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Eastern Approaches to Psychotherapy
Transcript of Eastern Approaches to Psychotherapy
Zen Buddhism is an offshoot of traditional Buddhism and incorporates more Taoist philosophy
Traditional Buddhism originated in north India and moved further east and came in contact with China and now can be form in Korea, China, Thailand, Japan.
Zen roughly translates to meditative state
There are main meditations used in Zen meditations: simple breathing meditation, observation of the mind.
Confucianism & Taoism
Confucianism considered to be the main philosophy adopted in Chinese culture, and Taoism to be complementary
Confucianism emphasizes ethics and morality
Taoism has principles of social coping and health keeping
Successful in life > Confucian thought
Confronting problems in life > adapt, appreciate Taoist thought ("Taoism at a glance", n.d.).
What is it?
What is it?
What are they?
Qi Gong & Tai Chi
Taoist Principles & Psychotherapy
Thanks for Listening
Buddhist teachings and practices have been around for an estimated 2500 years—Brought forward by its creator Gautama Buddha.
Buddhist Approaches on Psychotherapy and Healing
Animism & Shinto
Animism (animus= "soul, life") is the belief system/cosmology that non-human entities contain spiritual essence and that no difference exists between the spiritual and physical worlds
Entities of natural environment (animals, plants, geographic features, shadows, winds) all contain spirits or souls
Shinto ("way of the Gods") is seen more as a way of life rather than a religion
Based on respect for all nature and ancestor worship
Believe in "Kami"->"spirits", "essences" or "deities"
Basically, both believe in respect for, and peaceful connection to the natural world
What is it?
Stages of CTCP
Legendary philosopher of ancient China, founder of Taoism 2000 years ago
Honored as a deity in religious Taoism
Wrote the Tao Te Ching
Translates as the path or way
Emphasizes acceptance of unity and opposites, Yin and Yang
Achievement of harmony with nature, spiritual immortality, self development
Selves viewed as one with nature, seekers of balance, and an ongoing work in progress ("Taoism at a glance", n.d.).
Practices: Feng shui, meditation, scripture reading/chanting, tai chi, etc.
Qi gong: aligning breath, movement, and awareness for exercise, healing, and meditation; cultivate and balance qi
Tai Chi: Chinese martial art practiced for both its defense training and its health benefits; tao lu, neigong & qigong, tuishou, sanshou ("Wikipedia", 2014).
Guidelines: jing and ding(Three Relaxing Breaths", n.d.).
Three relaxing breaths exercise
Concept of synchronicity and harmony
Placing meaning to the events of life
When synchronicity is realized, may feel more connected with others
Life is given meaning through an interrelated world ("Psychotherapy in China", n.d.)
Chinese Taoist Cognitive
Developed by Dersen Young and Yalin Zhang
Modification of Rational Emotive Behavioural Therapy
Cultural factors important in the process of therapy and mental health
Tailored to be more indigenous and suitable for native Chinese people (Young, et al., 2008).
8 Basic Principles
1.) Benefit without harm to yourself as well as to others
2.) Do your best without competition with others
3.) Moderate desire and limit selfishness
4.) Know when to stop and learn how to be satisfied
5.) Knowing harmony and put one’s self on a humble position
6.) Hold softness to defeat hardness
7.) Return to the initial purity and back to the original innocence
8.) Following the rule of nature (Tsang, n.d.)
Assessment of Stress
Conflict and coping system
Evaluate effect (Tsang, n.d.).
-develop rapport with the patient
-introduction of Taoism stress coping and health keeping
-relaxation and meditation training
-analysis of psychological causes of the emotional disorder
-cognitive behavioral modification based on the Eight
-prepare for the termination of therapy examine the
ability of the patient to utilize the new ways learned (Tsang, n.d.).
CTCP and Mental
Applied clinically for the treatment of patients with neurotic and psychosomatic disorders
Taoism’s heavy emphasis on natural order without human interference
Helpful to patients with an anxiety disorder, depression, or to patients who have immediate family members with neurotic personality disorders
Young adult clients vs. older clients
Results of a randomized controlled study involving 143 patients with generalized anxiety disorder support the efficacy of CTCP.
Dr. Gallagher-Thompson’s group at Stanford University
Experienced less subjective burden and had substantially reduced depressive symptoms (Tsang, n.d.)
Carl Rogers &Taoism
Person Centered Therapy
Taoist let be attitude
Facilitator and Client relationship
-being authentic and establishing the relationship
-do nothing principle in Taoism
(Moss & Perryman, 2012).
Integration of Taoist
The growth of one’s non-genuine self into one’s genuine self is a central aspect of Taoism and the psychologies of Jung, Erikson, and Maslow
Jung: ego, or sense of personal self, emerges from a background of Self or Tao; divided self and whole self
Erikson: proceeds towards wholeness or integrity; resolution of eight tasks: series of eight inner and outer conflicts of each developmental period
Maslow: satisfy human needs; spiritual wholeness, or wisdom as the final stage in a psychologically healthy and satisfying life (Moss & Perryman, 2012).
in comparison with
Western: emphasizes improving one’s skills, changing one’s environment, and fulfillment of individual needs
Eastern Taoism: fundamental changes in attitudes, life will take its own course and one will eventually experience peace and fulfillment
Western and Eastern commonalities in basic core virtues: courage, justice, humanity, temperance, wisdom, and transcendence (Moss & Perryman, 2012).
Main Figures in Zen Therapy &
Joan Halifax Roshi
Based on the four noble truths which explore the nature of suffering and how does one free themselves from suffering.
The concept of the middle way which is essential in Buddhist philosophy as it seeks a middle or balancing point between self denial and self indulgence.
The wheel of life (samsara) explains six different realms of human existence. Each of these realms are dependent on the individual’s karma. There is a hell realm, realm of the hungry ghosts, animal realm, the human realm, the realm of the jealous gods and the god realm.
Wheel of Life
Each realm depicted in the wheel of life has a corresponding psychological state.
Hell realm – The hell realm represents being tortured by different emotional states including anger, depression, fear and guilt. One has to recognize that within the mind that the mind is the source of the suffering and it perpetuates the state.
Animal realm – The animal realm is one of instinctual gratification, drives of hunger and sexuality. The lasting happiness can’t be derived from the purely animal real.
Realm of the Hungry ghost – The realm is depicted by ghost which constantly eat or devour but are never satiated in their desires. They fail to recognize that the object of desire is a mere fantasy when they realize that they are still hungry. (as seen in addictions)
Buddhist psychology differs from western psychology in the sense that it is not at all focused on the development of the ego. In Buddhist psychology, they use the tools of the ego to try to disengage with attachment to impermanent things or impermanent states.
To achieve this, it relies on meditations to analyze the cravings and dissatisfaction whicch allows them to pass.
Freud and Buddhism – He believed that all psychological disturbance or issues come from an unresolved sexual or erotic tension or complex as a young child and the inherent conflicts which this has with the ego and the superego. Buddhism has a similar idea.
Applications to therapy
Mindfulness based stress reduction, mindfulness based cognitive behavioral therapy and dialectal behavioral therapy and acceptance and commitment therapy.
The study of mindfulness was originally a Zen practice which has been adapted to fit contemporary therapy.
A.C.T (Acceptance and Commitment Therapy)
ACT is one of the third generation behavioral therapy
The approach was developed in the late 1980s by Steven C. Hayes, Kelly G. Wilson, and Kirk Strosahl.
The core concept of the therapy is that suffering is from cognitive entanglement and experiential avoidance.
In this therapy, psychological suffering is represented by the acronym FEAR : Fusion of thoughts, Evaluation of experience, Avoidance of your experience, Reason given for behavior.
The healthy alternative that they provide is ACT : Accept your reaction and be present, Choose a valued direction and Take action.
The core principles of ACT:
cognitive diffusion – a technique in which one changes the way they interact or relate to thoughts and attempts to diminish their unhelpful functions (Hayes and Strosahl)
Acceptance – a process of actively being aware and embracing thoughts or situations without an unnecessary attempt to change their frequency or form
Contact with the present moment – encourages the client to stay in the present moment mindful of the opportunities within the present moment
Values – values are chosen perspective actions which can never be obtained as objects but what the person wants to represent or embody
Committed to action – setting their goals according to these values and then carrying them out responsibly
Self as context – one can be aware of one’s own experiences without attachment to them and diffusion and acceptance is fostered
Zen is based on Buddhist spiritual traditions and some clients because of their own religious background may be uncomfortable with using Zen or any other spiritual ideas in the therapy.
Zen is a comparatively young form of therapy so it doesn’t have the empirical and quantitative data that other traditional therapies, such as CBT or types of psychotherapy have.
ACT has some limitations in that the youngest form of behavior therapy and it has only been popular in the last decade. ACT lacks the quantitative empirical data that some of the more established therapies have.
We will be covering...
A brief look at Eastern and Western Approaches to Psychotherapy
Animism & Shinto
Conclusions and Questions
Support the Concept of True Self
Encourage and nurture towards Independence/Autonomy
Issues linked to our past experiences
Provokes the development of therapeutic presence
Diagnosis neurosis according to narrow and personal characteristics of the self
Healing power required external help via psychotherapy, medication
Believes in No-self
Encourage Interdependence/collectivistic relationships with others
Acceptance without Judgement
Promote compassionate and mindful therapeutic relationships
Power to Heal comes from Within eg. Engaging within emptiness
Traditional Western Approaches to Psychotherapy
Describe and analyze neurotic behaviour or suffering in association with one’s childhood experiences and family dynamics—and develop therapeutic methods to help with mental discomfort(Welwood, 1985).
Ideally believed in repressing sensations, feelings and emotions associated with fear, distress and pain to allow feelings of happiness and comfort to arise (Loy, 1992).
Promoting an Individualistic self which is intensely aware of itself, its uniqueness, sense of direction, purpose and volition. (Ho, 1995)
Psychotherapeutic goals were oriented towards curing the self via ego-strengthening, impulse control, and reality testing (Welwood, 1985).
Misunderstanding of Eastern approaches
Often ignored as a religion focused on a delusional retreat from the outer world and silent mediation, with a focus on suffering (Epstein, 1995)
Unscientific Measures of Healing (Ho, 1995)
Western world dismiss Eastern forms of therapy as ancient, outdated and unreliable sources to healing the human consciousness (Epstein, 1995).
How Western Avoidance of the East lead to form gaps within Psychotherapy
Western psychology and medicine soon experience itself to be incomplete (Welwood, 1985).
While more concerned with the causes and symptoms with psychosis the west showed to undermine what healthy functioning really consists of and how people can healing their minds from within (Welwood, 1985).
With therapist and clients in the West dissatisfied with spiritual emptiness and the growing attraction of Eastern therapy, psychotherapy finally decided to turn to the East for wisdom and guidance (Ho, 1995).
More balanced and critical approach (Ho, 1995).
The Four Noble Truths
Life is Suffering
Cause of Suffering
Cessation of Suffering
The Path to the Cessation of Suffering
Buddhism provides a practical path of living to escape from suffering, by means of liberation from attachment, known as the Eightfold Way (Geller & Greenberg, 2012; Marlatt, 2002).
The Noble Eightfold Ways
: Say nothing that hurts others
: Respect life
: Practice Meditation
: Control your thoughts
: Resist Evil
: Work for the good of others
: Free your mind of Evil
: Know the truth
Carl Jung & Hisamatsu
, no such thing as the true self (Welwood, 1985)
Healing from within
, power to heal internal mental discomfort is within the human mind (Welwood, 1985).
Awakening the heart
, considers the “Heart” and “Mind” to be of the same reality (Welwood, 1985).
, becoming panoramically aware of one’s environment while dissolving concept of self to help look at present situations in a larger way (Welwood, 1985).
Forms of Meditation
involves the development of insightful awareness of one’s moment-to-moment experience with a compassionate, non-judgmental stance (Hözel et al., 2010).
involves concentrating on a focal object, such as breath or a mantra to induce feelings of calmness (Siegel, Germer & Olendzki, 2008).
Integrated Body-Mind Meditation
(Tang et al., 2012).
Goal is not to change nor challenge the content of cognitive thoughts present within one’s mind, but yet to encourage upon a different attitude or relationship to thoughts, feelings, and sensations (Hayes, Follette & Linehan, 2011).
Buddhist teachings phrase this state as the “enlightened awareness of the true being (Marlett, 1998)”
, which is “thinking about thinking”, predispose one to misunderstand their cognitive phenomenas associated with their external environment, thereby inducing intense suffering (Toneatto, 2002),
are thoughts, feelings, sensations, images, and memories (Toneatto, 2002).
The collaboration between CBT and buddhist perspective can show to help correct these negative metacognitive beliefs a clients has about his/her external and internal environment (Toneatto, 2002).
Insubstantial or Illusory
Meditation & Neuroplasticity
Several different meditative and mindfulness trainings have shown to not only to have significant beneficial effects on psychosomatic behaviour but also change the brain itself (Tang et. al, 2012).
“You can use your mind, to change your brain to change for the better” - Rick Hanson
Meditation within Neuroscientific Research
Several Research has been done to explore through the benefits of Long-term Meditation:
Thickens prefrontal cortex
(control attention and enhance executive decision making) (Lazar et. al, 2005)
(interoception, self-awareness and empathy) (Lazar et. al, 2005)
Increased number of gyrification.
(Luders et. al, 2012)
Increase grey matter in different regions of the brain
(Luders, Toga, Lepore & Gaser, 2009)
Improves white matter of Anterior Cingulate Cortex
(Modulates Self-regulation) (Tang et. al, 2012)
Lazar et. al, 2005
Luders et. al, 2012
: Luders et. al, 2009
Integration and Application of
Buddhist Meditation within
Buddhism teachings has shown to significantly impact within various Clinical issues such as:
Borderline Personality Disorder
Depression and Depressive Relapse
Panic Attacks and Anxiety Disorder
Chronic Pain and Suffering
Buddhist Psychotherapy with
Alcohol and Drug Addiction
Buddhist psychologist would describe patient suffering with addiction to be seeking out for “
False and Temporary Refuge
” (Marlett, 2002).
False refuge is believed to be motivated by a strong desire or “craving” to engage in drug usage (Marlett, 2002).
Patients engaging in drug use, would wish to purse two paths (Marlett, 2002):
Temporary escape negative emotional state of mind (sensation of suffering)
Temporary induce a positive emotional state (eg. Getting “high”)
As people become increasingly attached to the behaviours which causes them to feel anxious and depressed, maintaining these emotional states is what soon shows to develop addiction towards alcohol and drugs.
However, these patients are always looking for a fix within their future, which avoids the individual to understand and accept what occurring within the present moment (Marlett, 2002).
Meditation and Addiction
Buddhist teachings explain people resort to false refuge as result of ignorance and not sinfulness (Marlett, 2002 ).
Meditation offers an addicted individual to become aware of his present state via The Four Noble Truths
Suffering and pain are essential within life experiences.
Caused by cravings and attachments.
: States the possibility of cessation of suffering by helping one to completely liberate and detach oneself of the negative thoughts and feelings associated with the addiction.
: Meditating a pathway out of craving, addiction and suffering while adjunct with the Eightfold Way towards Enlightenment.
Morita therapy was formulated in 1919 by neuroscientist, Dr. Shoma Morita (Gibson, 1974, p. 349)
Like Freud, Dr. Shoma was interested in Neurosis and tried hypnosis methods of healing, eventually abandoning these, he developed Morita Therapy (Gibson, 1974)
Was trained in Zen Buddhism but Morita Therapy is not a Zen practice (Gibson, 1974, p. 347)
What is Morita Therapy used to treat?
Typically used to treat "nervous" predisposition or (shinkeishitsu) basically, anxiety based neurotic disorders
Phobias (social anxieties)
"Trying to control the emotional self willfully by manipulative attempts is like trying to choose a number on a thrown die or to push back the water of the Kamo River upstream. Certainly, they end up aggravating their agony and feeling unbearable pain because of their failure in manipulating the emotions."
~Shoma Morita, M.D
Arugamama- acceptance of reality that is
Won the lottery? Death? These are natural emotions
Not trying to change or fix them, rather, coexist with them
Not directing attention to the feeling or state but rather working towards living a better life
West says it is necessary to change feelings before taking action
ex. Overcome fear of heights before diving into a pool
Morita says sometimes it is the action that can change the internal state
ex. Completing tasks successfully and increased confidence as a result
Natural Feelings & Acceptance
Action & Changed internal States
The self, Experience & Environment
The west tends to diagnose and label
Label your experience rather than explore it from the self
We are changing moment to moment when we observe we see this
Preoccupied with ourselves too much attention is given to symptoms
When we give attention to what we are doing we are engaged in the present
being in touch with the outside world
eliminates self-centered focus
Basic goals for client: Acceptance & Action
About acceptance of problems and the self & not about symptom reduction (etiology & cure are not of interest)
Does not provide theory through which clients can understand their neurosis- It is about seeing what
and doing what
needs to be done
(Similar to Behaviour Therapy)
Present centered not retrospective or prospective
“Nervousness” or shinkeishitsu
Self-consciousness which is natural self-reflection is accepted, however suffering occurs when one is trapped in self-reflection and continues to think in order to escape this cycle--eventually making it worse
Stop the cycle of negative self-reflection & criticism and to shift attention away from obsession with symptom reduction and allow the client to heal naturally through acceptance
What is a successful outcome?
Learns acceptance of internal changes in thought and feelings
Ground behaviour in the present reality of the moment
Successful therapy does not mean an ideal state constant happiness is attained, it is more so learning to take action in order to live a meaningful life not ruled by internal states
Main Ideas behind
4 Stage Process of Therapy
For neurotic, anxiety based disorders that involve a high degree of Perfectionism
(1.) Isolation and rest
(2.) Occupational therapy (light)
(3.) Occupational therapy (heavy)
(4.) Complex activities
Morita Therapy and The West
Cognitive Behavioural Therapy
Yoga is a physical, mental and spiritual philosophy and practice with an ultimate goal of attaining a state of permanent peace within the self.
Includes simple meditation, breath control and adoption of certain bodily postures
better health, improved quality of sleep, greater self-awareness both internally and physically and an overall improved quality of life.
A brief History
Yoga can be traced back to ancient India where the earliest mentions of it have been found in the oldest known existing text, the Regveda.
Thought to be composed approximately 1700-1100 BCE
Foundation of Yoga held in a text called
Yoga Sutras of Patañjali
which contain 196 sutras (rules/formulas)
"The stilling of the changing states of the mind" or "Union with the divine"
The Four Forms of Yoga
Not about the end result, but rather the process
Concentration & Peace
Layayoga (Kundalini Yoga)
Bandhas (internal locks)
Pranayama (breath control)
Mantra (chants or repetition of sounds or words)
Yantra (pictures or visual symbols)
• Mantra is a sacred word, chant, sound syllable or word believed to have spiritual and psychological power
• can be internal & silent or external & verbal
• important role in developing concentration during meditation
• chanting of mantras in meditation is practiced in Hinduism, Buddhism, Jainism and Sikhism
• (Aum, Om)
Layayoga (Kundalini Yoga)
• “The yoga of awareness”
• Focus is to activate and awaken Kundalini energy
o Kundalini energy is a feminine power (Shakti) that can be awakened to attain a state of peace and enlightenment
o Lays coiled at the base of the spine
o Linked in the west, to Freud’s Libido (energy) theory and the unconscious
• Awakened through meditation, chanting matras, pranayama breathing, asna (postures)
• Performed with a high degree of concentration, non-competitively and slowly, what the west typically knows as Yoga
• Focusing on physical and mental strength building exercises and postures described primarily in three texts of Hinduism
• Strengthens the body and encourages balance
• Used with various practices such as mantra (repetition of sound) and yantra (observation of verbal images)
• One route to a spiritual path—“realization through discipline” (Iyengar, 1966).
• Discovery of our own mind
• Meditation and contemplation with a goal to find reality and achieve awakening (Moksha)
• Was first described in the eightfold (or eight-limb) path
Patanjali's Eightfold Path (The Eight Limbs of Yoga)
(prohibitions, restraints, abstention from evil-doing)
(breathing techniques, control of prana or the life
(sense control, withdrawal of the mind from sense-
(contentment or bliss)
Yoga and Mental Health
Yama & Niyama
ACT and Eating Disorders
Clients with an eating disorder exhibit very rigid emotional avoidance and control strategies that ACT specifically targets
The therapist will try to facilitate creative hopelessness where a discussion around the client the client’s strategies to control their emotional internal experience do not work.
Mindfulness is presented as an alternative to the client’s control strategies
Encourage cognitive diffusion with the client’s thoughts and emotional experiences and once a level of psychological flexibility is created, encourage value based behaviors.
ACT and Eating Disorders
The therapist will get the client to examine what it is that they value and behavior which correspond with those values. For example, I value health and well being so that target behavior would be eating healthy and regularly.
Morita Therapy and
• Client-Centered Therapy
Morita Therapy and
• Gestalt Therapy
Yoga in the West
• Swami Vivekananda, in 1893 introduced Hinduism at the Parliament of the World’s Religions in Chicago
o Known for introducing Indian philosophies to the west
• 1960’s interest in Hindu spiritual yoga reached its peak
• In the 21st century the term Yoga was associated with Hathayoga and postures (asanas) as physical exercise
• Currently there is more of a focus on yoga in psychotherapy
Asana and Pranayama
Pratyahara and Dharana
Dhyana and Samadhi
• How to relate to the external world through ethical
• Non-violence, truth, not steeling
• How to relate to our internal selves
• Cleanliness of mind and body, satisfaction and contentment, spiritual openness
• Postures that are practiced in yoga
• Develop ability to concentrate and focus energy inwards
• Control of limbs and nervous system
• Popularized in the west and has been found to have a number of benefits
Reduction of stress and anxiety
o Improved flexibility, strength, and balance
o Reduced sleep disturbances
o Improved blood circulation
• Control of breathing
• Recognize breath in relation to internal states, emotional and physical
o Support that pranayama techniques aid in treatment of
o Improving autonomic functions
o ANB (alternate nostril breathing) activates the parasympathetic NS and decreases blood pressure and heart rate
• Withdrawal/sensory transcendence
• Attention away from external stimuli and detached from the senses we can look inwards
• Allows us to step back and observe our own pattern that stunt our personal growth
• Prevents us from engaging in thought patterns that are irrational or emotionally damaging
• Concentration on a single object
• Avoidance of all other thoughts, although awareness of the object still exists
• Being aware, but without focus, stillness of the mind
• The “busyness is gone”
• Self-knowledge in its highest form
• Eighth and final limb
• Described as a state of consciousness where, internal and external world merge
Yoga has been shown to treat many types of disorders:
Even provided as a form of couples therapy
Yoga & Depression
Yoga & PTSD
• A study was conducted on analyzing the effects of Hatha Yoga on decreasing psychological symptoms of depression and PTSD in female low income domestic abuse survivors
• 14 women ranging from 26-51 years
• 6 week hatha yoga intervention
• Results indicated a statistically significant decrease in symptoms of depression
• Participants reported common themes of their yoga experience after the intervention of:
o Coping skills
o Improved psychological and physical functioning
o Less excitable, and more centered
• A study was conducted on women with prenatal depression (in 2nd or 3rd trimester of pregnancy)
o Conducted to see if yoga would decrease symptoms of depression
• 20 min sessions of Hatha yoga, 2 times a week for 12 weeks
• Results demonstrated that women in the yoga group had a larger decrease in symptoms then those in the control group
• Compared to the parenting group, the yoga group showed a larger decrease in symptoms
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