“Self-Indulgent?”

“Is this self-indulgent?” This is a question that often comes from people who are making good use of psychotherapy and enjoying it. The fact that they ask this question indicates that they have achieved a certain kind of conflict. One voice inside says something like“I am finding this useful and even enjoying it.” “This is frivolity and luxury, a specious good to which you are drawn out of vanity,” is what a second voice says. Or at least something like that. These voices are subtle and changing, so that it is hard to characterize them exactly. There is an important inner challenge to thelegitimacy of being in psychotherapy. This challenge has wide implications for howa person goes about using and developing that person’s resources of mind and heart. When we first meet it, psychotherapy is strange, a very distinctive cultural ritual. Psychotherapy involves a different use of words. It asks for an exteriorization of inner monologue and inner dialogue. As one very skilled psychotherapist used occasionally to say to a patient whose silence was stretching out, “Do you think that you could do some of that out loud so that we could both hear?’ This seems like a simple enough question, but it is deceptively powerful, because it asks for a change in the terms of experience, from a single person’s interior field to a genuine two person field with all the possibilities of interchange and altered perspectives that that imply. An extremely intelligent man in his forties said, “I have said all these things that I’m saying to you in my head hundreds of times. There’s nothing new... read more

Compassion And Its Confounders

The Oxford English Dictionary describes compassion as: “The feeling or emotion, when a person is moved by the suffering or distress of another, and by the desire to relieve it; pity that inclines one to spare or to succor.” In my 1996 book, “Compassion : The Core Value That Animates Psychotherapy“ I called compassion ”The intelligent pursuit of kindness” . In 2012 I would say that compassion is the feelingful intuitive ingenious intelligent practical persistent even stubborn pursuit of kindness. I now would say that compassion was about “getting it” and then doing something with “it.” But what is “it”? “It” is the actual situation of the other as the other is experiencing it. “It” is the integral of what the other can say and what the other can’t say. “It” is what is obvious and what is denied. Thich Nhat Hanh who says “Compassion is a verb” and “Compassion is a beautiful flower born of understanding” also says “The essence of love and compassion is understanding, the ability to recognize the physical, material, and psychological suffering of others, to put ourselves “inside the skin” of the other. We “go inside” their body, feelings, and mental formations, and witness for ourselves their suffering. Shallow observation as an outsider is not enough to see their suffering. We must become one with the subject of our observation. When we are in contact with another’s suffering, a feeling of compassion is born in us. Compassion means, literally, “to suffer with.” This is a deep and ambitious, but not irrelevant characterization. The phrase “shallow observation” is important, because so much of what passes... read more

Compassion, Draft 2012

In my 1996 book, “Compassion: The Core Value That Animates Psychotherapy, “ I characterized compassion as “the intelligent pursuit of kindness.” I meant, among other things, to contrast how much intelligence and ingenuity are enlisted in the pursuit of aggression with how rare it is to discuss intelligence and ingenuity in connection with the aim of kindness. Of course, the deepest aim of medicine is to provide succor, to relieve pain and suffering as well as to prevent them in the first place. So compassion is the beating heart of medicine. Sometimes in the enormously complicated bureaucratic and technological structures where modern medicine functions, the heart ‘s beat is compromised. Of course, the term “pursuit” suggests that we are always striving to come close and perhaps not so often succeeding. In 2012 I would say that compassion is the feelingful intuitive ingenious practicalpersistent even stubborn pursuit of kindness. This makes explicit a great deal of what I left implicit in the previous millennium. I think we now might say that compassion was about “getting it” and then doing something with “it.” But what is “it”? “It” is the actual situation of the other as the other is experiencing it. “It” is the integral of what the other can say and what the other can’t say. “It” is what is obvious and what is denied. I could go on in this vein, but this is enough to intimate that the realm of compassion lies beyond the realm of algorithms, of rubrics, even of easily stated rules and principles. It exists in the realm of the problematic fallible human. It exists... read more

Someone Else

Patient: “I’d like to be someone else, really, anyone else. I’d like to slip out of my skin and be free to become something I can’t even imagine. As it is, this skin has a stranglehold on me. I’ll die in it like a prisoner in his cell. It’s really quite simple: I want to be free and I want my freedom to have genuine meaning. I want to go somewhere that is not on my map.” Doctor: “Isn’t this why people take up acting, or become writers, or playwrights or even painters or sculptors or musicians? But perhaps actors go at it most directly?” Patient: “But actors bend the knee to reality. What they do is pretend and often wildly off the mark. When you think about it, acting is pretty shabby, quite without real convictions or daring. Seeming to take risks while not really risking anything is like eating your cake and having it, too. I acted in high school and in college and was told I was quite good at it, good enough even to warrant trying to make a career out of it. But as an actor I disgusted myself.” Doctor: “Why was that?” Patient: “I was a confidence man trying to play a trick that had little if any meaning. I suppose that now I act some in everyday life and certainly when I’m trying a case.I don’t know how I ended up going to law school. It was a whim, that was then unbelievably boring and then turned into a test of how much unpleasantness I could tolerate, an ordeal that challenged me,... read more

“I’d Kill Myself If…”

“I’d kill myself if I could attend my own funeral.” The speaker is a seventy-five year old man, a lawyer who specializes in wills and estates, always peculiar, now semi-retired with a sterling professional reputation as someone who can craft a complex trust so that it can not be broken. He is from an old family, himself the beneficiary of rich trusts, but has made a fair amount of money by his own labors in the arcane province of wills and estates. “The reason that I would like to attend my own funeral is that I would be the center of attention while yet remaining exempt from the obligation to exert any effort. I would be glad even to pretend that I wasn’t there. In life, if you want to be the center of attention it requires such a lot of work. It saps your energy to arrange your self-presentation just so after having compiled extensive intelligence concerning the tastes and distastes of those you wish to arrange in circles around you. It has always been beyond me. I have tried but I never lasted more than a few weeks. I can’t imagine running for office. I’m simply not robust. I’m not even sure I could serve as a hereditary monarch unless I were permitted to remain out of sight for decades at a time.” He has shown me pictures of himself from decades gone by. Tall and thin with an air of elegance, he is a handsome man in these photographs, perhaps with just a hint of fragility. Long nose, long thin fingers, pale blue eyes – in... read more
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