Should we sing the blues or try to beat them? In a paper delivered at the 2006 Conference of the Association of Core Process Psychotherapists, Steven Silverton draws on Korean Zen, Heideggerian philosophy, and Elvis Presley to explore key differences between cognitive-behavioral and core process models of depression and anxiety.
Last Updated on Sunday, 27 October 2013 20:37
Written by Steven Silverton
This is an expanded version of a talk given at the inaugural conference of the Association of Core Process Psychotherapists, Edinburgh, October 2006, with References and Bibliography
I'd like to offer an image for the practice of Core Process Psychotherapy which I hope evokes something of my own sense of its value, uniqueness and potential impact, as well as some important aspects of the process. I want to talk about the kind of psychotherapy which I aim to practice - which is vital, alive, passionate, full-bloodied, embodied and quietly revolutionary. I think that we're offering is vitally important to our culture. And I think it's valuable to define how we're unique, as well as my sense of where we might cross over and connect with other traditions.
The image that I want to offer and explore with you is the therapy space as a “Heartbreak Hotel.”Now this image might be surprising. It is not original. As you may know, it's the title of a song by someone called Elvis Presley. It was Elvis' first no.1 and it's 50 years old this year. So, what's Elvis doing here? Am I about to claim that he was the first Core Process Psychotherapist? Perhaps a forerunner, some kind of neo-Reichian bodyworker, loosening up the American pelvis?
By the end I hope to make it clear why I have chosen this image. I'll be using quite a few musical metaphors in this talk, and again I hope it will become clear why.“Heartbreak Hotel” is a rock'n'roll song, from the earliest period of Elvis' career, arguably the most vital period. Rock'n'roll came from a synthesis of black blues music with white country music. The blues is based on a 5 point scale, called the pentatonic scale. (It contains two notes which are flattened or 'blue' when stood alongside a standard major scale) And I want to explore the image along five dimensions. Bear with me here: the first two might feel a little bit like 'so what? is there anything new here? ' But bear with me: like a musical phrase, this will only ‘make sense’ once you hear the whole thing!
The genesis of the song was a newspaper article about a suicide, which Mae Axton, one of the song's co-writers, read and was affected by. The man in question had a left a note which read: 'I walk a lonely street'. Mae was very affected by this, and said to Tommy Durden, the co-writer: 'Let's put a heartbreak hotel at the end of that street:
And so the words go:
Well, since my baby left me,
I found a new place to dwell.
It’s down at the end of lonely street
At heartbreak hotel.
You make me so lonely baby,
I get so lonely,
I get so lonely I could die.
And although its always crowded,
You still can find some room.
Where broken hearted lovers
Do cry away their gloom.
You make me so lonely baby,
I get so lonely,
I get so lonely I could die.
Well, the bell hops tears keep flowin’,
And the desk clerks dressed in black.
Well they been so long on lonely street
They aint ever gonna look back.
You make me so lonely baby,
I get so lonely,
I get so lonely I could die.
Hey now, if your baby leaves you,
And you got a tale to tell.
Just take a walk down lonely street
To heartbreak hotel. i
So there is loss, suffering, mourning...and there is a place for this to be. Yet the whole feel of the song is far from despairing. It’s full of vitality and humour.
Now just as the blues is a creative response to suffering, originating in the hard lives of Negro slaves in the Southern states of the USA in the late nineteenth century, the dharma, the teachings of the Buddha, also have their origin as a creative response to and path through suffering. More precisely, the word which we translate crudely as 'suffering' is, in Sanskrit, 'dukkha'. The etymology of this word gives a clue as to the multiple resonances:
The origin of the word "dukha" in Sanskrit (Pali: dukkha), translated variously as "pain," "frustration," or "suffering," is unclear. Native grammarians derive the word from the adverbial particle dus, meaning "bad" or "badly," and the substantive kha, meaning "cavity" or "hole." The word dukha is then taken to mean someone who has a "badly (functioning) axle-hole," that is to say, someone whose chariot or cart is not working properly. The contrary is then someone who is su-kha, namely, someone who has a "good axle-hole" or whose chariot or cart "runs swiftly or easily." Others have suggested that the words dukha and sukha may be forms of the Sanskrit words du-stha, meaning "standing badly," or "miserable," or "ill," and su-stha, meaning "well situated," or "faring well," or "healthy." Regardless of origins, however, in both Sanskrit and Pali the word dukha (or Pali dukkha) encompasses a range of meaning not easily captured in modern English usage. ii
So the sense here is of mis-alignment, something out of tune or 'off'.
In the Buddha's first discourse, he outlines what he calls the Four Noble Truths. (More accurately, Ennobling Truths, according to Stephen Batchelor, They are not ‘inherently’ noble, but when used as a vehicle for enquiry and practice, their effect is ennobling). This is his first attempt to put into words his realisation under the Bodhi tree. The story goes that he just sat, for six weeks. He was in some doubt as to whether what he had realised could be taught at all. The first discourse is an attempt to language the realisation in a way which would be intelligible and helpful to those with ‘but little dust’ in their eyes.The proposal in the discourse is that if dukkha can be fully known, our ceaseless quest for satisfaction can come to a stop, and an experience of freedom can arise which opens up a path for ourselves and our relation to others. So dukkha, can be a kind of doorway. In fact, listen to this, from the Pali canon - the earliest collection of discourses:
Just as, when rain pours down upon a hilltop, the water courses with the slope, filling the clefts, the gullies and the creeks; these being filled fill the streams...the rivers...the great ocean. In the same way...dukkha is a cause for trust, trust is a cause for gladness, gladness is a cause for joy, joy is a cause for serenity, serenity is a cause for happiness...for collectedness...for knowledge and vision of things as they really are...disenchantment...dispassion is a cause for liberation, and liberation is a cause for knowledge of the ending of the outflows of selfhood.iii
This sounds incredibly counter-intuitive. You start with something unpleasant, something which most of us would like to get rid of. We'd all prefer a smooth running cart, wouldn't we? And you end up with joy, bliss and freedom.
So what's going on here?
In terms of my own experience, my understanding is that maybe it's a bit like this: you are on a meditation retreat and you have acute pain in the knees. The thought then arises, as you sit there in agony: 'the retreat leader has fallen asleep and forgotten to ring the bell. Meanwhile I am suffering permanent damage to my knees. I may need an operation. I may be crippled...' At this point, out of desperation you decide that there is really nothing for it but to practice. So you try to be with the pain in your knees as pure sensation. You make space for these body sensations just as they are, without adding on anything to them. And as if by some grace, beyond your will yet also dependent on that subtle shift in your attitude, from a situation of agony there is now just sensations moving: tingling, sometimes hot, sometimes cold; energy moving in the legs and knees and feet. The experience of agony and of someone suffering agony has transformed. The sensations are fluid and the sense of 'suffering' out there being experienced by a solid ‘I' who suffers has softened. There is then a simultaneous realisation that suffering and sufferer co-arise. The storyline about painful knees co-arises with the sense of a discrete ‘I’ who is the subject and object of this story. With this realisation, there is wisdom - a direct insight into the conditions of embodiment, with full acceptance of the consequences of that ('the ills that flesh is heir to' in Hamlet's words) and there is a compassion - a direct and radical acceptance that this is how things are. No more resistance, no more fighting, no more struggle.
This may last just a second or two. As you have this experience and start to feel pleased with yourself and that perhaps you've made some kind of breakthrough and you think about it and start imagining 'wow, I'll tell my friends about this. Maybe I'll even give a talk about it,' it goes and you’re back with painful knees again. But you had a glimpse of what the Buddha might be talking about.
Now the psychotherapy situation has an obvious difference compared to the meditation situation. There is not just the private world of the mediator. There are 2 people. The therapist is called upon to make some kind of response to what the client brings. But the crucial point here is what kind of response, what kind of space the therapist makes in themselves. If the therapist can receive the suffering without trying to make it change, then perhaps it can be fully known, and there can be the same kind of shift towards spaciousness, the same kind of loosening up. The attitude here is well conveyed in the Rumi poem:
This being human is a guest house.
Every morning a new arrival.
A joy, a depression, a meanness,
some momentary awareness comes
as an unexpected visitor.
Welcome and entertain them all!
Even if they’re a crowd of sorrows,
who violently sweep your house
empty of its furniture,
still, treat each guest honorably.
He may be clearing you out
for some new delight.
The dark thought, the shame, the malice,
meet them at the door laughing,
and invite them in.
Be grateful for whoever comes,
because each has been sent
as a guide from beyond. iv
In the example of the painful knees what changed the situation from agony was the turning towards the pain, the decision to make space for it, make it welcome, not resist it, to fully know it in other words.
When the therapist makes this space in himself he does not know what guests will come. He opens the hotel, like the desk clerk in the song he sits at the reception desk (he may or may not be 'dressed in black'!), but does not know who will come through the door. He is engaging in an improvised dialogue. A kind of call and response, which we in our work call resonance and reflection.
3. Call and Response
In order to engage in this, there is preparation and training and practice. Like a musician she learns the scales, the nuts of bolts of how selfing patterns itself, and the practice and discipline of being with what arises internally and in relationship, with spaciousness, and without being thrown off-centre, or - more accurately - practising a continual coming back to centre, until this practice becomes a kind of second nature. I have been playing the guitar for more than 30 years and I don't need to think about chords and scales. I can use them quite intuitively. My body knows them without me having to think about it. At the same time I'm always learning, always discovering.
haven't been a psychotherapist for quite as long- 8 years in fact - but I feel that there is something similar, comparable in therapeutic work. We train, we practice, practice and keep practising. There is improvisation within a structure. We make space to receive what the client brings; we allow ourselves to be affected; and we respond and into that response comes all of our practice, all of our preparation. Our response is improvised in the moment, yet is informed by a specific kind of intentionality, a specific kind of attunement to the client’s being, to our own being, to interbeing, to ‘subtle layers of knowing at all levels of our interbeingv, as Maura Sills puts it.
4. Significant Moments
Now within this dialogue there are significant moments, moments when something happens. Daniel Stern describes these as Now Moments and Moments of Meeting. These are moments of very good attunement in the present. These are subtly and sometimes emphatically reconstructive
Stern also calls them ‘shared feeling voyages’’. They are
simple and natural yet very hard to explain or even talk about. We need another language that does not exist (outside poetry) [or music?] […] This is paradoxical because these experiences provide the nodal moments in our life. Shared feeling voyages are one of life’s most startling yet normal events, capable of altering our world step by step or in one leap.(173)
They are the currency of therapeutic change. They are moments of kairos, as distinct from chronos:
In the natural sciences and in managing the daily schedules of life, we use the ancient Greek view of chronos ... the present instant is a moving point in time headed only toward a future.... vi
Kairos is the passing moment in which something happens as the time unfolds...it is a small window of becoming and opportunity. One of the origins of the word comes from shepherds watching the stars. As the night progresses and the stars turn in the sky, they appear to rise and then fall against the horizon. The moment when a star has reached its apogee and appears to change direction from ascending to descending is its kairos vii
When the present moment of doing something together is charged with greater affect, and a stronger kairos , so as to get elevated as a sort of peak amidst the other surrounding moves and present moments; when the something that gets done together involves a time voyage of riding vitality affects across the span of a present moment. When all these conditions are met, a nodal event occurs that can change a life. viii
Looking back, it was a moment like this which changed my life and which set me on course to becoming a psychotherapist. I was a client in psychotherapy, the first therapist I saw, this was in 1991, when I was 30. I was saying something about how I felt lack of confidence, that I was sure to be rejected, in relation to a particular woman. She said something very simple, I can remember the words: ‘So you’re ‘’no good’’ ’. The effect was amazing. She was a psychoanalytic practitioner and I was lying on the couch, and I actually felt myself being very physically turned upside down. Something in me came loose from its moorings and the effect was cataclysmic. What she had done was put ‘no good’ in quotes, as it were. At that point a space opened up between me and ‘no good’ which had been completely closed down beforehand. I was ‘no good’. Now what opened up was the possibility that I was not ‘no good’, that there was a me which existed prior to and apart from this conviction, and this me suddenly surfaced again and felt deeply recognised.
In the course of a long-term psychotherapy relationship, there are hundreds of significant moments, and a few which like that one stand out in relief.
As we attune ourselves to our clients, as we resonate and reflect, we prepare the ground for such moments. We can theorise these afterwards – in terms of reparative emotional experience, and so on, but at the time these moments are unpredictable and unwillable! Maura “it is everything that you’re doing and nothing that you’re doing’ [interview] and
something that has meaning but no agenda or goal. It is mostly very fleeting and non-verbal. When we try to find words to describe it, it’s gone, yet we know we have been changed by the experience. ix
Healing occurs in silence. Healing occurs not when you are doing something, and healing generally occurs in a mysterious fashion. I am sure as practitioners you have got a good sense of that. You can be trucking along and doing the best you can and you are following this, doing that, listening to the other and sometimes it just seems to be as though you are at a tangent. Healing comes in an unlikely manner. It sometimes seems like a benediction or grace descending. It is almost nothing that you are doing but everything that you are doing.x
I’ll turn again to a poet for the last words here, Jimenez:
My boat struck something deep.
Sound, silence, waves.
Or perhaps, everything happened
And I’m sitting in the middle of my new life.
Juan Ramon Jimenezxi
5. Art not Technology
From the point of view of practice this is more like an art than a technology. This distinction comes from Heidegger, whose work I discovered through Stephen Batchelor, and of course am learning more about through Franklyn Sills as well.
Heidegger makes a distinction between a problem and a mystery. A problem is something that can be laid our before us objectively. It can be defined and broken down into component parts. We can then apply a sequence of known procedures to address the problem and solve it. For example, to repair a broken-down car. The development and use of technology is an outcome of this way of looking at the world. It is an outcome of what Heidegger calls 'calculative thinking', which reduces the world to objects and problems to be used or solved.
A mystery is something that we ourselves are involved in, so that subject and object cannot be neatly separated out. Our condition of being embodied, of being alive, is itself a mystery. When it comes to approaching a mystery, we need to engage what Heidegger calls 'meditative thinking'. In other words, to let ourselves be impacted, to let the world or experience come to us and inform us.
In his book “The Faith To Doubt’ Stephen Batchelor quotes the French philosopher and artist Gabriel Marcel:
A problem is something which I meet, which I find complete before me, but which I can therefore lay siege to and reduce. But a mystery is something in which I am myself involved, and it can therefore only be thought of as a sphere where the distinction between what is in me and what is before me loses its meaning and initial validity. A genuine problem is subject to an appropriate technique by the exercise of which it is defined: whereas a mystery, by definition, transcends every conceivable technique.xii
Or as Jung says, ‘I cannot experience myself as a scientific problem’.xiii To approach a mystery, we need not calculative mind but meditative mind. Here we are in the territory of what Keats called 'negative capability':
when a man is capable of being in uncertainties, mysteries, doubts, without any irritable reaching after fact and reasonxiv
This a kind of radical openness - a fertile ground of possibility, free of preconceptions.
A Place of Quest-ioning
This kind of opennness, and willingness to embrace not knowing has deeply informed the Rinzai Zen tradition of Buddhhist practice, which Stephen Batchelor immersed himself in for his 11 years as a monk in Korea. A lot of the time the practice consisted of long meditation retreats during which the monks would sit with the question ' what is this?' .I have sat on retreat with him at Gaia House and have had a small taste of this. For me it has some resonance with the Focusing process developed by Gendlin, which has been influential in the development of CPP. The kind of openness we need to receive and enquire into our felt sense of how it is now seems very congruent with the kind of meditative openness and enquiry which the question ;'what is this?' tends to facilitate.
The Rinzai Zen tradition is best known for its koans. The original meaning of this word is 'public case'. When we think of koans we probably think of stories like the disciple who is asked by the master 'what is the sound of one hand clapping?'. The disciple wrestles with the question, usually for a long time, and then in a moment of breakthrough, 'gets it'.
I do think there is an analogy here with our clients. Often there is a kind of stuckness, a predicament which cannot be solved at its own level, cannot be solved as a problem. There might be a demand that it is solved in this kind of way. I once had a client who told me that I should be able to fix her like a mechanic fixes a car. If I couldn't, why should I be paid?
That might sound absurd to our ears but actually this is a prevalent attitude in our culture. It is the technological attitude, the attitude of calculative mind.
In fact it is not too far removed from the attitude of the National Institute of Clinical Excellence, or NICE for short. CBT is a very valuable therapeutic approach which helps a lot of people. But in driving forward CBT as a response to the epidemic of what is called 'anxiety and depression', which are the recommendations of The Depression Report,xv there is a danger. My question is, what is being missed here? What is the call of 'anxiety'? What is the call of 'depression'?
Maybe part of the call is to respond to something in our culture that is 'off' or out of tune. If we pre-define the problem and the solution we will not hear that call. We will not make this heartbreak a guest, we will not come to know it, and we will not find out where it wants to take us.
Let me give an extreme example to illustrate my point. Suppose that we were CBT practitioners in Nazi Germany and a concentration camp guard came to us suffering from anxiety and depression and our remit was to apply the procedures of CBT to get him back to work. Within 6 sessions. That would be our SMART objective. From our vantage point now we can see that such an approach takes no account of the cultural, ethical and existential context.
In the same way, perhaps there is now an Inconvenient Truth (as Al Gore puts it) that we would be ignoring were we to take 'anxiety' and 'depression' at face value. We are in danger of destroying our planet. Of course we're anxious and depressed!
And then there is the existential predicament. The predicament of being in a body and subject to death – what the Zen masters call ‘the great matter of birth and death’. Should we be trying to fix the ‘problem’ of unhappiness on its own level? I will leave it to Beckett to have the final word here:
We are happy. (Silence.) What do we do now, now that we are happy?
Wait for Godot. (Estragon groans. Silence.)xvi
I think the value of the kind of therapy we practice is precisely that we protect the space from the agendas of SMART and NICE. We resource and catalyse a creative response to the individual, cultural and existential predicaments we face with our clients. And the form of the work and its outcome cannot be know in advance. It is an improvised, co-created music of call and response, in which transformative moments arise.
Beating The Blues – Or Singing The Blues?
The logical consequence of developing therapies which are effectively technologies (in Heidegger’s sense) is that therapy can be computerised. And indeed, that is happening. There is a CD ROM called ‘Beating The Blues’ which is designed to enable clients to apply a CBT approach to their depression. Now I am not saying that this is an evil thing – no doubt it can help people without access to a therapist and indeed that is the intention behind it. But I would like to argue strongly for a psychotherapy which can make heartbreak a guest and ask what it needs. Not beating the blues but singing the blues.
Of course we have to engage with the technological, calculative attitude which is prevalent in our culture. We cannot avoid this. But I think that we have to do so on the basis of offering Mustard Seeds, to allude to that famous and wonderful parable from the sutras.
The birth of RocknRoll music was unpredictable. It came out of an immersion in musics with deep ancestral roots and was a creative accident, improvised in the moment. This is clear from the stories of all those present at the first Sun Sessions, which produced Elvis’ first records. Elvis’ appearance on the cultural stage was also a pivotal moment, changing everything which came afterwards.
I think that what is wonderful about the kind of open-ended process-based therapy we practise, with deep roots in a tradition but with a wide embrace of the unfolding moment, is that it can act as a resource for and catalyst of this kind of response, this kind of dynamic, full-bloodied, embodied, response in the life of individuals which cannot be predicted, or in any way guaranteed, in advance.
Elvis of course has been hugely mythologized. I wonder if part of the reason for this is that he personifies something for us: an original creative genius which became formularised, commoditised and stuck, ending in deep personal unhappiness for the man, so that the hugeness of his spirit could be expressed only through addictions to food and drugs. Perhaps he symbolises something about American culture - which is increasingly global culture.
One of the birthplaces of the blues and all the music which derives from the blues was New Orleans. We have just lost this city, in all likelihood as a result of climate change. For me this is a deeply sad and resonant event. Perhaps we are paying the price of our own bloatedness, our own addictions, our own denial of genius. There was no Heartbreak Hotel for Elvis – no place he could go to reconstruct himself. Perhaps like any myth, his myth endures because of the complexity of meanings we can read into it. I would like to think that by keeping Heartbreak Hotel open, we can help individuals to find their own response, from their own creative wellspring, to their individual predicaments, which are of course inseparable from all of our predicaments.
i Words and music by Mae Axton and Tommy Durden
ii The Relation Between 'Action' and 'suffering' in Asian Philosophy. Larson, GJ - Philosophy East & West. Volume: 34. Issue: 4. 1984: 351.
iii Rhys Davids, CAF., Woodward Fl., (trans.) (1917-30)
iv ‘The Guest House’ (Barks, C et al Trans.) (1995): 109
v Corrigall, J, Payne, H, Wilkinson, H (eds) 2006: 201
vi Stern (2004): 5
vii Ibid: 7
viii Ibid: 176
ix Corrigall, J, Payne, H, Wilkinson, H (eds) 2006: 201
x "Inner Processes of the Practitioner Talk" given by Maura Sills to the CSTA AGM on the 14th of October 2000
xi In Ortiz-Carboneres, S (Ed) (2005)
xii In Batchelor, S (1990): 43
xiii Jung, C.G., 1995:17
xiv In Gittings, R., (ed) (1970)
xv Centre For Economic Performance's Mental Health Policy Group (2006)
xvi Waiting For Godot, Act Two in Beckett, S., 2006: 56xvii See Rhys Davids, Caf (trans) (1980), for the full parable. Also see Silverton (2005) for a full discussion of its meaning for therapists.
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