The Possibilities of Dialogue
January 2007
Banner photo: Herby Sachs/version-foto.de
Psychotherapy: Caring for the Human Heart
Lee K. Wolfson is a licensed psychologist currently serving as the student psychologist for the University of Pittsburgh Medical School, U.S.A. He also has a private practice.
Jill Brennan is a Senior Accredited Counselor/Psychotherapist with the British Association for Counselling and Psychotherapy. She works for the Manchester Mental Health and Social Care Trust. (These interviews were conducted separately by e-mail.)
Why did you choose therapy as your career?
Lee: This is a question that I still ask myself from time to time, especially when I am facing a very challenging patient. One factor was that I had a professor who was a source of great inspiration. Not only did he encourage me to apply to graduate school, he also encouraged me to study Buddhism. This was in 1972, around the same time I joined the SGI. The second was that I had an intense curiosity about the inner life of human beings.
Jill: I wanted to work with people in a life-enhancing, value-creating way. I feel privileged that every day I am visited by people who share with me their unique insight into the human condition.
What influence has your Buddhist practice had on your understanding of human behavior and psychological health?
Jill: It has had an enormous influence. Buddhist study has given a profound and coherent philosophical grounding to my understanding of human behavior and experience. For instance, modern Western psychology tends to be rather narrowly focused on the internal world, while Buddhism connects the intrapersonal with the interpersonal and environmental realms.
Lee: Understanding human behavior as well as psychological health begins within your own life. Since I began my Buddhist practice before I commenced my career, I had already begun the process of learning how to examine my own psychological state, or life condition. Part of my education and growth as a therapist also involved going through my own analysis. The combination of my Buddhist practice and working with a very skilled analyst helped me see more clearly ways in which my own karmic tendencies might interfere with my ability to help patients.
My study of Buddhism also taught me that psychological health is not a state of perfection. Rather, Buddhism teaches that we possess both positive and negative life conditions as conveyed through the concept of the Ten Worlds. Psychological health lies in developing the capacity to embrace our life in its entirety.
How does your practice impact your approach to your work on a day-to-day basis?
Lee: My daily Buddhist practice helps me approach people with the spirit that this may be my only opportunity to connect with them heart-to-heart, which is an attitude I learned from SGI President Ikeda. It also gives me a sense of purpose and focus.
Jill: Buddhist practice helps me maintain my own life force, so that I can be a strong positive influence on my clients and my environment. Attending SGI discussion meetings develops my capacity for encounter and dialogue with others. Above all, I try to keep an attitude of unconditional respect toward everyone I work with.
Is it sometimes frustrating not to be able to talk about Buddhist concepts or approaches in your work?
Jill: In a sense I do talk about Buddhist concepts in my work all the time. Buddhist thinking is often in harmony with common sense and good psychotherapeutic practice. For example, psychological research suggests a link between rumination on past events and depression. In gently reminding my clients that life begins from this moment and that holding onto the past only exacerbates depression, I may not use the phrase honnin-myo (true cause), but I am using a concept which is both Buddhist and in accord with psychology.
What can be frustrating is working with someone who has what, in a Buddhist context, would be framed as an engrained karmic problem for which psychology does not have a solution.
If a client defines a problem as a theological or philosophical issue, I will sometimes identify my faith and ask if a Buddhist perspective would be useful. Depending on their response I might offer Buddhist concepts and explanations as alternative perspectives on problems.
Lee: I knew from the start that it would be a breach of professional ethics to introduce my patients to Buddhism directly. However, in the last 15 years, core Buddhist concepts have become more mainstream in Western psychology. I have learned how to integrate these principles into my work and have found that most of my patients have responded positively.
More recently, I became intrigued with the last part of our daily Lotus Sutra recitation. Here, Shakyamuni states: "At all times I think to myself: How can I cause living beings to gain entry into the unsurpassed way and quickly acquire the body of a Buddha?" Here we find the Buddha pondering this question of how he can help other people become Buddhas themselves. I would have thought the Buddha already knew the answer, but instead, he embraces the question itself.
This reminded me of a quote from Rainer Maria Rilke, the German poet: "Be patient toward all that is unsolved in your heart and try to love the questions themselves. . . . Live your questions now, and perhaps even without knowing it, you will live along some distant day into your answers." So I have embraced the same approach as Shakyamuni, to constantly ask myself how I can help each person I encounter become truly happy and trust that together we will live into the answer.
What makes therapy rewarding for you?
Jill: Witnessing my clients improving their lives and becoming happier.
Lee: My work as a psychotherapist has provided me with an opportunity to deepen my capacity to live more fully in the moment and to engage in a kind of dialogue that is both intimate and challenging. My intention is to relieve suffering. Even though I am not always successful, I find the challenge and the questions that I must embrace deeply fulfilling.
Students often come to see me when they are having difficulty handling the enormous pressure of medical school and they are suffering from anxiety, depression or some other kind of stress reaction. Once I feel that we have fully explored their current problems, I always ask them to talk about why they initially chose medicine as a profession.
This is a direct path to their hearts, and it often helps them reconnect with their deepest aspirations and ideals. This also helps them find the courage and tenacity they need to complete their studies. When all else is said and done, it is indeed, as Buddhism teaches, the heart that is most important.
