Is a Buddhist Psychotherapy Possible? An Examination of How Buddhist Principles and Meditation can

Benefit Western Psychotherapy

Many psychotherapists today are beginning to realize that the goal of therapy

should be to confront and effectively diminish narcissism, a goal that Buddhism has

perfected long ago. There are those who believe that the merger of Buddhism and

traditional psychotherapy is paradoxical in nature. Others however, believe that the two

fields were destined to coalesce and that both fields have much to learn from each other.

By comparing the similarities, differences and common ground between traditional

psychotherapy and Buddhism, and by examining the physical and mental effects

meditation has on the individual, it can be shown that not only is a Buddhist

psychotherapy possible, it is imperative. Despite many conflicting perspectives, adopting

Buddhism in a therapeutic context would be an invaluable asset for increasing the

happiness and well being of people in Western society.

Today, many psychotherapists of traditional Western psychology are becoming

ever more interested in the potential of incorporating Buddhist perspectives and practices

with the traditional psychoanalytical methods of therapy. This interest was perhaps first

attributed to the famous psychologist William James in the early 1900’s. During a

conference at Harvard, James stopped and brought his attention to a Buddhist monk from

Sri Lanka. He offered the monk his chair and declared that the monk is better equipped to

lecture on psychology then he is. At the time, James had made the prediction that in

twenty-five years, Buddhism would be the predominant psychology being studied and

applied in the West. (Epstein, 2004) James did not anticipate that over the subsequent

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years, the ideas of Sigmund Freud would reign supreme in the arena of psychotherapy.

Furthermore, his prediction did not come true due to the wide spread notion that science

and religion are incompatible. Strictly speaking however, Buddhism is not a religion

because “it does not have any sacred scriptures whose words are law; no fixed cannon; no

rigid dogma; and no Savior or Divine Being through whose favor or intercession one’s

eventual salvation is assured.” (Aitken, 1993) In fact, it has been argued that Buddhism is

inherently a psychology, closely related to science in that the principles and techniques

outlined by the Buddha are empirically observable. (Mikulas, 1991) The Buddha urged

his followers not to accept anything on hearsay, authority or argument, but instead to

accept what is empirically and experientially verifiable. (Christopher, 2003) Regardless

of it’s non-theistic religious status and its close resemblance to a science, Buddhism has

been perceived as something foreign, exotic, unorthodox and alien to the general West.

Fortunately, these prejudices are being lifted and Buddhism is becoming more prevalent

then ever before. With over 300 million followers worldwide, the Buddha’s teachings

have come a long way.

It is important to note that the Buddhist teaching represents a philosophy, a

psychology and an ethics. The Buddha’s teachings provide a set of beliefs about reality

(philosophy), a theory of the human mind and human behavior (psychology) and a set of

recommendations for appropriate conduct (ethics). (Bodhi, 1999) The most important

aspects of the Buddha’s teaching are contained in the Three Marks of Existence, the Four

Noble Truths and the Eightfold Path, which are integral to the development of Buddhist

psychology. The Three Marks of Existence are transiency, sorrow and selflessness. The

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Four Noble Truths are; suffering exists; suffering arises from attachment to desires;

suffering ceases when attachment to desire ceases; and by practicing the Eight Fold Path,

freedom from suffering is possible. The Eightfold Path is divided into three qualities;

Wisdom, which includes Right View and Right Thought; Morality, which includes Right

Speech, Right Action and Right Livelihood; and Meditation, which includes Right Effort,

Right Mindfulness and Right Contemplation. Buddhism and postmodern psychotherapy

are similar to the extent that they both attempt to understand the Mind and to find a way

to alleviate human suffering, but many of the teachings conflict with the traditional

notions of self and reality held in the West.

Perhaps the most difficult difference to reconcile between the two schools of

thought is the understanding of the “self.” The Buddhist perspective holds that the self is

not an entity, or a substance, or an essence. Instead it views the self as a dynamic process,

a shifting web of relations between perceptions, ideas, and desires.” (Galin, 1999) This

concept of non-self (anatman) is contrary to the Western perspective, which maintains

that the self is a rigid entity. This notion is central in the traditional psychotherapy of

Freud, which maintains that the construction of an integrated and whole self is the goal of

psychotherapeutic practice. These views are seemingly diametrically opposed to one

another. The Buddhist perspective stresses that the achievement of enlightenment is the

transcendence of the self, or the complete recognition that the self is an illusory concept.

This severe dichotomy is indeed problematic, and causes considerable tension between

the two disciplines; however, some believe that the conflict arises out of a semantic

misunderstanding.

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Many Westerners misunderstand the meaning of anatman, confusing “self is not

an essence or an entity,” with “self does not exist at all.” Instead, it should be noted that

the Buddhist tradition believes that the ordinary persons view of self as a lasting and

unchanging entity is the main cause of his suffering due to his futile attempt to hold on to

that which is in constant flux and has no existence outside of shifting contexts. (Galin,

1999) In other words, most people are whirlwinds who wish they were boulders. They

cling to things in the hopes that they will provide them with a certain "weight." They try

to solidify their loved ones into statues, not realizing that though a statue remains

unchanging, it has no love to give. Many try to become immortal by making their

children and grandchildren into clones of themselves, or by getting onto television or into

the history books. They even cling to unhappy lives because change is too frightening.

Instead of denying transience, impermanence and the illusory constructs of the self, one

must confront these truths and embrace them. The grandeur of this perspective is

difficult to fully grasp and apply without arduous training. The main source of training,

as noted in the Eight Fold Path, is meditation.

Although there are many different forms of meditation, they can be divided into

two primary categories: Concentration Meditation and Insight Meditation. Concentrative

meditation focuses the mind on a single activity, such as breathing or repeating a mantra,

which aims to eliminate all other thoughts from awareness. This kind of meditation has

been popularized in the form of "Transcendental Meditation.” Buddhism, however, is

more concerned with practicing insight meditation (vipassana), the goal of which is

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illumination into the nature of mental states. In contrast to traditional psychotherapeutic

technique of probing the psyche of the patient with questions in a causal manner,

vipassana brings awareness and attention to feelings, thoughts, and sensations exactly as

they occur and taking a passive and detached perspective on the minds inner workings,

without censorship or judgment. This awareness allows for a better understanding of the

impermanence and non-substantial nature of all phenomena, but may not necessarily

always be the correct meditative prescription for patients. Meditation may have different

effects on the individual and may have very different clinical applications. The

distinctions between various forms of meditation are important to understand when being

applied in a therapeutic context. Recognizing how a meditative technique should be

applied in therapy according to the goals being sought is fundamental. This can be quite

an arduous procedure, since there are many variables to take into account. However,

research in this field is growing quickly, which will hopefully make it easier to assess

which meditation technique will benefit the patient. The following is an overview of the

recent scientific evidence for the cognitive changes taking place during and after

meditative practice, and the causal relationship between meditation and treatment of

specific disorders.

Over the last four decades, hundreds of studies have been conducted to reveal the

significant psychological and physiological effects of meditation. The findings were

astonishing. Concentrative Meditation, specifically Transcendental Meditation elicited

positive changes for people suffering from asthma, stuttering, type 2 diabetes, and

premenstrual syndrome. Meditation also proved to enhance immune function in cancer

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patients, and reduce symptoms of distress in cancer patients. Mindfulness meditation, or

insight meditation, benefited people suffering from obsessive-compulsive disorder,

insomnia, phobias, eating disorders and anxiety as well as helped to alleviate feelings of

aggression and addictions. Furthermore, there are several different kinds of meditative

techniques, which have been shown to catalyze an increase in perceptual sensitivity,

mental processing speed, concentration, reaction time and motor skills, short and long

term memory, academic performance and creativity. (Walsh; Shapiro, 2006)

Furthermore, there have been a variety of studies that utilized brain-scanning techniques

to reveal the effects meditation has on the brain.

“In 2003, a study took place to measure electrical activity prior to and

after an eight-week mindfulness meditation program. The study showed that

meditation produced significant alterations in brain function. Another study,

which took place in 2001, used single-photon emission tomography to study

meditation in eight Buddhist meditators and found increased regional

cerebral blood flow in the thalamus, cingulated gyrus, inferior and orbital

frontal cortex and dorsolateral prefrontal cortex. A study in 1990 examined

three Tibetan Buddhist monks and found that meditation was associated with

both increases and decreases in resting metabolism and with changes in EEG

readings, including increased beta activity and asymmetry in alpha and beta

activity between hemispheres.” (Kelly, 2008)

It is important to note that the scientific findings that verify positive benefits to

overall health and mental well-being aren’t yet fully understood and are limited by the

boundaries of current scientific understandings of the brain. Furthermore, research studies

are limited by many factors, mainly experimental design problems. These range from

small sample sizes and suboptimal controls, to subject selection bias and consistency

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problems. Regardless, it is quite evident that meditation can change the function of the

brain in an enduring way.

These findings suggest that meditation has much to offer psychotherapy. Perhaps

the combination of relaxation, cognitive and attention restructuring, self-observation, and

insights, inherent in meditation, attribute to the efficacy of meditation being employed in

a therapeutic context. (Carpenter, 1977) Western psychology has much to learn from the

traditions of mystical sciences. It’s preoccupation with the contents of consciousness

(thoughts, emotions, impulses, memories, self-concepts and images) has prevented it

from taking into account that the core sense of existence is not located in the content of

consciousness, but is located in the awareness itself. This awareness is outside of

thought and images, memories, and feelings, and cannot be witnessed, but must be

experienced. Meditation acts to heighten awareness of the observing self and to change

patterns of perception and thinking. In other words, meditation is like a raft, which allows

one to traverse the waters of mind. (Epstein, 2004)

Daniel Brown and Jack Engler studied experienced meditators and surprisingly

discovered that they were just as anxious as everyone else. (Brendand, 2008) The

implications of these findings were quite profound as they reveal that meditation, on its

own does not necessarily help solve emotional problems. Meditation is effective at

establishing a framework within which a person may become more accepting and less

defensive, but without a conscientious and experienced therapists intervention, there is a

danger of stifling progress. Thus, meditation should not be a replacement for traditional

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therapy. Traditional therapy can be quite helpful in many areas where meditation cannot.

Areas such as relationships, communication skills, intimacy and early wounds are more

effectively remedied with Western therapy. But others go even further and suggest that

the goal of meditation, which is to realize that the self or ego is illusory, is absolutely

irreconcilable with the therapeutic goal of facilitating development of a functioning ego.

This argument is not popular and is quick to dismiss the serious potential of integration,

but it does bring about a general misunderstanding as to the implementation of meditation

into psychotherapy.

It has been cautioned that before combining therapy and meditation, the

developmental levels of patients must be carefully considered. (Corton, 1985) Meditation

can be used as a powerful tool for healing, but if used inappropriately, can cause a lot of

harm and confusion in a patient who is not prepared or mature enough to apply the

teachings effectively. Utilizing the meditative teachings effectively may require a

sequential approach, in which traditional psychotherapy precedes meditation. This may

be more beneficial than a blended approach because it respects the developmental tasks

of the patient in therapy. Before meditation should take place, self-identification, ego

development and an increase in self-esteem are all necessary. In the words of John

Engler, “you have to be somebody before you can be nobody.”

It has been made clear that there are numerous differences and conflicting

perspectives between Buddhism and traditional Psychotherapy. However, there are many

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commonalities between the two, which further establishes the possibility of integration.

The following is a list of components common to both psychotherapy and meditation:

Telling the truth; releasing negative emotions; the need for effort and

consistency; authenticity and trust-avoiding self-deception; integrity and

wholeness-accepting all one's experiences and allowing things to be as they

are, rather than living in a world of illusion and denial; insight and

forgiveness directed toward oneself and others; opening the heart and

developing the capacity to give and receive love; awareness and

nonjudgmental attention; liberation from limiting self-concepts, from fear

and delusion, and from the past and early conditioning. (Vaughan, 1989)

These commonalities as well as the results yielded from research on mindfulness

meditation, has prompted the integration of mindfulness practices into clinical therapeutic

settings. These relatively new clinical fields, namely, “Mindfulness Based Cognitive

Therapy,” (MBCT) and “Dialectical Behavioral Therapy,” (DBT) utilize Buddhist

mindfulness techniques outside of the Buddhist framework. Mindfulness techniques are

used to help the individual recognize that thoughts are “just thoughts” and help patients

make the distinction between self, thought and event. MBCT has been found to be highly

effective in reducing depressive relapse in patients with three previous episodes from

78% to 36%. (Brendand, 2008) The goal of MBCT is freedom from the tendency to get

drawn into automatic reactions to thoughts, feelings, and events, by teaching patients how

to pay attention to thoughts without judgment. By doing so, patients learn that clinging to

feelings and thoughts, is mentally detrimental. Furthermore, the application of

mindfulness is not only used during therapy, but is encouraged to be utilized at all times.

Similarly, DBT combines standard cognitive behavioral techniques with mindfulness

awareness, distress tolerance, and acceptance, which are also largely derived from

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Buddhist meditative practice. DBT is effective in treating patients with borderline

personality disorders and suicidal tendencies. However, the effectiveness of such

treatments often depends on the quality of the relationship between the patient and the

therapist. Regardless, these more integrated clinical therapies are paving the way for

future Buddhist psychotherapies by clearly demonstrating their efficacies.

The Buddha once said that “in the sky, there is no distinction of east and west;

people create distinctions out of their own minds and then believe them to be true.” For

too long, Western science and traditional Western psychotherapy has largely ignored the

potential of studying and incorporating esoteric perspectives on the nature of self and

reality. Today however, in a highly global community, the boundaries between east and

west are finally being blurred. The successful marriage between Buddhism and traditional

psychotherapy is imperative, and is fortunately now underway. If all goes accordingly, it

will be remarkably beneficial and rewarding for both fields. There is however, an urgent

need to develop evidence for utilizing Buddhist techniques in a therapeutic context. In

doing so, the effectiveness of these techniques can be gauged and the techniques may be

applied appropriately. The door has been opened and now it is time to begin the

exploration and mapping of this new and promising territory.

Bibliography

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New York1993: Pantheon Books.

Bodhi B. A comprehensive manual of Abhidhamma: The philosophical psychology of

Buddhism. Seattle: BPS Pariyatti, 1999.

Carpenter, J.T. "Meditation, Esoteric Traditions-Contributions to Psychotherapy."

American Journal of Psychotherapy (1977): 394-404.

Christopher, Michael S. "Albert Ellis and the Buddha: rational Soul Mates? A

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Corton G. "Can East and West meet in Psychoanalysis?" American Journal of

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