Therapy and meditation

by Mark Epstein

Psychology Today

Vol. 31 No. 3 May/Jun.1998

Pp.46-53

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 the process. "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 necessary. 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 holding back. 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 are. 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 connection. 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 the time." 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 burden. 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 altered. 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. -------------------