THE SIMPLE EGO SPECTRUM

Buddhism is a non-self psychology.  For self we can also say ego.  Thus, applying this principle to psychopathology and psychotherapy, we can say

the more ego, the more delusion
the less ego, the more awakening

Thus it is possible to envisage a spectrum from maximum ego to minimum ego which will also be from maximum delusion to maximum enlightenment.  At one end of this spectrum will be the psychotic person, completely lost in his own world.  At the other end is the Buddha, unconcerned about self and consequently full of wise compassion.

Most people are somewhere in the middle of this spectrum:

The way that one recognises where a person is on this scale is from the extent to which they show the characteristics of ego.  These include

• asserting a personal identity
• talking about self without concern about the other
• self-advertisement or self-pity
• lack of contact with immediate reality

The mad client has little psychological contact with the therapist.  The work of the therapist will largely be aimed at creating conditions in which such contact may become possible and building upon such tiny signs of it as naturally occur.

The narcissistic client seeks ego support from the therapist.  Such a client may idealise the therapist, but this idealisation can easily flip into an equally sharp rejection when the therapist does not provide what the client seeks.  The worker needs to be rather indulgent and accommodating.

The neurotic client typically seeks to seduce the therapist into a role that is supporting to the client's ego.  Where the narcissistic client is lost in his own identity and "needs", the neurotic client needs a partner to keep his game running.  Here we encounter all the phenomena known as transference.

The wayfarer is exploring.  He is capable of having an intelligent and objective interaction with the therapist.  The therapist should be careful to ensure that this does not become abstract and superficial.  

One is not likely to encounter many true bodhisattvas, but, in principle, one may encounter people who are eminently sane but who, nonetheless have invidious existential situations they have to deal with.  In this situation, the therapist acts as a good friend and companion.

If the therapist invites the client to tell her about a third party in the client’s life,

• the mad person will be unable to do so in any objective way
• the narcissistic person will respond with statements about himself
• the normal person will also probably begin with self-referential statements but can readily be coaxed into some degree of empathy for the other
• the wayfarer will immediately discern the perspective of the other
• the Buddha will perceive the perspective of the other with a depth of understanding for the human condition not just of this one person, but all.

According to where they are on this scale, clients need different styles of work.  The more ego there is, the more fear there will be.  Defending an identity involves a lot of wariness.  Thus with the client at the left hand end of the scale one has tread much more carefully and effort must go into not frightening the client, whereas with the client nearer the right hand end one can be more challenging and take more risks.

With the normal client, object related work will commonly proceed well and if one goes forward with small steps of gradually increasing depth, shifts in perception can be expected.  Clients who are more narcissistic will find such work more difficult or meaningless because, for them, little exists outside of their solipsism.  With these latter clients one has to be patient and watch for naturally occurring signs of contact with a reality outside of self.

A MORE COMPLICATED PICTURE

The above gives us a simple model of some considerable utility.  At the same time we must recognise that all such models are simplifications.  In reality, the great majority of people have at least fragments of all the first four positions and these will tend to manifest according to circumstances.  The therapist, therefore, will do well to notice what conditions trigger which aspects of the character of the client: what brings forth a narcissistic pattern, what stimulates bold exploration, what triggers habitual fears, and so on.

Furthermore, it is not only the client to whom these considerations apply.  The therapist also has all these aspects.  The narcissistic part wants to be affirmed by the client, wants the client to act in ways that make the therapist feel and believe that she is a good therapist.  When these kinds of “narcissistic supplies” are not forthcoming, the therapist may feel peeked, as, for instance, when the client tells her that his previous therapist was so much more understanding than she is.  Also, the therapist has her own neurotic worries and sometimes the material presented by the client will trigger these.

Considering all this, one can see that the interaction between therapist and client is likely to set off a range of dynamics.  The chemistry between the two personalities will produce a reaction.  The client will not, therefore, manifest identically with different therapists.  The client will quickly assess what he can and cannot broach with this or that therapist.

As therapists we learn a great deal from observing these reactions occurring in ourselves.  On the one hand, one does one’s best to be there for the client in as altruistic and empathic a manner as possible.  On the other hand, things are bound to happen that set off triggers.  Learning to observe these rather than, out of shame or pride, rushing to cover them up or excuse them, is an essential skill from which much of our development as therapists flows.  Seeing the ego forces at work in oneself provides the foundation for compassion and understanding, without which the therapist cannot help but fall into judgementalism which will wreck the therapy.

We can say that it is, therefore, incumbent upon the therapist to “work upon herself”, but a caveat is in order.  The kind of “work” that is needed is to put as much attention as possible into understanding the human condition in general and the condition of the client in particular.  Therapy itself is thus a spiritual practice for the therapist.  Along the way, as shown above, she will encounter inner reactions and by allowing herself to experience these in all their depth she will discover more and more about the human condition.  A therapist needs humility.

In spiritual language, this last aspect is contrition.  Contrition has two levels.  The simple level is that one learns from one’s mistakes.  When one fully realises that one has made an error, one resolves not to do it again.  This, however, is the more superficial level.  The more important level is that one sees that errors of this kind are the human lot.  Even if one manages to avoid exactly this fault in the future, one will commit others.  When one sees such an error, one experiences ego pain (hurt pride).  One learns the power of this pain.  One sees how it runs lives.  In this way one arrives at a much deeper understanding of what the client is up against.

THE CHIMERA OF PROGRESS

In principle, according to this model, the work of therapy is to facilitate the client's movement along this spectrum from left to right and the development of the therapist can be described in similar terms.

There is, here, however, a pitfall, in that the pursuit of progress readily itself becomes an ego game.  The therapist preens herself looking at her good results and clever interventions and laments clients who seem to slide back.

The notion of progress from left to right is a good description from the outside view.  It is not, however, the attitude that the therapist needs.  The therapist has the inside view.  She may allow herself to stand back and make an assessment during supervision, perhaps, but the primary attitude that she needs in the session is a total acceptance of the client just as he is.

In fact, if one errs in this matter, it generally gives better results to err on the side of resisting the client's "progress" than trying to hasten it.  Be cautious.  Don't set goals or you set the client (and yourself) up for failure.  Appreciate everything the client presents and see it in a realistic way.  Do not make light of the difficulties involved in bringing about change.

Essentially the therapist needs an authentic trust in the process, a faith that the universe is unfolding as it should and whatever the client manifests is part of that benign reality, whether it seem so at the time or not.  The ideal therapist is empty of ego and of ambition.  Perhaps none of us are so ideal, but it is a thought worth keeping in mind.