Introduction
This essay mainly consists of two parts. In the first part, I will briefly discuss the reasons why I agree to the rationale which suffering is necessary for leading a noble and satisfying life. Base on this understanding, “suffering” does deserve an in-depth discussion if we need to have a more comprehensive review on its implications for a psychotherapist’s work. Therefore, I will examine suffering, as the key concept, in a light of Buddhist and western psychology respectively. Prof. Karunadasa’s discussion framework on the meaning of suffering will be adopted to facilitate my discussion from Buddhist perspective. It is because his framework clearly reflects four important aspects when we facing suffering: the recognition of its existence, the understanding of its nature, the coping strategies and the role of the sufferer. Besides, I will also adopt Miller’s discussion in his book Facing Human Suffering to illustrate the western understanding of suffering. His core ideas suggest suffering, as a direct, holistic and fundamental experience, has been reduced into and replaced by symptoms and a set of clinical labels when western psychology has been constructed as an applied science. As a result, suffering as a construct is omitted. Here, I attempt to point out suffering is given a contrasting meaning and position in Buddhist and in western psychology. In fact, these differences, as the fundamental concern, are necessary for taking into careful consideration when western practitioners try to draw reference from the Buddhist tradition and vice versa.
In the second part, the discussion of implication will be the focus. Following the previous discussion, I would suggest one of the significant implications is to advocate psychotherapists re-visiting their attitudes towards suffering as well as the role and position of suffering in the helping process. Furthermore, the dialogue and integration between Buddhist and western psychology has been started for a rather long period of time. Nowadays, it also becomes an inevitable and popular trend that many psychotherapeutic approaches have been developed and put into practice. Therefore, it is also worthy to discuss the implications for the practical level if we consider suffering is necessary for leading a noble and satisfying life. The discussion will be supplemented with a case illustration which is abstracted from Stephen Levine’s book Meetings at the Edge. This aims at demonstrating how to make use of suffering constructively and how the intervention will be when a psychotherapist adopted the Buddhist understanding of suffering.
On the whole, after having discussion on suffering regarding the two different traditions, I wish to suggest some significant implications for psychotherapist’s work both at the fundamental and practical levels.
The message of Buddha
“Both formerly and now, it is only stress [dukkha] that I describe, and the cessation of stress [dukkha].”
This is the message of Buddha. Siddhattha Gotama attained enlightenment when he was thirty five years old after his six-year struggle. Subsequently, he dedicated himself to convey this sole message in the rest of his life, which is completely encapsulated in the Four Noble Truths, and it is so important for him to expound this message to his five old colleagues in his very first sermon at the Deer Park at Sarnath. Both from his real life experience and his teachings, Buddha acknowledges dukkha is a daily experience of every sentiment being. Buddha himself has confidently confronted with suffering and finally attained enlightenment. He clearly demonstrates that suffering is not our only destiny. We can move beyond of it by our own effort. Therefore, suffering, in a Buddhist sense, occupies an indispensable position and is necessary for leading a noble and satisfying life: no grit, no pearl!
The recognition of suffering: a perspective of Buddhism
Dukkha, as the key concept in Buddhism, is often translated as “suffering”. It also contains a deeper philosophical meaning such as “imperfection”, “impermanence” and “insubstantiality”. Although the translation may have pessimistic sense from the Buddhist view towards life, Buddhism is in fact neither pessimistic nor optimistic. It only states a fact that suffering is a reality and it can be ceased. Therefore, in the Fourth Noble Truth, Buddha also recommends a path of practice to get rid of suffering so that people can lead a noble and even an enlightened life. The path, namely the Noble Eightfold Path which is composed of eight factors: Right View, Right Thought, Right Speech, Right Action, Right Livelihood, Right Effort, Right Mindfulness, and Right Concentration. All these interrelated factors are essential for Buddhist training and discipline, which leads to clam, insight, enlightenment and nibbana. In other words, they lead to the cessation of suffering. Undoubtedly, if we pay attention to the content of the Nobel Eightfold Path, we can also note that Buddhism does consider suffering is closely related to morality. It stresses on the practice of Right Speech, Right Action and Right Livelihood. These ethical conducts (sila) are responsible for controlling the unethical acting-out behaviors so as to bring a “happy” and harmonious life both for the individuals and the society.
Additionally, there are three levels of suffering according to Prof. Karunadasa. The most elemental level refers to physical pain and oppression such as birth, decay, pain and sickness. The second level is in relation to psychological experience. Let say, affliction arose from associating with unpleasant experience or separating from the pleasant one; and the last level is about the mental affliction which originated from grasping the five aggregates. We can also define them as the explicit forms of suffering because they are easily identified. On the contrary, Buddhism clearly points out that suffering can also be implicitly existed. For example, happiness, as denoted as the opposite of suffering in our ordinary sense, is also some kind of suffering due to its nature of impermanence. Therefore, unlike the western tradition, Buddhism recognizes that all activities within the samsaric world are suffering.
Although there are many forms and levels of sufferings, they can be simply regarded as “because of attachment, suffering comes into being.” We trapped ourselves into the process of attachment because of our deep rooted “ignorance”, a fundamental confusion pertaining to our own existence and the world. Ignorance is directly related to one’s grasping at the self (atta) and identity through developing the ideas of “this is mine” (etam mama), this is “I am” (esoham asmi), and this is “my self” (eso me atta). It is an attachment to a false notion of self. So, it can be said that this “ignorance” is our deeply ingrained grasping mind that projects and apprehends intrinsic being or essence to our own selves and the various factors of existence. Therefore, to realize the truth of “non-self” (anatta), one can cease one’s suffering. Again, this understanding is also contrary to the ego theories and the attachment theories of western psychology.
Moreover, Buddhism also adopts other very different orientations when facing the issue of suffering. Firstly, it rejects that suffering is caused by self, or by external factor, or by both self and external factors, or neither by self nor by external factor. On the contrary, Buddhism explains human suffering on the basis of the dependent origination. Accordingly, dependent origination refers to “This being, that exists; through the arising of this that arises. This not being, that does not exist; through the ceasing of this that ceases.” It expresses the invariable concomitance between the arising and ceasing of any given phenomenon and the functional efficacy of its originative conditions. When it is applied to the problem of suffering, the abstract principle becomes encapsulated in a twelve-link formula disclosing the interlocking chains of causes and conditions. The formula begins with ignorance is the primary root of the series, though it is not the first cause. Ignorance conditions the arising of volitions which then conditions the arising of consciousness and so on. The corollary of this formula, other than talking about the arising of suffering, also constantly accompanies with the condition of cessation. It shows the way when ignorance ceases, all the following conditions successively cease.
Secondly, Buddhism rejects any interpretation of suffering. It is because interpretation implies an attempt of rationalization which will result in avoidance, acceptance or provoking of secondary emotion. Moreover, Buddhism also does not trace the causes of suffering to any transcendental reality such as a Creator God or higher being. On the contrary, it stresses on self-disciplined in body, speech and mind, which is a self-developed and self-purified process. And there has been nothing to do with any belief, prayer, worship or ceremony. Therefore, what man can rely on is his own effort: one should be his own refuge.
Conclusively, Buddhism acknowledges suffering, as a reality of life, has positive function and occupies an indispensable role in leading a noble and satisfying life. In addition, as suggested by Prof. Karunadasa, suffering is dependent origination in nature, which is sustained by our deep-rooted “ignorance” – an attachment to the false notion of “self”; however, it can be ceased according to the principle of Dependent Origination. Furthermore, Buddhism also rejects any interpretation of suffering and does not trace the causes of suffering to any transcendental reality. The last but not the least, Buddhism considers suffering is closely related to morality. These entire Buddhist understanding of suffering should be taken into consideration when we discuss the implications for a psychotherapist’s work.
The absence of suffering: a perspective of western psychology
“In clinical psychology, psychiatry, and the other mental health professions the amelioration of the suffering experienced by clients has been replaced by – and, I would argue, reduced to – a concern with eliminating what are construed as the symptoms or manifestations of mental disorders, disabilities, disease, and dysfunctions. The client’s agony, misery, or sorrow is viewed as a mere epiphenomenon to be replaced by a description of clinical syndrome that is presumably more easily defined, measured, and scientifically explained as the consequence of some technical design flaw in the person’s nervous system, cognitive processes, or learning environment that is amenable to change.”
This quotation, I would suggest, adequately reflects the fundamental attitudes of western psychology towards human suffering. The denial of suffering in western psychology is not because of fear, carelessness or ignorance but a natural consequence which is caused by its over-dependence on scientific inquiry to build up and validate its knowledge. The mainstream view of science and the scientific method were maintained dogmatically in psychology throughout the first half of the 20th century. For the reasons, as a scholar and practitioner who worked in the field of psychology for more than thirty years, Miller conveyed the following message:
“Science has become our secular religion, and scientific experts are our priests, science’s representatives on this earth, wielding power and authority. We put our faith in science to bring us salvation. Calm our fears. And protect us from suffering…A scientific world view, or Weltanschauung, is a necessary component of the knowledge base of clinical, abnormal, and professional psychology but it is far from a sufficient knowledge base.”
John Mcleod in his book Narrative and Psychotherapy also shared the similar ideas with Miller. He critically reviewed the historical and cultural development of psychotherapy, one of the major applications of psychology from traditional to post-modern society. He noted that various new pieces of scientific technology were introduced during its evolutionary process. Some counselors and psychotherapists employed psychometric assessment methods such as personality and adjustment questionnaires, projective techniques and behavioral inventories to measure aspects of the functioning of their clients. He concluded that the construction of psychotherapy as an applied science conceals the true cultural foundations of therapeutic practice. Started from different context and orientation, both Miller and Mcleod realize the undesirable influence of Scientism to psychotherapy though they are not intended to undermine its contributions. For example, science helps “psychotherapy” out from the mysterious and religious traditions such as the idea of demonic procession when someone is suffered from emotional or psychological problems. In fact, nowadays, it would be very foolish to deny the tremendous power and impact of science and technology in our daily life. However, we also need to be alerted, as we discussed, suffering as a construct or concept is omitted in western psychology. Scientism, I would suggest, is the major cause. Scientific inquiry denotes a process of knowing which stresses on objectivity, free of value (moral neutrality), observation, measurement, repetition and transferability. All these scientific features unavoidably reduce suffering into symptoms and a set of clinical labels of DSM-IV, which can then be objectively observed, measured and manipulated without any value judgment. And of course, they are portable and transferable after being de-contextualized and de-moralized. As a result, emotional pain and suffering, and the agonizing moral choices, personal betrayals, and injuries that occasion them, are redefined as disorders of the person produced by the brain, psyche, or environment. The meaning of human suffering is fundamentally altered. Obviously, these understanding and orientation to suffering are fundamentally contrasting to those of Buddhist.
Implications at the fundamental level
Western psychology reduces suffering into symptoms, as the invented substitutes, can adequately fulfill the criteria of being an applied science so as to join the modernization project. It spends a lot of efforts and resources to study suffering in the medical and mental health setting. However, paradoxically and even ironically, suffering slipped away from its hands. What left is only symptom! But symptom is not suffering. When we talk about symptom is not equal to work on suffering. Similarly, the extinction of symptom is also never equal to the removal of suffering. So it is the reason why Miller disseminated the following idea:
“…going back to the time of the ancient Greek philosophers Socrates, Plato, and Aristotle, is to try to alleviate the emotional pain and suffering of human existence. I would submit that our ultimate purpose, whether we like to or not, is to help people find a way to come to terms with personal suffering and make a life for themselves that they can regard as worth living.”
So I would suggest if we accept Buddhist understanding of suffering, at the fundamental level, one of the significant implications, even contribution, is to advocate psychotherapists re-visiting the meaning of suffering in their practice and re-discovering suffering in a moralized manner. As mentioned by Miller, physical pains, abandonment, betrayal, conflict, manipulation, and exploitation in personal, social, and economic relationships are the common patients’ themes that all of them are the morally and culturally related issues. Psychotherapist is recommended to bear in mind the attitude of moral neutrality in psychotherapy, to a large extent, only blinds us from the truth of suffering.
On the other hand, when Buddhism develops its “secular” application by having joint venture with psychotherapy, it can also learn a lesson from how scientific inquiry transforms western psychology into a symptom-focused practice resulting in a loss of the “grit” which is essential for leading a noble and satisfying life. Therefore, I would argue, as the extinction of symptom is never equal to the removal of suffering, symptom-focused practice can only contribute its effort on dealing with the surface of the suffering. The worst case is to keep us hibernated and numb. In fact, Buddhist practice purposively invites radical and holistic change in human existence rather than just re-appropriating the suffering superficially. These are the reasons why I support it is necessary for taking into a careful consideration when western practitioners try to draw reference from the Buddhist tradition and vice versa.
to be continue …