Thursday, January 29, 2009

Chuang Tzu, Perceived Reality, and Psychology

What we determine as real determines who we.  But who are we really?  Psychology claims to assist us in finding the reality of our internal self.  Psychology helps us cope more efficiently with conflicts in our lives.  “You are being taken advantage of because you are not assertive enough.  Let us help you be more assertive.”  It certainly helps to be one.  But in some ways it introduces another reality.  If you are to be mentally healthy, you must be assertive.  Or we hear psychological theory that believes in good self-esteem.  “You need to feel good about yourself.”  So a person who uses to feel ok for feeling ok now feels bad for feeling ok.  Or a person who uses to function well dependently is now labored co-dependent.  The national bestseller, Feeling Good: The New Mood Therapy, claims cognitive therapy to be substantially superior to the use of antidepressant and traditional psychotherapy.[i]  This is to be applauded.  I love the David Burns’ statement regarding self-esteem. 

“Then how can I develop a sense of self-esteem?”you may ask.  The answer is—you don’t have to!  You don’t have to do anything especially worthy to create or deserve self-esteem; all you have to do is turn off that critical, haranguing, inner voice.  Why?  Because that critical inner voice is wrong![ii]

While cognitive therapy is a wonderful tool research also indicates that approximately 50 percent of those who recovered experience relapse within the first two years.[iii]  It is also interesting to note that even among those who receive treatment, the functioning level is still at one standard deviation lower than norm.[iv]  While cognitive therapy contributes significantly to the treatment of depression it seems to suggest that when you do not think right you feel wrong.  Feeling bad does not belong to the human experience.  In essence cognitive therapy suggests that one feels wrong because one thinks wrong.  There is nothing really wrong except that one feels wrong.  And this feeling wrong is the wrong feeling.  So think right.  While this reframing is enlightening, it also suggests at the very same time that feeling wrong isn’t right.  A potential conflict is introduced at another level. 

Another interesting example of this complexity is introduced by Foucault regarding psychoanalysis.  Freud sees neurosis as a symptom of repressed sexuality.  Foucault takes this a step further and suggests that repression is caused, in the first place, by the construct we create.  It is not so much repression as the construct that results in repression.  So Freud can psychoanalyze and brings everything to consciousness, thereby resolving conflicts.  But other causes remain, a defined sense of self carefully constructed  resulting in other forms of repression.  Reflecting on Foucault’s critique of psychoanalysis Dreyfus writes:

The ultimate form of alienation in our society is not repression and exclusion of the truth but rather the constitution of the individual subject as the locus of pathology.  Given our modern Western understanding of reality in all accounts of ourselves, whether hey be pseudoscientific or existential, “Man has a relation with himself and inaugurates that form of alienation that turns him into Homo psychologicus.”  All forms of psychotherapy can at best provide only isolated and temporary “cures.”  As manifestations of our everyday cultural practices, all psychotherapies solve individual problems without combating our general malaise.[v]   

 Every claim to reality whether, it be theological, philosophical, or psychological, brings with it potential conflicts.  Every reality implies a self one ought to be.  Psychological theories introduce ideas aiming at resolving conflicts.  But one needs to be aware, every idea has an inherent potential for resolving and creating conflicts. 

While we struggle with the ‘this’ and the ‘that’ in mental health, Chuang Tzu introduces us to wu wei, the art of doing nothing.  Psychological theories seek inner reconciliation through cognitive, behavioral, and interpersonal interventions.  The difference between current psychotherapies and religion

"lies in the present historical context where psychological theories have heightened awareness of the self.  This context forms the new reality through which one assesses oneself and others.  The self that must be reconciled is the self that must come to define itself through this awareness.  In this awareness, the language has changed.  Instead of sin, we have the libido.  Instead of mutual dependency, we speak of codependency.  This is the reality that the self must be reconciled to…This is also where wu wei differs from these approaches.  While wu wei may employ, to some extent, cognitive and behavioral interventions, it questions the philosophical and theological basis of this definition of the self.  It questions the interpretation of reality upon which our culture arrives at the meaning of 'healthy self.'"[vi]

Chuang Tzu invites us to return to the basic, the undifferentiated reality, to the principle of heaven and earth.  It is a return to the self as is.  It is a return to what is before we become dissatisfied with ‘is’ and obsessed with ‘ought.’  It is a return to the state prior to the ‘this’ and the ‘that’ distinction.  In this message, Chuang Tzu invites us to the sacredness of life. 

Notes

[i] This research studied 44 severely depressed patients.  19 of the patients were given cognitive therapy while the rest received antidepressant only.  Results show that 15 out of the 19 showed a substantive reduction of symptoms after twelve weeks of active cognitive treatment.  Two showed some improvement and one dropped off.  On the contrary, only five of the twenty five fully recovered.  Eight dropped off because of side-effects and the rest only showed partial improvement.  A. J. Rush, A. T. Beck, M. Kovacs, and S. Hollon, “Comparative Efficacy of Cognitive Therapy and Pharmacotherapy in the Treatments of Depressed Outpatients,” Cognitive Therapy and Research, 1, no. 1 (1977): 17-38.[ii] David D. Burns, Feeling Good: The New Mood Therapy (New York: Avon, 1980), 79.[iii] National Institute of Mental Health/National Institute of Health (NIHM/NIH) Consensus Development Conference Statement, “Mood Disorders: Pharmacologic Prevention of Recurrences,” American Journal of Psychiatry 142 (1985):471.[iv] Leslie A. Robinson, Jeffrey S. Berman, and Robert A. Neimeyer, “Psychotherapy for the treatment of Depression: A Comprehensive Review of Controlled Outcome Research,” Psychological Bulletin 108, no. 1 (1990): 40.[v] Dreyfus, Foreword, Michael Foucault: Mental Illness and Psychology, xxxvii. [vi] Sorajjakool, Wu Wei, Negativity, and Depression, 47.

 

5 comments:

  1. Chuang Tzu talks about "every reality implies a self one ought to be". At the end of the article he states that we should stop concentrating on ought to be and focuses on what is. I think this is brilliant! In this society, it seems like we are always trying to be better than what we are and comparing ourselves with everyone else around us. I think by us concentrating on making ourselves better we are missing the moments that make us in the now. There is a saying that I say in Griggs hall that read "You can't change yesterday, but you can ruin today by worrying about tomorrow." I think this quote fits what Chuang Tzu is saying perfectly. We shouldn't worry about what ought to be, tomorrow instead we should concentrate on what is, now.

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  2. I propose that there is an alternate way to look at how cognitive therapy 'works.' I definitely agree with your statement that cognitive therapy is often linked to the idea that "one feels wrong because one thinks wrong." However, I think that cognitive therapy can be less focused on the idea of what is right or wrong. When I work with clients using cognitive techniques, I try to help them examine how their behaviors to date have been both advantageous *and* disadvantageous. Additionally, I help them to consider how a different set of behaviors can potentially lead to another set of advantages and disadvantages. Ultimately, it is up to them to decide whether they are satisfied with the status quo or wish to change. I choose not to emphasize what is right or wrong because I feel it is not my place/is not my job to define for someone else (in general or in a therapy session). Indeed, behaviors that many would view as significantly dysfunctional can serve an adaptive purpose for an individual and help them navigate in the world. Under such circumstances, would it really be appropriate to say definitively that such behavior is wrong?

    I also do not think that cognitive therapy always promotes the idea that it is wrong to feel bad. Say, for instance, that one is working with a client who has masochistic tendencies. In this case, the client may hold the view that it feels 'good' to feel 'bad' (similar to right/wrong, it is important for the individual to define what good and bad mean). So, I think that cognitive therapy can be a tool where the goal is not to correct someone's 'bad' or 'wrong' behavior, but to help people think more critically about their behaviors, thoughts and actions, and consider how changing these things may or may not be of benefit. Angela H.

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  3. Angela, really appreciate you enlightening me on the use of cognitive behavioral therapy. What I really like here is your statement about how a dysfunctional behavior may serve as an adaptive purpose...this really answer many questions I have for myself.

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  4. People have been battling with the definition of self as part of the developmental process. Societal pressures continue to cause friction especially when the 'undifferentiated self" is forced to adhere to some standard. For the most part, it has been stated elsewhere, that the struggle exist in trying to determine who one is, who they would like to be, and what others would like them to be. I think that people have a core self that is later informed by their environment. Attempts to mold this core self with societal standards is what creates some of the issues that individuals experience through out life. The thought of doing nothing is an interesting concept because it might allow for acceptance of the core self as is. Social conformity might be helpful; however, to the extent that it allows for harmony among others.

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    I told him that once while in high school agirl friend of mine and I put clothes pins on our nipples and ithurt so much I took them off immediately. There were cops and feds all over the place.

    ReplyDelete