Kind Recognition

I can’t remember a Winter season in Silicon Valley with such sustained cold. 2/22 usually means Spring-like conditions; white plum blossoms dropping and pink cherry blossoms shyly peeking out. Yet, today plum blossoms cling tightly to branches and nary a pink flower can be found. I want warmth but my weather app shows only rain and cold for the next 10 days.

Each day I am reminded how much the engine of human internal experience runs on expectation and assumption. This now must mean that before. Incorrect. This now is merely what is occurring. And that occurrence often lacks connection to what has been or what will be. Yet, moment to moment the human brain is wired to habitually make probabilities certainties, unknowns knowns.

So much of human suffering can be boiled down to that basic misapprehension, its flawed mentation, and all the incessant efforting we do to make it so. Believing an internal illusion of knowing what can’t be known and predicting with an accuracy the human brain utterly lacks, is foolish and oh so human. And of course, we believe the mind’s limited, distorted narratives of certainty will be replicated in real life. Hardly ever is that borne out to be true.

When human functioning evolves to a point where producing heedless internal suffering become the default, alleviating that suffering becomes a necessity.  Tibetan Buddhist teacher Dzogchen Ponlop says that the most powerful medicine we can offer for suffering of any kind is simply kindness. And I would add clear knowing. Recently, a patient who finally understood they had been lost in delusional thinking, was asking me how to calm a disturbed mind. I wrote the following equation on a sticky note: clarity + compassion =  a calm mind.

That formula gives rise to what I call kind recognition. “Adding kindness to recognition helps us soften into and receive ‘this is hard.’ When life is truly distressing, relying solely on mindfulness may feel harsh or sterile or may activate existing habits of disassociating or disconnecting from experience. Kind recognition begins by recognizing what has arisen; for the fact of its arising cannot be altered. What comes next is the ‘ow!’ of it. The key becomes allowing ourselves to receive the ‘ow!’ with openheartedness and then remaining open to distressful thoughts and feelings that follow. Kind recognition builds our capacity to meet distressful feelings and difficult circumstances with less blame, shame and avoidance. It also promotes the cognitive-affective responsiveness needed to remain engaged, empowered and able to make skillful choices” (Miller, 2014)*.

Kind recognition is similar to distress tolerance but different. It is not an effort to escape, change or avoid distress, rather the capacity to welcome distress with openheartedness and wisdom. A good example is: all things come and go, including painful and pleasurable experience. That recognition can in and of itself lessen a reactive mind insisting distress will never end and needs to be ignored, avoided or ended. Such efforts most often lead only to harmful choices and behaviors.

I have posited that much of the diagnoses listed in the DSM could be viewed as outcomes of internally-driven efforts to end painful experience. And that would be very human. It is merely the severity of distortion and reactivity that morphs everyday human suffering into a mental health issue.

*Miller, Lisa Dale. Effortless Mindfulness: Genuine Mental Health Through Awakened Presence“. Routledge 2014.

Year of the Water Rabbit

Weeks of rain have come to an end and raging waters now occupy a once dried-out creek. The speed and power of the water invigorates my morning racewalks and I find myself wishing it will never abate. And such is the mental suffering of clinging to permanence where there is none; especially here in typically ever-sunny Silicon Valley.

I often muse on my walks—mind wandering in waves of creativity. Lately I’ve been musing on possible meanings and resonances of the year of the Water Rabbit. This past Water Tiger year was so demanding and unforgivingly active. Not unlike the raging waters that have carted away sediment and felled dead trees all along the creek. Same element, yet Tiger and Rabbit represent antithetical animal energies and symbolisms.

Let’s start with contemplating the astounding properties of water. Water molecules want to cling to each other. Surface water molecules do not have other water molecules on all sides so they strongly cohere with their closest molecular neighbors. This affords water one of the greatest surface tensions of any liquid and makes water able to hold objects afloat.  

Water can flow in any direction. This uber-mobility means water molecules are constantly colliding and applying pressure in all directions. That is how water—seemingly uncontained and not solid—has so much strength. It dissolves more substances than any other liquid and cuts through almost anything including metal and rock. Yet water can also be a wellspring of gentleness and healing.

That gentleness leads us to consider Rabbit’s surprising characteristics. While rabbits are generally regarded as innocent, harmless, and adorable animals, they actually possess very sharp sight, hearing, and smell. Their almost 360° panoramic vision lets them see objects behind them. Additionally, rabbits have extremely strong hind limbs and leap great distances with ease. Rabbits also possess a highly sophisticated dorsal vagal freeze response. This protects them from predators either by stopping and hiding in place or ‘playing dead’ should they be captured. Also noted for fecundity, rabbits have an astoundingly high annual offspring production rate.

Putting all this together a Water Rabbit year feels simultaneously powerful and subtle. Gentle determination might best describe energy manifested in flexibility, adaptability, keen sensory embodiment and limitless creativity. No more stomping around foisting and forcing personal gain onto others. Best to rely on gentle, deep listening and other-centered consensus building to accomplish all aims.  That sounds enticing and so juicy given the full plate of transformative actions 2023 seems poised to require.

With that I wish you a healthy and happy Lunar Year of the Water Rabbit! Xīnnián hǎo!

New Year’s Reflections

Slowing down took a few days. My psychobiological system had been going non-stop with no time off for almost three years; ever since COVID shut down Silicon Valley on March 15, 2020. I and my organism forgot what time off—genuine reflective time—feels like physically, autonomically, emotionally and conceptually. I am slowly returning to an old friend—myself.

I’ve had many patients (mostly engineering types) tell me with great pride “I haven’t taken a single vacation day in years”. And proceed to recite how many vacation days they have accrued. Sometimes it was in the triple digits. That used to be the zeitgeist in this non-stop work locale. And so, I too succumbed to that outlook all in the name of service to those who suffered so much during the pandemic.

I am not a fan of New Year’s resolutions. No one keeps them past Jan 31. And unlike intention setting, goal-setting is often quite limiting. As my system has slowed and weighted itself in time and in body, my view of what constitutes a good life is shifting. This shift is not an outer endeavor nor is it about where to focus my efforts as I move forward into 2023. It is an inner inquiry into what is genuinely helpful and meaningful to put out in the world. That inquiry is in process and it will lead to significant creative shift for the Groundless Ground Podcast and Integrative Psychotherapy Blog. And that feels super exciting for the artist in me.

My entire professional life could be viewed as continuous waves of content creation, flowing from medium to medium consistently reflecting the ocean of clear awareness that pervades all thought, all speech, all action. Being a light in a world of darkness is for me the highest aim of everything I have ever and will ever produce.  Returning to this, this most precious attribute of my life has been a great gift of this time off. I have a few more days of basking in the slow beauty of passing time. May your New Year be filled with incandescent beauty.

As We Think?

I start most days racewalking the Creek trail. In late Fall and Winter my headlamp illuminates a few feet ahead, until dawn finally lights the path. Raccoons scurry by; egrets perch quietly. Though skunk smell often hangs in the air, I have never seen one.

This morning my mind produced a disturbing thought/image… what if I got sprayed by a skunk? How would I remove the smell? With no answer in mind, I continued enjoying the special feeling of a Winter Solstice sickle moon hanging low in the sky.

A little more than halfway through my walk, the trail dips closer to the creek and I hear familiar bubbling waters and duck calls. It is too dark to see any of this. Suddenly I detect a faint movement of white close to the ground on my left. My mind races to determine what it is.

As my head turns, the headlamp illuminates a beautiful skunk, white tail straight up in the air. I startle and chuckle quietly… synchronicity? Power of mind? Intuitive foreshadowing? Please don’t fear me and spray! My body speeds up to avert the very image mind conjured up only a short while ago.

We are such strange creatures—so at the ready to connect dots, create meaning, assign deterministic frames to what are probabilistic random events. Randomness does not sit well in a meaning-making animal that spins tales of thought’s power and intentionality. We believe as we think, so life occurs. The grandeur we accord to our inner thought world is astounding. And we use this exceptionalism to distinguish ourselves from all other mammalian brothers and sisters. Want to hear how much we actually share with these animals? Listen to the Groundless Ground episode I recorded several years ago with Professor Kristen Andrews author of “Animal Minds”. It will blow your mind.

I finished my walk musing on my own penchant for meaning-making. How pattern recognition and superstition marry in my brain fooling me into believing I somehow made that skunk appear! Silly human.

Love remains…

When Alzheimer’s disease progresses—annihilating ability to word-find, understand language, and speak cogently to loved ones—what remains is affect; particularly affection. In the early stages, this disease has periods where sufferers exhibit highly reactive emotions that often present as angry, nonsensical or delusional. These periods are particularly hard on close relations and caregivers.

One very difficult experience I recall happened eight years ago in a favorite Upper East Side restaurant. Mom and I were dining and suddenly her neighbor came up to the table to say hi. Startled that she didn’t recognize him, Mom launched into a hysterical rant about how I was planning to kill her. Increasing agitation caused her to suddenly get up and leave the restaurant. I ran after her knowing she would never calm down if I caught up with her. So instead I followed her as she wandered the streets agitated and lost; finally ending up at her building. From across the street I saw her smiling and talking with the doorman. When I entered the lobby she sneered at me. Then let me accompany her up the elevator and into her apartment. She never spoke of what happened in the restaurant. Just as she never admitted to having Alzheimer’s, even through the five years she spent living in a Memory Care facility.

Four months ago her deteriorated physical condition required a transfer to a medical model nursing care unit for memory patients. Though it is considered the best unit of its kind, it is nothing like the family-oriented, loving memory care environment she thrived in. She no longer eats and sleeps most of the time. Mom is making it clear: I am ready to bring this horrible last 10 years of my life to a close.

For the last four years Mom has not known who I am. Yet, when I arrive, though she cannot speak much, she immediately brightens in her affect. The love is palpable. She laughs when I make jokes. I can’t tell if she understands anything I say, but her eyes display interest as I relay the goings-on of my life. I hold her hand when she lets me. Play Beatles songs she and my Dad adored. If she gets agitated I stand behind her wheelchair holding her shoulders gently to restore parasympathetic response.

These days it is especially hard to leave at the end of a visit, knowing it may be the last time I see her alive. Sadness pervades the field between us. We stand together in the awful knowing that she, a highly intelligent and deeply caring woman, has been utterly decimated by Alzheimer’s. And even so, our mutual love remains… triumphing spectacularly over this dread disease like a victorious army refusing to lose its most precious treasure.

AI Image Generators and Bias

Text to image AI generators are a rabbit hole of wonder and bias. As a test I entered, “enlightenment arising from the prefrontal cortex”. Below are images produced by Dall-E 2 Open AI. All male, though the second from left might be viewed as female or androgynous.

Then I typed, “enlightenment arising from a female prefrontal cortex”. Below are the images Dall-E 2 Open AI generated.

I was taken aback by the cultural male-female stereotyping this AI generator was so clearly mirroring.

In the first grouping:

1. A cerebral, serious emotive tone pervades images 1, 3, and 4; the most male-like and Caucasian
2. Image 2 (the most female-like) has a softer more contemplative feel.
   And though the skin is brown, the face is European.

In the second grouping:

1. Image 1 looks dazed and entranced, not awakened
2. Images 2 and 4 are joyful, elated, with no contemplative feel at all
3. Image 3 is a feminized rehash of a traditional Buddha image
4. All four are Caucasian.

AI generators are supposedly trained on massive quantities of information regarding image types and features that human minds associate with specific concepts and/or words. Therefore, one could expect an AI generator to consume a wide swath of information, gather that into the most common associations, and deliver an image reflective of that process.

I suspect what may have been delivered in this case is a mash up of existing stereotyped male favoritism found in two necessary sources: medical illustration and religious iconography. Images are a vehicle to plainly see societal assumptions, especially wholly incorrect ones.

Group 1 delivers a very specific message: enlightenment occurs only in Caucasian male brains. Most surprising for me is the vast majority of depictions of enlightened states come from thousands of years of Asian Art: Upanishadic, Buddhist, and Taoist religious images. Though the vast majority of those images are male, none are Caucasian. Add into the mix medical illustration, which until very recently only depicted male anatomy of the head. Now the scale tips so radically and completely toward Caucasian male. The Asian origins of the framework of enlightenment is utterly wiped out! Could this also be helped along by the more recent Western image bias for depicting meditators as Caucasian males?  Maybe.

Group 2 delivers another sort of specific message: when enlightenment occurs in a female brain, happiness is all a woman will experience. No awakening, no clarity, no shift in understanding. And frankly, as someone who been a female meditation practitioner for many decades, until very recently, my scholarship of textual material and dedication to practice was largely minimized by male teachers in both Yogic and Buddhist training contexts. So, the AI generator is merely following suit. One can almost forgive an AI generator for its Caucasian female bias. It is clearly feeding from the trough of blond Caucasian blissful females gracing mindfulness and meditation magazine covers and Instagram posts. The assumptive biases of Group 2 make my stomach turn even more than those depicted in Group 1.

What is to be done about this quagmire of bias and lack of accuracy in AI image generation? I don’t have an answer. I do have an unsettling concern that the AI world care little about historical inaccuracies and doing their part to discontinue millennia of imagistic injustices and biases.

Meditation is not a performative act

Listen to Groundless Ground Podcast Episode 60

This is a very special and quite different kind of episode to finish out Groundless Ground Podcast Season 5. I have a frank discussion about the pitfalls of packaging and delivering meditation as a performative act in health contexts with Donna Sherman—clinical social worker and teacher of practical wisdom from yoga sciences, mindfulness meditation and behavioral sciences. Since Donna has studied extensively in the Tantric yoga tradition and I have expertise in Buddhist psychology, we interview each other about the ancient science behind Yogic and Buddhist meditative practices. Donna’s Therapeutic Yoga Nidra is the NSDR (non-sleep deep rest) practice I refer to my patients. And Donna is also a longtime dear friend and colleague from whom I have learned so much. It is hard to imagine a good life without her along for the ride! And wow, 5 years and 60 episodes. What an adventure Groundless Ground has been and much gratitude to every listener! GG listeners continue to be my greatest inspiration.

Graduating Psychotherapy

“I’ve graduated!” Most mental health professionals would not expect a patient to utter this proclamation at the end of therapy. Yet I have heard it more than once. The first time I was a bit taken aback as even I was lacking appropriate context for this framing. At the time I remember inquiring, “What about your accomplishment feels like graduating?” Their answer was so simple. “I have learned so much and radically changed because I have embraced this knowledge and use the skills in my daily life. I am still me, and yet, I am a me I could not have imagined being before I started this work. Therapy was not school but it feels like I have earned a degree!”

Though I don’t agree, psychoeducation is often considered separate from the therapy itself. I have always been a big fan of educating patients as part of the therapeutic process. Getting them excited about knowledge I have worked so hard to gain. Wisdom from biology, neuroscience, social science, psychology, and contemplative science is often as much of an ‘ah-ha!’ moment producer as directly perceiving mind, or landing firmly in embodied presence, or experiencing how goodness, kindness, openheartedness melt away anxiety, depression, loneliness and meaninglessness. It is all part of delivering an integrated package of resources for symptom alleviation and awakening.

Completing therapy fully equipped to meet life’s challenges with intelligence, humility, flexibility and inner strength is the aim. If accomplishment of that goal that feels like graduation I am all for it!

More Perfections of Post.news

Saul Tobias offered on Post.news a lovely explication of the six pāramīs (generosity, virtue, wisdom, zeal, patience, concentration) from the Mahayana Buddhist tradition. You can read it here. Following in Saul’s footsteps I would like to add how the following forms of virtuous conduct can be applied on Post.news and all other social media sites.

The Theravada Buddhist tradition (the teachings of the historical Buddha found in the Pāli Canon) teach ten paramitas. They are as follows: generosity, virtue, renunciation, wisdom, zeal, patience, truthfulness, determination, goodwill, equanimity. 

Renunciation: Restraint is a profound tool for creating a social media environment that is both thoughtful and informative. Renunciation means the impulse to post harmful content gets recognized and assessed internally for wholesomeness and usefulness to the community at large. Renouncing self aggrandizement and posturing can go a long way toward fostering civility and care in a social media environment. 

Truthfulness: This paramita seems self-evident yet so hard to put into practice in daily life. Our internal distortions, negations, evasions, and biases show up full force in social media. We so want our own views to be affirmed and yet disagreement can be a rich part of human interaction—as long as there is a commitment to honest debate and deep listening.

Determination: Once again, the historical Buddha was a big fan of checking ignorance and reactivity in thought, word and deed. Determination to respond thoughtfully takes a lot of zeal to be real instead of getting lost in habit reactivity and posturing. 

Goodwill: Also translated as friendliness or lovingkindness, mettā is an altruistic aim to resonate a kind of love which is unfettered by self-interest and bias. In the Udana Nikāya, the Buddha famously said, “Searching all directions with your awareness, you find no one dearer than yourself. So you shouldn’t hurt others if you love yourself.” Applied to social media, attention-seeking can often lead to posts that emphasize benefiting oneself rather than seeking the welfare of others. Goodwill and renunciation complement and strengthen one another. 

Equanimity: This paramita is for me the outcome of practicing the preceding nine paramitas. In Buddhist psychology equanimity is described as a neutral feeling tone of experience or a mental quality of impartiality. Equalness as a perspective builds distress tolerance and cognitive-affective flexibility by lessening self-absorption or what is known in pop psychology as ‘taking things personally’. Recognizing humanness and its inherent imperfection is a wonderful virtue to practice as one engages in social media. All humans are prone to misapprehend primarily because our perceptual apparatus views everything through one’s own mind-psyche-experiences.

May this post be of benefit to all who read it!

The Creatrix and Post.news

My first 24 hours on Post.news and wow… the artist in me has reignited. The angst and grief of the last few weeks of Twitter dissolution has given way to the fascination of interacting in a cauldron of intelligence, realness (weirdly enough), and a chance to diversify to other communities and voices I rarely had access to because of the ever-present social-media-generated algorithms dictating who I am and forcing me to stay in that box. So far relatively bot-free! And no ads! And a virtuous intent I can get behind.

The two decades I spent in the visual art world were years of me as rebel, technical fiend, technology envelope pusher (when online visual creation tools sucked!) and advocator for every human awakening—not in today’s woke way—in the ancient wisdom tradition way. Yes art, particularly interactional installation art can do that. And the raw nature of Post.net and its UX has a similar feeling of engaging with a newborn that is learning about itself and the world simultaneously.

Slowly I am finding other mental health professionals as more people get invited and sign up. Building community will take time but Twitter feels so horrible when I visit the site that I am convinced this is the way to go. Post.news uses a points system instead of ads, which feels a little like what Clubhouse tried to do a year ago and it pretty much failed over there. We’ll see if it works here. I get that this is way to keep ads away and reward “creatives”. That label was attached to a lot of crappy content at Clubhouse which is why I didn’t stay on it.

In other news, Youtube has granted my channel a new name. You can now find it at https://www.youtube.com/@integrativepsychotherapy