Beyond Self-Esteem: How appreciating others can help you to value yourself

About a month ago, I set a conscious intention to be less self-critical and to increase self-esteem. Several weeks afterward, I had an insight during a sitting meditation. It came to me seemingly out of nowhere. I was just easing into the present moment, not thinking of anything in particular. Then, it suddenly occurred to me: When I don’t value myself, I also depreciate everybody who made me who I am right now. On the flip-side, appreciating other people who had a beneficial impact on my life can help me value myself more.

First, on a biological level being overtly critical of myself means being critical of generations of people who came before me and transmitted their genes. But this goes much further. When I trace back the lineage, it includes human evolution and the origins of life on the planet as a whole. Imagine you rewind your life history from the day of your birth hundreds, thousands, and millions of years back. Phylogenetic relationships, cause, and effect, make us embody knowledge and information that we’re not fully aware of. It’s vast potential. Thinking of myself as a self-contained individual cuts me off from greatness. Mindfulness of relationships makes me feel esteem. But let’s fast forward again.

Second, since my son was born, I have become more mindful of what it takes to raise a child. I have become more appreciative of the efforts and sacrifices that were made to keep me alive and make it into adult age. Think of all the efforts that went into feeding you, bathing you, and sheltering you. You would not be reading these lines if they would have been entirely absent. As infants and children, we are so vulnerable. We can’t make it without somebody giving us at least some degree of love and care, even if it was only for moments you cannot remember. Infants die when left on their own without any support die. I’m still around and so are you.

Third, I’m made up by what I learned from my partner, parents, teachers, and peers, or people who randomly influenced my life. Who makes up the person you are in this moment? There is a whole bunch of people who more or less directly affected who I became and who I am right now. There have always been others who have given me something that made my day that made my life worth living. Can you remember anybody or any situation in which you received a gift, perhaps a smile, some wisdom, or a simple present? Have you carried it with you in your heart? Is it part of you now? I’m confident that you will find something, even if it takes some assistance.

Finally, I embody everybody who came before me and influenced me up to this moment. Would I ever want to devalue all of these people? No. Having self-esteem means becoming more aware of how my environment and the people who are part of it shaped who I am. This awareness enables me to value myself more. For me the fact that I am part of something bigger than myself is comforting. Appreciating everything that made me exist, survive, and thrive is empowering. On the flip-side, you and I leave an imprint on others, too. Think of somebody who received something from you, perhaps something that changed this person’s life in a particular moment, such as a smile or kind words.

Ethics, Meditation, and the Need for Therapists Self-Care

“This client is a mess!” On multiple occasions, I have heard therapists talk about the people who seek their consultation in patronizing, disrespectful or even abusive ways. This ranged from lack of empathy and reducing somebody to psychopathology to blunt insult. Sometimes I felt outraged. Why do marriage and family therapists, clinical counselors, social workers, and psychologists who have chosen a profession dedicated to serving people to recover from mental illness lose empathy?

I concluded that it must be about burnout in a high-stress work environment when therapists talk disrespectfully about their clients. Of course, there were times when I was talking or at least thinking of clients in less than friendly ways, sometimes probably without being aware of it. When I’m not doing well, I can’t support others. Psychotherapists have the responsibility to be their best selves to assist their clients and to make ethical decisions on an ongoing basis. I believe that self-care can help prevent burnout and compassion fatigue through a reflective meditation practice.

Today, self-care is an imperative in highly stressful therapeutic work environments with ever-higher workloads and training requirements. It has become a buzzword in the mental health field that can obscure more significant social and organizational problems that cannot be resolved by individual therapists. Burnout, compassion fatigue, and vicarious trauma may be the result of unrealistic expectations of productivity in which numbers rather than people count. To prevent them large healthcare companies commonly encouraged therapists to “take care” of themselves. Employers may readily associate meditation and mindfulness with self-care. These practices are supposed to recharge exhausted therapists so they can get the job done. I found that self-care through reflective meditation can be more than just becoming better equipped to stay on a treadmill. It may be about changing body and mind as well as relationships with others in unexpected ways. For me, meditation has become a comprehensive form of self-care that helps me to cultivate contentment, to know myself better, and to become ethical.

 

Caring means cultivating contentment

The first avenue towards self-care through meditation is probably the most intuitive: meditation can help relax and recharge the exhausted therapist to foreclose knee-jerk reactions to challenging situations. It can help shift gears and activate the parasympathetic nervous system that makes me ‘rest and digest’ – if I allow it.

“Is it selfish to just take time for me to rest and enjoy?” a colleague asked me recently. I was able to relate to the question. For me, a central obstacle to benefiting from peaceful and pleasurable states during meditation has been my reluctance to allow them.

Many years into my meditation practice I noticed that there was a sense of guilt when it came to relaxation and pleasure. In part, this was a result inflexible instructions that caution practitioners vehemently to not become attached to pleasurable states. I often worked too hard to calm the mind, which was of course counterproductive. Now I know for sure that I don’t want meditation to be some sort of self-discipline that has the result of treating myself harshly. Don’t get me wrong, it can be helpful to have a schedule for sittings and to stick with one particular instruction for a while, but I found that this only makes sense when it leads to more ease and gentleness with myself, more care.

I don’t want self-care through meditation become another “should” that makes me feel bad about myself when not performed “correctly.” For me just taking some time to step out of everyday life’s busyness and to do nothing, in particular, can be a form of meditation. I found that adjusting my posture, changing it, laying down, and letting my mind wander can all be part of an open meditation practice. I don’t have to pay attention to anything, in particular, to allow a whole range of pleasurable states to arise. Just permitting myself to rest may lead to a deep relaxation that can come with a feeling of interconnection and being cared for, perhaps the ultimate form of ‘self-care.’

Once my nervous system has calmed and becomes less emotionally reactive, I am usually in a better position to make ethical decisions in everyday life as well as in consultations with clients. Relaxing, calm, and pleasurable states during meditation may set the stage for distinguishing ‘right’ from ‘wrong’ off the cushion. But I found that the cultivation of tranquility is not enough for self-care to become wholly transformative.

 

Caring means getting to know the self

Self-care through meditation can be about more than taking a break from hard work to recharge and go back to the same situation. It can lead to self-knowledge and insights about how to act ethically. To care for the self, I have to know the self. For me, this can include an awareness of a boundary crossing that had gone unnoticed. During meditation and in reflections afterward, I can catch unconscious needs and wants. Just noticing them during the sitting and redirecting myself to the save heaven of the breath might not be enough to get to know what is going on in my inner world.

Self-care through meditation can also be about processing and integrating thoughts, emotions, body sensations, and desires. For me, this is only possible if I am ready to follow a train of uncomfortable, embarrassing, or even painful experiences for a bit during meditation. This openness to my mind as it is in the present moment became an ethical practice that requires ongoing self-reflection. When I meditate I allow myself to experience whatever comes to mind. It is not about getting rid of my needs and wants but rather to become aware of them. Attended to with care my inner world may hold surprising answers to ethical dilemmas that I’m unable to tackle through linear rational thought. I might get answers to questions I couldn’t even think of when I allow myself to be curious. As a result, it may become easier to feel empathy and more likely that I remember values that I want to live by because I can put thoughts and feelings about my own and other’s actions into perspective.

For me, the key to knowing myself and my experience through meditation is a doubling that can take place by writing down what has been going on during the sitting and thereby opening up the possibility of reflecting upon it afterward. Moreover, talking with other people about the experience and being asked questions about it sheds light on blind spots that I would not have thought of before. An awareness of my unconscious habits and desires is key to making choices about where to go next and what ethical decisions to take to take care of others and myself. This reflective process may result in the development of longer-term dispositions in regards to how I want to present with people who seek my consultation as well as in relationships more generally.

 

Caring means becoming ethical

Finally, self-care through meditation can result in the development of moral qualities. If I get to know my inner world and myself, I can start to make conscious choices about how I want to act and about the type of person or therapist I want to be. Ethical self-reflection is about the development of ‘character’ or a preferred identity.

Momentary insights about myself in a relationship with others gained upon meditative reflection can lead to what has been called virtue in philosophy. Virtues such as honesty, integrity, or kindness may have universal value. However, what qualities to focus on and how to apply them may depend on where you come from as well as on the particularities of an ethical challenge. I learned that in Greek philosophy the care of the self was the foundation of ethics, a notion of self-care that has been largely forgotten today. It was about skillfully monitoring, managing, and challenging personal needs and wants to develop one’s moral character. Today, virtue ethics can complement the ethical codes of professional organizations that require conformity rather than personal development on behalf of the therapist.

Virtue ethics take into account that the personal and the professional are interconnected. It is about how to be a good person or a morally good therapist who can make choices about how to show up with people who seek consultation and how to handle power differentials adequately. Thus, virtuous therapists are motivated to do what is right because they judge it to be right, not just because they feel obligated by their professional associations or the fear of negative consequences of an action.

A reflective meditation practice that includes journaling and conversation about the content of one’s experience allows for an ongoing ethical development of the therapist. It does not give universal answers but rather prepares the ground for better-informed decision-making that takes into account more variables of a situation. This approach goes with questions like “What thoughts, emotions and body sensations am I aware of as I consider this ethical dilemma, and what are they telling me to do?” “What decision would best define who I am as a person,” or “Who do I want to be as a therapist?” Caring here is about cultivating personal qualities that I can feel good about in the face of ethical dilemmas and actions that are congruent with my therapeutic approach as well as my self-image.

 

Comprehensive self-care

During meditation, self-care can take the form of relaxation, self-knowledge, or the development of virtues. One session may primarily focus on one of these processes. However, for me most of the time they are interlinked, both in a particular meditation sitting as well as in an ongoing practice over time.

Sometimes self-care requires calm states of mind for undervalued or hidden thoughts and feelings to arise. Once I get to know them better in a particular situation, I can make a conscious decision about the care that is often no longer just about myself. It involves making decisions about who I want to be in relationships with others. This mindful awareness may include correcting some of the stories my mind makes up to divert my attention from boundary crossings or violations. Insights in the wake of meditation can lead the way. Some bright moments have made me reduce my workload and therefore the risk of burnout and compassion fatigue. Other insights motivated me to challenge unethical practices at work. When they were resolved, I felt less stressed, no need to return to a treadmill.

A comprehensive approach to self-care cannot guarantee ethical decision-making in the everyday practice of clinical counseling, psychotherapy, and life. But it can make it more likely to move into a more thoughtful, considerate, and compassionate direction. Comprehensive or integrative self-care is an ongoing process that does not end with relaxation, a particular insight, or virtue. Self-care through a reflective meditation practice seems to require the whole person to become ethical anew again and again in every new situation to take ‘good’ care.

 

Valuing ‘Monkey Mind’: Towards Experience-Near Mindfulness

Long live monkey mind. Over the past years, I explored innovative forms of mindfulness that help me understand my world and experience better by allowing thoughts and emotions in meditation. I used to be convinced that I’m not a good meditator or that I will never be able to be fully mindful. Then I found out that this was largely the case because the instructions I used were counterproductive.

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For a long time I thought that I have a “monkey mind” that can never be still and calm. In some respects I do, but things are a bit more complicated and interesting. There is hope for anybody who cannot calm one’s inner chit chat by force. In an open and experience-near form of mindfulness having a “monkey mind” or being easily distracted and driven by seemingly random thoughts and feelings is not an obstacle but an entry point into exploration, insight, and more knowledge about ourselves and our worlds.

For many years I set myself up with instructions that told me to come back to the breath or the body when my mind wants to go somewhere else. But when I force myself to focus on some object of attention for a longer period of time my mind naturally wanders. Standard mindfulness instructions suggest to gently take attention back to the original object of focus.

The metaphor used is training a puppy who constantly wants to run away. Well, I found that constantly telling myself “sit, sit, sit” does not have the effect of being gentle with myself. Most long-term practitioners have difficulties with focusing their attention on an ongoing basis without being distracted. For me sustained concentration has only been possible when I was removed from society and everyday life. Many years ago I thought the inner silence reached on long-term retreats would be ideal meditation. It became the gold standard for measuring the progress and quality my meditation: having a clear mind without thoughts, just perfect balance, ideally all the time. But this was a set-up.

I found out that my mind settles down naturally when I don’t try hard to be a good meditator and when I allow myself to be with whatever experience comes up in an open and nonjudgmental way. It may be only for a couple of minutes in a longer sitting but these moments come with ease. On the one hand, this makes meditation much easier because I don’t set myself up for failure by trying to do the impossible, that is forcing myself to not have thoughts and emotions. On the other hand, it is also challenging since the thoughts and emotions that come up may be scary, annoying, or uncomfortable.But even if they are, when I take an accepting or tolerant stance towards them they become less threatening. In fact, there is a lot to learn about how I routinely deal with myself and my world.

When I get insights about how automatic patterns of thoughts, feelings, and behavior work, it becomes clearer to me what conditions have negative effects and what kind of conditions have positive ones. This is the first step towards making informed choices based on understandings gained during meditation.

Another effect of allowing thoughts and emotions into meditation is that even if I think of my experience as negative, I might find that there is much positive content in my mind that is pushed towards the periphery of awareness. Bringing this content more to the center of attention helps me to become aware of things that make me feel good about myself and others. This positive and life affirming inner self-talk would go largely unnoticed or pushed aside when I would constantly try to focus on a precontemplated object of focus.

For more information about experience-near mindfulness see Sati Sangha https://satisangha.org/and read “Unlearning Meditation.”

 

 

How to Treat Men who Committed Domestic Violence?

In the mental health field Domestic Violence (DV) is often associated with personality disorders and commonly conceived as the problem of individual men. But this approaches falls short of accounting for broader social, cultural, and economic issues that are at the root of the problem.

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While each individual has to be accountable for his own behavior, we need to take up a broader perspective to understand violence against women as well as viable ways to stop it.

All kinds of interpersonal violence have a history. They are broader problems that go far beyond individual offenders or perpetrators of domestic violence. I found that it is important for men who have abused to become mindful of the ways in which they have more or less consciously followed a culture of masculinity that condones or encourages violence to solve conflicts.

For the past ten years, I have been working with men who have abused, first as a researcher and then as a counselor. During this period of time, I have not come across somebody who was violent by nature. The men had often undergone severely traumatic experiences in their childhood or youth. Sometimes they were hardly aware of the fact that the people who had abused them in the past had at some point become their role models. Moreover, they followed a dominant form of masculinity that normalizes aggression and can be readily observed in movies, video games, and politics. At the same time, they learned very little about how to communicate effectively or express personal feelings and needs. In other words, they were socialized into a gender straitjacket that encourages individuals to control and dominate others in order to become men.

Even gender justice approaches that take into account inequalities of power often fail to see the complexity of violence. In the 1990s, Kathleen Ferraro already pointed out that a prior generation of feminists got it wrong. She argued that authoritative talk, writing, and law in regards to “domestic violence” created interventions and ideas that are not necessarily helpful. They construct and perpetuate a unified image of ‘battered woman’ versus ‘male batterer.’ This is problematic because women who have experienced abuse have their own independent will and can make choices; they are much more than victims. At the same time, men who have abused are much more than ‘batterers’ or ‘perpetrators.’ In fact, I believe that this type of labeling may hinder men from changing because it commonly leads to defensiveness.

The victim/perpetrator division also results in the tendency to target individual men for treatment while obscuring broader social problems. I have often heard from men that they found it hard to change because the skills they developed during group therapy were not valued in communities in which the use of intimidation, control, and dominance over others is often considered masculine. This is not just an issue for men. Some of my group participants reported that they were belittled and verbally attacked by female partners when they showed vulnerability and cried. A multifaceted approach to “domestic violence” needs to challenge ideals of masculinity that stop men from showing tender feelings. I found that men are often overwhelmed with the expectation of being the ‘dominant’ gender. Evidently, nobody can be invulnerable and this is even more obvious for people who struggle because of racism and economic inequalities.

The culture of machismo is often seen as the root cause of violence against women. But similar to the psychiatric fallacy the myth of “culture” as being the sole reason for intimate partner violence eclipses other social and economic factors. Research has found that men who are more marginalized than others are more likely to commit domestic violence. This does not mean that affluent men are necessarily more peace loving. We know this is not the case. It merely means that some men who suffer from multiple forms of discrimination based on skin color, lack of formal education, or unemployment are more likely to use brute force to empower themselves. Usually the violence is not directed against the wealthy, mostly white males, who own a disproportionate amount of the word’s resources and control post-colonial societies like the United States. The violence is commonly directed against partners, spouses, and family members.

What does this mean for counseling with men who have committed domestic violence? On the most basic level it means that we have to differentiate between the men themselves and the problem of violence. If you are a man who has verbally or physically been abusive the first step towards healing yourself and your relationship is to draw a line between you as a person and the violence with its multiple causes. This does not mean to let go of responsibility. In the contrary, once you can see the problem as a problem that is not just about you, there is no need to become defensive, get stuck in shame, or to bury your head in the sand. You are much more than a man who has abused. It’s time to disentangle yourself from the social expectations tied to being a tough guy or your endeavors to fit into the box of male gender roles. Have the courage to embrace your own vulnerability to break the cycle of abuse. People who really care about you are going to support you in the process of change. Then think of all the positive and loving actions that you have performed in your life in relation to others. There are ways to empower yourself peacefully in equitable relationships for the sake of both your partner’s and your own health and wellbeing.

 

Cracking the Armor: Men and Trauma

Cultural gender expectations shape how we experience trauma. What I found in my own research and work in psychotherapy time and again is that men are reluctant to disclose their emotional wounds because they are afraid that this would make them appear less masculine.

People regardless of their gender are wounded to different degrees physically, psychologically, or both at some point of their lives. It is part of the human experience. After the trauma it is common to avoid stressful memories and situations associated with violation among both men and women. However, for men there is an additional predicament.

Rigid norms about what it means to be a man have a profound impact on how we deal with distress and whether or not we seek help. As men we may deny support or delay help-seeking because we fear that reaching out would result in a loss of masculinity. Many men who experience symptoms of post-traumatic stress after a distressful life event feel less manly, because they have learned that being a man in mainstream society is ideally about power and control.

In my qualitative research and clinical work I found that once men identify that there is an emotional wound, they often tend to rush into re-framing it as something positive. For men living through trauma is often seen as a necessary means to become tough and invulnerable. Some men even see it as a way to obtain a sense of masculinity. In popular culture artists like Jay-Z assert, “What doesn’t kill me makes me stronger.”

Post-traumatic growth is all about the positive change occurring in an individual after the experience of a highly stressful life event. The above-mentioned quote may be a way to acknowledge one’s own ability to survive traumatic events and learn from them. However, the personal growth and the integration of traumatic experiences usually occurs only if you are prepared to be vulnerable.

The masculine armor may become cumbersome in the long haul and make healing more difficult. Recovery from post-traumatic stress depends on how you deal with the wound inflicted on you in the here-and-now rather than about what happened in the past. For men who follow mainstream ideals of masculinity divulged through the media and politics, it is very typical to toughen up and pretend nothing has happened. But no human being can be invulnerable. Other people and circumstances in various ways of course affect the men I encounter in my field studies and clinical practice. To accept this fact is often the first step towards healing.

The attitude of invulnerability can be problematic when the armors keeps men from acknowledging personal needs and emotions. It can stand in the way of communicating with loved ones, seeking help, and healing from trauma. Healing is most likely to take place when the trauma is accepted and integrated into one’s life and identity, so it can drive preferred changes. How has your sense of manhood transformed as a result of the traumatic event? Cracking the armor may mean to liberate masculinity as you know it and become open for new ways of being a man. The ability to be vulnerable is part of this process and it needs tremendous courage to embody it.

 

Mindfulness and Depression: A Matter of Acceptance?

Are you able to accept depressed mood as it is? Being more accepting of negative thoughts and emotions does not necessarily mean to give up. In the contrary, it can be the first step toward change. In one of our recent mindfulness meditation group sessions in Hillcrest some participants noted that “depression” is not necessarily a “bad thing.” This was a keen statement that made me think about mood disorders in new ways.

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There is something I would call the “depression paradox” in America. On the one hand, people feel depressed perhaps more than ever before in human history, on the other hand, it seems to have become ever more unacceptable to feel down.

In the American popular culture there is a tacit imperative to claim that everything is fine even if that’s simly not true.  Particularly in Southern California to smile and be happy all the time can be an expectation that is not conducive to wellbeing. Feelings of sadness are commonly not talked about. Above all, it is unacceptable to display them in public even though going inward and being unhappy can be an important way of processing life events.

As a family therapist I meet many people who have difficulties to accept that symptoms of depression such as hoplessness, irritability, loss of energy or interest in daily activities, and fatigue may come and visit for various reasons. The result of avoiding negative feelings is often rigid emotion management based on social conventions in which any negative feeling must immediately be reframed and turned into something positive. Sometimes this is promoted by psychological self-help literature that asks people to smile or engage in positive self-talk when there is actually a need to acknowledge a moment of suffering.

If the symtoms become severe and last longer than two weeks it is important to seek professional help, but even then, the first step towards healing is to accept the fact that you are hurting. This sounds more simple than it is.

In the 1980s, the Stanford anthropologist Gananath Obeyesekere claimed that in Buddhist cultures, i.e. in Sri Lanka, the renunciation and withdrawing from the world is considered a way to enlightenment rather than a sign of psychopathology. He argued that the Western psychiatric diagnostic category of Major Depressive Disorder does not necessarily apply to people who follow Theravada Buddhism. Although this is a bold assertion, it remains a fact that in countries where Buddhism is commonly practiced, the psychiatric prevalence of depression is very low.

This makes sense if one considers the first Noble Truth of Buddhism, namely, that life means suffering and that suffering stems from attachment to transient things. From this point of view depressed mood can be a normal consequence of human craving and aversion. Perhaps it becomes more prevalent in neo-liberal consumerist cultures that make us obsessed with ‘progress’ and ‘success.’ To what extent does our longing for the latest and most cutting-edge style, body image, product, degree, or job make make us prone to ‘depression’?

Ultimately, I believe that whole-hearted acceptance of where I am at right here and now can lead to new actions rather than fatalism or the believe that nothing can be changed. With a little bit more awareness of what is going on, I’m more prepared to notice that change is inevitable. But maybe acceptance is too big of a word. As the meditation teacher Jason Siff argues, “tolerance” may be all we can hope for in the face of dispair. In an open meditation practice it is important how we relate to negative thoughts and rumination rather than to pull ourselves out of them. Simply denying that they are there and wishing that they would be gone has never served me in reaching greener pastures.

Increase Compassion by Remembering the ‘Good Stuff’

Recently, I asked participants in a domestic violence offender group about how they would define compassion. Some connected it with sympathy, others with doing what others want you to do. The fact that for most of them the word was not part of their daily vocabulary did not mean that they had never been compassionate. Unsurprisingly, they could remember some ‘good stuff’ and doing so may also help you to feel more secure in your relationships this year.

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The term compassion is not something we readily hear on the news; it’s hardly used in block buster movies. Although the word ‘compassion’ sounded strange to some men in the offender group, they were all familiar with acts of kindness that come out of concern for another person. They also agreed that there is a difference between feeling what another feels and acting upon this feeling.

Commonly, in psychology this distinction is made to distinguish between empathy and compassion. Empathy has been defined as the vicarious experiencing of an emotion that is congruent with, but not necessarily identical to the emotion of another individual, as well as the knowledge or understanding of another’s feelings tied to it (Eisenberg and Janet Strayer 1990). Compassion is more than that.

In broad terms, the term compassion refers to the ability to be touched by the suffering of others and the desire to alleviate their suffering. It has been associated with the vicarious experience of distress in response to another person’s suffering, a variant or blend of sadness or love, and as an evolutionary adaption that motivates helping behaviors for the sake of survival, reproduction, or both (Goetz, Keltner, and Simon-Thomas, 2010).

The great news is that compassion also spreads. It reproduces itself because the recipients of compassion tend to become more compassionate themselves. Some researchers argue that higher “attachment security” is closely related to higher levels of compassion towards others and altruistic helping behavior (Shaver and Milkunicer (2004).

Attachment security or feeling valued, safe, and cared for in a relationship may be a result of your past experiences. It includes instances of having been treated supportively as a child, being involved in security enhancing close relationships during adulthood, being able to call upon mental representations of being cared for, being influenced by a security enhancing context, or a combination of these factors.

From this perspective, our human capacity to experience compassion is enhanced through trusting, secure, and protective relationships. While people with more attachment security are said to be able to show more compassion, little is known about the positive effects of compassion on attachment security and wellbeing in relationships.

In my own clinical practice, I found that even people who went through intense trauma, including many domestic violence offenders, “big” and “small” acts of compassion are common. Sometimes they are not seen as such and remain undervalued or not integrated into a coherent story about personal values and relationships.

For the men who had abused in the past, communication in the group provided a way to expand awareness about the benefits of compassion. In the past year, several had cared for sick family members, supported someone who struggled with everyday life problems, or intended to do so in the year to come. The group discussion provided them with a rare forum to develop a language around these act, to share and celebrate them.

In my opinion, one of the keys to cultivating compassion is to remember and become aware of the “small” compassionate acts we already perform. Once we value, understand, and enjoy them, we may create more possibilities to practice compassion – perhaps with the result of enhancing our own and other’s sense of safety and “attachment security.”

When I focus attention on the ‘good stuff’, I change neural pathways in my brain, a process called neuroplasticity. The term neuroplasticity is used to refer to our ability to change the physical structure of our brains throughout the lifespan (Siegel 2010). We can literally grow new synaptic connections through sustained and focused attention on compassionate acts. Is this going to increase your compassion? Try it out.

By reflecting and talking about past instances of turning empathy into action you may turn neural pathways into superhighways that inform future action.You turn something that is already present into the forefront and thereby make it more powerful. How have you acted compassionately lately?

 

 

 

Beyond the Brain: The Hidden Causes of War Trauma

Nowadays, much hope is put into neuroscientific efforts to penetrate the brain in order to understand and cure trauma, but almost nothing is heard about the political and social root causes of Post-Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI). The U.S. government’s latest plan to increase military spending made me think about this dangerous shortcoming.

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War is profitable and corporate business is going to benefit tremendously from the Trump administration’s proposed $56 billion upsurge in military spending. ‘At what cost?’ I asked myself and came to the conclusion that increases in military spending are likely to have a negative impact on mental health. I followed a simple line of thought: Further inflation of the U.S. military industrial complex serves profiteers that make money with wars through which people are killed and traumatized. In other words, trauma caused through war is linked to big business.

This is a good time to remember that a root cause of war-related PTSD and TBI is state-sponsored violence. Focused on the latest neuro-babble mental health professionals are commonly reluctant to speak out about the social and political nervous system of war trauma. I was one of them, until I realized the need to have a broader discussion about ethics that reaches far beyond the closed doors of a ‘psychotherapy’ practice. When I heard about the planned increase in military spending I thought of a wreath-laying ceremony that I attended a couple of years ago at San Diego State University. Back then nobody addressed the economic and political forces that drove the wars in Iraq and Afghanistan and caused the death of the honored servicemen, let alone the mental health issues of veterans who survived them.

A root cause of mental health problems among veterans lies in the military industrial complex. Corporate profiteers care little about the suffering their business causes for veterans or civilians. During the wreath-laying ceremony, I noticed that the chairs in front of the memorial were covered with flyers promoting a panel of San Diego’s military industry that was organized by the SDSU alumni association. The flyer said that the city ought to remain “competitive” in the global market of military technology. Evidently, there were no critical voices at the ceremony. Emotions remained invisible behind the stern faces of the servicemen and women. To work through existential insecurity caused by war trauma would be synonymous with breaking the norms of militarized masculinity as well as the economic forces that drive it.

While veterans and their families suffer, corporate business continues to benefit from war and military spending. Almost a decade ago, anthropologists Matthew Gutmann and Catherine Lutz in their book Breaking Ranks: Iraq Veterans Speak out Against the War pointed out that an estimated three trillion dollars had entered the coffers of corporate war profiteers. The militarization of U.S. American society can be observed when looking at an ever-higher resource allocation for military purposes, but also the overall normalization of war in society that comes with it. Military spending goes hand in hand with talk that legitimates military actions on TV and has an impact on popular culture in which violent movies and video games have become the new norm. Confronted with the cultural and economic war machinery, people seem to be made believe that life is a state of permanent warfare. From this dangerous and distressful point of view, society must be subordinated to the military rather than the military to the needs of a democratic social order.

The recently proposed increase in military spending should be concerning to health and human services professionals as well as their clients. In 2010, the U.S. Federal government was already spending as much on the Defense Department as for Medicare and Medicaid together. Federal funds to promote psycho-social development and wellbeing that prevent physical and mental trauma are likely to be further cut in the wake of increased military spending. This is going to be the case despite the fact that the United States accounts for the by far largest share of the worlds total military spending (40,1%), distantly followed by China (8,2%) which occupies the second rank. Unfortunately, the huge military budget did not bring peace and democracy to the world. In the contrary, it fostered the emergence of more terror and mental disorder.

There is a growing number of veterans who are speaking out about the post-traumatic stress experienced as a result of U.S. sponsored war, including torture and the massacre of civilians. Unfortunately, the majority remains silent. Militarized masculinity with its hallmark of stoic endurance may have something to do with it. The outcomes are devastating. By the end of the Iraq War, the number of suicides had dramatically eclipsed the number of troops dying in battle and accounted for nearly one death per day. Many of those who risked their lives for dubious reasons have become marginalized and mentally ill after deployment.

At the wrath-laying ceremony I learned that veterans are in need of acknowledgement and recognition for the sacrifices they made. I’m still moved by their commitment to serve a broader common ‘good’ and their honorable intentions, perhaps a commitment to create a better world. But in order to serve wounded warriors dramatic increases in budgets for health and social services are needed rather than steroids for the military industrial complex. I believe that for mental health professionals who treat PTSD and TBI it is an ethical responsibility to give a voice to veterans who are silenced in wrath-laying ceremonies and recent policy-making initiatives. It is part of our work to provide spaces in which they can enrich stories of trauma and go beyond cookie-cutter narratives that locate the cause of traumatic stress in the brain.

Welcome to McMindfulness: A Critique

In recent years, the ancient Buddhist practice of “sati”has been translated into U.S. American mainstream and pop culture. It is now commonly known as mindfulness in English and has thoroughly changed.

In a Huffington Post article titled “Beyond McMindfulness”, some critiques argue that as a secularized technique mindfulness is decontextualized from its original transformative purpose and its social ethics. It is made to fit the corporate world, the military, and other institutions that are unlikely to change as a result of mindfulness seen as a banal self-help technique. In this sense, mindfulness becomes part of the mental defilements it originally was supposed to counter.

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Today, there is a tendency to see mindfulness as an individual, private, and internal affair. As Zen teacher Ted Segal illustrates in his blog post “mindfulness or heartfulness”, people may seek for a technique that is in line with what is represented in popular media. He gives the example of a visitor whose primary motivation was to “get to know himself better” and makes clear that mindfulness is not about self-absorption or developing insight into the self and should rather be called “heartfulness” to avoid confusion. He points out, “using one’s unique gifts to benefit others is what brings happiness”. The Zen teacher admits that ten years ago he would not have disagreed that the practice is about introspection but changed his view with increasing insight.

It is not surprising that in a society in which individualism is an ideal and ever higher expectations of productivity are considered normal, meditation is seen as a technique to know more about oneself and ones strengths. In my opinion there is nothing wrong about introspection as long as it is for the sake of developing more fulfilling and loving relationships. The danger lies in an uncritical adoption of mindfulness that shifts the burden of injustices and domination onto the individual. The practice of mindfulness is abused when employees, students, or soldiers are held responsible for stress generated by organizations that create environments that are not conducive to mental and behavioral health.

Based on popular depictions of mindfulness you may think that it is another way to calm down hyperactive kids, become more productive at the workplace, or cope with the high exigencies of everyday life in a post-industrial information age. While this may be true on a superficial level, it is about much more. A McMindfulness perspective reduces mindfulness to a mere coping technique removed from its original embededness in ethics and the transformation of relationships. Mindfulness can not be measured by money and status but only by the quality of our relationships with other people and the enviornment we live in.

Just Being or Becoming? A Mindfulness Controversy

Is mindfulness about the present, past, or future? People writing and doing research on mindfulness meditation are often not aware of the controversies that surround this practice in Asian Buddhist history. Evidently the cultural context in which mindfulness is practiced today in hospitals, corporations, or even the military is very different from the one in which the historical Buddha developed this practice about 2500 years ago.

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The contemporary mindfulness movement in medicine, psychotherapy, and education defines mindfulness primarily in terms of present-moment awareness. Accepting what is without necessarily judging it in any way may have positive effects on individual’s wellbeing in post-industrial societies in which striving for future achievements and goal-orientation often result in stress.

Susan Smalley and Diana Winston from the UCLA Mindful Awareness Research Center point out that mindfulness is about “bare attention.” Similar to other authors who translate the practice into American popular culture they argue that present-time awareness such as taking a breath to become aware of one’s impulse before acting upon it, is already enough to make wise action likely to follow.

From this point of view you have to be fully present with what is in order to become more discerning with your thoughts and emotions. As Susan Smalley and Diana Winston point out in their book “Fully Present”:

“In practicing mindfulness you are not trying to change who you are, but to become more fully present with your experiences” and later they go on “you may also become more discerning of your thoughts, feelings, and actions, and that awareness will give you greater opportunity to make positive changes, if you wish to do so.”

Here change is a by-product of mindfulness and not its goal. This is in line with Jon Kabat-Zinn’s approach that emphasizes the negative effects of striving for positive treatment outcomes in Mindfulness-Based Stress Reduction programs. He used to ask his patients at the Massachusetts Medical Center to leave their hopes and aspirations for change behind after the first session.

Responding with a more balanced and detached view on a difficult situation may indeed follow, but not necessarily.

Some of my Buddhist friends point out that a sniper can be mindful, too. Without ongoing ethical reflection, the evaluation of the benefit of an action, and related personal change mindfulness does not necessarily lead to wellbeing in relationships.

From a different angle you need to be more discerning with your thoughts and emotions in order to be able to be fully present with your experience and accept it. Some historians argue that this comes closer to what has been taught in Theravada Buddhism, which contains the oldest Buddhist scriptures. As historian Robert Sharf argues, the type of mindfulness that enters U.S. popular culture is a product of Buddhist reform movements of the early 20th century rather than an ancient practice. Other scholars agree.

In his article “Is Mindfulness present-centered and non-judgmental” Georges Dryfus points out:

“Mindfulness is then not the present-centered non-judgmental awareness of an object but the paying close attention to an object, leading to the retention of the data so as to make sense of the information delivered by our cognitive apparatus. Thus, far from being limited to the present and to a mere refraining from passing judgment, mindfulness is a cognitive activity closely connected to memory, particularly to working memory, the ability to keep relevant information active so that it can be integrated within meaningful patterns and used for goal directed activities. By paying close attention, practitioners of mindfulness strengthen their cognitive control because they increase their ability to retain information and thus see their true significance rather than being carried away by their reactions. What is well attended to can be maintained by working memory and thus become available for appropriate evaluation.”

Meditation teachers like Thanissaro Bikkhu argue that the “bare awareness” approach largely misinterprets what the historical Buddha meant when referring to mindfulness. For him the non-judgmental and completely accepting stance towards one’s experience comes in a later stage of mental training in which the meditator has developed the skill to willfully enter a state of choiceless awareness through concentration. This bare awareness is then founded on a set of skillful thoughts and actions that are in line with the ethical values adopted and remembered through mindfulness practice.

In my opinion, both perspectives can be helpful. I’m not sure which one should come first in the training of the mind. I started with practicing non-judgemental awareness for many years before I came across other possibilities and found this practice very beneficial. Being more directive to shape one’s experience seems to be a complementary step at any point. When I first notice things as they are without judging them, it gives me some distance to disassociate from dominant themes. In a second step I can see them more clearly, each thought, feeling, body sensation in its context and relation to another. Third, I thus discern what I want to cultivate and what I can let go of.

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