Integrating buddhist wisdom and clinical science by Transcultural Clinical Meditation

Marja K. Taams & Maurits G.T Kwee (Transcultural Society for Clinical Meditation)

Abstract

This article supposes to be a seminal presentation of a framework for Clinical Meditation (CM), defined as a subfield of clinical psychology and complementary counterpart of psychotherapy. The thesis is submitted that CM is to clinical psychology as psychotherapy is to clinical psychology. CM pretends to be a scientifically substantiated way and process of systematic treatment or planned intervention by a professionally trained expert who methodically establishes, structures, and handles a relationship in order to help a client to experience (embodied) salutary states of well-being - varying from relaxation to bliss to Satori (Light) - by certain well-described consciousness transforming systems and techniques. This new transcultural discipline tries to empirically answer the question of specificity, 'which meditation technique works for whom and under what conditions?' Endorsed by technical eclecticism as a practical and constructivism, including social learning, as a theoretical mainstay, CM follows a specified algorithm: (a) multimodal assessment (life history plus structural profile) and (b) counseling (narrative rebiographing and/or multimodal / rational emotive behavioral counseling) in order to ensue (c) an idiosyncratic choice for a technique of meditation (to eventually adopt a lifestyle of 'enjoyed awareness'). Always on the lookout for new meditations, the innovating clinician's guiding principle for selection is empirical pragmatism. The 'Master of Clinical Meditation Studies' (a postmodern Sensei) is well-versed in a number of listed 'empirically congruent' effective techniques, especially NeoZEN. The future might bring about a quantum leap in technique development: the modification of consciousness by manipulation of the human genome.

'Who is The Buddha? A dried piece of manure!' 'When you meet The Buddha on the road, kill him!' Classic Zen sayings

Clinical Meditation

This essay sets the stage for the study by the Transcultural Society for Clinical Meditation (TSCM) of Clinical Meditation (CM) as a new psychological discipline. (Transcultural stands for: beyond cultural confines & national boundaries (transcontinental), Society for: free web-based membership, elibrary, eJournal, awards, academic curriculum, PhD-thesis coaching, conventions, lectures, workshops, etc. Clinical for: individual matching, tailoring, diagnosing personality and psychopathology (according to the Diagnostic & Statistical Manual for Mental Disorders; APA, 1994), and Meditation for: especially Buddhist meditation (NeoZEN). CM is defined as a subfield of clinical psychology and complementary counterpart of psychotherapy. It is based on the academic knowledge gathered from the second half of the 20th century on until now about the clinical application of meditation techniques originated in the East. Its goal is understanding and helping individuals to practice meditation in order to alleviate existential-emotional suffering, attain states of and beyond pure emotion to ultimately realize a level of consciousness known as Kensho or Satori (Light or a 'total reality awareness'). CM supposes to be a health profession that respects the canons of empirical science and endorses a wholistic BioPsychoSocial-and-Spiritual outlook of existence. Outcome studies reveal that a selection of meditation techniques secured favorable results in the areas of health promotion, prevention, care, healing, and managerial functioning. As yet, CM - although capable of mitigating and extenuating clinical symptoms - cannot (yet) make adamant claims for cure (Haruki & Kaku, 2000).

CM operates in a space amidst the company of many disciplines in the interface between medicine and the human sciences. It adopts a clinical attitude implying an idiographic, personalistic, or individually tailored - second person - interpretative psychology of human existence. This holds the middle ground between a first person (introspective or experiential) and a third person (analytic or experimental) psychology. The adjective clinical denotes an individual stance in approaching problems and proposing solutions. These are mostly centered around: choosing meditation techniques, matching these with clients, setting the goals of a training, and implementing the technique(s). The CM-professional is a 'clinical scientist' who bears 'clinical responsibility' for 'clinical judgements'. In working clinically with people adequate knowledge of personality development, health and abnormal psychology is a prerequisite. A caveat is appropriate to offset possible deleterious (side) effects occurring in people for whom CM is counterindicated due to serious (slumbering) psychopathology.

As far as context is concerned, CM is to be considered as an indigenous contribution from the Asian region to the human sciences in general and to clinical psychology and psychotherapy in particular. In the East these fields of study never existed before becoming influenced by the West. A compelling reason might be the ubiquitous existence in the orient of non-analytical philosophies traditionally viewing 'bodymind' as an inseparable whole. Although its roots, inspiration, and techniques stem from the orient, it is unequivocally imperative that CM wishes to establish its foundations on the solid soil of experimental, social, and cross-cultural psychology, in the context of 'positive' (Seligman & Csikszentmihalyi, 2000) and 'conjunctive' psychology (Mikulas, 2001). To date, postmodern constructivism, including systems, social, and cognitive learning theories, provides CM of a profound philosophy of science and (meta)theoretical underpinnings for research that help to solve the ultimate quest of scientific specificity: 'which meditation technique works for whom and under what conditions?' Solutions are advisably written in a replicable manner like in music.

CM versus psychotherapy

The thesis is here submitted that CM is to clinical psychology as psychotherapy is to clinical psychology. Compelling vagaries appear when delineating CM's boundaries vis à vis psychotherapy, giving rise to many questions. Although there is no generally accepted definition of psychotherapy, our consensus-based conceptualization is: a scientifically substantiated way and process of systematic treatment or planned intervention by a professionally trained expert who methodically establishes, structures, and handles a helping relationship in order to reduce or eradicate a client's psychological problems, conflicts or disorders, by certain well-described systems and techniques. Psychotherapy emphasizes cure which is an obvious goal for any serious therapeutic endeavor. Simply phrased, psychotherapy is due to help people out of the muddle, for which meditation is not especially apt, nor meant. Since the 'raison d'être' of meditation is Satori, its therapeutic effect is but a propitious epiphenomenon as growth and self-actualization might be for psychotherapy (Kwee, 1990).

Bearing this cardinal difference in mind, we contend that CM is: a scientifically substantiated way and process of systematic treatment or planned intervention by a professionally trained expert who methodically establishes, structures, and handles a relationship in order to help a client to experience (embodied) salutary states of well-being - varying from relaxation to bliss to Satori - by certain well-described consciousness transforming systems and techniques. Satori, nirvana, moksha, salvation, or enlightenment, the rose of spirituality can be called by any other name. While adhering Occam's razor believing is to be abandoned and parsimony should be paramount, i.e. one should not needlessly multiply explanatory principles. Therefore, the bottom line is not to define Satori or Buddhahood and to heed Wittgenstein's phrase instead: 'Whereof one cannot talk, thereof one must be silent'. It cannot be overstated that the CM-expert is skilled in assessing psychopathology and in referring those who need psychotherapy and/or medication.

By securing a relative BioPsychoSocial health before starting CM, clients have the opportunity to plant their feet on the ground, and are ready to safely discover that in the pursuit of spirituality the sky is the limit. The professional who practices CM uses the features of BioPsychoSocial-and-Spiritual healthy states of being as a benchmark for the clients's status. Thus s/he will benefit from an insightful helicopterview on aberrant conditions from which predictive understanding will ensue (Walsh & Shapiro, 1983). A 'health first' focus does not mean that the chronically ill and those who suffer from life threatening disease are excluded from CM. If they are not indicated for psychotherapy, CM as healing is helpful in mobilizing fighting spirit while accelerating acceptance of a forthcoming death. The catch is that psychotherapy is to cure emotional disorders (and restore health), whereas CM is preserved for growth, healing, and prophylaxis. As a precaution to avert the onset or exacerbation of adverse effects, psychotherapy is not to be confused with or substituted by CM.

CM is based on techniques

Meditation inspired secular techniques like Morita Therapy or Naikan Therapy should be classified as psychotherapy if its function and purpose is cure. Similarly, techniques devised as therapeutic, such as Gendlin's 'focusing' (characterized by an inward 'listening' to the body) or self-hypnosis can be subsumed under meditation if its use serves that function and purpose. However, almost all meditation techniques stem from spiritual schools. Frequently, these form a sect or a cult where - in the worst case - disciples pledge their allegiance to some pundit or guru. CM's adage is: Let's be aware of the dangers of zealotry, bigotry, or any other form of fanaticism. Nobody has the wherewithal, therefore call no man master but put parity and scientific inquiry first. Outstanding carriers of old traditions, like the Vedic Maharishi Mahesh Yogi or Taoist adept Mantak Chia, although endorsing science, remain constrained in the shackles of their monolithic systems and atavistic cultures. In the space of consciousness transformation a plethora of meditation techniques exists in dire need for an integrative approach that respects the canons of science.

We assert that there are as many meditations as there are gurus and speculate that there exist hundreds if not more than one thousand techniques worthwhile to investigate. The recondite Osho Rajneesh (1988) described an eclectic collection of 112 techniques, reading of which is like a bewildering odyssey in the twilight zone. Although these techniques differ in their arrangement, their fundamentals remain the same: relaxation, watchfulness, and a non-judgmental attitude. In a landmark text Goleman (1988) presented a typology of meditation techniques and differentiates: Hindu Bhakti, Jewish Kabbalah, Christian Hesychasm, Sufism, Transcendental Meditation, Patanjali's Ashtanga Yoga, Indian Tantra and Kundalini Yoga, Tibetan Buddhism, Zen, Gurdjieff's Fourth Way, and Krishnamurti's Choiceless Awareness. Despite this exotic profusion of orientations they can be reclaimed to the grand powerhouses: Buddhism, Christianity, Hinduism, Islam, Judaism, and Taoism. The blending of the first and the last gave birth to Zen, the ultimate flowering of and benchmark for meditation. In what I (MK) call NeoZEN - elaborated on elsewhere - the electronic transmission of Zen (and its postmodern stance toward life and death) is likely to boost a 'new millenium renaissance'. NeoZEN is a clinical psychological approach to Zen (a Buddhist meditation practice for inner liberation that traveled from India via China and Japan to the West) tailored to the individual, that includes scientific evidence and the Buddha's extant instructions, that travels back to the East in a regenerated condition, rejuvenating and revitalizing its practice, as Dhammawest or West-ayana: the dhammawheel that turns from the West to the East.

The traditions of the Middle East (Christian, Islam, Jewish) are predominantly verbal, extravert, and prayer oriented and differ from those of the Far East (Buddhist, Hindu, Taoist) characterized by silent, introvert, meditative practice. Although the former traditions also gave birth to meditation techniques (e.g., kyrie eleison, sufi zikr, kabbalist kavvanah), and praying can be done meditatively or might even be treated like a meditation, praying is obviously not meditating. The same reasoning is applicable to ceremonies (e.g., drinking tea), rituals (e.g., freemasonry), and extreme sports (e.g., bungee jumping). It all depends on the mentality from which it is done. If it is a Do (Tao), a way that one has chosen for to practice through and through, it will work like a meditation. A formal technique might last from a few minutes to a few hours wherein procedural steps are followed, marked by a beginning and an end. A technique is a springboard requiring the effort of the meditator who eventually arrives at the other shore. Satori might happen by means of a meditation technique, but is not equivalent to its application. A meditative lifestyle bolstered by what we call 'enjoyed awareness / attention', that is pervasive in each breath, is what one might want to adopt on the road toward self-realization.

Technical eclecticism in CM

Technical eclecticism is espoused by Lazarus (a.o.1997) to provide a rationale for using other than behavioral techniques in Behavior Therapy. It lead him to precurse Cognitive Behavior Therapy and develop Multimodal Therapy, that includes Rational Emotive Behavior Therapy (Kwee & Ellis, 1997). He enunciates that it is scientifically warranted and clinically sane to practice any technique, no matter where it was originated or who spawned it, as long as empirical evidence has proven its effectiveness and theoretical consistency is the guiding principle in explaining why it works. Nowadays, technical eclecticism is a principal route to psychotherapy integration and apt to be imported into the fledgling field of CM. A panoply of impalpable meditations is available to be tested for its adequacy. In fact, any de-automated activity is meditative. Thus, anything BioPsychoSocial - specifiable in the BASIC-I.D. (Behaviour-Affect-Sensation-Imagery-Cognition-Interrelationships-Drugs/entheogens) - can be experienced in enjoyed awareness or had been specially arranged to become a meditation technique (or a Do).

An individual's proclivity for some of these modalities might provide directions if not the clue for matching clients with meditation techniques. Whether one has a penchant for doing (B, I.), thinking (I, C), or feeling (A, S) does matter in getting the technique of choice. Basically, a 'doer', 'thinker', or 'feeler' might profit from a respective corresponding kind of meditation, unless overextensions require otherwise. In order to gauge structural tendencies, one rates questions on a scale from 6 (high) to 0 (low) centered around each of the following items:

B - How much of a doer am I?;

A - How deeply emotional am I?;

S - How much tuned in to senses (pleasures and pains) am I?;

I - How much do I think in vivid pictures?;

C - How much of an analytic thinker or planner am I?;

I.- How much do I engage in social activities?

D.- How often do I engage in recreational drugs?

Despite its subjective nature, these ratings entail relative pointers needed in CM to avoid haphazard or capricious choices. CM is in dire need for a psychotechnology, i.e. a collection of techniques, to match clients and meditations.

If one's only tool is a hammer, one treats everything like a nail. In respect of individual differences, CM's challenge is to look for as many effective techniques as one can get. To be on the lookout for auspicious techniques is not a license to use a ragtag blend from anywhere and everywhere without a sound rationale. Syncretistic confusion is decried. The responsible way to such an enhancement of clinical acumen is to neglect arbitrary notions and to remain theoretically consistent. A case in point is Transcendental Meditation for which exists an awesome string of studies proving its effectiveness. Its use therefore can be corroborated, but there is no need to buy into the 'theory of creative intelligence' or undergo some sacred ritual. On the other hand: the Laughing & Smiling Meditation has not been scrutinized specifically, but its relative effectiveness is decidedly proven by subjective reports, increased endorphin levels, and forehead temperature cooling. To jump on this bandwagon there is no need for esoteric theorizing or going 'sannyas' (Kwee, 1996a; Panksepp, 2000).

Selecting CM techniques

Formal and informal practices make meditation a modus vivendi like breathing. Informal meditation is zeroing in to enjoyed awareness by checking in one's formal practice from time to time during any activity or by remembering that 'today is a gift, that's why it's called present'. Widely practiced through history is the essence of Vipassana applied by Gautama Siddharta to attain Buddhahood. He disseminated his technique to emphasize that there is no human or divine authority to recognize and no-one to take the effort, but oneself. For The Buddha 'dogma is not only unknown; it is anathema' (Humphreys, 1987). The essence of the Buddha's meditation is mindful self-observation: watching or witnessing the constancy of natural breathing during any activity, until after a knack, 'something' happens with the meditator. There is a subtle - though profound empirical - relationship between breathing-and-thinking as parameters of body-and-mind. One might observe, for instance, that a short breathing stop goes in tandem with a stop in thinking, which kind of breathing relaxes, arouses, etc. (e.g., Haruki, 1993)

Watching the whole body breathing enables one to watch other conjoint phenomena of the BASIC-I.D. palette. As time goes by, the rushing, restless, tensed, or worried 'bodymind' calms down. Subsequently relaxation and tranquility abound. This process equals counterconditioning by systematic desensitization, a highly effective cognitive-behavioral technique, during which stressful images are counteracted by a relaxation response. The state one eventually slips in is kensho or 'little' Satori - blissed awareness, flowering silence, fragrant emptiness - ultimately leading to 'big' Satori. It is a serious hoax that the arithmetic for Buddhahood is to stay 48 minutes in an unfathomable void (Rajneesh, 1984). Vipassana is the prototype out of which numerous varieties with the same core have been developed by many denominators down the ages, like Chan (Chinese), Dzogchen (Tibetan), and notably Zen (Japanese). Applications of these have been scrutinized in the past decades and proved to accrue salubrious clinical results. Although the essence is almost decidedly the same, differences in method, procedure, and form warrant distinctive naming.

Examples of the best available (groups of) techniques are collected in a Compendium (see Appendix). Such a body of procedures and methods serves an evidence-based practice. To complete the list is an ongoing process of constant updating. The criterion for inclusion is 'empirical congruence'. Murphy and Donovan's (1997) review on the effects of meditation provides an example for a solid basis of selection. Techniques are included for which evidence of minimal effectiveness - i.e. relaxation (a springboard for meditation) - exists. Meditation is more than mere relaxation that is quantitatively measurable by BioPsychoSocial testing. Spirituality is a quality that can only be approached subjectively and impossibly be fully controlled objectively. This is the inadverted limit the quest of science sadly stumbles upon. Just doing nothing or taking a nap accrues the same objective results as meditation, but misses the quintessential and pervasive context: 'Seeking Satori'. The CM-expert is trained in as many techniques of 'mind-emptiness' as possible. Since it is impossible to be well-versed in all and everything, learning from and referring to bona fide teachers is a fair option.

Critical constructivism in CM

A technical eclectic stance implies the rejection of theoretical eclecticism, but does not mean functioning in a theoretical vacuum. CM embraces the tenets of postobjective and postrational constructivism, because the very heart of its existence, Satori - absurd from a positivist's point of view - finds acknowledgement therein. By adopting critical constructivism CM endorses hypothetical realism, relativism, and contextualism: reality can be approximated but not accessed. This is in contrast with radical and social constructivism that eschews all forms of realism and objective criteria, contending that experience is a personal construction created in a conversation through a cultural process of 'languaging'. Such an extreme position is not perse discarded, but for the sake of clarity and a systematic approach to CM, it is imperative to stay within the realm of inter-subjective competence. The reality of Satori cannot be accessed objectively. Lacking verbal equals, it can only be approximated by descriptors like e.g. apperceptive, brightness, clarity, contentless, energized, fresh, fully functioning, wakeful, etc.

CM shares the contructivist's view of human beings as 'actively, complex, socially-embedded, and dynamically, developmental self-organizing systems'. It emphasizes spiritual meaning making as a creative process in the never ending quest of humankind to discover what life is all about. A pillar CM rests upon is the Socratic wisdom of 'not knowing' (which is different from knowing nothing). Reality constructions are relative and fallible as are human beings themselves. Depending on context, time, place, and person, any construction is impermanent and as yet far from universal. Neopragmatism, where utility serves as a criterion for the adequacy of the knowledge applied, is adhered as a practical stance toward life. Critical constructivism as a psychological metatheory respects and shelters a wide range of explanatory principles, a.o. those derived from living systems theory, social and cognitive learning theory. The latter espouses that cognitive processes determine the degree of emotional influence activated by impinging external events (Neimeyer & Mahoney, 1995).

Social learning is anchored to experimental and social psychology, notably principles of classical, operant, and vicarious conditioning. Indeed, as relaxation is a necessary step and inclusive goal, de-automatization from daily rut by de-conditioning underlies most if not all meditation techniques. Meditation disassociates the meditator from whatever dust was acquired during one's lifetime by practicing a learned technique. To date, it proofs adequate to draw on counter-conditioning, generalization, habituation, (self-)reinforcement, extinction, exposure, punishment, trial and error, aversive stimuli, stimulus control, self-efficacy, and so forth, to explain a technique's working mechanisms. Satori, it is said, will be due realized discontinuously, as a sudden happening like a knack after diligent training of a skill. The meditator's training-field lies between the subjective 'observer' and the objective 'observed', to be transcended by 'the witness'. If this sounds nuts or far out, we may be all beguiled by a 'folie à plusieurs'. Perhaps there is nothing to be found but an outrageous 'construction'.

An algorithm for CM

The CM-expert provides an algorithm for solving questions posed by the client. The formula is: (1) multimodal assessment (life history plus structural profile) and (2) counseling (Narrative Rebiographing and/or Multimodal / Rational Emotive Behavioral counseling) in order to ensuing (3) an idiosyncratic choice and motivated practice of evidence based meditation technique. Some form of outcome evaluation helps to secure a good quality of one's services. Typically, the client is a seeker who comes for growth, self-actualization, or enlightenment by means of meditation. This usually inheres earlier interest in Eastern philosophies plus a meaning making and investigating mentality. It cannot be overstated that CM is counter-indicated if conjectures exist for serious psychopathology and the treatment of choice would be a magic bullet. Clients are served best when they are able to imbibe CM and are not hampered by emotional disorders or other stagnating conditions. An overall or multimodal scrutiny of the client's psychological status at intake is therefore a dire necessity.

Thus, CM starts with the Multimodal Life History Inventory (Lazarus & Lazarus, 1991) that accrues a map of the client. It screens aberrant conditions such as emotional disorders, cognitive dysfunctions, and behavioral anomalies. A BASIC-I.D. assessment reveals issues to be dealt with, the structural profile, and the client's potential for the powerful and synergistic interaction of all modalities. The ideal CM client has minimal problems to deal with therapeutically. However, this relative absence does not necessarily mean that the client is psychologically cleansed and ready for meditation. An inherent part of CM is Narrative Rebiographing: a (re)construction of one's emotional life story through (re)telling and meaning making until emotional pains are desensitized and a healed self-story emerges. Also Multimodal / Rational Emotive Behavioral Counseling might be needed e.g. for the skill of sane reasoning, including acquiring a relativistic outlook, in order to be better able to appreciate 'the Absolute', that is irrational by nature. A logical choice for a technique of meditation / enjoyable awareness will ensue. The entire process of CM might take 13 to 26 sessions within a time frame of a half year. The mentioned procedures are to be applied flexibly. As an idiosyncratic venture, CM denounces a Procrustean bed. Growth needs individually tailored suits, not straitjackets. After intake, the counseling - whether Narrative Rebiographing or Multimodal / Rational Emotive Behavioral Counseling - and the practice of the meditation technique (after its choice sometime during the process), can be conducted simultaneously. The meditation technique is principally practiced as homework and ends with the client's skilled independent self-application. CM can also be practiced in a group. After an individually based intake, the counseling and meditating can be done in the presence of others in the spirit of learning from each other.

By adhering the here presented standards, including a detailed Curriculum to be developed, CM is ripe to become an academic profession. Such a Curriculum would for example entail a two year course in the theory, research, and practice of CM. The TSCM has been established in order to promote and educate Masters of Clinical Meditation Studies (CMS). These are postmodern Senseis who are skilled in the art and science of bridging the best of two worlds. TSCM will thus be able to debunk charlatans and protect the society at large for excesses in the mushrooming market of spirituality. TSCM's transcultural core practice is mindfulness or witnessing of which NeoZEN is an exponential offshoot. Mindfulness is defined as:

(A) Establishing a presence of mind while relating in a watchful (attentive, alert) & mindful (not forgetful) way to experiences entering CS via the senses & to any thinking or feeling passing on the screen of the mind

(B) Thereby, focusing receptively (no purpose, no desire) in loving kindness from now to now, in a choiceless awareness (non-expecting, non-evaluating) & in a mirrorlike fashion (without identifying, clinging, reacting)

The working alliance in CM

What does it mean to methodically establish, structure, and handle a helping relationship? Rapport is a bicycle CM rides on while searching for fertile soil where techniques can take root (compare Daisan and Dokusan? in Zen). The multimodal concept of the 'authentic chameleon' secures the 'Master of CMS' - who is above all a teaching counselor - a far reach in accomodating people. On a deeper layer authenticity entails Rogerian genuineness, warmth, and empathy as well as other care bestowing qualities among which humor and compassion stand out. This was recognized earlier by Buddhist teachers who emphasize and place compassion before 'sympathetic joy' because it is much easier to call forth (Conze, 1975). Compassion is a desireless 'cool' (though embodied) love with humankind and existence itself. It encompasses an empathic vicarious exuding of the client's woes. Without a fair amount of humor, joy, and enjoyment, this might drain the clinician. To draw on an arsenal of koans, jokes, and wise stories helps establishing the appropriate tone of energetic bonding with the client (Kwee, 1996b).

Despite CM's resting on the bedrock of science, its practice is not a science but rather an interpersonal art. It follows scientific standards in arguing expertise, but the implementing of techniques in CM is a craft like wine making. Its procedures are highly structured but the actual riping, blending, or coloring depends on the weather, artistry, and taste of the craftsman. Thus, a lot depends on the momentum of the issues raised or being dealt with, serendipity, and lucky strikes. Unlike in psychotherapy the working relationship in CM is significantly less intricate. The 'Master of CMS' takes a clear-cut didactic stance. S/he is a sophisticated teacher who scores high on support and directive ness, without succumbing into the pitfall of becoming authoritarian or a guru ('gee-you-are-you!'). Neither is one an impeccable 'holier than thou' or immaculate being totally out of orbit nobody can identify with. Rigorous training is called for in order to be (cap) able to practice what one preaches. (Clinical) psychologists and psychotherapists are decidedly the best candidates to become a CM-expert.

Professionally handling a CM-relationship means firstly that confidential material will not be abused or exploited. Just like in psychotherapy disparagement, harassment, sexual engagement, and other predatory activities are naturally avoided. Multiple relationships might impair the helping relationship and blur the appropriate distance required to be effective. Instead of exhorting, one assiduously practices 'rightness', notably not pretending enlightenment, nor promising Nirvana. As meaning making is ubiquitous in CM, handling the relationship also means handling hard work uncovering the values that thrives the client. Because this implies discovering intended meanings, what happens might be called a hermeneutic process of helping. Like in hermeneutics - a discipline concerned with exegetical interpretations of religious texts - clients' histories are short on objective facts by which one could verify its validity. Only the client can. The helping relationship facilitates growth such - to paraphrase Maslow - that 'what a man can be, he must be'.

CM and Narrative Rebiographing

Narrative Rebiographing is a counseling technique of (re)telling that might be considered as a prolonged intake during which a broken self-story is repaired. It views clients as texts to be interpreted jointly in a meaning making process. This usually results in a 'narrative truth' for the protagonist that is persuasive not for its evidential value, but rather rhetorically. The 'self' is defined here as an ever-changing self-story, i.e. a (re)construction of a client's emotional life history. Each individual expounds the best possible self-story but depends on a memory that abstracts, selects, and distorts in between a pollyannaish and an atrabilious spectrum. The client continually modifies her/his self-story to meet the demand characteristics of the particular situation. In a way the self-story is the construction of an 'apologia' sustaining an improved self-image that reflects the 'self' of the moment for a better future. (Seemingly similar is Yoshimoto's introspective life history analysis practiced in Naikan Therapy, influenced by the Jodoshinshu school of Japanese Buddhism; Sasaki, 2000)

Unlike its intricate use for therapy - where the psychoneuroimmunological effects of 'putting stress into words' have been substantially demonstrated (Pennebaker, 2001) - the use of recounting for emotional balancing in the relative absence of a serious disorder is relatively more simple. Drawing on metaphors from literature and history rather than from physics, the read thread in Narrative Rebiographing is a travel metaphor. CM-counseling reroutes misdirected travelers on their way toward self-development and growth. The counselor is a guiding fellow-traveler who displays the creative liberty to uncover the subjective, illogical, irrational, unconscious, negative, poetic, dark, chaotic, symbolic, soft, cyclical, earthen, in short, the Yin besides the Yang aspects, while rebiographing. In co-constructing one's life journey parallel areas require covering: the family, school, career, friends, sexuality, bonding, housing, spirituality, etc. Although free to structure the story, the client is advised to follow a chronological order in life's emotional vicissitudes from birth through all developmental phases to the present juncture.

Analogous to the mechanism of cognitive restructuring, narrative restructuring follows a scheme, lead by the central theme: 'How do I relate with others and with my "self"?' To reveal what is hidden, paradoxical tactics might be necessary to defy defensive reactions or resistance. These include reversals, exaggerations, wordplay, similes, riddles, associations, ready wit, humor, funny finds, serendipity, as well as jokes, koans, wise stories, and other semantic artistry. Typically, the story teller gains self-knowledge as s/he gets to the bottom of beguiling intentions and other motivations explaining the vagaries of past conduct. The assemblaging of short stories into a meaningful whole similarly ensues when watching a movie, play, opera, soap, or reading a novel, poem, comic, or imbibing the Bible or the Lankavatara Sutra. Clients who have learned from mistakes are able to tell coherent 'healed' stories out of earlier fragmented pieces and usually finish with a sigh of relief or an observable 'aha' or 'haha' response. This is a safe sign to round up the Narrative Rebiographing and to start the journey beyond meaning and words (Kwee, 2001).

REB-Counseling in CM

Rational Emotive Behavioral Counseling, sustaining humanistic growth, is compatible with Zen pragmatics (Kwee & Ellis, 1998) and CM. Whereas Narrative Rebiographing targets the cognitive Gestalt of a story at a macrolevel of abstraction, REBC focuses on the irrational chattering mind at a microlevel: the moment to moment fluctuations of self-talk. Peace of mind is found not via thought stopping, e.g. by a mantra, but via thinking through by relativizing on the cognitive level. As in Zen REBC emphasizes self-investigation lead by the stoic adage that people become emotionally upset not by events but by the views they take of them. This sounds like an echo of The Buddha's words in the Dhammapada: '...by oneself is one injured...by oneself is one purified...No one purifies another' (Phillips, 1963, p.71). REBC's cornerstone is the A-B-C model scrutinizing that it is not the Activating event that creates disturbed emotional and behavioral Consequences, but largely people's own irrational Believes. Irrationality equals any kind of absolutistic thinking that results in emotional turmoil.

By pointing out that life is a hassle, Ellis epitomizes The Buddha's contention that life is filled with suffering from attachment (toraware). This includes clinging to irrational ideas such as 'S/he must love me or else I am a worthless human being' impacting equanimity. While the meditative solution is to detach, distance, or disidentify from such an embodied thought, ingrained irrational belief systems are more profoundly dealt with by REBC. To modify disturbed affect the counselor disputes irrational cognitions by testing empirical reality and emotional function. The result might be: 'By thinking so I won't reach my goal regaining equanimity. There is no evidence that s/he must love me, nor is there any proof that my worth depends on being loved by her/him. The fact is that if s/he already loves someone else s/he must not love me, which feels sad and regrettable, but is no reason to detest myself as a human being. My worth cannot be judged because there is no accurate way to rate it. My mere existence warrants my value.' Like in (Zen-)Buddhism, REBC corroborates an impermanent self by abolishing 'ego' and viewing it as ever-changing.

By dealing with disturbing cognitions as above recurrent worrying can be controlled. REBC applies whenever emotional states inflict serene relaxation. In short, it is about eliminating the (less intense) varieties of depression, anxiety, anger, sadness, while promoting joy, love, serenity, silence is mainly the meditator's domain. An insight in the limited number of these so-called basic emotions helps to pinpoint the goal of rational self-analysis and to understand Satori as a state beyond emotion. Endorsing constructivism Ellis does not deny the existence of Satori, but rather stresses the relevance of behavioral practice to underscore the newly sane beliefs plus concomitant feelings. This emphasis on doing corresponds with The Buddha's empirical stance: 'Do not accept anything...because of the reputation of the teacher. Accept what you can see for yourself as valid...then you will choose this as your practice...' (Kalupahana; De Silva, 1996). The congruence with Ellis' notion that even REBC is not sacred - one will be in neurotic trouble when believing dogmatically in REBC - is evident.

CM is trans...what?

In relativizing one discovers by the narrative concept of 'self' the intimate and mutual relationship between 'I-and-me', notably pervasive in meditating ('I' watch breathing that goes by 'itself' from within 'me'). This is in principle culture-free as is relativizing, breathing, and the mystery of 'itself' (mono-no-aware). However, CM does not show a primrose path for the mystic. It outlines a psychologically sound preparation for a demystified meditative practice. This encompasses a transcultural stance insisting the use of techniques for the quest of liberation. For communication purposes and by lack of better words one wisely incorporates outlandish, but generally accepted terms, like the Japanese Satori. CM breaks with the cultural jackets and vested interests that surround meditative practice, but leaving its essence intact: the naked dealing with death in pectore. A sterile monastery life, advantageous for many beyond any doubt, is denunciated as culturally redundant escapism. 'Sex, drugs, and rock&roll' seem to be the better experiences for the younger generation to be made functional whilst engaging in a spiritual purification process.

A perfectly culture-free CM seems not feasible as even pharmacological effects are culturally if not ethnically bound (Herrera, Lawson, & Sramek, 1999). But CM is decisively not transtheoretical nor transpersonal in the strict sense, in as far these schools indulge in abundant theorizing. The transpersonal purview seems to me to be largely antithetical to science by practicing ignotum per ignotius (explaining what is unknown by what is still more unknown). Do we really have to imagine the edge of the universe? Apparently it is also based on a partially fallacious understanding of the East where pragmatics prevail and analyzing is decried as anti-Zen. Alas too often surrounded by esoteric, archaic, or secretive bogus, the quintessence of meditation is to have a clear-cut tool to experience embodied notions leading to Satori. Notwithstanding, CM concurs with some transpersonal tenets enumerated in the ethical foundation, attentional training, emotional transformation, motivational redirection, awareness refinement, and wisdom realization, betraying a Buddhist outlook (Watson, 1998). CM remains at odds with the transpersonal gallimaufry expounded elegantly as 'perennial', particularly as espoused by Wilber (1996). Intellectualizing on whatever 'whereof one better shuts up' (to prevent a quagmire only few geniuses can gauge) impresses as a variety of escapism and a special case of filibustering (Ellis & Yeager, 1989).

Social learning suffices to explain across cultures what happens in Zazen (sitting in absorption) as far as scientifically conceivable: the 'ultimate' desensitization of the fear of death. During this process, that might take a lifetime of ceaseless practice (Dogen 1200-1253 C.E.), the meditator is pestered by makyo, (non-conscious) 'bedeviled' distractions due to the habits of doing, thinking, and feeling. While sitting in any posture, standing, walking, or lying awake for one hour a day, the meditator practices CM's self-counseling, relaxing, and 'absorption'. Lengthy arduous cataleptic sitting in lotus is perhaps nothing but a culturally bound ordeal, only to discover that the sudden knack occurs otherwise. One witnesses how mindful relativizing gradually moves toward emoting and beyond into emptying. This is a quantum leap that takes time and only happens if the fear of death is dissolved. Meditation rekindles this 'extinction' process toward the gate of Nirvana. It is told that the 'self' only disappears after a successful 'sui'-cide (or a metaphorical 'hara'-kiri) - to be differentiated from 'soma'-cide - analogous, partly identical to, and certainly going beyond what is called 'petit mort': an intergalactic orgasmic liberation sucking one into a cosmic black hole of nothingness and life creation!? @#$%^&*(nomind)_+{}|~:"<>.

© Marja K. Taams & Maurits G.T Kwee (Transcultural Society for Clinical Meditation)

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Ellis, A., & Yeager, R.J. (1989). Why some therapies don't work: The dangers of Transpersonal Psychology. Buffalo, NY: Prometheus.

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Appendix 1 On Meditation Techniques

CM disparages the uniformity myth or equivalence paradox of clinical meditative and secular relaxation techniques. The leading principle for selecting techniques is pragmatic empiricism, the hallmark of progress in clinical science. The concept of 'empirical congruence' as a minimal standard denotes a humble but logically correct alternative for validation (Mahoney, 1999) not always feasible nor absolute necessary for the innovating clinician. The collection is not exhaustive, incomplete, and in need for constant revision (see for references a.o. Kwee & Taams, 2003; Wang, Sasaki, & Haruki, 2000; Murphy & Donovan, 1997; Feuerstein, 1998; Blows & Srinivasan, 1992; Lichstein, 1988; Rajneesh, 1988; West, 1987; Shapiro & Walsh, 1984). To date, the only study on the classification of meditation techniques was done at Waseda University (Koshikawa & Ichii, 1996). This was in line with Haruki's (1992) classification of Eastern self-practicing techniques (ghyohos), based on a 'body-mind-behavior-society' synthesis model, and exemplified by the mother of all meditation Yoga in it diverse modes, Qigong, Taichi Chuan, Zazen, Breathing, Nenbutsu (Buddhist incantation), Makkoho (4-movement gymnastics), Shiatsu (finger pressure massage). Below effective relaxation techniques and a Compendium of meditation techniques according to a multimodal analysis are presented.

It seems to us that enjoyability is a motivating criterion for the client's choice of a technique. 'If there is no laughter, there is no Zen' seems still to be a valid recommendation. After all, there is no goal, the way (CM) is the goal. For instance, if one prefers nothing but

Relaxation techniques:	Autogenic training	Biofeedback.
Breathing relaxation	Clenched hand/open hand	Clin.standardized meditation
Differential relaxation	Dohsa method	Ocular relaxation
Progressive relaxation	Quieting response train.	The relaxation response
Respiratory one method	Self-hypnosis	Whole body breathing

Behavioral meditations (->Body moving)	E.g. Dynamic meditation Hatha yoga	Karma yoga Taiqi qigong techniques
Affective meditations (->Stirring emotions)	E.g. Anger meditations Crying meditations	Makyo desensitisation Laughing&smiling medit.
Sensory meditations (->Concentric sensing)	E.g. Sensory awareness Mindfulness meditations	Pranayama techniques Patanjali's Raja yoga
Imagery meditations (->Mind (non-)picturing)	E.g. Self-remembering Choiceless awareness	Golden flower meditation Qigong imaginal techn.
Cognitive meditations (->Thought evaporating)	E.g. Koan techniques Mantra yoga	Praying/chanting medit. Jnana yoga
Interpersonal relations (->Joint practices)	E.g.Tantric yoga Sexual kungfu techn.	Monastery life as medit. Sufi (dancing) meditation
Drugs / Biology (->Entheogens)	E.g. LSD, XTC Mushrooms	Cactuses Marihuana, Hasheesh

(shikan) precisely (ta) sitting (za) - as promulgated in Soto's Zazen - austerely sitting in a lotus posture for seemingly infinite hours like a breathing corpse is the ordeal. This will culminate to the point that one faces death (the finiteness of life) and a learning to overcome epiphenomenal fears no-one is immune for. Such a way is analogous to the cognitive-behavioral technique of 'flooding', a massed exposure of fearful stimuli in imagery. Others might prefer what I call 'makyo self-desensitization', a quaint term for imaginal graded exposure to dispel the fear of death and defenses by bits and pieces. When only sitting proved to be too difficult to start with one shifts back to a lower gear by applying a secular relaxation or meditation technique that begins with some activity in a preferred modality, assessed by one's structural BASIC-I.D. outlined above. A preliminary dwelling in a modality functions mostly as a purgative effort facilitating a serene inward stillness and a return to meditative breathing.

The way, road, or path is not the same as the vehicle. Many like less strenuous high-speed transportation, spinning off 'backdoor' Zen and illuminating pioneers like the late Allan Watts or Timothy Leary. In many quarters devouring 'entheogens' - psychedelics, soft drugs, and other substances inducing spiritual experience - is like embarking on a space-shuttle for an enchanting journey in the (micro)cosmos. To stay on course in the right orbit requires self-discipline in dealing with sensory seductions evoked by 'cleansed doors of perception' (Smith, 2000). Living in Holland, where traveling by rocket is affordable, I (MK) have the prerogative to stay out the hassle of illicit conduct. Taking off as many times as one wishes, the liberty to enjoy and experiment leads to the conclusion that at the bottom line all depends on the pilot (who might remain automatic) and the destiny of choice. No doubt, artificially induced spiritual experiences can only impact the lives of those who are ready for it. The indiscriminate hallelujah of the sixties, recommending everybody to drop-out and fly, should be replaced by a sense of reality epitomized in clinical guidance that stimulates learning by a disciplined use of these tools. 'Who teaches The Sole Buddha who teaches everybody who does not teach her/himself?' This koan (intellectual meditation object that cannot be solved intellectually) _ la Rinzai evokes concentration and contemplation on solving, such as 'He can only teach himself if he does not teach himself'. Meditation starts by a sudden awakening from dwelling on the puzzle, (re)turning in the 'herenow', and going beyond conception. Absorbed attentive witnessing is the alpha and omega inherently present in all techniques and the root to which the meditator resorts. Novices might still be tantalized by the question 'Who was The Buddha's teacher?' Even the answer: 'He was a self-made man who practices meditation independently with little guidance, much self-study, and discipline', does not suffice. As a living tradition Zen is in a constant and dynamic evolution up to the present constructivistic map. Although, lately, research in meditation seems to accrue nothing but more of the same, CM's future appears to be bright. Consider the impetus galvanized by the unveiling of the human genome and other high-tech innovations. By modifying molecules nanotechnology might be able to e.g. transform metal into gold or recreate missing body parts. Cellular chips might engineer a permanent condition for Satori. Due to these changing frontiers in science it is possible to envision a hard-wired quantum leap Doctor Faust dared not dream about. Humankind is poised to get a democratic voice in creation itself, with all its ramifications. If our evolutionary future is to become gods, we should prepare ourselves to be worth this formidable task. CM's challenge is to proof its usefulness at this cutting edge going forward.

Appendix 2 TSCM Course Outline on NeoZEN/Buddhist Psychology

This course is meant for anyone who is professionally interested in comprehensive postmodern Buddhist teachings. However only students who have already earned a masters degree in clinical or counseling psychology from an eligible considered university can be offered the TSCM degree of 'Master in Clinical Meditation Studies'. The course consists of 12 Power Point Presentations (PPP) with underlying literature, video material, meditation practice, and individual supervision. Each presentation covers 50-60 slides and will take two hours to present (including some time for a few imminent questions):

I - Introductory level

NeoZEN 1 Buddhist psychology - introduction to its practice

NeoZEN 2 Buddhist meditation: hypotheses and results from brain research

NeoZEN 3 Buddhist practice and cognitive behavior therapy

NeoZEN 4 The interface between Zen & Rational Emotive Behavior Therapy

II - Bachelor's level

NeoZEN 5 Zenmasters: in search for bull - from India to China

NeoZEN 6 Zenmasters: finding the bull- from China to Japan

NeoZEN 7 Zenmasters: riding on the bullp- from Japan/Tibet to the West

NeoZEN 8 Zenmasters: the10th bull picture - from the West back to the East

III - Master's level

NeoZEN 9 Rational Emotive Behavior Therapy/Counseling - rearranging kamma

NeoZEN10 A multimodal approach to basic emotions and wellbeing

NeoZEN11 Clinical psychopathology - recognizing emotional disorders

NeoZEN12 Transcultural Clinical Meditation: overview of principles&nbsp&nbsp

The course can be attended by 30 students and will take 6 days in total divided in 3 seminars of 2 days each, respectively leading to certification on 3 levels as indicated above. Thus each level entails 2 days and each day consists of 2 PPP (4 hours) and the necessary exercising-discussing-evaluating (4 hours). The seminars require reading of for about 1200 pages, thus 100 pages per PPP (the titles will be referred to in further detail in a syllabus). Certification of each level follows after examination of the literature the student has read. The master's level requires in addition a final paper (15 - 20 pp) and individual supervision on one's own meditation and on the applying of meditation with clients. Three cases should be submitted in the supervision (combined cases of meditation & therapy on clinical dysfunction or meditation & counseling on managerial functioning).

Investment in time: a day's seminar = 8 hours training + 12 hours reading (100 pages), totaling 20 hours a day. This makes 240 hours for the whole course. In addition, one's own meditation practice (at least one hour a day) plus supervision on one's working with clients (4 supervision hours per client, totaling 12 hours). (The time investment for the final paper depends on the individual student.)

ACKNOWLEDGEMENTS AND CORRESPONDENCE.

This is an updated article, earlier published in: Constructivism in the Human Sciences, 6, 95 - 112. Thanks are due to Y.Haruki, Y.Ishii, R.Kawano, Y.Sakairi, and G.Sugamura for their endorsement of the TSCM. Requests for further information on TSCM and its Master of CMS program can be sent to dr.k.t.kaku@planet.nl

3.8. Well Being. Integrating Eastern Knowledge in Western Culture and Western Knowledge in Eastern Culture

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