In dialogue with Pamela Saunders on the meaning of Buddhism in today's world and on the work of Rainer Maria Rilke (a poet whose work we both resonate to), I would like to point to the following as relevant to our work as psychotherapists:
Psychoanalysis has devoted itself to unconscious mental processes and internalized relational processes, particularly centering on anxieties, depression, hate, envy, shame, etc., but has paid little attention to such positive emotions as compassion. The latter is underscored in many religions, in ethical humanism, and, particularly, in Buddhism. It is encouraging in these difficult times to see a growing interest in the need for greater compassion between individuals and nations, as we are becoming increasingly aware that our world and its people are highly interconnected and interdependent.
An excellent volume on this subject is:
Visions of Compassion: Western Scientists and Tibetan Buddhists Examine Human Nature edited by Richard Davidson & Anne Harrington (with a chapter on human nature by His Holiness the Dalai Lama) and published in 2002 by Oxford University Press.
Rainer Maria Rilke underscored the humanness of the helper, as did Post-Kleinian psychoanalyst Heinrich Racker who spoke of the myth of the ‘sick’ patient and the ‘well’ psychoanalyst. Rilke (1934), in his “Letters to a Young Poet,” noted:
"And if there is one thing more that I must say to you it is this: Do not believe that he who seeks to comfort you lives untroubled among the simple and quiet words that sometimes do you good. His life has much difficulty and sadness and remains far behind yours. Were it otherwise he would never have been able to find those words” (p. 72).
Rilke (1984), with a similar sensibility to author James Baldwin, in his “Letters to a Young Poet,” had this to say of the human condition:
“For one human being to love another human being: that is perhaps the most difficult task that has been entrusted to us, the ultimate task, the final test and proof, for which all other work is merely preparation” (p.195).
Brian Koehler
New York University .
It seems to me that compassion plays a highly significant role in clinical work. In particular, the therapeutic transformation of fear, paranoia and hatred enacted in the here and now of the relation between the therapeutic partners.
Compassion, as his Holiness the Dali Lama, Tenzin Gyatso, has defined it ( The Compassionate Life published in 2003 by Wisdom Publications):
"In simple terms, compassion and love can be defined as positive thoughts and feelings that give rise to such essential things in life as hope, courage, determination, and inner strength. In the Buddhist tradition, compassion and love are seen as two aspects of [the] same thing: compassion is the wish for another being to be free from suffering; love is wanting them to have happiness...True compassion is not just an emotional response but a firm commitment founded on reason. Because of this firm foundation, a truly compassionate attitude towards others does not change even if they behave negatively. Genuine compassion is based not on our own projections and expectations, but rather on the needs of the other: irrespective of whether another person is a close friend or an enemy...Of course developing this kind of compassion is not at all easy!...Whether people are...friendly or cruel, ultimately they are human beings, just like oneself. Like oneself, they want happiness and do not want suffering. Furthermore, their right to overcome suffering and to be happy is equal to one's own. Now, when you recognize that all beings are equal in both their desire for happiness and their right to obtain it, you automatically feel empathy and closeness for them...We should consider enemies our best teachers! For a person who cherishes compassion and love, the practice of patience is essential, and for that, enemies are indispensable....Fundamentally, the basis on which you can build a sense of caring for others is the capacity to love yourself...the capacity to love yourself is based on the fact that we all desire happiness and want to avoid suffering. And once you recognize this love in relation to yourself, then you can extend it to other sentient beings."
These ideas can be extended to the clinical situation. Many psychoanalysts (e.g., Leon Grinberg, Mike Varga) believe in the positive nature of the negative transference, i.e., the person needs to enact what was pathogenic in previous relationships with her/his analyst. The pull on the analyst is to respond in kind (the talion principle-an eye for an eye-which as Gandhi cogently pointed out-makes the whole world blind)--what Grinberg called-projective counter-identification--identifying with the internal objects projected into oneself (a form of identification with the aggressor in the patient-also, patients may unconsciously introject, as pointed out by Searles, the aggressor in the analyst) and an urge to retaliate in kind (e.g., in effect, saying I am not the bad object in this room-you are!). Enactments are inevitable. It is up to the analyst to help foster greater awareness of the subtle interpersonal processes and enactments occurring in the hear and now in the relationship. Winnicott spoke of (in his excellent and far-reaching paper "Use of the Object") the need to survive a phase of maximum destructiveness (which is partly in the service of creating externality, separation, etc.) by not retaliating or emotionally (or even worse, physically) withdrawing. Enactments have been termed disruption-repair cycles by infant researchers such as Dan Stern and Beatrice Beebe. It is important for the analyst to be aware of, and own, and acknowledge to the patient, her/his part in the disruption in order to engage in reparative work.
Brian Koehler
