The Intersection Of Spiritual And Psychological Health

Carrying on from last post about forgiveness, we begin to see how the principles of spiritual development and psychological health intersect. It is understood that we are not talking about religion in any organized sense, or about any rigid set of beliefs about this or that. Isn't it telling that on any given street of significant size there might be several different churches, synagogues or temples, each offering the real "truth" as only its teachings can provide, each believing that it has the "right" way, probably the only right way to that truth, and each sure of its special place at God's side. Of course this assessment can be carried around the world, with each country and each religion claiming that oh so special place in the scheme of right things for itself.

This is not what we're interested in here. We are instead interested in the core spiritual principles and teachings of many of the world's wisdom traditions. These, not surprisingly, tend to be very similar, if not exactly the same. I'm willing to conclude that these principles and teachings are rooted in an understanding of the human condition and the human psyche, so that when we are instructed to practice, for example, forgiveness, it is not simply in order to meet an arbitrary and perhaps nice, if naive "be good" agenda - or to be controlled by the power of the State for its own nefarious purposes, as in religion as the opiate of the people - but because it is understood that this experience is central to the deepest levels of health, or wholeness, or healing that the human psyche can achieve.

"I'll give you everything I got for a little peace of mind" sang Mr. Lennon. I recently read through most of a biography of Marlon Brando - I couldn't finish the whole thing. It was, frankly, too painful and a history of too much self-indulgence to be altogether tolerable. One of the themes running through the book was Mr. Brando's endless search for some peace of mind, a quest which he did not succeed in (despite, incidentally, decades of psychoanalysis). At one point he is quoted as saying to a fellow actor that he - this other actor - could never portray a certain kind of experience because he, the other actor, had never hated the way he, Mr. Brando, hated. The sense of this hatred is palpable throughout the book, and I don't think it's any accident that Mr. Brando failed to achieve peace of mind in its presence. The two are indeed mutually exclusive, as we have been instructed over and over again.

If psychotherapy is to be able to help clients achieve some experience of relaxation, of peace of mind, of happiness, then it seems all too obvious that certain principles and practices which have been discovered to lend themselves to the attainment of these experiences will need to be, at some point in the process, employed.





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A Little On Forgiveness

So let's talk about forgiveness, or more precisely, self forgiveness. If the thesis that you are punishing yourself is accurate, then in place of a punitive relationship with yourself, a relationship of forgiveness, tolerance, compassion and acceptance of your humanity becomes the antidote, and the key to your liberation from the heavy psychological hand of this internal prison guard/enforcer.

You understand of course that we are entering the realm of spirituality, but not only spirituality. This is also the realm of psychological health, happiness, freedom and well being. It may not be just as simple as "love is all you need", or it might be just that simple, as long as we distinguish between the principle and its implementation. The simplistic notion that one needs to just "let go" has to be abandoned, and in its place the realistic practice of actively cultivating an integrated, felt experience of self love will be undertaken.

How to do this? You can use whatever methods work for you: visualization, self soothing, self hugging, self talk, self parenting, singing to yourself, etc. Welcoming the inner part of you who has transgressed. Practicing an understanding and supportive relationship with that part of you.
Treating yourself gently rather than harshly. Engaging a new belief that says that you will be a better person for offering yourself forgiveness than for imposing punishment.

Oh yes. There is the element of time. While "just let go" is supposed to happen instantly, the reality is that forgiveness develops over time and with effort and intention.






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Being "Bad"

What about those very deeply established feelings and beliefs that many people live with, sometimes knowingly and sometimes, maybe mostly, unknowingly, that they are "bad". This often takes the form of struggling with "inner voices" of self judgment, self criticism, and shame.
Shame being about who you are, as distinct from guilt, which is more about what you've done.
Sometimes there are no identifiable "voices", just the gnawing feelings of badness, of imperfection, of failure to live up to some internalized - and generally impossible - set of moral standards. There is usually no wiggle room; after all, these are matters of MORALITY, and so no room for self forgiveness, understanding, tolerance of one's flaws or mistakes, or acceptance. One must, typically, be punished in some form for one's transgressions, and people are incomprehensively creative in inventing ways to see that sentence is carried out, usually from within, without the need of external authority.

This can range from relatively mild self denigration to complete self denial in the form of severe dissociation or amnesia. Mostly we live in the mid zone, with addiction, neuroses of one kind or another, co-dependency, non-nurturing relationships, power struggles, varying degrees of physical, emotional and spiritual violence, both self imposed and imposed by others, self hatred,
malaise, anger, anxiety, depression and despair.

Oh, and let's not forget the inability to apply to oneself all of the consideration, understanding, tolerance and forgiveness that one can more readily and naturally extend to virtually anyone else. At this point the situation becomes slightly bizarre, if common.

To be continued......................







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A Work/Life Dilemma

What if you are youngish, have a well paying job, with good health benefits, and flexibility insofar as seasonal down time is built in, which you like, and now you have a primary relationship which, of course, needs attention and nurture, and you work 60 to 80 hours a week which makes this nurture impossible, and indeed you get lost to yourself in this job, by which I mean that you do not now know what your actual needs and wants are and you are not doing the things that you can identify as central to your deeper passions and creative fulfillments, because you simply operate on automatic pilot, though you do the job well? (Breath).

What you get is some feeling of financial security, and this is important to you because you grew up poor and didn't like it, the possibility of creating a small nest egg, a feeling of control, and of course the health benefits, which you may actually need to use because you also haven't felt really well for several months now.

What do you lose? Yourself, your relationship, the possibility of having a family, maybe your health, your passions, your joy, in some meaningful way your happiness.

What would you do in this situation?






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Enhanced Functioning In The World

How to be more functional and effective in the world? In relationships, in marriage, at work, as parents, as partners, as individuals. How to discover and identify who one truly is, in terms of one's needs and wants, in terms of one's souls' desires, in terms of what is of fundamental importance, and what isn't. How to trust others to truly be present for you, especially when this has not been a common experience in all of your life? How to find the kind of balance in life, among all of the various areas of demand and desire, that is a prerequisite for real satisfaction, fulfillment and happiness? How to live as though your depths actually mattered?

Hmm. As I like to say, on at least one level, none of this is rocket science. That is, it's not so difficult to understand the basics. Be true to yourself, as in, listen to your heart and soul, and follow their lead. Show up, that is, be present to yourself and to those you care about. Be willing to take meaningful risks in order to be true and real. Ask for and accept the genuine support of others who care about you. Learn to set your priorities in order, and to apply your energies in proportion to those priorities. Choose you battles: not everything is worth a big effort. Pace yourself.

Don't imagine that you will wake up one morning and somehow, miraculously, be "finished", that is, free from all of your old patterns; re-born into a new person who has no neurotic tendencies;
a person for whom everything now is easy and fluid and fresh and without conflict and without difficult feelings and without aspects of self that you don't like. Instead, understand that whatever changes you want to make will require consistent application of skill and awareness. Understand that your old patterns will indeed continue to present themselves, on a regular basis, and that that doesn't mean that you are failing. It simply means that you are now aware of them, and this awareness opens the door to possibility.

Step One: Awareness; Step Two: Acceptance; Step Three: Choice; Step Four: Application
Something like that. Quite orderly, really.





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A Bit More On Cost

So here I am with a client who has been unemployed for about 4 months now, is three months behind on the mortgage payments, and is awaiting the "call" from the previous employer who has promised a job "next week" for a couple of months now (there is a huge bureaucracy involved, so this sort of delay is not surprising). Therapy is truly helping this person. It's not a "brief" therapy. This could go on for quite a while. By now I'm carrying a back bill of 6 sessions. Not tremendous, and not nothing either. This affects my income, which, in case you wonder, is not large. I enjoy working with this client, not least because I see the steady progress that is being made in some pretty significant areas, and because of the commitment that this client has made to healing.

I'm willing to "carry" this client. I expect to be paid some day, but who knows? In spite of today's headlines that declare that the recession is officially over, this client is caught up in the same financial circumstances that literally millions of other Americans face: the highest unemployment rates in decades; unprecedented home foreclosure rates; a general economy that, before today it seems, has been shrinking. Yesterday, when a check was offered at session's end, after we had talked about the relationship between client's shame and the lack of money, I gave it back and told this client to go buy food instead.

I'm not telling this story to garner praise for my generosity. To me this situation seems obvious and inevitable: one does not take money for therapy when one knows that the client has had to borrow money for food, and when there is an established therapeutic relationship in place that is benefiting the client.

When people I feel a connection with ask me about my work, my stock answer is that it's a good thing that my wife has a real job. We certainly wouldn't be able to live on what I make. And partly, this is because of personal decisions I've made regarding my fees, my non-relationship with insurance companies, and situations like the one described above. Also, I'm not a very good "business" person, not unlike many creative people, so "marketing" isn't something I do. Oh well. C'est la vie.

I know there are "high powered" therapists who make huge incomes because they are good business people, because they approach their private practices as businesses first, and, not insignificantly, because they see largely wealthy clients. This has never been my approach, or my motivation for practicing as a therapist. It's not where I come from, either personally or professionally. So what about every one else? The "average" person, or the poor person needing therapy? A client at a private, expensive residential treatment facility that I used to work at once said, in expressing his gratitude for his situation, that while he was fortunate to be able to pay for his treatment, "poor addicts just die". And so it goes.

Or does it have to?







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The Cost Of Therapy

Typically, psychotherapy is pretty expensive. This is because it has its roots in an aristocratic white social environment, and because it developed out of a western medical milieu where professional medical people held high status and commanded high fees. Nowadays, "psychotherapists" include medical doctors (psychiatrists), psychologists (PhD's, PsyD's, or EdD's), and Masters level practitioners including clinical social workers (MSW, LISW, LCSW, etc.), and clinical counselors (LPCC's, LCPC's, etc.).

The debate about the cost of therapy is never ending, and there does not seem to be any clear cut way of resolving the dilemma. I say" dilemma" because many people who would benefit from good therapy will never have the opportunity to do so because the cost of the service is out of their reach. This is no different in many cases from the costs of medical and health care in general in our current economic system and insurance/(obscenely) profit driven health care system.

So what to do? There are community "mental health" agencies that are supposed to pick up this slack, and make therapy (or more commonly, "counseling") available to the masses. The reality however is that these agencies are typically government funded, and we all know what happens to funding for all "non-essential" services as a general rule: it is, of course, drastically cut. This means that many of these community mental health agencies go out of business. The ones that remain spend most of their time and energy struggling to survive, to raise funds, to meet ever increasing paperwork demands, and to provide direct services to ever growing numbers of people. It is not uncommon, for example, for a therapist at such an agency to be expected to see 25-30 clients a week. Plus do all the paperwork involved. Plus attend meetings. This is not possible if it is also expected that the therapist will be able to remain healthy and to provide quality service.

Then there are the private practice therapists. If insurance is funding the service, it may also not be uncommon for a therapist to see 30 clients (or patients) a week. If insurance is not funding the service, this number is likely to be considerably lower. Still, we all know that there are millions of Americans who do not have health insurance, and so are left to fund therapy services out of pocket. This is where the high cost becomes problematic for many.

The dilemma is extended when you factor in the legitimate need of the therapist to be able to make a living. So what does "make a living" mean? Of course this is different for every person.
Is the British surgeon who makes a million dollars a year under the socialized health care system, and living very well, being deprived because she or he is not making the 2 million she would make in unregulated America? You see how this goes.

So it becomes a very personal moral, ethical, practical and spiritual consideration for each practitioner. How much do I charge for my services? What are my legitimate needs? What are the "customary and usual" fees in my community? Are these within my personally acceptable parameters? Are they too high? Too low?

To be continued......................





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