S2E10 The Middle Path

Dr. Pete and Dr. Rubin have mentioned the Middle Path time and again on When East Meets West. In this episode, they finally dissect and present the foundations of this practice, how it links to behavior, and how it may impact our emotional functioning. The doctors illustrate the three waves of CBT, the goals of finding the middle way in order to create flexibility, and the importance of functional contextualism.




Pete: So there's this thing we've said on here and When East Meets West called ‘the middle path’.

Nikki: The middle path.

Pete: And Nikki and I, hey Nikki, we're going to talk about ‘the middle path today.

Nikki: Hey Pete. And I'm really excited, before we were hitting the record button, we were like, what are we talking about today? And we had some options. When I was like, I really want to talk about the middle path. I was really excited to hear you talk about the middle path.

Pete: I was trying to convince her to talk about something else. And she was reluctantly saying I'm really excited for the middle path.

Nikki: I really was because it's one of my favorite things to talk about clinically in my own life and of course. Just excited to hear some of your wisdom from some of your Zen Buddhist training because obviously, that's where this comes from.

Pete: Well, now that we've set it up that way, I hope we don’t let anyone down.

Nikki: People are like, this is not really cool.

Pete: Why is she so excited about this? They’re boring 01:17] they get excited about really boring things.

Nikki: That is true, we do. We do get excited about boring things.

Pete: You definitely get more excited about boring things than I do, though. I'm just going to put that out there.

Nikki: That's actually true. Yeah.

Pete: Okay, listener. So Nikki, she geeks out more than I do, for sure. So middle path, so let's just ease our listeners in just some of the Western behavioral science. So how have you seen it how does it show up in your clinical practice, the notion of middle path?

Nikki: Well, it's going to be hard to say it from a strict behaviorist lens, since it's straight up borrowed from Zen Buddhism from an eastern perspective. Though, I would say, if we go back to the second wave in cognitive behavioral therapy, folks like Dr. Aaron Beck, who is a very famous psychiatrist, considered the father of cognitive therapy. You know, that kind of work where the focus was predominantly on cognitively restructuring, we've talked about that before. Which is basically changing our thinking, right, would be to change our thinking to what is accurate. And I would say that the middle path helps us from a cognitive standpoint, understand this, like compromised, right, that things are not going to be all good or all bad. And then from a behavioral standpoint, I would say that's a concept I'm often using, in my own mind, as I'm trying to shape behavior with patients. And then also, as I overtly share that concept with individuals to help cultivate flexibility in responding, right. Because it's like, there's not like it, as opposed to I often mind like a pendulum swinging. So if you're watching our YouTube channel, you can see me doing it. Right, that there's a pendulum swinging and the idea is to try to settle somewhere and get near the middle.

Pete:  Yeah. Well, maybe just for a minute, I'm going to just even expand a little bit. So just because we've dropped the second wave, and just for anyone who might be tuning for the first time, in a very simple way, the first wave is behaviorism. Like, how do I get a rat to the end goal? The second wave was, as Nicky said, Aaron Beck with cognitive, the father of cognitive therapy. So he says, actually, thoughts impact how we get to that end goal, as well. And then the third way that we're often discussing here on When East Meets West is acceptance based strategies that are really borrowed from the eastern spiritual practices.

Nikki: Yes, and mindfulness explicitly.

Pete: Yeah. So that's like my 22nd description of the three waves.

Nikki: That was a beautiful elevator pitch. I love that.

Pete: Are you sold?

Nikki: I am so sold. That's ob., yeah. So that that's my little summary from a Western lens here. So I'm so dying, as I said to hear how is this talked about through an Eastern lens?

Pete: Yeah, well, in exactly the way that you would anticipate and so in particular, it starts with part of the Eightfold Path. So as we've discussed, there's the Four Noble Truths. So the first is that life is suffering. The second is that suffering is created by attachment. The third is there's a way to get out of suffering, which is the Eightfold Path. And the fourth is that Nirvana kind of path of enlightenment. And I mean it's so interesting, because nothing in eastern spiritual practices really rigid. And I find that the Four Noble Truths are kind of very discreet and concrete and they're misleading in a way, you know, because people feel like that there's this like, very simple four way of getting to this idea of enlightenment. And frankly, there's no such thing as enlightenment which you learn in the end. Because once you believe you're enlightened, then you're not.

Nikki: Then you’ve already failed.

Pete: You wouldn't see it as a success to fail, but the truth is like, you know, the idea. So that's interesting, right? Because there's no end.

Nikki: Yes.

Pete: And that's why we've talked a lot about the Eightfold Path here. Because I think that that's ultimately, the ritualistic behavioral way of living in an Eastern spiritual practice is by practicing the Eightfold Path. In fact, the full path is it highlights the middle way of moderation so it's like, right speech. It's not saying like, no speech or all speech, it's saying like, right speech, finding that middle way of what to say. You look curious.

Nikki: Yeah, I've mentioned this before, in a previous episode, I think this is where it's very interesting to me in terms of like the translation of the language, because I think like, for English speakers, right. You know, and I would be curious if in other languages, if this would be similar or not. But the word right gets very confusing, right. Like I just said, right, again. We have a whole episode called righteousness and rigidity and leisure one, because we can get so attached to being right. And I think that it's like, from the way it sounds I like the way it sounds like right effort, right speech, though. Maybe that's I think there's almost like a translation issue. Because like, what you're saying, Pete is that the sentiment of that is really like, right.

Pete: You are correct.

Nikki: It's like effective speech, effective effort, which is the language that we use in a third wave CBT approach because it's about like, or love other languages. It's like workable, right, not workable.

Pete: Manageable, workable. Yeah. Those are the verbs to use. No, that's a really good point. And there are a lot of things that are not translatable. And I guess we do the best that we that we can and I've never really thought about it that way. The ultimate goal is to avoid extremes, you know, and I think that that's what we're getting it and so you're right, it would be like workable speech, or workable mindfulness are manageable, because right means that there's a there's right or wrong. I mean, I'm sure there must be a scholar out there that has interpreted right in a different way but I don't know. Like maybe right means commitment to.

Nikki: Yeah. Well, it's like, I'm reminded of a story you've told a few times of like, when you first started practicing Buddhism that you like, refilled in different ways, you know, that you wanted to, like, meditate the right way. Or like when you were at your aunt's funeral, that it was you thought something was wrong, because you were feeling sadness in the moment. And I wonder if part of that is like an over attachment to the language of, right like, I'm not when…

Pete: There’s a literature about that.

Nikki: Well, big ups UCS… [crosstalk 07:58]

Pete: You can’t take a girl out but whatever the saying is.

Nikki: Yeah, you can take; I’m tired today I can't. Yeah, so it's like, what I keep hearing you say is like, what the message is, it's not linear, right? It's what we say over and over again, here we go guys, is the middle path.

Pete: Right.

Nikki: Coming back to there isn't perfect; there isn't one way to do something.

Pete: No, and even there's eight ways at least.

Nikki: Yeah.

Pete: Yeah, at a bare minimum. It's also sometimes called the middle way depending on the interpretation, but the idea is just avoiding extreme. So like, and so in cognitive therapy, maybe you'll talk a little bit about all or nothing, because I think middle path really to me links most directly to all or nothing cognitive distortion.

Nikki: Well, get in there. you are also a CBT therapist.

Pete: And you're just a better teacher of it.

Nikki: You love to say that.

Pete: I do love to say it.

Nikki: It's so not true, guys.

Pete: I'll keep saying it, but it's okay. So all or nothing, or black and white thinking is a cognitive distortion so David Burns, as we've highlighted, you know, several cognitive distortions. I also like to think of all or nothing behaviorally, so everyone listening, you know, it developed in the second wave, but really if I bring that construct to the first wave. everyone listening has either gone to the gym or not gone to the gym, or goes to yoga five days a week, or doesn't go to yoga at all.

Nikki: Well, I think what you're highlighting there is, and this is real, solid CBT stuff is that thoughts, feelings and behaviors influence one another. So if you have a belief, yes, you know, I can only go to the gym five days a week or not go at all that's absolutely going to influence what you do.

Pete: Correct. Exactly. So I think it's important for People because if they can't connect with their thoughts because there are a lot of people, and that's the thing about mindfulness or meditation is that we build a relationship with the thoughts, but we might not be there yet.

Nikki: Yeah.

Pete: So you might not realize it but you know that you either go to yoga six days a week or you don't go at all and you're like, I don't get why I'm like that, you know? And so whenever it feels more accessible, whether it's the thought feeling or behavior, that's what you want to start with. And so I think behaviorally everyone out there has been an extreme like, I eat no sugar or sugar, you know I do a sugar cleanse, right?

Nikki: Yes. Or I'm eating all the Oreos that I want, yeah. And that goes back to this concept you and I highlight over and over again, which is, that's because the way the brain is wired, right, that it's, it's much easier to, frankly, process information and in binaries, right. And this is like, goes back to our dialectics episode like, that's why it's hard to hold two opposing things at the same time because it's, you know, sometimes I joke with people, I'll say, like, Look, it's a lot easier to process two data points versus 17.  

Pete: Exactly.

Nikki: It's just, you know, our brains don't like it, it's harder.

Pete:  So what we think about is that really nothing is yes or no. And that's the way that I view the world. And so whether that's my cognitive and behavioral Western practice, or if that's my Eastern spiritual practice, I don't see anything in those dyads anymore.

Nikki: Well, I was going to say, because your practice that and you were like, whether it's my Western or Eastern, I was like, well, here's another middle path, it's both.

Pete: It's both real times.

Nikki: Real time. It's both. Yeah and when you say you don't see it anymore, I'm going to gently challenge you on that to say your brain still wants to and you're just very skilled at knowing that. And I'll say, I always share this with people I'm working with you know Pete and I, we live the stuff we're talking about, like we live the stuff.

Pete: Most of the time.

Nikki: Well, when I say that, I don't mean it actually is like we're perfectly mindful.

Pete: You’re not?

Nikki: No, sorry guys I'm not. I mean, in the way of like, we're walking around saying we're humans, too.

Pete: Yeah.

Nikki: We struggle too, all the things that we're saying are hard for you guys they're hard for us too. And these approaches help us and hopefully will help you navigate this human experience, with just a little bit more ease and maybe a little bit more grace and a little bit more like softness

Pete: Said so sweetly and in such a soft voice, I feel so calm.

Nikki: I'm glad I'm glad.

Pete: So I'll share one of the teachings. So this is one of the Eastern teachings is a story. So I've said on here that Cowen's and stories and one of the SUTA, which is a story of the Buddha describing the Eightfold Path, because, again, in any of these Eastern spiritual practices, they were really focused on avoiding extremes, central indulgences. you know, really trying to be mindful of what you're doing, it's like we talked about, like with eating, it's like thinking and recognizing where your foods coming from. So, he says, monks, these two extremes ought not to be practiced by one who has gone forth from the household life. there is an addiction to indulgence of sense of sense pleasures, which is low course, the way of ordinary people unworthy and unprofitable. And there is an addiction to self-mortification, which is painful, unworthy and unprofitable.

Nikki: Wow, that's intense. I like it.

Pete: It goes on. Avoiding both these extremes, the perfect one has realized the middle path. It gives vision gives knowledge and leads to come to insight, to enlightenment and to Nirvana. And that is the middle, and what is that middle path realized? It's the Eightfold Path. So they're saying is like, you get this calm, you get this peace, you get this release of indulgence by practicing this middle path and this middle way through the Eightfold Path.

Nikki: Yeah, and I think that maybe what listeners can take from that, too, is this concept that when you hold tightly to like, the extremes that we're talking about, like something rigid. maybe it's not even maybe it doesn't feel that intense, maybe it's something linear, maybe it's something that you think there's one way to do something that in the short term that's going to feel better to your brain. but the more you stick with that, that's what's going to lead to suffering, that is actually releasing this grip on things have to be one way. And that's what the middle path is. Obviously, it's what you're saying, that's going to create more peace in your life.

Pete: Well, what you also said before is the flexibility and that's what key.

Nikki: Yeah.

Pete: Because I think I'm going to rewrite this now as far as right mind, right mindfulness because you're absolutely correct. And so even like, right understanding, one of the Eightfold Path, it's like, that doesn't mean there's a right or wrong way to understand something, it means be open and flexible to how you see and understand something. you know, be open and flexible for how you think and recognize a thought, thoughts are not reality. And so speech, think about what you're saying, that's kind of what I say a lot about mindfulness or mindful living is it's thinking before you speak.

Nikki: Yeah, it's the pause.

Pete: It's the pause.

Nikki: It’s the spaciousness and it's worth acknowledging and that's very hard. You know, it's like, that's so hard and this is where I say to people over and over again, to the point I'm sure they're extremely annoyed with me is…

Pete: Never.

Nikki: Well, it’s debatable. I'm like; they call it a practice for a reason, right? Like, it's really hard, it's really hard to be mindful. It's really hard to walk the middle path, you know?

Pete: Yeah. I mean, if it were easy, we would all do it. I mean, that's the only thing I’ll say. I feel like if all this stuff was easy, we would do it, we certainly live in a more peaceful way. I think if we could get, so here's my dream. Can I share like a little fantasy?

Nikki: Yeah, please?

Pete: It's G, I promise, but it's that we would have people in leadership roles that are practicing mindfulness or middle path.

Nikki: Yeah, I'm down with that. I love that.

Pete: That’s it, I'm not saying [crosstalk 16:50] I’m not saying it like in any anger.

Nikki: Yeah, I love that. And I'm going to say, I don't think that that's actually a fantasy because I think that the way, this is so broad, but like, where we are currently in human experience in human history, there's obviously been resurgence in interest in these ancient concepts. Right, we wouldn't be having this podcast if there weren't and so, I don't think that's impossible that maybe some of that will begin to trickle in.

Pete: Yeah. Yeah, let's hope. I mean, I like your optimism, I will share and your hope, or your optimism, but I do remain, I mean, my pessimistic by any means but I think it's challenging. You know, one of the beautiful dialectic is that what gets people into leadership roles often is not a very mindful practice.

Nikki: Yeah, it's so true. It's so true. Yeah, it's an uphill battle. So if that's a challenge, and I think that's the appropriate word here for people in leadership roles. I think that like, we don't want to, like pendulum swing the other way away from the mindfulness, or the middle path here to say, like, let’s gives up, there's no point in this.

Pete: Exactly.

Nikki: It's like, that's where every individual listening to this, it's like, and you can practice this in small ways out throughout the day. And I mean like concretely, if everybody was doing little by little all the time, like, there'll be more of that in the world?

Pete: Yeah, I mean, that's grassroots, right, at any level. And so if I am even working at a, you know, a very entry level job in a large company, my interaction with my superior, that is mindful or flexible, or middle path can certainly lead to that person maybe reflecting on their own rigidity.

Nikki: Yeah.

Pete: And what I mean by this is, that people in leadership often believe that they got there because they have the right skills or tools or knowledge or theory, so that there may be inflexible for imposing or integrating a new idea, or new principles. And so what we're trying to say is like, is there a way that those individuals might be able to gain some insight and some flexibility so that maybe they're going to lead in a more effective way?

Nikki: Yeah, I totally agree with that and I was just thinking, as you're saying that, Pete, that's also just so applicable, though, like, in literally every context, right? Like, in relationship people are like, I'm in this relationship, because I did it right. Or I got this job because I did, right. Or I'm a parent because I did this right. And what you and I really saying today is, can we let go of that concept oddly of being right and use the right? Buddhism, they're encouraging us to use which is really like, come back to the middle path, come back to this idea that there isn't right and wrong. There is no more best and worse, it's like, again, and that's actually such a beautiful overlap with modern behaviorism as I've talked about before. we refer to as actually functional contextualism means that it means a behaviors function is determined by the context. And the reason that's important is because the context is always changing. You know, there's never a one size fits all I tell people like you in mindfulness I'm like, there's not a behavior you can do that works the same.

Pete: Yes.

Nikki: Effectiveness, weight and every situation like you can't be mindful in every situation we have to for example, distract sometimes.

Pete: That's right.

Nikki: Like just there's no one size fits all and so like the more you can bring that into your concept of living, again, like things become actually like a little bit easier.

Pete: Beautiful. Well, Nikki, this was great. And I know we're going to continue on our middle path and listeners, just remember the middle path it gives vision, gives knowledge and leads the calm to insight into enlightenment. This has been when East meets West, I'm Dr. Pete Economou.

Nikki: And I'm Dr. Nikki Rubin, be present. Be brave.

Pete: This has been When East Meets West all material is based on opinion and educational training of doctors, Pete Economou and Nicki Rubin.

Nikki: Content is for informational and educational purposes only.