Some time ago, I listened to a class given by Mr. Xu Yuxin, and he talked about the meaning of the four words “wisdom, cessation and determination” in life in Buddhism, which triggered me to think about psychotherapy, especially the treatment of eating disorder patients, which I am facing most nowadays. He focused on the difference between wisdom and wisdom. Wisdom probably refers to our ordinary “reason” and “cognitive ability”, while wisdom is the “great wisdom” sought by Buddhists, which is the understanding of life. In my thinking, it is equivalent to the “growth” pursued in psychotherapy. Mr. Xu pointed out that wisdom is something that we all have, but it is not reliable, and there are at least three things that can make wisdom go astray – “love makes wisdom dim”, “profit makes wisdom dim”, and “profit makes wisdom dim”. There are at least three things that make wisdom go astray – “love makes wisdom”, “profit makes wisdom”, and “lust makes wisdom”. Although this explanation is simple, it is a bit enlightening for me and I would like to share it with my friends. In my experience, it is common for families to tell me, “My child does not want to see a psychiatrist, he says he understands everything the psychiatrist says, he is better than the doctor. What can I do? What can you do to convince him?” Either the patient himself tells me “I understand everything you say, but I just can’t do it”. As doctors, we all know that knowing and doing are two different things, and that psychotherapy is not at all about reasoning or intelligence, but about the fragility of the role of “intelligence” in the pursuit and maintenance of mental health. “The intellect is really fragile. Think about it: “love makes us lose our judgment” – loving someone can make us lose our judgment, and fear and anger can make us lose our minds. “Profit makes us lose our wits” – the most common macroscopic example – the destruction of the environment and the plundering of the earth’s resources; “lust makes us lose our wits “There are many other desires besides profit, such as the pursuit of “control” and the pursuit of “perfection” that we commonly see in patients. With so many things clouding our sanity, how can we dare to hope that “wisdom” can solve our life’s puzzles? Perhaps this is why Buddhists rarely talk about “wisdom”. So, where does the psychological “growth” we seek come from? In other words, how does psychotherapy work, and how do we cure the disease? These eight words I found on the Internet reminded me of the current medical practice. The so-called “precepts” can be understood as the rules and boundaries set in psychotherapy, including behavioral therapy, for example, the location, which is very important in psychotherapy, must be a standardized therapeutic environment, preferably fixed; the time, which must be punctual and regular, can be fixed. -confidentiality – what is talked about in therapy will not be exposed in other settings; and even fees – clear partnership, responsibility and commitment of both parties, all of which are used to help patients and These are all used to help both the patient and the therapist to become “settled by abstinence” – to gradually feel reassured and secure in their commitment to therapeutic exploration and change. The most energy-efficient thing to do is to have peace of mind. With the word “determination” in mind, it is easy to achieve a certain level of commitment in everything you do, and this is also true in psychotherapy. This is the insight into the life of the patient in psychotherapy brought about by “determination and wisdom”. Patients with eating disorders usually start in adolescence, when they are in a period of physical and psychological radicalization, when the pursuit of autonomy and unique development and the basic human need for security and attachment collide strongly. Patients at this time are in an extremely contradictory state: on the one hand, they are extremely sensitive to and resentful of restrictions from the environment, and stereotypically demand autonomy; on the other hand, they set very strict self-imposed restrictions, and keep themselves more and more tightly in a box, so that no one else can get in and no one can get out. For a certain period of time, anorexics experience the benefits of strict dietary restriction (abstinence) (fixation), and they focus on pursuing their weight, academic performance, and their own self-congratulation. However, such unnatural restrictions increasingly provoke resistance from the mind and body. They begin by relying on stricter abstinence to strengthen their fixation, but as interpersonal detachment and emotions sink to a low point, fixation fails to bring wisdom and brings them to the brink of death. Most bulimics transition from the anorexia stage, from unlimited abstinence to another “self-limitation-self-indulgence” circle. The restrictions from the outside world are invariably resisted and feared. So, is it freedom, or is it bondage? This is a question that is faced head-on in the treatment of eating disorders and may persist throughout. The psychotherapy training I received emphasized standardized treatment settings and clear boundaries, and the eating disorder ward I was in had a rather special set-up – no leaving the ward during hospitalization, no leaving the ward for 1-2 weeks, group meals and regular rationing, many wonderful things from the outside world were not allowed to be brought in, etc. It really felt like There is a sense of purity in the Buddhist sect. Such special “commandments” are not common in psychotherapy, but have become a necessary part of the inpatient treatment process for patients with eating disorders, which has inevitably caused many patients and even family members to question and resist. So how do we understand the limitations of these external circumstances? As I mentioned earlier, in the pursuit of freedom and autonomy, while resisting the inner turmoil, patients with eating disorders see the restrictions from the outside world as a tiger and a wolf, but trap themselves physically and mentally in a cocoon. Therefore, in my opinion, the focus of treatment for eating disorders is precisely the opposite – to unlock the mind and body, and to learn to live in harmony with the restrictions (moments) of the environment while pursuing freedom of mind. As Tzu said, “If you want to do what you want, don’t exceed the rules. Most of the rules of hospitalization are aimed at the internal restrictions imposed by the patients themselves, for example, the “regular group meals” are aimed at the patients’ internal precept that “they must be as modest as possible and use all means such as delaying meals, throwing up, throwing away, hiding, etc. to achieve “This is a commandment. By making the chains of the patient’s compulsive mind and body useless through external rules, the patient may instead be relieved. Some patients who need to be hospitalized are already tormented by the struggle between “freedom and bondage”, and they can easily adapt to the rules and experience the peace that comes from following them. Once they feel the restrictions from outside, they fight against the external forces with all their might, as if all the troubles are caused by the outside world and they would have been fine if they were allowed to make their own decisions. The situation of these patients when they are first admitted to the hospital is similar to that outside the hospital, most of them are fighting against the external forces of their family members, and they naturally shift to fighting against the external forces of the medical care in the hospital. The difference is that the rules in the hospital are like flood control levees, allowing you to let the waves go, but always constant, so that you can always wait until the wind and waves calm down. Therefore, whether active or passive, the acceptance of external rules (precepts) will always bring inner “fixation”; with this “fixation”, the understanding of life can be expected. Of course, just as people who study Buddhism have different intentions, there are those who are dedicated to Buddhism, those who are forced to enter the empty door to avoid troubles, and those who are desperate to enter the empty door, they may also observe the precepts of Buddhism, but may not be able to “generate determination” and “develop wisdom” at the same time. This has to do with the original intention, the guidance of the master during the practice, and the degree of personal effort. In the same way as psychotherapy, the understanding and expectation of inpatient treatment for eating disorders can also be viewed in the same way.