psychotherapy

The following essay is by psychotherapist, Buddhist teacher and Yoga teacher Michael Stone, and is the second of a two-part exploration of suicide, yoga, and Dharma. The essay is excerpted from “Awake in the World: Teachings from Yoga & Buddhism for Living an Engaged Life” by Michael Stone (Shambhala Publications, June 2011)

In ideas of suicide, beliefs become dangerously polarized. In fantasies of suicide, the world becomes “outside” and separate from “me.” The world shrinks to the small action of “me” and “my death.” This is a selfish importance that can only be healed through returning back to a lived body, a network of relations, a life filled with meaning that comes through embodied experience, not through more storytelling.

Title: Awake in the World: Teachings from Yoga & Buddhism for Living an Engaged Life
Author: Michael Stone
Publisher: Shambhala
ISBN: 978-1-59030-814-1
Available from: Shambhala, Amazon.com Kindle Store, Amazon.com, Amazon.co.uk and Amazon.co.uk Kindle Store.

The selfishness of suicide is, however, a small seed of selfhood. By processing the desire to die through staying close to what the patient feels in his or her body, we bring up insight into impermanence, showing us how what we feel is changing. What we desire in one moment becomes something entirely different in the next. The desire to jump gives way to a fantasy of wanting to find a husband, a better job, a more meaningful community. A seed must be closed tightly within itself in order to finally blossom. In this way the body of the therapist and the body of the patient enter despair together. The pain of the patient is fully felt by the therapist, and the patient is thus encouraged to face his or her overwhelming desire for the transcendent, the absolute, the eternal. Our deepest transformations occur when there is no hope, where nothing is left, not even the desire to live. Yet there is only this moment. A death in the future is not engagement with this actual experience now. It’s a projection into the future.

What’s disturbing about this is that the “I” maker” (ahaṅkāra) can be overwhelmed by the selves it has created. Those selves are real, as real as any story we tell. But can we truly listen to these selves in a way that they can express themselves and begin moving toward wholeness again? When we create space for free listening, we make room for free speech. We also make room for a wider spectrum of feelings. When we don’t play the same records over and over, we reroot our openness of body and heart, allowing feelings and thoughts to move through awareness with less clinging. In the chains of words and ideas that come forth when we can hold the space of listening without judgment, the person in pain often has a surprising discovery, a spontaneous new arrival of insight that can only happen in the creative space of held silence.

If we do not believe that the unconscious blocks that repress the expression of feeling can be supported by nonjudgmental listening, then we fall into the violent medical mentality that your symptoms are just functions of the brain. And if everything is a function of the brain, symptoms have no meaningful purpose. We need to rediscover our relation to the power of accompanied silence, of free listening, of self-expression. Again, the wish “to be dead” is a wish to attain peace and security at a time when one feels exactly the opposite. Every year, worldwide, an estimated three-quarters of a million people take their own life, making suicide and attempted suicide subjects we need to explore with much more creativity and interest.

Suicide is an attempt to resolve feelings of being overwhelmed by one’s own image of oneself, or part of oneself. Suicide is an attack on one’s own representation of one’s body as an object. It’s as if the death of the body can help one get rid of intolerable mental states and feelings. Suicide is a cry for help. Paying attention to this cry is practicing pain dharma, friendship dharma, and patience dharma. If we value the subjective experience of the person, can we let go of our fixed personal, cultural, and professional ideas about death and listen to the truth of the inner turmoil of that individual? Bearing witness requires that we put aside our fixed views. In this context bearing witness is experiencing the inner life of another, opening to our own feelings about what’s showing up, eventually leading to compassionate action. The action we take, our moment of authenticity, requires courage, and we may have to bear the results of our courage and action. From the Yoga perspective, as soon as we speak of action, we’re talking about ethics, because action always has a consequence both internally and externally. If the primary motivation for taking action is ahiṃsā—not having the intention to cause harm to body, speech, or mind—how is suicide reconciled as an action?

To acknowledge one’s intention is never simple. This is as true for the person feeling pain as it is for the one helping her. It requires willingness to take responsibility and recognize this ambivalence. I feel traditional therapy is misguided on so many fronts, not the least of which is knowing how to work with the mind. A therapist should not simply identify or recognize patterns but move from knowing about something to actually allowing it to simply be. Going back into the past often misses the functioning of the symptom in the present. The past is past. The past can only be experienced now. The past is what the mind is doing in present experience. A patient exploring suicide is exploring his or her pain in the present, and the past is encoded in the present. The hard work of the therapist is just to listen and explore what is present, not what is past. If it’s not present, it’s not here.As a caricature, psychoanalysis ceases to be a study of identity and becomes instead an exploration of traumatic memories—it becomes, absurdly, an exercise in “proving” causal links between particular traumatic experiences and particular symptoms. This, of course, gives rise to the famous problem of the analyst’s “suggesting” particular memories to the client.

Someone entertaining suicide is not only talking about future death. She is talking about present suffering. She is not describing historical trauma but rather current suffering. Suicide is not only a natural psychic reflex for surviving actual helplessness but is also an abstraction. We don’t know what death will be like, only that something must be able to lift us out of this present and persistent pain. We need theories and abstractions about death, partly because the feelings that come up around suicide are so painful. Our theories and abstractions make the pain more bearable to us. The effect of embracing death and feeling what lies below our fantasies of our own termination brings about, at a critical moment, a radical transformation. The experience of looking deeply into death is a requisite for an engaged life. This implies that the crisis of suicide is a necessary phase in the life of any of us. Suicide itself may be too quick a transformation. The job of Yoga technique is to meditate on what is going on in the felt body in order to slow a hasty charge toward death and anchor us back in life.

Suicide is yelling out: “Life must change; Something must shift; I can’t do this any longer. Having tried to change everything ‘out there,’ the only thing that can now change is inside me.” And so suicide is a quick termination of what is so painful inside. The body, however, can be called in at this crucial junction. Attentiveness to the body dissolves this false dichotomy between inner and outer, me and not me. When we tune in to the breath, we tune in to life here and now. Life here and now is changing, and so there is no fixed self anywhere to be seen. This opens us up to change, freedom, and flexibility. Suicide is an attempt to move from one place to another through force. But force is exactly what got us into this mess to begin with. To force the body, the world, or ourselves into one frame is a kind of violence. Opening to change, through the body, unfixes us and paradoxically grounds us in the flowing conditions of our lives. In the Yoga Vaśiśṭha, there is a wonderful moment during the dialogue between Vaśiśṭha and Rama concerning the way we cause suffering for ourselves where Vaśiśṭha declares: “The mind experiences
what it itself has projected out of itself. By that it is bound.”

A young man who was contemplating suicide came to see me. His sister, who was studying Yoga at our center, recommended that he visit. He was estranged from his family and had nobody to turn to. He showed up early for our first meeting, and his eyes never left mine. He sat forward in his chair and seemed eager to talk about what he was planning. I asked him how he was going to find the pills he needed. He was shocked that I was prepared to talk about death, as he described it,“all the way.”

“Yes,” I said, “I am with you all the way.”

“No,” he demanded, “you can’t be, because all the way is all the way and you won’t be there.”

“But I am here,” I said.

“But that’s not all the way.”

“It is, though, it is all the way,” I said, almost protesting.

“How is it all the way?”

“Well, I am here with you now. I can talk about this with you, plan it, listen to you. I understand. I have felt this pain.”

“You can’t feel what I feel.”

“No, I can’t. I can’t ever feel what you feel. But I know pain, and I know that pain changes. I know that pain is deadly. I know you know that, too.”

“Pain is not deadly, I am deadly.”

“I don’t understand.”

“Pain is pain. Deadly is me. I am dead.”

“If you are dead now, what have you got to lose?”

Suddenly, and out of nowhere, we both smiled. We had each other cornered. But we also had each other. In a way we were arguing about death. And the arguing made us both feel alive. In a sense I was asking him: who does this mad voice inside you belong to? But of course there is no way to answer that question. However, posing the question allowed us to investigate. This person did not take his own life. Six years later he is still in pain, still stressed, but working through his pain by making art and living with a wonderful woman. He wants to be a father. In this heated conversation, the person with whom I was speaking moved from wishing to control the outcome of his life to wishing to communicate with me. This is the real healing factor in any kind of helping work.

Psychiatrists and psychologists often “contract for safety” with suicidal patients; these patients avoid hospitalization based on their assurances that they will contact their clinicians if the inclination to commit suicide overwhelms them. Contracts for safety, or suicide prevention contracts, ask the patient to make a commitment, either verbally or in writing, to avoid self-destructive behavior and to keep the clinician informed of any such suicidal impulses. Such contracts don’t work. The real safety contract is in the quality of our ability to communicate and accept each other. Refusal to sign a no-suicide contract does not necessarily indicate that the patient is in imminent danger of suicide, just as agreement to a contract does not mean that the risk of suicide and self-destructive behavior is lessened. The mental state of a patient is not static. Patients may have inconsistent and complex motivations for agreeing to or refusing a contract.

Suicide moves from being one option to being the option when meaninglessness grows. Suicide is an attractive and logical solution when the pain and suffering that one is experiencing can’t be met in a way that offers relief. Internal hatred must be transfigured into love through communication. This is ahiṃsā in action. Likewise the Buddha said: “Hatred is never quelled by hatred in this world. It is quelled by love. This is an eternal truth.” Especially for the caregiver or friend, seated meditation with concentration on breathing is the primary way to remain centered in the midst of turbulence. Under some conditions we must accept suicide. Skillfully, like the Buddha, we take advantage of each context to wake up. After Channa takes his own life, the Buddha says: “Without reproach was the knife used by the brother Channa.”4 The Buddha is not condoning suicide. He is exonerating Channa. Can we do the same? Can we take each person’s story to heart, one by one by one? Can we hear the pain of our friend who is dying to die? What can we offer? What good is it to blame or introduce anything other than loving action?

The practice of ahiṃsā is not to kill another living creature. But we do this every time we eat or pick our vegetables. Through a longer chain of causality, we do it every time we buy petroleum. One of the ways we take life is by not listening, by shutting down, by imposing our expectation on others. Someone who is in pain needs to be heard. Someone who wants to take her own life and is telling you about it desperately wants to connect, desperately desires intimacy. And you are there, in that moment, as best you can, to offer it. To offer yourself. Sometimes we think we know what a cry means, and sometimes we can’t know. But we can put our bodies right there in the center of suffering and know it fully and mutually.

A therapist rooted in nonharming understands that when someone who wants to die is sitting face-to-face with you, that person is you. The first teachings around nonharm mean that we drop our expectations and favorite ways of doing things, we lay aside our viewpoint and professional obligation, and we serve someone exactly as he or she is. You can’t preset the rules for this. If someone is speaking to us as a therapist or friend or sibling, can we meet them exactly where they are? Can we continually check in with ourselves: what is going on now? If I am distracted, what is my most believed thought? Then we can return to our body and breath and then back to the person with whom we are working. We can’t forget that the fundamental lesson of this yogic path is that difficult and even painful feelings are our opportunity to wake up to a more genuine way of living. This is as true for the person in pain as it is for the clinician or friend. We can always love more and more deeply.

Yogic ethics rely heavily on awareness practice, because if we can’t return to this live moment, we are caught up in our theoretical understanding of the situation or in hope or fear. What is appropriate in one context may not be appropriate in another. Ethics are always a dialogue between our cultural background, our ability to open to present experience, and our individual ethical conscience. It’s amazing how our ethical conscience changes over time. Usually we can bring only a certain percentage of awareness to a situation, and then the unconscious ideals of the culture and our own past conditioning come in as a default position. One of the ways we can bring stable integrity and wisdom to our approach to someone in dire straits is to work with our fear of death. The more we fear death, the more we accrue our basic narcissism. If we are trying to keep someone alive who wants to die, we are closing down the possible expression of some major knot now coming to the surface in that person’s life (and by extension, in our own lives as well). A culture that hides, sanitizes, and represses death and dying is a culture afraid of its own mortality, thus setting up a world where heroic ambition, persona, and competitive self-interest are the most rewarded values. This is imbalanced. The greatest attachment we all have to work through, Patañjali reminds us again and again, is abiniveśa, the fear of letting go of our clinging to the life of I, me, and mine. Our attitude toward death is a central factor in the healing process because it influences the way we perceive life. With someone wanting to die, we don’t know how to talk about death because we don’t want to influence them one way or the other. But my experience is that time and time again, opening up the topic of death allows the person with whom we engaged to speak freely and openly, without expectation.

Chögyam Trungpa says that when we go as far as we can in imagining and talking about death, some real sanity develops.5 It is much healthier to explore the psyche’s ambivalent and twisted desires than it is to clean up the warehouse of the mind so it’s all sanitized and perfect. How we act is in every way influenced by the all-embracing awareness and tenderness we can bring to the unconscious habit energies and turbulence of mind and body. Suicide is not just death’s call. It’s a wake-up call. This is an entirely practical approach. What’s going on right now? What is this person saying? How am I listening? These questions are a matter of value: do we value our ideas that one should live and be healthy or do we most value what is occurring in this very moment?

When we give up our ideas about value, ironically, things become meaningful. In this way, there is no zone of comfort, but there is the marvelous flux of intimacy out of which healing is possible. When we begin to take these teachings seriously—when we look directly at the truth of impermanence, the movement of the gunas (qualities of nature), the stability of awareness, the emptiness of selfimage— we learn that the most practical tool of awakening is giving up the task of looking for certainty. When we place burdens and cultural expectations on others, especially those in need, we are setting a bar that nobody can or should ever live up to. Expectations are the roots of violence.

When we give up our desire to be helpful, to help others to live, even to want life to go on for a young person in need, we can drop right into the unfolding flow of life as it really is. Life as it really is contains both the transcendent and the imminent, both phases of joy and phases of discontent. The moral tragedy of the satifaction-dissatisfaction cycle is that it sometimes makes life feel impossible. When I recently learned that author David Foster Wallace hung himself in the suburban garage in which he wrote, I felt a kind of relief. A tension had been building in me while I explored his work. He struggled so much with a superior intellect and a creative and solipsistic mental life. For reasons we can never know, it became too much for him. He tried. He sought help. He changed his writing styles over and over again—he included lengthy footnotes to deal with his tangential thought process and endless elaborations. Who am I to judge his actions? I miss him here in the community of writers I admire. I also relate to his struggle.

The base or substance of life, like the substratum we call silence, is not a blank nothingness but an interwoven fullness, a brightness, a roaring murmur of activity. In the absence of so much chattering and knowing about this and that, there is no collapsing vacuum. Instead, we begin to see that solutions don’t come from isolating ourselves from the circumstances of our lives and our bodies. Life comes to feel precious not in an individualized way but as some inexplicable part of a larger whole. When we lose sight of how each moment of our lives is a resonant connection with all of life, regardless of whether it is pleasant or painful, we will continually yearn for something else, even finality.

The dharma, friendship, and trusting in the body and breath help free us from being overidentified with our symptoms. There is no security against death. We can imagine the moment of death as a rebirth into new form. Death is both a discontinuity and continuity. The one we love and know discontinues, yet the fluids and flesh return to earth again and begin a new life. At death we do not slip into nothingness—we slip into existence. The waves become the water once again.

For the person who wants to die, the horror is that his demons refuse to die. Madness would be an easier escape, but he is not wired to go mad, he is wired to bear his pain. The sheer weight of these inner demands needs attention, but sometimes the personality is not strong enough or not skilled in knowing how to listen. A third ear is needed: a companion, a mother. The world is the only reality of which we can be sure, but if the world is unbearable, if he can’t bear the pain alone, who are we to judge? Having made the decision to die, he lives his truth by refusing to live in the world. From the perspective of Yoga, his death is impossible. In describing his own suicidal fantasies, poet Jim Harrison writes with rare eloquence and poignancy:

“Beauty takes my courage away this cold autumn evening. My year-old daughter’s red robe hangs from the doorknob shouting Stop.”

This is an excerpt from “Awake in the World: Teachings from Yoga & Buddhism for Living an Engaged Life” by Michael Stone (Shambhala Publications, June 2011)

Michael Stone is a respected Buddhist teacher who draws on his background as a psychotherapist, yoga teacher, author and activist to bring the practice of mindfulness into conversation with contemporary culture. He developed the acclaimed Leading Edge Mindfulness for Clinicians Course in Toronto and has educated over one thousand medical professionals about the intersection of mindfulness and clinical practice. Michael has the distinction of being the youngest Buddhist teacher in Canada and maintains a busy travel schedule, teaching workshops and retreats throughout North America and Europe. He is the founder of Centre of Gravity: a thriving community of yoga and Buddhist practitioners exploring the convergence of traditional contemplative practices and modern urban life. He makes his home in downtown Toronto.

Michael Stone is a respected Buddhist teacher who draws on his background as a psychotherapist, yoga teacher, author and activist to bring the practice of mindfulness into conversation with contemporary culture. He developed the acclaimed Leading Edge Mindfulness for Clinicians Course in Toronto and has educated over one thousand medical professionals about the intersection of mindfulness and clinical practice. Michael d maintains a busy travel schedule, teaching workshops and retreats throughout North America and Europe. He is the founder of a thriving community of yoga and Buddhist practitioners exploring the convergence of traditional contemplative practices and modern urban life. He makes his home in downtown Toronto.