3) Freedom from Self-Esteem Concerns

Psychotherapy Without a Self

Ronald D. Siegel

Anatta

The Western View of the Self

• Emphasis on separateness vs.

connection to family, tribe, nature, etc.

• Healthy (Western) development:

 Individuated

 Aware of Boundaries

 Knowing one’s needs

 Clear identity and sense of self

Narcissism in Western Psychology

• DSM

 Character disorder

• Behavior therapy

 Self efficacy

• Psychodynamic psychotherapy

 Healthy narcissism or self esteem

Narcissism in Buddhist Psychology

• We suffer when we don’t know who we really are

• Attempt to buttress self is central cause of suffering

• Our concept of “self” is based on a fundamental misunderstanding

Therapeutic Benefits of Glimpsing Anatta

1. Increased affect tolerance 2. Radical acceptance of parts 3. Freedom from self-esteem concerns 4. Deeper connection to others

Thinking Homunculus? Default Mode Network

Constructing “Me”

• Identity is a construction project

• Mind is a world- building organ

 Makes order out of chaos

 Constructs reality from data streaming in at break-neck speed

Sense Contact

• Coming together of

 Sense organ

 Sense object

 Awareness of object

• Six senses

 Seeing

 Hearing

 Smelling

 Tasting

 Touching

 Thinking

Perception

• Evaluates sense experience

 Conditioned by culture and language

• Constructs and categorizes

 Resolves ambiguity

Feeling

• We add an affective or hedonic tone to all experience

 Pleasant

 Unpleasant

 Neutral

Intention and Disposition

• We try to

 Hold onto the pleasant

 Push away the unpleasant

 Ignore the neutral

• We develop habits of intention

 Dispositions

 Learned behaviors or conditioned responses

 Identity or personality characteristics

Where do I Begin and End?

Superorganism

Intention

Feeling Perception

Consciousness

Sense Organ Sense Object

The Construction of Experience Who Am I?

• Two types of self-reference

 Narrative focus (NF)

• Enduring traits

• Talking to ourselves about ourselves

 Experiential focus (EF)

• Moment-to-moment experience

• The mind-body in action

Medial Prefrontal Cortex (mPFC)

• Links subjective experiences across

• Holds memory of time

 Self traits

 Traits of similar others

 Reflected self- knowledge

 Future aspirations

The Study

• Half of subjects engaged in 8 week MBSR course, half on wait list

• All trained in narrative focus (NF) and experiential focus (EF) modes of responding to adjectives

• All asked to do each approach while in fMRI scanner

The Results

• In novices, experiential focus (EF) reduced self-referential activity in medial prefrontal cortex (mPFC)

• In MBSR participants, EF resulted in more marked and pervasive reduced activity in mPFC, along with increased engagement in several other areas

The Conclusion

• There is a fundamental neural dissociation between two forms of self-awareness:

 The self across time

 The unfolding of moment-to-moment experience in the present moment

• Mindfulness practice enables us to see these as separate

 To see how the separate “self” is created out of a narrative

To study Buddhism is to study the self.

To study the self is to forget the self.

To forget the self is to be enlightened by all things.

To be enlightened by all things is to be free from attachment to the body and mind of one's self and of others.

-- Dogen 13^thCentury

No one Home

• Continuous flow of moment-to-moment experience

 New “self” born and dies each moment

• Not even a stable witness

 Just impersonal experience unfolding

A human being is part of the whole called by us universe ... We experience ourselves, our thoughts and feelings as something separate from the rest. A kind of optical delusion of consciousness. This delusion is a kind of prison for us, restricting us to our personal desires and to affection for a few persons nearest to us. Our task must be to free ourselves from the prison by widening our circle of compassion to embrace all living creatures and the whole of nature in its beauty. The true value of a human being is determined by the measure and the sense in which they have obtained liberation from the self.

Nargarguna

Thus neither self nor non-self Are to be apprehended as real.

Therefore the Great Subduer rejected Views of self and of non-self.

1) Affect Tolerance

And I, Sir, Can Be Run

Through with a Sword Selfing & Affect Tolerance

• Not “my,” but “the”

 Anger

 Sadness

 Fear

 Joy

 Lust

Not Knowing

Beginner’s Mind

2) Acceptance of Parts

Our Polytheistic Mind

How Was Your Meditation?

• Part trying to attend to the breath

• Part fantasizing about the future

• Part judging myself

• Ask the committee!

Jung’s Shadow

• We identify with some parts while rejecting others

• We become defensive when shadow is illuminated

We’re all Bozos on this Bus

• Dandelions in a field

• Not a path to perfection, but a path to wholeness

• Boundary of what we can accept in ourselves is the boundary of our freedom

– Zen Patriarch

The Trance of Unworthiness

• Eastern meditation teachers are surprised by Western self-criticism

• Anxiety is primal mood of the separate self (Tara Brach)

• Related to Western cultural emphasis on the separate self

3) Freedom from Self-Esteem Concerns

Self-Evaluation

What Realms Define Me?

• Skills & Talents

• Accomplishments

• Pedigree or Group Membership

• Moral Standing

• Appearance

Lake Wobegon

Where all the women are strong, all the men are good looking, and all the

children are above average.

The Failure of Success

• The pain of I, me, me, mine

• Narcissistic recalibration

• Impossibility of winning consistently

Wrong Wall?

As If by an Unseen Hand

• Adaptive value to identifying with “self”

 Evolved through natural selection

 Self-preservation and promotion instinct shared by other animals

It’s Getting Worse

Narcissistic Personality Inventory

• I just want to be reasonably happy

• I want to amount to something in the eyes of the world

• If I ruled the world it would be a better place

• The thought of ruling the world scares the hell out of me

• I am much like everybody else

• I am an extraordinary person

• I always know what I’m doing

• Sometimes I’m not sure of what I’m doing

Egos Inflating Over Time: A Cross‐Temporal Meta‐Analysis of the Narcissistic Personality Inventory

Journal of Personality, Volume 76, Issue 4

Suffering in Isolation

• If we’re not happy, it’s our fault

 Failure to buy the right consumer product

 Inherent weakness

• Psychiatric diagnostic system can exacerbate problem

 Only sick people have the disorders

He’s just an ordinary kid.

-- Barry Magid (Ordinary Mind)

I get my money from Mommy.

Self-Esteem Autobiography

4) Connecting to Others

Us and Them

Enemy

Enemy

Meat Meat

Meat

Meat

Enemy Servant

Servant

Enemy

Servant Servant

Servant

Servant

“Do unto others as you would have them do unto you”

It’s not just a commandment, but a law of nature.

Judgments

Relational-Cultural Theory

• Grew out of feminist critique of conventional psychology

• Benefits of mutual connection

 Energy and vitality

 Greater capacity to act

 Increased clarity

 Enhanced self-worth (efficacy)

 Desire and capacity for more connection

Three Objects of Awareness

• Mindfulness of sensations, thoughts, feelings in “me”

• Mindfulness of the words, body language, mood of the other

• Mindfulness of the flow of relationship

Life in a Space Suit

• Defenses against pain insulate us from one another

• We imagine they keep us safe, but they leave us more vulnerable

Make a connection, not an impression.

It’s About Other People

Service

Embracing Insignificance

Poor Prognosis

Wat Tham Sua

Tiger Cave Temple Krabi, Thailand

King of England, 1387

Narcissistic Threats

• Anxiety often involves threats to us or our loved ones

 Self image

 Health

 Wealth

 Fantasized loss of pleasure

 Anticipated disappointment

Loving-kindness for the Competition

Looking Through Another’s Eyes Condon, Desbordes, &

Miller (2013)

My Mantra

Self-Compassion

• Self-kindness

• Common Humanity

• Mindfulness

Why Are You Unhappy?

Because 99.9% of everything you think, and everything you do, is for yourself. And there isn’t one.

-- Wei Wu Wei

Implications for Treatment

• Psychotherapy without a self can help us

 Embrace ordinariness and insignificance

 Foster connection, acceptance, and psychological flexibility

Therapeutic Progress

“mine”

about me Not about me

“mine”

about me Not about me

-- Adapted from Engler & Fulton

For recorded meditations, visit:

www.mindfulness-solution.com www.sittingtogether.com

email:

[email protected]

About the Presenter

Dr. Ronald D. Siegel is an Assistant Professor of Psychology, part time, at Harvard Medical School, where he has taught for over 30 years. He is a long time student of mindfulness meditation and serves on the Board of Directors and faculty of the Institute for Meditation and Psychotherapy. He teaches internationally about the application of mindfulness practice in psychotherapy and other fields, and maintains a private clinical practice in Lincoln, Massachusetts.

Dr. Siegel is coauthor of the self-treatment guide Back Sense: A Revolutionary Approach to Halting the Cycle of Chronic Back Pain, which integrates Western and Eastern approaches for treating chronic back pain; coeditor of the critically acclaimed text, Mindfulness and

Psychotherapy, 2

Edition; author of a book for general audiences, The Mindfulness Solution:

Everyday Practices for Everyday Problems; coeditor of Wisdom and Compassion in

Psychotherapy: Deepening Mindfulness in Clinical Practice, with a foreword by His Holiness the Dalai Lama; coauthor of the professional guide Sitting Together: Essential Skills for Mindfulness-Based Psychotherapy; and professor for The Science of Mindfulness: A Research- Based Path to Well-Being produced by The Great Courses. He is also a regular contributor to other professional publications, and is co-director of the annual Harvard Medical School Conference on Meditation and Psychotherapy.

Ronald D. Siegel, Psy.D.

20 Long Meadow Road Lincoln, MA 01773

781-259-3434 [email protected]

For recordings of mindfulness practice instructions, including meditations for working with anxiety, depression, relationship issues, addictions, and other difficulties, please visit

www.mindfulness-solution.com

For additional recorded meditations, and patient handouts, please visit www.sittingtogether.com

For information about mindfulness and psychotherapy programs, please visit