Therapy and meditation
by Mark Epstein
Vol. 31 No. 3 May/Jun.1998
Copyright by Psychology Today
A Path To Wholeness A Buddhist psychiatrist who has been meditating for
decades elegantly describes how psychotherapy and meditation can help us
manage our most powerful emotions--and make us feel more alive and whole in
"Stop trying to understand what you are feeling and just feel," my first
meditation instructor told me. This instruction seemed insanely simple: the
ability to just feel should come as naturally as the ability to breathe.
Yet, in twenty-five years as a psychotherapist and practicing Buddhist, I
have found that most of us have not learned how to be with our feelings
without rushing to analyze them, change them, or escape them.
If we really want to live a full life, both the ancient tradition of
Buddhism and the modern one of psychotherapy tell us that we must recover
the capacity to feel. Avoiding emotions will only wall us off from our true
selves--in fact, there can be no wholeness without an integration of
feelings. Both traditions have discovered that the way to plumb the full
depths of our emotional being is by letting ourselves go, by surrendering
to who we really are. And both traditions understand that we need a state
of reverie in order to know our emotions. Whether that reverie comes
through meditation or the quiet holding space of therapy, it is always
Buddhism has always made the self's ability to relax its boundaries the
centerpiece of its teachings. It recognizes that the central issues of our
lives, from falling in love to facing death, require an ability to
surrender that often eludes us. Psychotherapy, through its analysis of
childhood, has tended to turn us in a reflective direction' searching for
the causes of unhappiness in an attempt to break free from the traumas of
the past. Too often, though, it degenerates into finding someone to blame
for our suffering. But within psychotherapy lies the potential for an
approach that is compatible with Buddhist understanding, one in which the
therapist, like the Zen master, can aid in making space in the mind.
Many of us come to therapy feeling that we are having trouble I letting
ourselves go: we are blocked creatively or emotionally, we have trouble
falling asleep or enjoying sex, or we suffer from feelings 5 of isolation
or alienation. Often, we are afraid of falling apart, but the problem is
actually that we have not learned how to give up control of ourselves.
People come to me most often because they are unhappy with how they feel,
not because they are not separate or individuated enough. The traditional
view of therapy as building up the ego simply does not do justice to what
people's needs actually are.
In my work as a therapist, I have adapted Buddhist teachings to meet the
needs of my patients, many of whom have neither the time nor the
inclination to pursue formal meditation practice. I have found that
therapy, through a reciprocal exchange of feelings, can also enable us to
let go of the defenses that block us. While the method may differ from
formal meditation, the intent is the same: to recover a capacity for
feelings that we are all afraid of.
Cross-Legged on a Cushion
Meditation seeks to create an inner holding environment for the raw
material of emotional experience through non-judgmental awareness. In this
way, meditation acts like a stealth bomber, sneaking through all the
defenses and illuminating the central fortress of the heart. When I was
first instructed in what is known as "mindfulness meditation," I was taught
to simply note whatever I was feeling, pleasant, unpleasant, or neutral. My
observing mind functioned almost as another person, watching the flow of
sensation with relative ease. This created a very different relationship
with my internal world from the one I was used to. My chronic tendency was
to shrink from the unpleasant and reach for the pleasant. Mindfulness
meditation encouraged a dispassionate acceptance of both.
Since feeling states are experienced primarily in the body, the ability to
maintain a continuous state of physical awareness gives an enormous boost
to the capacity to bear feelings. This is fortunate, because one of the
most common occurrences in beginning meditation involves the
re-experiencing of terrifying feelings. Even in meditation, these feelings
can still seem intolerable, but the entire thrust of meditation practice is
designed to increase their tolerability.
Because mindfulness of feelings involves the careful attention to the flow
of pleasant and unpleasant sensations in the body, there is none of the
usual picking and choosing that otherwise colors our experience.
Cross-Legged on the Couch
Opening your attention to your body, feelings, and mind does not have to be
restricted to the meditation cushion. It's a process you can attempt with
all aspects of your life, and certainly one you can pursue with a
therapist. One teacher of mine told me that to achieve a dispassionate
state, he would pretend he was dying and that I there was nothing to be
done. "Rather than judging something," he told me, "take no position. Stop
leaning into circumstances I and rest in your own awareness." Buddhism
teaches us again and again that uncovering and experiencing difficult
feelings does not make them go away, but does enable us to practice
tolerance and understanding with the entirety of our being.
The same tolerance can be practiced in therapy. I remember being asked in
my first session with a therapist if I was aware that I was sitting on the
edge of my seat. I was not aware of it. I was sitting the way I always sat
when talking with someone. "What's wrong with the way I'm sitting?" I
wanted to ask. My therapist waited, as if to give me time to get over my
sudden self-consciousness and notice how I was sitting. He was right. I was
perched like a bird on the edge of my chair and was very uncomfortable
there. "You give yourself no support," he said softly.
I spent the rest of the session feeling what it was like to sit back in my
chair, making use of my whole body. Already, I was forging a connection
with the physical environment that I had been denying myself. My body was
the unconscious I was so interested in plumbing. For all my meditation
training, I still needed the help of a therapist to show me where I was
My therapist, just like the Buddha, began with mindfulness of the body. My
therapist could just as easily have been a Zen master in the manner in
which he related to me. His teaching drove home the lesson of my years of
practicing meditation in a particularly vivid and helpful way.
This therapist did not present himself as an authority figure who analyzed
my psychic configurations. He did not interpret my Oedipal dilemma. He was
not remote and silent. He was very available, quite humorous and playful,
and paid particular attention to what prevented me from being part of the
relationship with him. My therapist was asking something of me that was an
improvisation. He was asking for meditation in action, not for a mere
witnessing of psychic debris.
Tolerating our Tempests
If we stop backing away from our unpleasant feelings, we are able to see
how they color our experience and how scared we I are by them. And we can
learn to sit with these difficult feelings, I no matter how terrifying they
When Betsy, a patient of mine, was learning meditation, she discovered an
anxiety in her chest that seemed to run through her like a hollow core. At
first, she was deeply afraid of that place. But with some attention, she
learned to rest her attention in the hollow core, and saw that it was a
rich source of mysterious feeling, sometimes sad and lonely, but at other
times filled with the energy and inquisitiveness of a child. The hollow
space became an enriching space as well as a scary one, filled with
unanticipated qualities that expanded her sense of her own reality.
It is my experience that emotions, no matter how powerful, are not
overwhelming if given room to breathe. Western therapy can learn to make
use of the Buddhist emphasis on acceptance of feelings rather than talking
and analyzing. The therapist and patient can create a situation in which
these unacknowledged emotions are finally given breathing space.
Love and Death and Zen
The major obstacle to love, I have found, is a premature walling off of the
personality that results in a falseness or inauthenticity. When someone is
so uncomfortable with his own sense of emptiness that he struggles to keep
it at bay, he won't be able to be open with another person. He will simply
be too ashamed to reveal himself in any real manner. In this case, therapy
is effective when it allows a person to discover their own capacity for
All of our intimate relationships have intense emotional exchanges that
test our ability to know and bear feelings. When I first fell in love, in
my adult years, I traveled with my future wife to a rocky point on the
coast of Maine that had always been special to me. Embracing her with the
surf pounding, we were both filled with a sense not just of love, but of
death, as if we were holding on tightly to each other while our lives
passed before us. These feelings seemed linked with an implicit sense of
the preciousness of our love. In our hug on the beach, we were breathing
each other's emotions, making them make sense in a way we could only do
with each other's help. Lovers often inject breath into each other's
emotions, as parents do in a different way with their children, making
those very feelings more tolerable by virtue of their being held and known.
During orgasm, at the moment of death, while one is falling asleep or
ending a dream, the underlying luminosity of the mind shines through. In
Buddhism, this luminous mind is compared to a clear blue sky. But we have a
powerful resistance to experiencing the mind in all of its brilliance. We
are afraid to truly surrender to it.
THE FRUITS OF SURRENDER
Like meditation, psychotherapy can seem like a long walk that suddenly
opens up into an extraordinary vision of something that has always been
available but has been unrecognized. A long-time patient of mine, Greta,
came to see me every week as she navigated work and family, successfully
raising three children alone while working at a full-name job. She wanted
therapy because she felt lonely and was vaguely aware of how judgmental she
was toward most people. When disappointed or hurt by someone, Greta's
tendency was to write them off forever.
Over the years, we developed a very strong connection. My work with Greta
felt like untangling my daughter's knotted hair or like untying a fine gold
chain. 1 would get one little strand free, open up a little space, and then
start working on the next piece. One evening, after having been at my
office that afternoon, she was struck by a huge wave of love for me that
made her feel very peaceful. That evening she dreamed of herself with her
father when she was three or four years old and felt with great conviction
the unconflicted love she had for him at that time. In a second dream, she
heard herself yelling at him, "Can't you shut up? You're talking at me all
She remembered how relentlessly he had pursued her as she grew up, how
needy he was. He would become irate whenever she disappointed him and she
finally had to close herself off from him in order to find some peace. "The
defense is what hurt," she told me.
Greta's breakthrough reminds me of an old Zen story about an aged Chinese
monk who asks permission to seek enlightenment in an isolated cave. Taking
his robes, his begging bowl, and a few possessions, he heads out on foot
into the mountains. On his way he sees an old man carrying a huge bundle.
This man is actually the bodhisattva Manjushri, who appears to people at
the moment they are ready for enlightenment.
"I am going to the furthest mountains," the monk tells Manjushri, "to find
a cave. I will stay there and meditate until I die or realize awakening."
Manjushri then drops his bundle onto the ground, and instantly the monk is
enlightened. He, too, has put down his whole defensive self, the entire
But he's still a bit confused."Now what?" he asks Manjushri. And the
bodhisattva, smiling, silently reaches down, picks up his bundle and
continues down the path.
Putting down our burdens does not mean forsaking the conventional world. It
means being in that world with the consciousness of one who is not deceived
by appearances. Once Greta, for instance, had recovered her love for her
father, she could continue to fend him off with forgiveness instead of
rancor. She still needed her defenses, but she was not imprisoned by them.
And as the newly enlightened monk realized when he saw Manjushri pick up
his bundle and head back to town, everything had changed but nothing was
From the book Going to Pieces without Falling Apart by Mark Epstein, M.D.
Copyright [C] 1998 by Mark Epstein. Published by arrangement with Broadway
Books, a division of Bantam Doubleday Dell Publishing Group, Inc., New
York, New York. All rights reserved.
PHOTOS (COLOR): A Buddhist psychiatrist who has been meditating for decades
By Mark Epstein, M.D.