is also t"e #ossi&ility of
s"ar#ening t"e edge of our o'n meditation #ractice. t is t"e edge of &eing s"oc5 a&sor&ers for ot"er
#eo#le6s #ain. T"at is considered to &e 8uite an ela&orate and intense form of meditation #ractice in every
4udd"ist disci#line. t is e$actly t"at 5ind of #ractice t"at is re8uired of us in order to #ut into effect t"e very
sim#le formula and reci#e t"at 'e descri&ed J t"e surrender of #ersonal territory.
*"enever 'e tal5 a&out t"is model or design for treatment( '"at stri5es #eo#le a&out it is t"e sense of
generosity. T"e #eo#le on t"e treatment team are o#ening u# t"emselves to suc" a degree: t"eir "ome lives(
"o' t"ey live( dissolving t"e &arriers of #rofessionalism. t ta5es courage to do t"at. t seems sim#le &ut is
actually 8uite "ard to do. t is "ard to do( not only &ecause of t"e mec"anics of t"e '"ole t"ing( &ut 'e ris5
&eing called names for doing t"at( li5e Afostering de#endence@ or A&rea5ing do'n t"e &oundaries@ of '"o you
are and '"o t"ey are. Bo( t"e generosity t"at 'e tal5ing a&out is also t"e courage to 'or5 'it" #eo#le and
e$#ose ourselves( our lives( our #ractice( and "o' 'e relate to #eo#le not +ust in t"e confines of an intervie'
room. T"at is t"e #art of t"is #ractice of 7e$c"anging ourselves for ot"ers7. T"at is t"e tec"nical name( '"ic"
many of you "ave "eard. 4ut t"en t"ere are all 5inds of 'ays of #racticing t"at. T"ere is actually a formal
re"earsal to do suc" a t"ing. Certainly. am not going to try to give t"e formal instruction of t"at #ractice
tonig"t( e$ce#t &y coming in t"e side door( t"e side door &eing #syc"ot"era#y.
n any case 'e are already doing suc" a t"ing. To t"e e$tent t"at 'e do not ac5no'ledge t"at 'e are doing
it( 'e are in trou&le. To t"e e$tent t"at 'e don6t ac5no'ledge t"at '"en a "ig"ly distur&ed #erson 9or anyone
for t"at matter: 'al5s into our environment 'e are not at t"at moment as "ig"ly distur&ed as t"ey( 'e are in
trou&le. And '"en 'e are in trou&le( 'e #roduce trou&le. All t"e 'or5 t"at "ave &een descri&ing 'it" Mr.
California is t"e #ossi&ility of ac5no'ledging e$c"ange( '"ic" &ecomes t"e ground-&ase of relations"i#. n
fact 'e live #rimordially at t"e level of e$c"ange 'it" ot"er #eo#le and 'it" our environment in general. *e
do not recogni?e t"at most of t"e time( and t"e #ractice of e$c"ange is to 5no' more a&out t"at and to go
furt"er to'ards it 'it"out #rocrastination and "esitation.
A crude e$am#le of t"e &asic e$c"ange is '"en you go to a movie on auto racing and t"e film is vie'ed from
t"e #oint of vie' of t"e driver6s seat and t"e #icture is s#eeding around curves. *"en you stay 'it" t"e driver
and e$#erience "is life t"at 'ay you notice t"at everyone else in t"e movie t"eatre is also going &ac5 and
fort" 'it" eac" curve. *ell( 'e are doing it all t"e time( es#ecially '"en 'e are in intimate contact 'it"
anot"er #erson '"o is in #ain and in more or less silent a##eal to us. T"e #ossi&ilities of e$c"ange 'it"in t"e
#syc"ot"era#y environment are e$tremely intense. To deny or ignore t"at( to try to #reserve oneself in t"e
face of t"at( is dangerous. Mostly it is dangerous to oneself. 4ecause if one does t"at long enoug" t"e ot"er
#erson +ust disa##ears and says( A didn6t get along 'it" "er. Didn6t 'or5. Didn6t clic5Fcouldn6t tal5 to "er( so
6ll find anot"er t"era#ist.@ ,r it mig"t lead to '"at is called a 7negative t"era#eutic reaction7 '"ere t"e
#atient struggles to ma5e "imself felt( to &rea5 t"roug" t"e t"era#ist6s #rotective armor( and "e 'ill do so in
"is c"aracteristic 'ay. 4ut it "urts us. t "urts our develo#ment not to ac5no'ledge t"at t"e &asis of "uman
intimacy is t"is e$c"ange. T"e #ossi&ilities of furt"er ac5no'ledging it and actually using it "ave to do 'it"
t"is formal #ractice of a&sor&ing anot"er #erson6s 'retc"edness and recoiling from t"at 'it" some 5ind of
gentleness. T"at is '"at 'e meant in #revious tal5s &y t"e e$#ression: T"e dar5ening of t"e lig"t in+ures "im
in t"e left t"ig". ;e gives aid 'it" t"e strengt" of a "orse. Eood Fortune. t is a matter of ta5ing t"e #ain and
coming &ac5 out 'it"out &lame or aggression. T"at is strengt". T"at is t"e same as '"at 'e "ave &een
tal5ing a&out in regard to t"e treatment service( '"ic" 'e are #resenting as #ossi&le model. t must &e
#ossi&le for #eo#le to e$tract #rinci#les from( t"e foremost &eing nonaggression. t turns out t"at 'e could
actually s'allo' aggression( eat it u#( and come out 'it" &its and #ieces of somet"ing t"at is useful to
nurture ot"er #eo#le. t seems t"at in t"e #ast it "as &een #ossi&le to tal5 directly to #syc"ot"era#ists a&out
t"e #ossi&ility of e$c"ange 'it"out necessarily tal5ing a&out t"e formal #ractice &ecause t"ey are doing it all
t"e time.
T"e essence of intensive #syc"ot"era#y from t"e vie'#oint of contem#lative #syc"ot"era#y is t"is situation
of e$c"ange. t mig"t seem a little &it &aro8ue( a little too muc"( to tell #eo#le '"o feel over&urdened(
over'or5ed( seeing #atient after #atient( 'or5ing 'it" difficulty after difficulty( in variety of agencies( to go
furt"er into ot"er #eo#le6s #ain. T"ey are already on t"e verge of '"at conventionally is called 7&urn-out7 and
'e 5no' "ealt" #rofession #eo#le "ave a "ig" rate of suicide( alco"olism( and on and on. t seems
#arado$ical to say( t"at t"e essence of #syc"ot"era#y is ta5ing more #ain on( s'allo'ing furt"er( and t"at is
actually t"e 'ay to &e more useful to #eo#le and "ave less &urn-out. %evert"eless( des#ite t"e #arado$ical
logic of suc" a situation( it seems to &e true. T"e more 'e are a&le to do t"at( t"e more 'e are a&le to do.
T"e more 'e are a&le to do( t"e less &urn-out t"ere is. 4urn-out comes from t"e suffocation and t"e feeling
of &eing &om&arded( t"en feeling slig"tly #aranoid( and t"en "aving to get out of t"at situation. *"at 'e are
recommending in 'or5ing 'it" #otential &urn-out( is to go furt"er into t"e ot"er #erson6s #ain and to use t"at
very sense of suffocation as t"e im#ulse to come out 'it" 8ualities of 'a5efulness: t"e &asic out-&reat" t"at
'e "ave &een doing.
t is a 'eird logic( '"en 'e loo5 at it from one #oint of vie'. f 'e actually said somet"ing li5e t"at to #eo#le
rig"t off t"e street( t"ey mig"t "ave loo5ed at us li5e 'e mig"t "ave loo5ed at Mr. California '"en "e told us
a&out 7"er7. ;e cannot #rocrastinate( "esitate in surrendering "imself to "er. ,nce again( t"e #atient is
confronted 'it" #eo#le '"o are trying to do +ust '"at "e is( transcend some as#ect of ego( of going &eyond
t"eir o'n limited( constricted sense of territory. ;e is confronted 'it" a lot of #eo#le '"o understand e$actly
'"at "e means and are doing it in 8uite a different 'ay. Bometimes t"ey are very disci#lined a&out it and "e
is envious of t"at. Bometimes "is envy leads "im to accelerate "is o'n #ractices: #rostrating on t"e
side'al5( s"aving "is "ead( eating dirt( ot"er t"ings. t is an interesting edge for "im to e$#erience. ;is #at"
of recovery is e$actly t"e same as our o'n. T"e more 'e understand a&out our o'n #ossi&ility and +ourney
of recovery( t"e more 'e could &e useful unloc5ing side roads t"at "e "as ta5en on "is o'n.
Discussion
H: t 'ould "el# me if you 'ould e$#lain '"at Mr. California6s mista5e is as you understand it or as you see
it>
E!: T"at6s #art of t"e trou&le 'e "ave in tal5ing to "im. ;e 5no's '"at 'e are doing more or less and "e
says( A*ell( '"at do you do t"at is so different t"an '"at do> Dou use e$actly t"e same 'ords as do.@
H: *ell( t"ey are not e$actly t"e same are t"ey> "ave my o'n idea of '"at "is mista5e is: t"at '"at "e is
#rostrating "imself to'ard is anot"er ego( anot"er invention of a single 'ill some"o'( and it is anot"er
#erson to "im.
E!: t is a cosmic #erson. mean( it is a real #erson '"o lives( 'e t"in5. 4ut s"e also e$ists in "er ma+estic
form in an astral state of &eing and t"ere&y "as access to all of our consciousnesses e$ce#t "is is more
o#en to receive and recogni?e "er.
H: ;ave you met "er>
E!: Bometimes feel "ave. Llaug"terM remem&er distinctly one time '"en felt totally gave in to "er
reality. t"in5 it "ad somet"ing to do 'it" '"at 'e tal5ed a&out t"is morning. *"en 'e 'ent t"roug" a #eriod
of struggle. *"en "e 'as trying to convince me of "er reality and "e +ustifia&ly felt t"at 'as trying to
convince "im of "er unreality and 'e got into a "ead to "ead struggle a&out t"at. *e &ot" gave u#. T"en
'"en felt t"at &ecause "is &odily e$#eriences 'ere so #o'erful( so sensi&le a delusion( t"at t"ere 'as no
'ay in t"e 'orld t"at anot"er "uman &eing could say t"at it is not true. Mig"t as 'ell say it is real. T"en '"en
you actually try t"at on a &it -- mig"t as 'ell -- and soon enoug" you are acting and you are tal5ing as if s"e
'ere real. Buddenly( communication is a&solutely fluid and t"ere is no o&struction and it feels a little cra?y.
H: *ell( s"e is real. Rig"t>
E!: Des. Dou6re getting it too> Llaug"terM
H: Can you say anyt"ing a&out t"at( '"at "is mista5e is( '"at t"e difference is as far as you "ave gotten 'it"
it> E!: T"ere are a lot of 'ays of tal5ing a&out "is mista5e. ;e feels "is only mista5e is "is "esitation at not
going 'it" "is &elief( "is understanding( and 'it" "is instruction. 4ut 'e "ave already come to a##reciate t"at
"e is on a uni8ue #at"( a strange s#iritual #at". ;e 5no's t"at #eo#le "ave &een off on lonely s#iritual tri#s
t"at "ave &een similarly 8uite uni8ue. *e "ave agreed t"at doing suc" a t"ing 'it"out a teac"er is e$tremely
dangerous and t"at #eo#le "ave often follo'ed t"em t"roug" to t"e #oint '"ere t"ey &ring t"emselves to t"e
verge of insanity. t is instructive to loo5 at some of t"ose #"enomena. T"ey include desert fat"ers( t"ose
'"o live in t"e desert and did ascetic #ractices. T"ey include a num&er of Bufis for e$am#le. ,r t"e 7masts7
in ndia( t"at Me"er 4a&a 'or5ed 'it" for many years. T"ey include a '"ole almost res#ecta&le tradition of
#eo#le '"o #ut t"emselves on t"e verge of lunacy in order to e$#erience attainment. Bo '"at is t"e
difference> ,ne t"ing t"at "as &een #ointed out to "im is t"at "e is lac5ing in any +oyfulness as com#ared to
t"ose #eo#le '"o "ave &een on uni8ue s#iritual adventures( at least t"e ones '"o made it 'ere not li5e "im.
*"en t"ey came out of it( li5e Bt. 2o"n of t"e Cross( t"ey 'ere tal5ing flo'ers and stars and &eautiful t"ings.
T"ey 'ere tal5ing a&out "el#ing #eo#le and devoting t"emselves to t"e service of ot"er #eo#le. And "e "as
not done t"at. Bo 'e remind "im of t"e edges '"ere "e mig"t get lost in a cul-de-sac of s#irituality( '"ic" is
often t"e function of meditation instructors. t could &e ordinary: A 'ant to go on retreat. must go on retreat.@
T"e 8uestion mig"t &e( '"y at t"at #oint in one6s life to go on retreat> T"at retreat could &ecome a cul-de-
sac in one6s #ractice or it could &ecome a furt"er develo#ment. Bo 'e "ave to "ave some 5ind of confidence
t"at 'e could recogni?e a s#iritual #at"( or at least t"e &asic c"aracteristics of it t"at ma5e sense and ot"ers
t"at don6t. And 'e "ave to remind "im of t"ose.
H: *"en you are tal5ing a&out self-#reservation in t"e face of anot"er6s #ain( t"e t"era#ist going dee#er into
anot"er #erson6s #ain. 'as t"in5ing of an analogy to a lifesaver. *"en someone is dro'ning( t"e idea is not
to dro'n 'it" t"e dro'ning #erson and t"ere are 'ays t"at t"e lifesaver ma5es t"e +udgment. Could you tal5
a&out "o' t"e t"era#ist can ma5e t"e +udgment of "o' far a t"era#ist can go into anot"er #erson6s #ain
&efore s"e is going to get lost in it "erself.
E!: *ell( '"at is t"e first t"ing you 'ould do in lifesaving>
H: A 8uic5 assessment of t"e situation( '"ic" is largely intuitive. T"en( t"ere are releases you can use '"en
you feel li5e you can6t save t"e #erson &ecause t"ey "ave got you around t"e nec5.
E!: Des( t"at is t"e first t"ing. First( you reali?e you a##roac" anot"er #erson carefully '"en s"e is dro'ning
&ecause "er tendency is to flail out and #us" you do'n and you may com#letely lose it at t"at #oint. Bo you
a##roac" "er from t"e side or from t"e &ac5. Des> T"en( t"ere are 'ays t"at you "old "er carefully 'it"out
strangling "er to deat" so you don6t add to "er misery. T"ere are 'ays t"at you &ring "er in carefully( and
guide "er. T"ere is a '"ole set of guideline t"at "ave &een 'ell 'or5ed out &ecause #eo#le "ave actually
a##roac"ed dro'ning #eo#le and &een 5illed &y t"em. T"en eventually( t"e met"ods get 'or5ed out and
no' t"ere are a '"ole set of guidelines t"at seem to 'or5 '"en you are trained t"at 'ay and you don6t get in
too muc" trou&le &y a##roac"ing a dro'ning( des#erate #erson. n 4udd"ism( t"ose are called #ractices of
t"e si$ #aramitas of "o' you can stay afloat and "el# #eo#le at t"e same time. 4asically( t"e #ractice of
e$c"ange and of a&sor&ing anot"er #erson6s #ain is +um#ing in to t"e #erson '"o is screaming for "el#(
dro'ning. T"en( "o' you conduct yourself in a frig"tening situation is anot"er 5ind of disci#line.
H: Could you say somet"ing a&out your o'n individual 'or5 'it" t"is #erson and may&e clarify some ma+or
differences 'it" R.D. 1aing and "o' "e 'or5s 'it" some very distur&ed #eo#le and t"e a##roac" t"at you
are descri&ing.
E!: really don6t understand t"e 'or5 "e does. t is really "ard to tell from 'ritings '"at 5ind of 'or5 anyone
does. %o. s"ouldn6t even try to do t"at. *"at am #ersonally doing no' is so mundane t"at rarely even
ta5e notes anymore. t is +ust #ractical and #ragmatic. mig"t say somet"ing a&out one of t"e last meetings
"ad 'it" t"is fello'. ;e 'as lying on "is sofa in "is living room and seemed 8uite gone. t 'as a &it of a
s"oc5 to me &ecause t"e #revious times "ad seen "im "e 'as vital( alert( and #resent. T"ere 'as very little
tal5 a&out ;er &ecause "e 'ould start tal5ing a&out "er and say. 7 don6t 'ant to tal5 a&out "er7. ,ver t"e
#ast mont" or so( "e "as &een #laying 'it" t"e #ossi&ility of renouncing tal5ing a&out "er. ;e "as s#ent t"e
#ast t"ree years li5e t"e Ancient Mariner( tal5ing to every&ody a&out "er( '"at s"e is doing to "im. ;e did
e$actly t"at a&out *illo'. 4ut "e is "earing "imself doing t"at and says( 7%o( am not going to tal5 a&out "er
again7. T"e team "as &een 'or5ing 'it" our tendency to say 7T"at is great7. 4ut( +ust letting t"at "a##en=
accommodating t"e ne' #ossi&ility t"at "e 'as e$#loring. ;e "ad &een doing t"at until t"is #articular "our
'"en "e 'as silent( morose( and o&viously very involved 'it" t"e mindless #ractices t"at 'e "ave come to
identify 'it" "im: mindless #ractices &eing #ractices '"ic" desync"roni?e "is mind and "is &ody and
facilitate "allucination. T"at is anot"er long story. n any case( "e 'as giving clear signs of doing t"at.
,ccasionally( "e 'ould sto# and "e 'ould loo5 sadly at me. tried not to interru#t alt"oug" felt offended &y
t"e &reac" in t"e relations"i# t"at 'e "ad &een "aving. For an instant felt grief-stric5en. T"en. said to "im(
7B"e is leaving you( isn6t s"e>7 At t"at #oint( "e &olted u# and said. 7*"at made you say t"at>7 And said( 7
+ust feel t"at s"e is going a'ay. B"e is going to leave you. 2ust li5e you al'ays 'anted "er to( and no' you
don6t li5e it7. T"at interc"ange "as &ecome #art of t"e relations"i# no'. t is in t"e air t"at s"e mig"t &e
leaving. T"eir relations"i# mig"t &e over. t sounds very cute( intuitive( or magical( t"at 'e could tune in li5e
t"at. T"ere is no 'ay to descri&e t"e events t"at lead me to say suc" a t"ing &ecause of t"e mont"s and
mont"s of accumulation of e$#erience 'it" "im and t"e trust t"at '"at e$#erience in myself mig"t &e
related to '"at is going on in "im. 4ut also 5ne' t"at 'as leaving in a cou#le of days( and 5ne' "e 'as
trying to ignore t"at. 5ne' t"at 'as 'orried a&out "im and t"at mig"t miss "im. And "e avoided t"e
#arting t"at 'as in t"e air and &lamed "er for it( +ust li5e "e &lames "er for everyt"ing. ,t"er'ise( it is very
mundane.
H: Dou felt "is grief '"en "e 'as laying on t"e couc">
E!: felt my grief.
H: Don6t you t"in5 "e 'as in grief too>
E!: ,&viously. made t"at assum#tion t"at "e 'as in grief or im#ending grief or struggling against grief.
H: Do t"ose intuitive assum#tions seem to &e correct for you>
E!: Dou 5no'. don6t 5no' &ecause do t"em so often t"at "ave sto##ed 5ee#ing count of "o' many
times t"ey a##ear correct. 2ust let t"at go. 4ut t"in5 it is really im#ortant J at least 'it" #eo#le '"ere some
5ind of relations"i# "as develo#ed and '"ere t"ere is some 5ind of disci#line 'it"in t"e relations"i# -- to &e
generous and offer t"ose "ints and intuitions and at t"e same time not &e attac"ed to t"ose intuitions.
H: More im#ortant to offer t"em t"en '"et"er rig"t or 'rong>
E!: Des( #ut t"em in t"e air. 1i5e #utting t"em out on t"e coffee ta&le. t"in5 t"ere is a #oint '"ere you could
com#letely trust t"e relations"i# to &ear t"at strain if you are not attac"ed to &eing rig"t or 'rong. T"at is t"e
crucial #oint.

Talk $&: October &.1982
The %ature of Courage in Psychotherapy
*"ile tal5ing a&out t"e #ractice of #syc"ot"era#y t"ere "as &een no dou&t t"at 'or5ing 'it" #eo#le is a
#ractice t"at re8uires effort( #ersonal disci#line and t"e continuous re"earsal to do suc" a t"ing #ro#erly.
Training to do t"is is not a matter of learning "o' to drive a car: learning t"e gears( tec"ni8ues( or strategies.
T"at 5ind of training is missing t"e #oint and everyone '"o "as &een involved in t"at 5ind of #syc"ological
training 5no's somet"ing is 'rong. T"e real #oint is involved 'it" training ourselves( and "aving e$#eriences
ourselves( and 5no'ing #recisely '"at t"at e$#erience is a&out. f 'e are going to tell t"e trut" to #eo#le and
"ave t"e courage to do t"at it "as to come from '"at 'e "ave e$#erienced ourselves.
t "as &een o&vious all along( t"at "o' 'e tell t"e trut" to #eo#le is our #ractice and t"at ta5e a &it of 'or5( a
&it of effort. Eenuine #syc"ot"era#y is &asically meditation in action. T"e first line of t"e &roc"ure for Maitri
!syc"ological Bervices reads( 7Maitri !syc"ological Bervices is a t"era#eutic action grou#7. *"at 'e mean
&y t"at( at least to ourselves( is t"at it is a grou# intensely involved 'it" t"e #ractice of meditation in action( of
"o' to e$#and our #ersonal #ractices into inter#ersonal 'or5. %o matter '"at 'e 5no' or don6t 5no' a&out
strategic t"era#ies( it is meaningless 'it"out #ersonal 'or5( 'it"out a direct relations"i# to our o'n mind and
&ody and communication. *"en t"at is going on first and alongside of our inter#ersonal 'or5( somet"ing
different "a##ens. ,nce 'e "ad a meeting 'it" ;is ;oliness( t"e 1Nt" Eyal'a )arma#a( and 'e as5ed "im
"o' t"e %aro#a nstitute #syc"ology #rogram could accommodate so many different sc"ools of t"oug"t( so
many faculty mem&ers "aving trained in different 'ays. ;e said: meditation disci#line is li5e a &eautiful( ric"
golden &rocade t"at you set out on a ta&le and no matter '"at you #ut on to# of t"at &rocade( it &ecomes
more &rilliant and &eautiful. T"at is t"e idea. ,ur #ersonal disci#line can actually accommodate many
trainings and s5ills( and t"ey are more "ig"lig"ted and made vivid &y our #ersonal #ractice.
t ta5es some 'or5 to do t"at and 'e s"ould not s"y a'ay from it. *e s"ould not #rocrastinate a&out t"at.
*e are tal5ing a&out evolving very sim#le and "onest 'ays of 'or5ing 'it" #eo#le. T"at "onesty only comes
from a #ersonal "onesty 'it" ourselves. t cannot come second. T"e courage 'e are tal5ing a&out no' is t"e
courage to actually #ractice t"e "onesty of meditation. t is easy to #ractice in t"is environment of )arme
C"oling 'it" its &la?ing autumn trees as a &rocade( #ractice &ecomes +oyful. *"en 'e go "ome to #ractice it
is more lonely. *"en 'e are #racticing alone in our room 'e mig"t 'onder '"et"er 'e are cra?y or not. t is
im#ortant to "ave some memory t"at t"e #ractice could &e delig"tful and gentle( as com#ared to '"en 'e
are alone in our agency or institution '"ere t"ere mig"t not &e anyone else tal5ing t"is 'ay. T"ere is an
as#ect of courage in doing t"is and am not tal5ing a&out anyt"ing t"eoretical. t is t"e 'ay &egan to
integrate meditation #ractice and clinical 'or5. t 'as lonely to do suc" a t"ing. t is #ossi&le t"at #eo#le 'ill
t"in5 you are doing somet"ing 'eird or e$otic. recall a letter received from an old friend after "ad 'ritten
a little #a#er relating meditation to #rofessional 'or5. ;e said( A4e careful a&out e$#osing t"is stuff your are
doing. !eo#le are going to t"in5 you "ave gone cra?y.@ felt very lonely reading t"at letter. %evert"eless(
#laces li5e )arme C"oling and %aro#a nstitute 'ere availa&le.
t is interesting t"at Mr. California is going t"roug" t"e same t"ing in "is o'n 'ay. For some reason told
"im( A*ouldn6t it &e 'onderful if you could convince your mot"er t"at you 'ere not cra?y all t"is time>@ And
"e agreed( if t"ere 'ere only some'ay "e could +ustify "imself to "is mot"er t"at 'ould mean a lot. t seems
t"at t"e t"ing "e is most afraid of is also leaving ;er &e"ind. T"at is( leaving t"e delusion( and facing t"e
"umiliation and des#air of a##earing cra?y to ot"er #eo#le. ;e 'ill "ave to say( A made a mista5e. 'as
'rong. t didn6t 'or5. 1et6s forget it.@ T"at does not seem to &e '"at "e can do no'. ;e 'ould love to "ave
"is mot"er6s acce#tance t"at "e is not insane and t"at everyt"ing "e "as &een t"roug" "as not &een in vain(
'ort"less( and degraded. ;e does not 'ant "is #arents to t"in5 "e is insane and t"at seems to also &e #art
of '"at all of us are afraid of. T"at is #art of t"e loneliness 'e are all 'or5ing 'it".
,n t"e ot"er "and( t"is loneliness is not necessarily as &ad as 'e t"in5. All our #atients are living 'it" t"is in
one form or anot"er. To t"e e$tent t"at 'e can taste t"at( understand t"at( 'e mig"t &e useful. *e can tell
t"em t"e trut" a&out loneliness( t"at it is also ric" and vivid and clear at t"e same time. *"en 'e come "ere
to study contem#lative #syc"ot"era#y 'e could feel t"at 'e are doing somet"ing outrageous and ris5y. 4ut
t"at does not seem to &e t"e case anymore. Many #eo#le are doing t"e #ractice of meditation and com&ining
it 'it" t"eir t"era#eutic 'or5. *e are "ardly alone in doing t"at. t is clear t"at #eo#le 'ant to go furt"er 'it"
t"is 5ind of 'or5 and 'ant to do it no'.
t is once again t"e same issue of not #rocrastinating. 4ut in t"is case it is t"e fli# side of t"e #atient6s idea of
#rocrastinating. *e feel 'e cannot #rocrastinate getting more do'n to eart"( a'ay from t"eories( and into
t"e ordinariness of 'or5ing 'it" #eo#le. T"e #atient is trying to leave t"e eart" in order to &ecome
e$traordinary. ;e is &asically stuc5. t 'ill ta5e courage on "is #art not to colla#se in des#air and ni"ilism(
and yet not to go for'ard 'it" '"at "e is increasingly recogni?ing as an a&surdity. t is a time for loo5ing
around to see '"at6s true and '"at6s not true. T"ere are favora&le signs: "e is 'or5ing 'it" "is mind in order
to "ead it off from 'andering into endless cosmic s#eculations 'it" t"e reminders t"at "e gives to "imself(
75ee# it sim#le( no t"eories7. ;e is &ecoming less #assive and #seudo-gentle in "is relations"i#s and less
fearful at e$#ressing t"e intelligence of aggression. ;is &ody seems to &e less of an alien cons#iracy.
T"e #atient<s courage to continue t"is 'ay is interloc5ed 'it" t"e courage of "is friends( t"e team mem&ers.
*e also must renounce our t"eories a&out "im( including '"at sanity is and '"at recovery s"ould &e li5e.
*e also can rely only on t"e ground e$#erience of recovery( and of going out &eyond ourselves 'it" t"at.
T"e courage of t"e #atient and t"e courage of t"e t"era#ist are inse#ara&le. ;o' on eart" can 'e transmit
t"e necessary attitude and s5ills to someone struggling 'it" an addiction of any 5ind( unless 'e 5no' t"e
ingredients of courage from our o'n e$#erience> T"at is '"ere t"e courage to #ractice mindfulness-
a'areness disci#line comes in: t"e courage to e$#erience aloneness( renunciation( and t"e true nature of
#ro+ections.
*e don6t 5no' if Maitri !syc"ological Bervices is t"e most ideal treatment situation in its #resent form. t
#ro&a&ly "as many refinements to go. 4ut it is going in t"e rig"t direction and 'e +ust cannot 'ait for t"e
most ideal situation to &e t"ere. T"at is anot"er as#ect of courage( not 'aiting for t"ings to get &etter &efore
going for'ard.
*e can start e$actly '"ere 'e are. Moments of recovery are s#ontaneously occurring. Courage means not
"esitating to relate to t"ose moments. *e do not "ave to go &ac5 to t"e infantile origins of illness and "o'
t"ose manifest in t"e t"era#eutic relations"i#. ;o' finally t"e multitude of "a&itual #atterns of transference or
'"atever( are eroded li5e 'ater erodes roc5. *e and t"ey do not "ave t"e time for t"at( if it 'or5s at all. T"e
meditation disci#line and #ersonal #ractice of relating to our o'n clarity and recovery( im#lies all t"e time t"at
'e do not "ave to 'ait for t"e nig"tmare to &e over. *e can a'a5en rig"t 'it"in it. T"at is '"at 'e are trying
to transmit to t"e #eo#le 'e 'or5 'it".
*e are only doing '"at #eo#le "ave 'anted to do for a long time. 2ournals and &oo5s are filled 'it"
conce#ts and t"eories a&out '"at is called 7em#at"y7. T"e issue of em#at"y and actual contact 'it" #eo#le
can only arise from our o'n e$#erience. Meditation is t"e fertile ground for t"e develo#ment of em#at"y.
Bome"o' no one "as tal5ed a&out t"at in 'estern #syc"ot"era#y. 4ut 'e are tal5ing a&out actually
cultivating em#at"y( cultivating e$c"ange. 4ecause of t"at s5ill arises in 'or5ing 'it" #eo#le. *e need to do
t"at. t is a &ig #ro+ect. !syc"ot"era#y is not li5e driving a car( '"ic" anyone could do. t "as to &e #ractice.
T"e more 'e can #ractice and discuss it toget"er( t"e easier and more delig"tful t"at 'ill &e.
7Recovery7 em#"asi?es t"e notion of #rocess. !er"a#s 'e are involved 'it" a redefinition of t"e notion of
recovery. t is not remission. t is not normalcy. t is not +ust t"e a&eyance of sym#toms &ut it is '"at
everyone 'e 'or5 'it" 'anted from t"e &eginning( '"en t"ey engaged in a course of illness. T"ey 'ere
loo5ing for somet"ing &eyond t"e falsity of constricted #ersonality. T"ere is a "int of &rilliant sanity and t"ey
'ant to recover t"at. Recovery from illness is recovery of intrinsic "ealt". T"at is t"e logic of t"e language 'e
"ave &een using. Recovery is #ossi&le &eyond maintenance( ma5ing do( or remission.
T"at is not enoug". f 'e settled for t"at as t"e end result of t"e t"era#eutic encounter( t"at is courting
trou&le. !eo#le &egin a course of illness in searc" for somet"ing &etter t"an '"ere t"ey started from. T"ey
don6t 'ant to go &ac5 to '"ere t"ey started from. From t"e #oint of illness( t"ere is no one to recover. T"at
"as &een left &e"ind. %o one '"o "as "ad a #syc"otic e#isode "as ever said( A +ust 'ant to get t"is over
'it" and &e +ust li5e 'as.@ %o one ever 'ants to &e +ust li5e t"ey 'ere or else t"e '"ole t"ing 'ould never
"ave started.