A true meeting of minds

MIND MOVES: Psychotherapy and spirituality have always been uneasy companions. Their relationship has been marked by intense mutual curiosity but also deep suspicion.

Partly because the experience of formal religious practice has been destructive for many people, psychotherapy has chosen to separate religious/spiritual issues form the work of healing psychological distress. It has concerned itself with the nuts and bolts of working with people on complex problems that afflict them, regardless of whether they are drawn to religious practice or repelled by it.

And yet the concerns of healthy spirituality and psychotherapy overlap and complement one another. They have each evolved in response to the challenge of emotional suffering and the search for meaning. And they each attempt to bring a particular methodology to promoting the general health of the psyche, or soul.

So, while it was very radical to open the recent World Congress of Cognitive Psychotherapy with a dialogue between Aaron Beck, founder of this therapeutic approach, and His Holiness the 14th Dalai Lama, it also felt like an occasion that was both timely and deeply relevant for the two respective disciplines they represented.

Billed as a meeting of minds, their discussion focused on commonalities in their approaches to understanding and transforming emotional suffering. While the focus of their dialogue was intellectual, the character of their discussion was marked by both wit and wisdom. His Holiness poked fun continually at Beck, in a way that communicated great respect and affection. At one point, he remarked that in his monastery younger monks were taught to bow to their elders. Now, he had found someone even older than himself and it was his turn to bow. And bow he did, laughing uproariously, bending forward and grapping hold of Beck's arm as they spoke.

Both traditions - Buddhism and CBT - represent ancient human traditions of trying to understand how the emotional mind works and how to ease its suffering. They both view painful emotions as the embodied experience of misconceptions of reality. Each discipline has its own strategies for steadying the mind in an emotional crisis, letting go of attachment to fixed negative beliefs, and emancipating oneself into more creative ways of thinking about life.

The practice of mindfulness meditation in Buddhism and the simple strategy of writing down negative thoughts in CBT are basic tools within each tradition for creating room to breathe in the face of distress. These practices allow us investigate those beliefs and assumptions that lead repeatedly to self-defeating behaviours. Although these beliefs may have been valid in the face of painful childhood experiences, both traditions encourage us to re-examine them in the light of current experience. It is often our insistence on thinking in a persistent negative way that causes a great deal of recurrent depression and anxiety.

Freedom is to be achieved by engaging with the real world before us, or within us, rather than hiding behind our biases and prejudices and insisting we are right. But this is difficult as it involves a letting go of some deeply held beliefs that have become part of our identity.

His Holiness talked a lot about the need for "loving kindness" to nurture inherent strengths in the personality and cultivate an appreciation of our connection with others. A balance of self-compassion and self-reflection is essential to achieve mental health.

In 1973 behaviour therapy opened itself to the mind and became cognitive behaviour therapy. If there was a single message in this dialogue, it was that we have arrived at a time where cognitive behaviour therapy needs to open itself to the heart, to a fuller appreciation of the role of humour, warmth and compassion in engaging people tormented by emotional distress.

As the dialogue came to a close, the Dalai Lama spoke of the inherent fragility of the human person. "We are born," he said, "out of a physical state of dependency and fragility and although we may harden ourselves to this basic truth, it remains a part of our nature. We do well to remember and recognise this fragility in others and ourselves." Before he left, the 1,400- strong audience rose and sang Happy Birthday to His Holiness to mark his 70th birthday on the day. He, in turn, reminded us that each of us has a birthday and, with a huge smile, he bowed to the audience and wished us a happy birthday. There was silence and a sense of profound reverence for his presence and for all that this luminous man embodied and represented.

Tony Bates is principal psychologist at St James's Hospital, Dublin.