Another Monkey

Sitting in a small office on hard wooden benches with a bare wooden table between us, in the suffocating heat of Chennai, India, I was talking with my yoga teacher, TKV Desikachar. I was in my mid thirties and confused about a number of things. My central questions were about my life direction; I was trained in general medicine, certified in psychiatry and knew yoga, but felt somehow inadequate, that I needed more training and qualifications, perhaps in acupuncture, Ayurveda, or something else. My teacher saw through my grandiose delusion, and told me: “Stop! You have everything you need. What is missing from the equation is you.”

He proceeded to give me a practice designed to locate the “I am” sense in the middle of my heart area, instead of my head, involving yoga asanas, breathing and chanting. I had been living in a mental world, constructed of thoughts and anxieties, but lacking a heartfelt presence. In this mental sphere, the main driver was doubt, or as I now know it, obsessional doubt. Doubt stands at the opposite pole from faith, or Sraddha in Sanskrit.

In this context, faith is not belief. It does not involve a deity, or certainty about anything, since if we are honest there is no certainty to be found anywhere. He described it as “a mother’s feeling toward her infant.” 

Over many years I came to experience a shift in this direction. The sense is of a relaxation in the belly and heart area, an openness and immediacy of contact with others and the world, and a quiet upstairs in the mental sphere. 

The wonderful aspect of this shift is the emergence of wisdom without thought. I can now be present and responsive with others, free from mental analysis, and trusting my entire system to respond appropriately, drawing on a deep well of insight. The source is not mine, and is not the result of qualifications or status. The source lies downward, not upward, and is drawn from experience, knowledge, teachings I’ve received, openness to the other, well-wishing and trust in life itself.

The second teaching I received from Desikachar that day was a story he told about his own early career. His most famous student was the philosopher J. Krishnamurti. As a young man, Desikachar was becoming well known in Europe and beyond, being both very gifted and the son of India’s most famous yogi, T. Krishnamacharya. He was offered the leadership of the European Yoga Federation, and asked Krishnamurti about it.

Krishnamurti's response stayed with me: “Sir, don’t become another monkey!” This has proved a profound teaching for me, and has helped me in my own career, and in my discernment of the ethics and direction others are taking.

What is it to become another monkey? We learn from many sources, teachers, guides, elders, friends, teachings, books, ancestors, and due to our individual natures we may express our learning in seemingly novel ways. It is tempting to take ownership of our success, to claim originality, special insight or a new approach.. Thus the paradox: we are of course expressing ourselves in an original way, hopefully. We may have synthesized the teachings of others in a refreshing way, or even had a leap of insight others may not have had. But the moment we claim ownership and begin to build a brand, the process of becoming another monkey may have started. The marketing of oneself, fabrication of an image, taking it on the road, selling it…often leads to a tarnishing or even falsification of the original insight. We see this in gurus of all stripes, influencers, wellness experts and guides.

Feeling good about what we are offering the world is important, and learning to express ourselves in our lives does matter. But the transition to self-promotion is the slope leading from authenticity to charlatanism.

As Desikachar would say about his own teaching, “I am just sharing what I have received.” He felt that once we receive something we have a duty to share it, but no claim to it.

Beliefs Taught to Children and their Consequences

When I was 16 years old, following a brief episode of involvement with a “Jesus-freak” community of young people, I asked my brother to guide me in a “real” dose of LSD. As he was quite experienced and had the right connections, he gave me 400 mcg of pure Sandoz product. The result was a very challenging 12 hour experience of great mystical import, which I won’t detail here. But one central insight that came out of this day, and which has informed an understanding of religious dogma ever since, is this:

Belief systems are a movement of thought based on fear.

Over the past 35 years in my psychiatric practice I have observed the complex interplay of factors underlying patients’ suffering, and broadly these predisposing factors fall into a few categories:

-Genetics: we can easily observe the prevalence of psychiatric disorders in close relatives going back a few generations, e.g. schizophrenia, bipolar disorder, etc.

-Intergenerational trauma: as we now understand, the traumas of our ancestors affect the gene expression and thus symptoms of later generations. An amazing example of this is PTSD symptoms in the children of holocaust survivors who had no direct experience of the trauma.

-Childhood and later life experiences, joys and traumas: we can all easily see these effects in our own lives. For example, the devastating effects of childhood abuse and neglect.

And finally, childhood conditioning in the form of teachings from both parents and society. This is todays subject, and one of profound consequence in my patients’ lives.

In its simplest form, this can manifest as religious doctrine, prejudices or morality tales presented to children as truth which defy reason and which children are asked to swallow whole, unexamined, irrefutable, not subject to enquiry or doubt.

I will start with a prevalent example in the West:

There was a man named Jesus, whose mother was a virgin, who taught the only way to salvation, who was Jewish as were all his followers, who was betrayed by Jews after teaching and performing miracles for only three years, put to death violently by the Romans even though it was still the fault of the Jews, who doubted everything at the end but all of this was God’s plan from the start, as He planned to have his son martyred to save everyone else, not everyone but only those who believed the right version of events, who so loved the world that He killed his son brutally and consigned the bulk of humanity to eternal suffering for not believing the right things, and then this dead son rose from the dead to prove his divinity and several people saw it, and fundamentally it was all the fault of a woman Eve who ate fruit she was told not to, and so on.

The confusion in a child who is repeatedly told this story, as truth, is consequential. That child is bound to feel baffled by the absurdity of this narrative: it sets up a condition of fear and self-doubt as the story clearly doesn’t make sense and difficulty thinking for oneself for fear of reprisals from family, religious authorities or a brutal deity. At a young age,  learning to think and feel for oneself is perhaps the most important developmental task.

In addition, the entire relationship with one’s body, whose primary drives are taught to be sinful, to one’s essential nature, which is taught to be corrupted from the start, and to one’s own insight, which is not to be used, is thrown off course.

With the dawning of a person’s sexuality, a profound conflict is set up, and perhaps the strongest drive of all is taught to be a problem stemming from the corruption that is our instincts, feelings and passions. If the body is sinful, then caring for it so it can experience life fully makes no sense. If the world is hurtling toward a resurrection event that will consign most humans to eternal punishment, then really nothing makes sense: not the benevolence of a creator, nor justice, forgiveness, lovingkindness, equality or faith in life itself.

These belief systems, taught to children, contain barbs like fishing hooks that are very difficult to remove, even decades later in a psychiatrist’s office. Fear is integral to the problem; if I question the doctrine, I may be eternally punished, excluded, frozen out of love and connection forever. I may be separated in some way from family and community,  perhaps eternally.

On a deeper level, these doctrines prevent a young person from coming to terms early on with the basic fact of uncertainty. Martin Heidegger described this as “thrownness,” the seeming arbitrariness of how we exist in a certain family, context and time in world events. In Buddhism, change and uncertainty are seen as the underlying facts of all existence. In existentialism this is sometimes called “meaninglessness,” but in grappling with this comes a young person’s sense of their own unique purpose, gifts and path. In yoga philosophy the term “sva-dharma” refers to one’s own individual path, distinct and wonderful, to be found through persistent inquiry, practice and study.

In my view it is fine to teach children the history of world religions, the ways different cultures developed as a result, and one’s own lineage going back generations. But it needs to be clear that the belief systems are just that, beliefs, and do not in themselves constitute truth. Truth is to be found for oneself, through study, experience, travel, relationship, and the wonderful practices for inquiry developed throughout the world called meditation.

“A person of scientific mindset will read hundreds of  books in the course of her life, but will always be convinced there is much for her to learn. A religious fanatic will read only one and be convinced she has understood everything.” (Author unknown)

Limitations on the Path of Self-Discovery

It is both normal and wonderful for young people to look deeply into who they are, yet I see many who have gotten waylaid, in my view, by questions of identity. This has increased particularly in the past 10 years, as the focus on race and gender have been emphasized, more and more, particularly on the left and by reaction on the right as well.

The deep philosophical questions I encourage in young patients involve such issues as:

What do I love?

What moves me?

Who am I attracted to?

Given the fact of death, what gives my life meaning?

Does the self have any solidity?

What is belief, in any tradition or system of religious authority, and is it relevant to leading a good life?

Am I drawn to spiritual practice and inquiry?

What is my responsibility toward the world?

However, in the current climate where I see teens immersed for years in gender identity questions or particularities of race, those essential questions may not be asked at all. By identifying more and more with a particular attribute, the multi-dimensional growth so important in teens can be missed.

In my tradition of yoga, there is a general term for our roles in life: dharma. We can have specific dharmas, or sacred duties, e.g. being a father, or a student, or a doctor, or a friend. But beyond those we have a unique path called a sva-dharma. This is unique to each of us, and cannot be imitative of someone else. It is developed and discovered through a process of learning about ourselves deeply, and proceeding in life according to our gifts, traits, inclinations and what provides meaning. When we live a life not according to sva-dharma, we become distressed, anxious or depressed. This is called a-dharma, or not-dharma.

On the other hand, when we make course corrections according to self-knowledge, even if the path is very challenging we feel calm, open, energized and good about this direction. This is sva-dharma.

I find it is best to explore one’s attributes such as gender identity, racial background, etc. as part of self-knowledge, particularly if it has caused pain or discrimination, but only as a step toward self knowledge. Then, if one can hold that understanding loosely without attaching too much importance to it, one can then move into more important questions involving how to live wisely and happily in this world, what work suits us, who to befriend and how to love.

Furthermore, what I have discovered through decades of yoga and meditation practice is that identity has a paradoxical nature. On the one hand, I am a very particular human being with a unique past, talents and weaknesses, things I love and many I don’t, who has a way of working and being in the world that are a direct expression of this unique nature.

But underneath that, beside that, parallel to that, there is no “self” here at all. It is simply a construction of thoughts, feelings and perceptions that are constantly changing. There is nothing to grasp or cling to as “I.”

When we identify with anything, be it a belief system, religion, gender identity, racial feature, political viewpoint, or conditioning from our family, we lose the sense of the empty nature of self. Reifying identity features separates people, and has throughout our history; my religion or race over yours, my beliefs, my country, the specifics of what I identify with sow division, hatred and violence.

Less or non-identification with these attributes means we are all simply a human family, we all suffer and will die, and we all deserve happiness and have a duty to each other. Even beyond that we are living beings among other conscious beings, on a planet that gives rise to consciousness. How amazing! How freeing! This is perhaps a better way to direct our gaze in the search for who we are.

Smoking Saves Lives

As rain pummeled most of California recently, my two sons were at my house, which is unusual as one lives in Dublin and the other, having recently wrapped up his life in London, is on an open-ended journey through the world. As they described it, they were about to drive up the driveway together, when Benjamin, who smokes, wanted to go in the house to roll a cigarette. They both went in, and at that moment heard a loud explosion and looked out to see our huge Italian stone pine fallen across the driveway, blocking the entire street. Had they not gone inside at that moment, they could have both been crushed by the gigantic tree, which even a week later lies only partially dismantled by a team of arborists.

My efforts to get Ben to stop smoking, a habit reinforced by seven years in London where it seems almost everyone smokes, have met a dead end; he finally put a stop to my father/doctor pained efforts by asking me to desist, saying that stopping smoking will occur through his own initiative and that my pestering only serves to increase his resistance.

I’ve noticed that when I am adamantly pushing for something, feeling so right in my position, as regards the lives of others, there is an accompanying hopelessness that change will occur, and yet I often feel compelled to repeat my admonitions. This started with my mother’s destructive drinking, failed there, and has failed everywhere ever since.

At the age of 66 it’s finally dawning on me that change doesn’t occur this way. The natural course of growth and discovery follows a twisting, winding path free from coercion. Truly, I have never followed anyone’s advice myself. All growth has come from experiencing suffering and seeking my own solutions, often with the help of great teachers. We never know what painful events will lead to, but there is an inherent drive toward wholeness in each of us. We often need an “adaptive stressor,” or hardship, to break an old pattern and begin on a better path.

So, at least this once, I will say the unsayable and admit to the collapse of my self-righteous system of advising others:

Smoking saves lives.

On Survivors of Happy Families

While it may be true, as Tolstoy says in the first line of Anna Karenina, that every happy family is alike, it is also true that the outcome of growing up in such a family is not so predictable. There has been an immense amount written about the ways in which childhood trauma, disturbed family relations, unreliable parenting and other forms of dysregulation affect a child and her/his future life course, but I have some observations about the opposite situation that may be counter intuitive.

Anyone who has practiced psychiatry or psychotherapy for any length of time has observed the obvious connection between early attachments and later problems in relationships; with almost mystifying regularity we tend to replay dynamics from our childhood parenting experience in our early (and later) intimate relationships. This can be improved upon, yet it takes hard work and often a long time, and plenty of guidance for most of us.

A more surprising discovery that has come out of my 35 years practicing psychiatry is the kind of troubles encountered by people who apparently had secure family attachments, a peaceful dynamic between parents, no disruption in their childhood development, and a loving environment. Of course there are a million kinds of subtle disconnect even in those idyllic settings, such as temperamental mismatch between child and parent or child and sibling, the “how did I end up in this family, since I am so different?” phenomenon. But overall, these families show no signs of the typical discord, abandonment or erratic parenting we see in the past of so many people who end up in our offices.

Take the example of a young woman from a stable, loving, intact family who begins to experience confusion and a profound sense of betrayal when her dating partners behave in ways that mystify her. Ghosting, duplicitousness, cheating, lying, manipulation, controlling behavior and/or violence are totally unfamiliar to her and were never present in her earlier life. She has no frame of reference in which to view this aspect of intimacy, and may try harder to accommodate, or assume it is her fault. Blindsided, it may be hard for her to imagine the shadow side of human intimacy and she is deeply hurt by it. She may persist longer than necessary out of this naive understanding of the ambiguities she is facing.

None of her intimate experiences, at least early on, match her expectations. The model afforded by her parents just doesn’t seem to be on tap. Her lens, in some sense, is a simple one, not up to the complexities of a world in which many people are ambivalent, hurt, unaware of their own motives, moved by complex unconscious forces. She is suffering from naivety.

Children who have experienced dislocation, divorce or complex family dynamics can be in some sense primed to the multiple dimensions of people’s motives, dark and light, and may already understand on some level that powerful unconscious forces are at work in all of us. They are less likely to expect anything in particular of others; this could be cynical, but it may also be a freedom from expectations that allows them to see an undesirable dynamic at play early and call it for what it is.

In the world of wine producing, so I am told by my expert friend, a vine that is given everything it needs produces uninteresting wine. The grapes that grow in difficult terrain, having to extract nutrients and water under less than ideal circumstances, develop more complex and desirable qualities. While we all try and give our children everything we can, we all fail to varying degrees. Despite our best efforts and fueled by our failures, we may produce offspring who are complex, rich in understanding, resilient, sophisticated in the ways of the world, and ready for anything!

Why Porn is Destructive for the Viewer

Over the years I’ve treated many people, mostly men, who have an addiction to porn and difficulty in sexual relations with a partner. I won’t address here what I think is wrong for the people making the porn, and why that is damaging as well.

The usual presentation is that of a man between 20 and mid-40’s, in a relationship and having difficulty sustaining erotic interest or performing to the satisfaction of both partners. His porn viewing usually began in early to mid teens and was his primary introduction to sexuality. It became a habitual pattern, often accompanied by some kind of substance use, and is associated with feelings of guilt. Efforts to stop are unsuccessful and the behavior persists even when he is in a relationship. His habit may cause conflict with his partner, or he may enlist his partner in joining him as part of their sexual practices. 

From a neurologic perspective, the intense visual stimulation separated from all other aspects of intimacy creates a habituation to this form of arousal. It is a kind of split within the self; erotic images of high intensity and frequency, divorced from the emotional reality of another person, makes the man unresponsive to the multi-dimensional but gentler stimulation of a living human person.

On one level, overstimulation alone is a problem. If one is addicted to cocaine or methamphetamine, green tea will provide no lift at all. On a more problematic level, porn viewing furthers a split within the male (heterosexual) psyche- I am less familiar with the dynamics of porn viewing in other sexual orientations- known as the “madonna-whore complex.” This refers to the separation of the erotic image, objectified and without the full spectrum of human capacity, from the idealized feminine, i.e. the madonna, mother and nurturer who deserves respect and protection, who is not an object of desire and who must be spared from any aggressive primal sexual urges. 

Fostering this split by viewing porn makes it difficult to have an integrated experience of the other person as a complex entity with a seamlessly shifting kaleidoscopic persona that can include mother, friend, erotic being, sorceress, antagonist or any other aspect of the feminine one may encounter in the course of an intimate relationship. 

In my experience, healing this split requires complete abstinence from porn viewing. This often involves a period of withdrawal symptoms as in any addiction, with discomfort and urges to resume it. It is best to substitute another activity in its place, preferably not involving a computer. Options could include learning a musical instrument, reading great literature including great erotic literature (e.g. D.H. Lawrence or Anaïs Nin), exercise, night walks, meditation, yoga or painting, and any of these can be shared with a partner.

All addictions lead to a limitation in experiencing the full range of beauty, joy, ecstatic feelings and most importantly, connection, available to us. The Sanskrit word “Duhkha,”often translated as “suffering,” is conceived in my yoga tradition as “a sense of restriction.” Eliminating that is my goal in this piece. 

On Clearing the Way for an Authentic Life

I often work with patients on the problem of identifying desires, intuitive responses, and how to live authentically. I find an essential step in identifying an “authentic self” is learning to wield the beautiful and often maligned word “no.”

Both yes and no are magical words, performative words, words that bring things into existence and clear non-essential things from existence, like a magic wand. As basic as they seem, there is art and practice involved in using them.

Behind these words lie many psychologically complex dynamics, including unresolved childhood fears, the sense of basic trust and safety, the faith in oneself and one’s essential value and lovableness, the benignity/malignity of others, the zero-sum vs. boundless nature of connection, and most essentially the capacity to be alone.

Many of us fear that relationships must be maintained through inauthenticity, by responding according to what we imagine others may want or fearing what we imagine others may think if we decline their offers. Much of what passes for conversation in social settings follows this pattern of inauthentic questions and inauthentic responses, leading to a superficial, vaguely dissatisfying sense of connection. Over time, this pattern of interacting with others becomes the default mode; the lack of depth or true meeting is covered over by quantity and noise.

Underlying all of this is the sense of faith in our interconnectedness to all of life, and how fragile we think our capacity to be loved is. Saying what we think others want us to say implies a deep distrust in the basic conditions of our security.

It is also based on the erroneous assumption that we know what others want, or think. I have been a psychiatrist for 34 years and I do not know what others want, or think, unless they tell me, and even then I know that it is constantly changing, that I am not the focus of their experience, which is also constantly changing, and that if I disappoint them that feeling will also soon pass.

On a yet more fundamental level, do we know what we truly want, or feel, or think about anything? To know this requires several things:

-Quiet and space. Meditation and yoga provide the daily opportunity to experience the quieting of the mind’s turbulence, and to find the “quiet candle flame” of deep desire or feeling underneath the mental noise.

-Freedom from the tyranny of other people’s beliefs, opinions, advice, religions, etc. Meditation also helps with this.

-Awareness of body sensations. The body has a deep system of response that gives wonderful information about what we want and don’t want, and this requires the ability to listen and feel for the slight tightening of the belly or chest that often underlies a “no” response.

Having identified what we feel, or want, or know in response to others, we are now in a position to practice the art of tact.

With a deep commitment to maintaining an authentic relationship to ourselves, our response to others can benefit from several principles.

All good responses contain these three elements:

They are true.
They are kind.
They are wise.

True is the easy part. Kind means care given in not harming the other. Wise means having considered the ripple effects of our words, and whether it is our duty to say them.

Not lying, conveying the truth, and treating the other as an equal are essential ingredients.

The art form arises in that particular moment, non-formulaic, given our command of the language, metaphor, poetry, humor, all leavened with kindness. So each instance of saying no or expressing our wishes is unique, arising from that specific moment. Even saying no can be an opportunity to honor the other’s existence.

The problem with ghosting

In the current environment it is all too common for people, especially using electronic media as a platform for communication, to simply disappear or “ghost” others. I hear this frequently from patients regarding dates they have had, even those that seemed to go well. I suspect that the endless opportunities for finding a limitless stream of other people online, the fear of confrontation, lives buried in distractions, and a certain cowardliness all play a role in this phenomenon.

The philosopher Martin Buber described the two ways of relating to others, and to the world, as the “I-Thou” relationship and the “I-It” relationship. In the latter, others are viewed as objects of peripheral concern, to be used according to our needs and discarded accordingly. “I-Thou” implies experiencing the other as having intrinsic value, a center of his/her own subjectivity, noble, and desiring of happiness as we are. In this relationship with the world, we bear a responsibility to treat them with kindness, to communicate our wishes and needs clearly and truthfully, even if this means disappointing them.

The beauty of no

In the search for an authentic sense of self, removing what it is not is the first step. This implies learning to say no to what does not belong. Michelangelo said that he found a block of marble and removed everything that was not “The David.” Otherwise we go through life acting and speaking in ways that are not authentic, and engaging in relationships that are strained and work that does not fulfill us.

No arises from the body. When an opportunity, an offer, or a person presents itself or themself to us, if we have cultivated some quiet in the mind and an open relationship to the body, we can immediately sense a visceral response. No is a slight contraction, often felt in the belly or chest area, or elsewhere. We can be in the habit of ignoring this, and override it with habitual “yessing.” The yes is followed by more visceral discomfort, and the distress augments.

Practicing no may evoke some fear, usually of the other person’s disappointment, anger or loss of connection. In practice, however, no often brings clarity to a muddled situation and raises our value in the the other person’s experience. No also frees the other person to pursue things that can be more suitable.

Saying no implies trust that there will be enough love, opportunity and resources for us in our lives. And most importantly, that being alone, for now, can be a precious experience leading to richer, more joyful connections. There is simply no way to have healthy relations with others if we cannot be well alone.

The joy of yes

Once the magical word no is mastered, the deck is clear for the truly spectacular word yes. Yes is the affirmation of life, of connection, of whole-heartedly embarking on a path, whether it be work or love or friendship. Yes is the taking full responsibility for action, the being in a position of choosing without reservation. Yes is the power behind all great tasks, the overcoming of all obstacles. 

The Decline of Romantic Love

I often hear from my patients, both female and male, of the odd turn that dating has taken in their lives. An example from yesterday: Sandra (not her real name), a lovely woman in her 30s, has a wonderful day with a man she just met, feels attraction and interest that seems quite mutual. He calls her the next day to say how much he enjoyed it. She does not hear from him again. 

This scenario, in various forms, seems to be becoming commonplace. Over many discussions with patients the elements we’ve teased out include a certain fragility, fear of intimacy, and lack of persistence, especially in men, who can easily sleep with a different woman every day through dating apps without going through the considerable effort of forging a lasting relationship.

The idea of chivalry, which to me is structurally important (at least unconsciously) in the dynamics of many relationships, seems to be in serious decline. Psychological differences between men and women in their mode of feeling, the fact that in general, men are still the pursuers and initiators in relationship, the fact that the evolutionary cost of intimacy is very different for men and women, all have become increasingly ignored in the panic of cancel culture and verbal policing that prevails, at least in the U.S., at present.

What do I mean by chivalry? I think essential to it is patience, gentleness and respect. The capacity to see the other as a noble being, capable of suffering and joy like oneself, worthy of the best care. The ability to endure some frustration along the path, and to delay gratification. To have these qualities means one has felt pain and loss oneself and come through it with more compassion and selflessness than before. 

Of course desire is very important; without it there would be no joining together in any romantic alliance. Desire can burn clean and bright, but it can be tempered with patience and kindness. Without the flame of desire, the other qualities can manifest as friendly yet passionless asexuality, which is fine but cannot ignite the wonderful blaze of mutual attraction that lights up the sky like a meteor shower.

At its core I feel this loss of romanticism is based on fear. Fear of getting involved in something bigger than oneself, fear of losing control of one’s feelings or the situation, fear of being deeply in love and having it not reciprocated or losing it eventually, fear of failing to live up to the extraordinary possibilities in love. Yet fear is a terrible guide. 

So, what to do? 

Meditation is quite helpful, in learning to observe the storms of one’s fears, desires and hopes arise and pass by without identifying with them. To see one’s pride, that element that fears rejection or loss, as a false image of oneself, and that the true underlying nature of being cannot be left or rejected. 

Finally, to develop courage, in the primal meaning of the word. A quality of heart willing to endure fear and discomfort, even loss, for a worthy goal. It is the implicit understanding that what can be burned up when one is rejected or experiences loss is one’s pride, that false image that covers up our true, open-hearted nature. 

Eros and the Hookup Culture

In my work with teens over the past 25 years I have been increasingly struck by a kind of cautiousness and self-protection in young people’s approach to romantic love. It appears to me there are multiple layers of defense against the risk of hurt in intimacy, that have increased over time. 

Signs of this include the rise of online porn, with its ersatz approach to sexuality, and the hookup culture in which genuine passion and ecstatic experience are almost surgically guarded against. In listening to many teens describe their sexual experiences, I am impressed by how shallow and meaningless these contacts often seem to be; free from any deep feeling for the other, deep sensuality, words of intimacy or flame of desire that could propel a developing relationship. 

At root, I’ve noticed a deep seated fear of exposure, loss, rejection or failure that underlies this detached version of sex and intimacy. The limited intimacy available in these encounters is often fueled (and damped) by alcohol, and seems often to involve servicing the male’s needs to the exclusion of all else. 

I could speculate about the sociocultural roots of this change, in terms of what these youngsters have witnessed with their parents and been exposed to online. Another possible root of this is the over-protection of young people, preventing them from taking risks in many areas of life including relationships. Of more interest to me is how to proceed to establish a more healthy and fulfilling approach to passion. 

Buddhist psychology can also be a good resource in understanding that avoidance of loss often deprives us of true intimacy, and the layers of self-protection keep us from caring deeply about anyone or anything. The outcome of all this is young people who lack strong feeling and conviction about anything, and are uncertain about what to do and who to be with. 

I often find myself teaching teens about the roots of romantic love, chivalry and courtship in history and literature, and the historical phases of our understanding of sexual love. Great novels can be a wonderful entry point for them, e.g. D.H. Lawrence (Lady Chatterly’s Lover), Hermann Hesse (Narcissus and Goldmund), Heinlein’s Stranger in a Strange Land for the loosening of sexual attitudes in the late-middle 20th century, and of course the works of Simone de Beauvoir and other prominent feminist writers in putting female sexuality on an equal footing with that of males. The poetry of the troubadours of the 13th century can be instructive; the roots of “troubadour” in Arabic and Greek are associated with  "finding", "music", "love", and “ardor,” and how to cultivate them via artistic pursuits. The chivalric tradition helps young people see that to pursue deeper passion may require patience, sacrifice and exhibiting some kind of excellence to win over the person one desires. 

In order to increase the vividness of romantic love in the lives of young people, which I think is a necessary developmental stage, we can encourage a certain degree of risk taking, explore Buddhist psychology to help them realize the futility of self over-protection, and expose them to the great works of literature that shed light on the beauty of romantic love through history. 

When Liking Is Better Than Loving

We all love our kids. And we say we love others, at least in California, quite a bit. The word has such a plethora of implications such as familial obligation, dependency, need or duty tinged with resentment, that it sometimes seems devoid of the power to convey real meaning.

It’s pretty easy to feel warmly toward young children, as they tend to be cute, innocent and dependent upon our care. As a child enters her teens, however, and begins to differentiate from her parents, the feelings between parent and child inevitably become more complex and ambivalent. She may show signs of moving away from us, physically and emotionally, as well as rejecting our status as gods. She probably develops a complex inner life, some of which by necessity is kept hidden.

At this point, some parents may distance from the child, no longer recognizing the non- compliant being who until recently was under their control and tutelage. Others may double down on trying to regain that control and compliance, and are frustrated when met with inevitable resistance.

I feel there is another way, which is to start getting to know the child as who they are becoming. This involves open-ended discussions, genuine curiosity as to what they are thinking and discovering, being willing to share observations, and of critical importance being willing to learn from them. The asymmetrical relationship of parent directing child begins to shift toward a more parallel, shoulder-to-shoulder walking together mode.

An image I sometimes share with parents is the idea of parent and teen walking side by side, looking in the same direction, let’s say along a forest path, and discussing the complex issues of living. Admittedly, one has more experience and a duty to protect, however the differential needs to sometimes shift to where the teen leads in insight and the parent learns. This allows the young person to begin to identify the locus of wisdom and insight within herself.

Finally, it is not enough to love your kids; you need to like them. And the only way to develop this is to spend time with them, to take journeys with them in which you are not always the expert, where you are in a process of discovery together. Liking implies all that loving does not necessarily include: admiration, interest, appreciation for their unique beauty and intelligence, and a desire to share in life’s great adventure together.

On Making A Request

A request has three aspects:

1) Concrete rather than abstract.

2) Specific rather than general.

3) Positive rather than negative.

It must be followed by: “Can you do that?”

The other person can say:

Yes I can to that.

No I can’t do that.

Or, they can negotiate.

The requester must decide whether their request is negotiable (most are) or non-negotiable (a few are not).

Once the request is complete, the discussion is over.

Relationships die in abstractions, e.g. “You should have known after so many years,” or “ if you loved me you would...” or “I thought I made that clear” or “my other partners knew this,” etc.

Relationships sink in negatives: “I need you not to...” or “I feel bad when you...” or “you never...”

This is part of “relationship hygiene.” Also, don’t bring up the past unless absolutely necessary (it rarely is). Stay in the present, and the way forward.

Avoid extensive discussions of past relationships. It gives the other person mental images they cannot get rid of. You are building something new; the past relationships haven’t worked out, have they?

Examples:

Instead of “you don’t spend enough time with me,” a request could be: “When you get home from work, at 6pm, I need you to sit with me on the couch for 10 minutes, hold my hand, and talk with me about our day. Can you do that?”

Instead of “you never tell me I’m handsome” a request could be: “twice a week I need you to tell me you find me attractive, when you notice I’m attractive. Can you do that?”

Instead of “you ignore me when we go to parties” a request could be: “when we go to the party this Saturday at 6pm, I need you to come up to me twice during the evening, touch me on the shoulder and look at me. Can you do that?”

The way you know it is a request is: if a third person were there, would they know exactly what you mean?

If you find yourself angry or upset, ask yourself: do I have a request? If you don’t, you need to drop it and wait until you discover what your request is. You can also ask you partner, if they are upset, “is there a request in this?”

Long painful discussions rarely lead anywhere, tax both of you, usually involve agonizing digressions into the past, and are not how you want to spend your precious, rare time on earth.

In my experience, making requests using this method is the only way to develop a peaceful, satisfying, lasting relationship. It requires of each of us that we reflect on exactly what our own needs are, and put them forward in a clear, concrete, specific, actionable way so our partner can satisfy them rather than guessing. It requires us to abandon our infantile wish that others should understand us like an infant is understood by a mother.

On Loving Your Ex

How do we go from the deepest professions of love and commitment toward those we value to a sense of alienation and pain, and how can we return from there? 

Our deep feeling for a beloved is made up of many things: evolutionary reproductive drives, idealization and aspects that are familiar from our upbringing, especially traits related to our parents. The one thing that is not always obvious is the possibility of genuine, unconditional love without attachment. 

During the course of a relationship, we often trigger each other’s wounds, and over the course of years this can end up depleting the source of goodwill and connection needed to sustain a relationship; commonly, this ends in a separation involving hurt, sadness, anger, resentment and great emotional distance.

At this point, we have a choice to make, one that will have an enormous impact on the future course of our lives, our families and our children. 

We can harden our hearts, doubling down on the sense of righteous indignation and resentment, holding the other responsible for our pain, re-telling the narrative of our victimhood endlessly to ourselves and others. This is the total abdication of responsibility, and shuts down any possibility of real growth. It closes off the avenues to genuine happiness, limits our future loves and causes a deep ongoing pain in the children’s lives, as they only have two parents and need to love both of them.

Or, we can consider that this is a grand opportunity to learn about Love, Phase 2. As we release the other from our expectations, let go of the sense of who-did-what-to-whom, and let the old painful stories fade away, the way is opened to learning something about genuine, unconditional love. 

This can begin with the practice of forgiveness: the simplest form is explained in the book by Jack Kornfield, “The Art of Forgiveness, Lovingkindness and Peace.” This process may be helped by the assistance of a wise therapist, one steeped in meditation practice. 

We can proceed from there by building a new, present-centered relationship with the former spouse, in essence getting to know them as they are now, in current time, in a spirit of non-possessive friendship. If they are a co-parent, we can develop a very deep appreciation of them as the other parent of our children, the only person who can love them at the same level we do. This is a role of special honor in our lives. We can compare notes and share ideas and perceptions about our children’s development. 

Beyond co-parenting is the recognition that there is something deeply special about this person who played such a significant role in our lives; and that, beneath any stories we had told ourselves, we still love them.

Living with a Narcissistic President

Narcissism has been perhaps the most destructive human trait throughout history; if we examine the personality structure of those who have inflicted the most suffering on others, it stands out along with sociopathy (which has several areas of overlap) as the most prevalent trait.

For the individual, an intimate relationship with a narcissist creates a well understood set of symptoms and dynamics, and tremendous pain and distress.

The narcissist commands our constant attention. Our internal response is one of threat, fear, hyper-arousal, anticipatory anxiety and difficulty stepping away from the cause of our distress, or even identifying it. It seems as if something terrible will happen if we withdraw our attention from the narcissist; and the moment we try to they draw us back in, either through seduction or threats. The worst thing that can happen, in their psychological world, is to be left alone with their sense of inadequacy, unlovability and emptiness, and thus they must constantly stir the pot, craving love and intimacy yet unable to tolerate it.

Under the sway of the narcissist, our world shrinks as we focus more and more exclusively on him/her. We begin to feel crazy; since they seem so sure of themselves and yet it makes no sense to us, we begin to doubt our own perceptions. For people with a shaky sense of self, this can result in identifying strongly with the narcissist, submitting to them; thus the sycophants throughout history who surround the powerful figure, kowtowing to and enabling them.

In our current situation, we have such a figure at the helm or our government. In myself, and in my patients, I see the same phenomenon: a sense of helplessness, dismay, fear, powerlessness and despair that such a person is causing so much damage and nothing can be done about it. It becomes a sick, addictive focus of attention; one is unable to take their eyes off this person, and the cascade of his words and actions each more horrible and inhuman than the last.

My fellow psychiatrists have written extensively about this in the media. Having worked with very disturbed patients for decades, both in hospital settings and in the office, psychiatrists all know what this is. It is an extremely destructive pattern of behavior, and it seems more than odd that non-psychiatrists are not more interested in the professional opinions of doctors. Perhaps it reflects the current trend of science-denial and alternative facts, where expertise and professional training count for less than unfounded beliefs and tribal instincts.

Once a disease is correctly diagnosed, we move toward treatment. In the relationship with a pathological narcissist, the only effective treatment is to remove oneself from the relationship, to sever the tie. In my view, the only way we can begin the process of healing as a nation and as individuals is to end the relationship with this figure by removing him from office; in the meantime, the best we can do is minimize the damage he can do and reduce the attentional reward he gets from his constant provocations. On a personal level, in addition to efforts toward limiting the damage he can do to our institutions, environment and standing in the world through political and legal action, we must step back from an obsessive focus on his awfulness. In place of this, I suggest reading great literature, playing and enjoying music, close relations with friends and family, exercise and daily spiritual practice such as meditation or prayer.

The Importance of a Profession

As I’ve gotten older, I’ve increasingly felt that there are several core elements essential to a fulfilled life. One of these is pursuing something in life that one becomes very good at, which can take the form of a profession.

Paradoxically, in a spiritual sense we are complete and whole as we are; our intrinsic worth is not tied to outer achievements, status or possessions. And at the same time, for most of us our engagement in the world takes the form of work that occupies much of our day. It has been my experience that by becoming highly trained and developed in one or more areas we experience more satisfaction, joy and freedom.

My father used to say that whatever we study, if we go deeply enough we find the answers to everything. One of the greatest scientist/thinkers today, E.O. Wilson specializes in myrmecology, the study of ants. Through that lens he has uncovered many truths about all life on earth. In a short story, Tolstoy told of a cobbler who’s every stitch brought him ecstatic communion with God.

As mechanization has progressed, the artisanal trades have diminished and corporations have come to dominate the world of work. As a consequence it appears to me that young people have lost the sense of becoming a master of one’s own fate through an arduous apprenticeship or training, i.e. developing a profession. Rather, young college graduates generally look for a job that may or may not develop and make use of their passions and skills. The idea is to survive, and fit in, and climb up the ladder of a company. Most of this is done sitting at a desk. College usually does not leave young people with deep skills beyond reading, writing papers and test taking.

In the Hero’s Journey, the young person sets out on an adventure that challenges him or her to the utmost. In the process he/she encounters the mentor(s), the enemies/obstacles, overwhelming challenges, and in the process brings back the elixir or the power to transform the world. If this journey is not undertaken, the young person can remain bound in childhood (e.g. the Puer Aeternus, or eternal child), and continue to float in all possibilities but commit to and accomplish nothing.

I have seen young people shy away from professional development because it is “difficult and long.” I tell them, “good- everything worth doing is difficult and long!” So instead of being an obstacle the difficulty may be a sign we’re heading in the right direction. To be a hero’s journey, there must, and will, be times we’re not sure we’re going to make it.

One final quality of a worthwhile profession, in my view, is this: we can never completely master it, learning about it never stops, and it is enriched by all our other interests, readings and pursuits. This way we remain fully alert, continuing to grow into old age, and sharing the depth of our understanding with others. We become the mentor.

A Yoga Perspective on Trump

Yoga philosophy, formulated by Patanjali around 300 BCE, offers an ethical system of conduct regarding our behaviors towards ourselves, and toward others. I find it a useful framework from which to examine the actions of the current president. 

Guidelines for behaviors toward others, called the Yamas, include the following:

Ahimsa- Non-harming or non-violence. T has been verbally aggressive, castigating and insulting to an untold number of people from the beginning of his campaign to the present day. His rallies have been beset by violence.

Satya- Truthfulness. Never before has there been a major figure in American public life who has lied so consistently, repetitively, easily, without a hint of regret or interest in self-correction.

Brahmacharya- Non-excess, materially and sexually. T has amassed a fortune at the expense of others, has serially been unfaithful to wives, and treated women as sexual objects.

Aparigraha- Non-greed. His obsession with status, golden fixtures, massive estates and continuing to amass unnecessary wealth is a dramatic display of the opposite of Aparigraha.

Guidelines for personal practices relating to our inner world, called Niyamas, are as follows:

Sauca- Cleanliness or purification. This relates to choices of foods, practices, emotions and words addressing cleanliness of mind, body and spirit. T appears to have no regard for his body, eating the lowest quality of fast food, failing to exercise and indulging regularly in many forms of toxic speech.

Santosha- Contentment, happiness. Being content with ourselves, our lives as they are, not always craving more (money, adulation, etc.). T is a bottomless pit of grievances and discontent.

Tapas- To heat, or cleanse. Daily practices like yoga, exercise and meditation designed to strengthen the body and clarify the mind. T’s daily practices appear to be junk food and tweeting conspiracies he has just watched on fabricated news sites. 

Svadhyaya- Self-study. The practice of getting to know oneself through reflection, open conversation in relationship with others, psychotherapy or many other means. T appears truly un-self-aware, apparently never having explored his wounds (which must be significant) or having developed any capacity to reflect on his own weaknesses and failings that have harmed others. 

Ishvara Pranidhana-Self-surrender. Giving ourselves to a higher purpose, e.g. the benefit of others. Not clambering for honor for ourselves. T speaks of himself constantly, claiming merit where he has none.

In every detail of yoga’s conception of a good life, T exemplifies the opposite. Much has been said by my colleagues about his psychopathology and malignant narcissism; from a psychiatric perspective, all of the patients in my practice of psychiatry have a healthier character structure than T, and as has been noted, he is too unwell to be treated psychiatrically as he has no insight even to begin the process. I think that the yoga system of analysis sheds a further light on what is wrong with the current occupant of the White House. 

Advice for our present time

For most progressive, liberal-minded people the events of 2016 have given rise to quite some anguish, if not despair. The causes have been elaborated too many times to bear repeating.

My suggestion is this: focus on being very well, strong in mind and body, happy, joyful, participating fully in life. It does not benefit the world at all for you to be morose, fearful and defeated; on the contrary, going forward valiantly radiating wellness has a greater positive impact on those around us, and thus the world.

Consider the French resistance fighters in WW2. From the subversive agents to the intellectuals such as Jean Paul Sartre, Simone de Beauvoir and Albert Camus, they became even more active, brilliant and focussed in their activities facing great personal danger.

Danjo-San pointed out that during a dark time when ignorance and violence are ascendant, forces of compassion arise to extinguish it. 

In “The Book of Joy,” based on a week of dialogues between the Dalai Lama and Desmond Tutu, these old men who have endured so much show how we can cultivate joy in the midst of great uncertainty, by practicing kindness, concern for others, forgiveness, gratitude and lovingkindness towards ourselves. 

I would add to this the following points: Take excellent care of your body, including a gentle practice such as yoga, regular meditation, vigorous physical exercise and attention to a plant based diet. Spend time daily in pursuits that evoke joy, such as playing music, listening to great music, reading great literature, cooking, being with good friends, gardening and producing art. 

Remember that the enemy is bad policy, not people. As General Wesley Clark said so well last week, the enemy regarding climate change is not republicans, but carbon in the atmosphere. Keep your spirit clean and strong so you can fight bad policy with clarity and focus.

Women’s particular pain after the elections

Many of us, men and women, are experiencing emotional distress and disbelief at the turn of events in U.S. affairs. However, there is a suffering particular to the women in my life, including partner, daughter and patients, that stands apart from that of the men. Male narcissism has caused untold misery throughout human history, from Attila the Hun to Mohammed to Genghis Khan to Stalin and Hitler, echoed in small scale through every abusive boyfriend or husband, domineering boss and gang leader. Women have suffered disproportionally from this, and almost no woman I’ve met has not been hurt by a man with this trait.

The elevation of a misogynistic narcissist to the highest office in the land affects women like a body blow. Just today, I have heard from my patients and family of women crying alone throughout the day, with traumatic memories evoked of physical and psychic violations throughout a lifetime. The hurt and rage are directed both at the president-elect himself, and at the men, and women, who elected him. The reflections I’ve heard are that it doesn’t matter what economic issues are involved- albeit he has advanced no plans to address any issue- but that fellow human beings would elevate a blatant violator of women to the position of ultimate authority.

I propose that we all, especially us men, address the specific suffering of women in this new situation. We may not have contributed to it, but it is our world and our responsibility to heal it and see that it never happens again. And to protect the ones we love from harm. I want to personally apologize on behalf of all men.

On Pleasure

I often find patients confused about the nature of pleasure, joy and ecstatic experience. Perhaps it is related to the Puritanical foundations of our culture, the idea that sensory enjoyment is sinful or wrong, which leads to repression of aspects of our nature. When there is a division within the self, between the drives and the voice of conscience that seeks to suppress them, I’ve observed that people live with an inner tension that erupts into behaviors leading to excess.

The Cat in the Hat put it succinctly: “It’s fun to have fun, but you’ve got to know how.” I often find myself exploring with patients how to increase and diversify the sensory satisfaction in their lives. Whether related to food and drink, touch and sensuality, strength and flexibility in the body, art and music, or in the literary and intellectual arena, it is worth attending to the process of growing our ability to appreciate our lives. 

As my teacher once pointed out during one of my visits to India, our body and senses are uniquely suited to the appreciation of this world in all its beauty. In yoga philosophy, the body and its desires are real, not illusory. Sensory satisfaction, when conducted mindfully, increases happiness and does not hinder spiritual development. However, some mastery is required to direct our senses in a healthy way.

In the yoga model of the mind, the mind is seen as a servant, not a master. If the senses are leading, and go wherever they will, it can be a rough ride, as we swerve from one craving or aversion to the next. So the first step in increasing our experience of pleasure is to stabilize the mind, which is the goal of yoga practice and meditation. The mind becomes more directable; this is sometimes called control of the senses, but it is more like directability of the mind toward objects of sense perception. 

In order to penetrate deeply into any sensory experience, the mind must be stable enough to stay with the experience throughout its duration, not wander, and not restlessly skip from one desire to the next. Georgia O’Keefe said, “no one sees a flower really, because to see takes time, like having a friend takes time.” So a prerequisite for joy and pleasure is the ability to sustain attention.

Another necessary quality is the ability to refrain or abstain. In yoga this is known as pratyahara. In Hermann Hesse’s great novel, “Siddhartha,” the young man on the spiritual path develops these abilities: “I can think, I can wait, I can fast.” Without abstaining from the wrong thing, we are not available for the right thing. 

An extension of this, from yoga philosophy, is the idea of connection. In a sense, all of life is connection: to our bodies, the air, food, water, people, nature, etc. The meaning of yoga, the Sanskrit root “yuj,” is connection, or union. There are three kinds of connection that cause harm: not to connect, to connect with the wrong thing, and to connect with the right thing too much. None of these lead to happiness or wellbeing. So, in learning to practice the “fine art of happiness,” we need to learn to connect with the right thing, the right amount. That goes for relationship, food, exercise and everything else!

An important aspect of this fine art, is the awareness before we leap into sensory experience, “what is the true nature of this thing I’m about to do?” Eating junk food, sweets, overindulging in drugs or alcohol, superficial sexual contacts, pornography, gambling, all of the addictive behaviors, if subjected to this question, will be seen to be forms of suffering. We can ask ourselves, “will this be a joyful experience now, later today, tomorrow, next week?” In seeing deeper into the nature of things, our tastes change, become more refined, and shift toward experiences that do not leave painful traces. 

On Literature and Psychological Growth

The world’s greatest literature contains the profoundest insights into the human condition ever expressed. More than the writings of psychology, psychiatry, philosophy or religion, the greatest of literary writers have used their art to depict the subtleties of our behavior and motivation in ways that are both astonishing and beautiful. I feel that a regular practice of reading the best of world literature aids tremendously in the process of self development, and over time becomes a pleasure of unsurpassed quality. 

The finer pleasures require a certain amount of discipline, especially at the outset. It is easier to eat fast food than to prepare and enjoy a wonderful meal made of fresh, organic ingredients, but the outcome is different both in terms of pleasure and wellbeing. As the Cat in the Hat wisely said, “it’s fun to have fun but you’ve got to know how.” When one shifts from reading catchy but poor quality writing to the best literature, at first one may experience restlessness or boredom, since the arc of narrative is often much longer, character development is slow and the time sense is dilated (especially in nineteenth century literature). An analogy might be switching from cocaine to fine tea. 

As we learn to slow down, calm down and reduce the hurry to find out “what happens,” however, we may notice a growing appreciation of the beauty of language, the layering of perspective about character, and we may be startled by the penetrating vistas into the human experience that open before us. Even if our attention span or circumstances only allow us to read a few pages before bed, over time entire novels will be completed and we can advance through many of the greatest works ever written. 

Where to start? It depends on our circumstances, age, what and when we delved into reading earlier in life, how it was taught in school, and what our needs are at a given time. Often we try a novel at a stage of life in which we aren’t ready for it, e.g. high school, and become discouraged. For example, I had somehow missed reading Moby Dick until the age of 54, a rather astonishing fact given my passion for literature and the book’s stature in world literature. When I finally approached it, I was dumbfounded by its brilliance, poetry, wisdom, and its comprehensive perspective on life. Another example: even with a personal connection to the family of the German Nobel Laureate Thomas Mann, I had avoided The Magic Mountain until my 59th year, when I was finally able to savor it in all its richness. 

I often give reading lists tailored to my patients, as an aspect of cultivating an “inner life.” While each list is different, there are some foundational books I usually include as I feel they are among the most profound and influential I know of. A partial list might include:

Hermann Hesse:
-Siddhartha
-Narcissus and Goldmund

Leo Tolstoy:
-Anna Karenina
-The Death of Ivan Ilyich
-War and Peace

Feodor Dostoevsky:
-The Brothers Karamazov

Charles Dickens:
-David Copperfield

D.H. Lawrence:
-Sons and Lovers
-Lady Chatterly’s Lover

Aldous Huxley:
-Island
-Brave New World

Hermann Melville:
-Moby Dick

Jane Austen:
-Pride and Prejudice

Charlotte Bronte:
-Jane Eyre

Emily Bronte:
-Wuthering Heights

Gustave Flaubert:
-Madame Bovary

Kazuo Ishiguro:
-The Remains of the Day

Yukio Mishima:
-Spring Snow

Thomas Mann:
-Death in Venice

Somerset Maugham:
-The Moon and Sixpence