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| Presence: A Radical Old Approach to Helping |
| Feature Articles - Treatment Strategies or Protocols | |
| Written by David J. Powell, PhD | |
| Tuesday, 10 April 2007 | |
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Science, psychology and spirituality are converging. In recent decades,
people are bringing together the richness and simple wholeness of
spiritual teachings from many traditions, east and west the direction
of technology and how it is shaping society; and the knowledge of
science. Although we may differ in approaches, we share the same end,
the betterment of humankind.
Science is traditionally based on the empirical method of direct observation, is absent of an appeal to scriptural authority as a source of validating truth claims. Science cannot address many dimensions of the full reality of what it means to be human — art, ethics, beauty, values, meaning, good or evil, and consciousness. However, science and spirituality are finding common ground in their mutual search for coherence in life, causation and an understanding of the nature of reality. Both seek to understand powerful emotions such as compassion and altruism. Modern psychology, perhaps because of its principal motivation of seeking to understand human pathology for therapeutic purposes, has focused most of its attention on negative emotions, such as aggression, anger, and fear. Little examination has been made of positive emotions, such as love, compassion, caring, and altruism. Why does someone step in front of a moving train to save an infant, sacrificing their own life? How can we explain the joy of meeting someone you love at an airport, the sadness of losing a close friend, the serenity of a walk through a garden or the total absorption of a deep meditative state? These experiences constitute the reality of our lives, our consciousness. These are not scientific but subjective, philosophical questions that perhaps only spirituality can answer. Science and philosophy have long understood the spiritual nature of these questions. Plato, writing 2,000 years ago, said: “The greatest mistake in the treatment of disease is that there are physicians for the body and physicians for the soul although the two cannot be separated.” Albert Einstein said: “How are we ever to explain in terms of physics or chemistry our first love?” Niels Bohr, the great physicist, wrote: “We find nothing in physics that has even a remote bearing on consciousness.” Buddhism speaks of luminosity, clarity, knowing, awareness and mindfulness. The Apostle Paul in the Bible writes of a “peace that passes all understanding.” Western science has, on the whole, attempted to understand consciousness solely in terms of the functions of the brain. However, quantum physics, with its logic-defying notions of nonlocality, and neuroscience’s understanding of brain plasticity, are pointing to another realm of knowing, awareness, and presence that may go beyond measurement strictly through brain physiology and neurobiological processes. Neuroscience can tell us when activity can be observed in the brain for a cognitive state. But it cannot, as yet, say why this is so. It can tell us when someone is dreaming. It cannot explain the content or meaning of the dream. One’s experience of visualization, creativity, imagination, an experience of a clear light state, a simple knowing, luminosity, “just getting it,” have been accepted by spiritual teachers for millennia. Scientists, such as Daniel Goleman, Paul Ekman, Anne Harrington, Stephen Kosslyn, et al., are now admitting there are other realms that science may not be able to measure or explain. Peter Senge, et al., in their groundbreaking book, Presence: Exploring Profound Change in People, Organ-izations and Society, point to a deeper level of learning and knowing, where we learn anew to see and sense, seeing from the whole instead of the parts. Scientists, corporate leaders, philosophers and theologians are realizing that every profound human change is based on an inward-bound journey of going to a deeper place where a new form of knowing comes to the surface. The core capacity needed to bring about change is presence. This is not simply awareness of the present moment (a good and essential starting point for change). Presence is deep listening, an openness beyond one’s perceptions and historical ways of making sense of something. It is first about “letting go” of old identities and our basic need to control. (Bill W. spoke of this in the First Step of AA). Then, it is about “letting come” of awareness in a larger field of change. We move then from recreating the past to realizing an emerging future. Christians call this grace or revelation. Taoists call it qing (energy), moving to qi (life force), into shin (spiritual energy). Buddhists speak of the quieting of the mind through meditation, dissolving the false duality of self and other. Hindus speak of finding a oneness. Sufis from the Islamic tradition speak of an “opening of the heart.” Jung spoke of one’s quest to find their true self. Psychotherapists can see it as learning to see anew, moving on to new awareness of what is and what is emerging and our part in it. This leads to spontaneous action and deeper learning. My favorite image is “the hatching of the heart.” I will call this presence. Presence At the end of your day of counseling, the only change that will make a difference is the transformation of the heart. A fundamental premise I hold is that if one does not transform their pain, they transmit it. What transforms pain? Transformed people transform pain. And what brings transformed people? Love always transforms people. Transformation starts with stopping (or suspending) our habitual ways of thinking and perceiving. French philosophers called this suspension process “epoche.” David Bohm, noted physicist, said, “Normally, our thoughts have us rather than we having them. We hang our assumptions in front of us.” To begin, we must suspend our ways of seeing the world. At first, when we try to suspend our thinking, we become fearful and hear the chattering of our mind that says to us, “Don’t do that. Be in control. People will think you crazy if you say or do that.” What is needed is a shift in our ways of seeing, seeing from the whole instead of the parts. This requires a redirection of our awareness toward the generative process that lies behind what we see, a redirection of turning our attention toward the source rather than the object. Physicist Henri Bortoft states that our attention naturally gravitates toward concrete particulars. What we need to do is to understand the whole found in the parts. This requires what Martin Buber, the Jewish theologian, called moving from an “I-it” to an “I-thou” relationship. Jon Kabat-Zinn, pioneer in meditation and pain reduction at Harvard, says we need to “purposefully refine our capacity for paying attention, ultimately to anything and everything that might be relevant to navigating the world with open eyes and hearts.” We move from paying attention and listening without judging, to a greater field of awareness. We move from suspension of our thinking and judgment to redirection of our attention to the whole. Through presence and mindfulness, we drop beneath our conditioned ways of seeing that reinforce a subject/object relationship. We are so accustomed to distancing ourselves from others by making them into an object, the “patient,” and we into the subject, “the therapist.” This blocks our observing whatever arises as it actually is. We need to develop a greater sense of nonjudgmental-ness and nondualistic awareness. One of the best things I have learned as a therapist is to practice “donut mind,” to be able to say “I don’t know, what do you think,” or “I could be wrong.” These phrases allow me to no longer be the subject, the expert, and to just be still, holding the whole in awareness, not having to have to know anything. This is counter-intuitive, as throughout all of our education we are taught to “know,” to become an expert in our field. Now you’re telling me to have a “donut mind?” We are seeking an inner knowing, a deeper heart source, a knowing of the heart, a gut knowing. Have you ever had the experience of an “aha” moment, when you just knew in your heart something was real and right? Have you ever been able to let go in therapy where words came out of your mouth and you wonder, “Where did that come from?” That’s heart knowing. In cultures around the world when people want to indicate a point of deep meaning to them, they gesture toward their heart. For most cultures, the heart is associated with a deeper meaning. The Chinese symbol for “mind” is a drawing of the heart. This calls for a spiritual rebirth, an awareness and openness to presence. Why do you do what you do? Science cannot explain your sense of giving, calling and altruism. We hopefully feel “called forth,” to be used as an instrument, where you cannot not do what you do, a heart knowing that this is who you are. Joseph Campbell, author of the classic book, The Power of Myth, spoke of what leads people to take risks for strangers. He said it requires a breakthrough of a realization that you and the other are two forms of the same life. W. Edwards Deming, the corporate quality management pioneer said that the cornerstone of our work is about simply creating ways to help people connect more deeply with one another, with their common concerns and with a sense of purpose. A new way of learning Traditionally, we have thought of learning by observing something, discovering how it works, inventing a new approach, taking new action, and producing those actions. Educator Thomas Dewey argued that we learn from the past through cycles of action and reflection that lead to new actions. This is often how we approach addiction treatment. We “educate” our patients into recovery. We provide psycho educational sessions to teach them the ravages of their disease, as if they did not already know that. We break through their denial by pointing to the wrongdoing they have done. By learning from the past, we believe, they will be able to change their future. Learning based on the past suffices when the past is a good guide to the future. But it leaves us blind to profound shifts when whole new forces shaping change arise. Instead, we need a new way of learning and working with patients. This new model begins with observing, becoming one with the world of our patients. We then retreat into our awareness through meditation and mindfulness, and reflection, allowing the inner heart knowing to emerge. This, Senge calls, is sensing, presencing, and realizing. In most of what we do, the patient and we “gather information” that conforms to our preexisting assumptions. “Of course that’s what you did. After all, you’re an alcoholic.” This reductionism diminishes us to an “I-it” relationship. We “see” what we want to see and are prepared to see. After all, we’ve been to school and we see our patients through the lens of ours and their past. In this old model of patient learning, they gain knowledge of their past, make decisions around what to do, and act on those decisions, often through a charismatic therapist figure who commands the person to commit to action. This mechanical model is similar to the traditional medical model of assessment, diagnosis, intervention and treatment. But, medicine is finding few ways of treating patients through what Larry Dossey terms “non-local medicine,” taking a page from the textbooks of physicists. In the new way of learning, presencing, together the patient and therapist become one in seeing from a deeper source. Together we become the vehicle for that source. When this occurs, changes happens, almost as if we are watching ourselves watch something happen. Let me illustrate. Have you ever had an auto accident, or something similar? As the accident is happening, everything seems to move in slow motion, as you watch the accident unfolding. Everything slows down, although only a few seconds pass. This is presence. At that moment, it seems as if time slows to complete stillness and you are drawn in a direction above your physical body, watching the whole scene from another place. There is a sense of totally forgetting oneself. Presence demands another type of seeing, of learning, an inner knowing, beyond the present “reality.” “It is seeing from within the source from which the future whole is emerging, peering back at the present from the future” (Senge, 2004). Now, most treatment centers are required to have treatment plans, all well and good for accreditation bodies, but perhaps a distraction to the process of presencing and realizing. Blind adherence to a plan detracts a counselor from the present realities and disables him from being fully present. Even worse, today we seek to manualize treatment, to assume that change happens when a counselor follows a prescribed plan, with steps for the patient to take to bring about change. We end up acting on our patients rather than in our patients. In manualized treatment we separate ourselves from what the patient and therapist are seeking to change, as if that were possible. The current buzzwords of funding sources these days are “evidence-based practices.” Don’t get me wrong. I am not opposed to evidence-based practices. We need to objectively and concretely demonstrate outcomes. However, blind adherence to “evidence-based practices,” to manualized methods of counseling, disregard what scientists and physicians are learning, that the single most important factor in patient change is the quality of the therapeutic alliance between doctor and patient. And alliance begins with presence, with entering into liminal space, a thin membrane or threshold of letting go and surrendering to what is emerging. The ancient Celts called this “tien a nog,” a space “just the other side” of our current reality. Instead, we need to develop a mutual stance of co creation with the patient. Usually it is an event in life that brings one to this letting go and co-creative process: sickness, danger, disappointment, tragedy. But, as AA tells us, letting go is a capacity that can be developed through nonattachment (as the Buddhists would call it). Francisco Varela and Eleanor Rosch of the University of California, Berkeley Department of Cognitive Psychology, state, therapists need to find a different sort of learning and knowing, what they term “primary knowing.” Traditional psychology requires an analytic knowing, offering a mechanistic, deterministic way of identifying the problem and finding a remedy or action for that problem. By contrast, Varela and Rosch say that primary knowing comes from an interconnectedness with patient and provider. Such knowing is open and not determinate, and requires unconditional presence, care and love. (Oh, now you’ve gone off the deep end, Powell. They never used the word “love” in my graduate school education). Perhaps the word “compassion” might be more palatable. Tibetan Buddhists call this “the natural state.” Taoists call this “the Source.” Christians call this “God,” for God is love according to the Epistle of John. When we are connected as therapists to that source, however you might refer to it, things become more integrated for all. Our locus of awareness shifts from a localized self to a generative sense of self, of “usness.” Have you ever felt an inner sense of oneness with your surroundings when walking alone in nature? In sexual union with another, have you ever felt as if the two became one? People often have great difficulty describing these experiences. But they will say, “Yes, I’ve had that happen to me.” But we turn away from these experiences because, for one, they are ineffable and indescribable. What words can you use to describe what just happened to you? “If I try to describe this, someone will think of me as a little ‘kooky.’” Although it was real and part of us, we fear other’s reactions if we try to describe the experience. (Why is it when we talk to God we call it prayer but when someone says God talks to them we call them crazy?) These experiences only happen when we are vulnerable, connected, surrender control, and surrender into commitment and in concert with a larger whole. These are mysterious moments, profound openings of the heart, what we are terming “presence.” Something is seeking to emerge through us, a spark, completely beyond achievement, a wedding of spirit with Other. Presence and counseling By now, some of you might be wondering if I have gone off the philosophical deep end. “Whatever does this have to do with counseling?” you might ask. It has everything to do with therapy. Medicine and science are realizing that there are four levels of doctor-patient relationships:
Which of these levels of doctor-patient relationship do you want? Research shows that most would opt for the third and fourth levels of relationship although what we collectively offer seems to be more on levels one and two. However, we are learning that we can co-create the system. The level of treatment we desire is the level of treatment we enact. What we seek is a wedding of the system as it is with the system we desire, a new form of doctor-patient relationship embedded in the current health care system. When this happens we will find ourselves on stage in a therapeutic play that we written (for we wrote it) exclusively for us. Conclusion What we now are learning with the convergence of science, medicine and spirituality is that seeing with the heart is indeed what heals. And to see with the heart requires an opening of the heart to others and ourselves. What is required is an experience of connectedness, real sensing and presencing, a rediscovering of the sacred space between people in “I-Thou” relationships, rich in life energy with the potential for connection. In the end, the success of our interventions in therapy depends on the inner condition of the intervener. That’s far more important than techniques or strategies for change. In short, the fundamental insights of twentieth-century physics have yet to penetrate the world of medicine and therapy: relationships are more fundamental than things. To paraphrase physicist Bohm again, the imperative of therapy is to evolve our awareness, so that it might naturally become more whole, more in line with our connectedness to others. Einstein summarized this when he said: “Our task must be to widen our circle of compassion to embrace all living creatures and the whole of nature in its beauty.” In this way, we will not just see the world as it is but as we are, for no human being, including psychotherapists, have a privileged view of reality. Martin Buber said: “Freedom and destiny are solemnly promised to one another and linked together in meaning.” But, as Native American teachers have said, often the longest road we will ever walk is the sacred journey from our head to our heart. C David J. Powell, PhD, President, International Center for Health Concerns, Inc. is an internationally recognized lecturer and trainer, and author of Clinical Supervision in Alcohol and Drug Abuse Counseling, and Playing Life’s Second Half: A Man’s Guide for Turning Success into Significance. References Senge, P., Scharmer, C.O, Jaworski, J., Flowers, B. (2004). Presence: Human Purpose and the Field of the Future. Cambridge, MA: Sol Publications. Readers have left 2 comments. 2. Untitled CLT, Unregistered Thought provoking!  Posted 2008-05-21 14:29:51 1. Untitled Georgia, Unregistered Back in the 80's and early 90's I use to work as an Native American Addiction counselor, meaning I worked holistic approach. I could not understand how most professionals separated the persons issues, first go to Tx. then they would not assist or touch any other issue then addiction. Well I had more success with accepting the whole person and whatever issues came along with that person because I used our native beliefs, values, teachings and spiritual teachings to assist. Of course, I got ridiculed, made fun of and laughed at by coworkers who were licensed or worked there longer than I. It is good to see more and more programs finally connecting and realizing the holistic approach! I may not work as a counselor anymore, but my vision of developing a private place where people can go called "Reclaiming our sacred Identities" is what I am working toward. I believe our native beliefs is a powerful way of coming from compassion and care. It is therapuetic/healing/spiritual and hands on teachings. It entails the science, medicine and Spiritual aspects. They say the longest journey is from the mind to the heart and the journey back from the heart to the mind.... Posted 2007-04-16 06:49:06              |
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