This forum on psychotherapy and meditation presents the theories and opinions of a distinguished group of dharma teachers, psychologists and East-West synthesizers, all of whom are associated with the vipassana sangha. Each participant was sent a list of questions. We then selected and edited their answers with an eye toward trying to represent all points of view as well as individual styles and approaches. Interestingly, a number of participants sent us notes saying that it was difficult for them to answer our questions with precision, either because the boundaries between the disciplines are too vague, or because they had not arrived at any conclusions in their own thinking about these topics. So, these answers are explorations, part of the ongoing and increasingly exciting dialogue between East and West about the issues of mental health, consciousness, liberation and the many methods of their realization.
Ram Dass: Western psychotherapy has focused on effective ego functioning. It treats the psychological self as real and encourages identification with motives, emotions and cognitive content.
Eastern spiritual disciplines consider the psychological self as a “relatively” real creation of mind and set as a goal of practice the breaking of identification of awareness with the components of the psychological self.
Western psychology reinforces one’s identification with one’s separations, while Eastern philosophy either reinforces one’s identification with the unity that lies behind all manifest form, or discourages identification with either unitive awareness or the diversity. Western psychotherapy rearranges the furniture in the room, Eastern techniques help you get out of the room.
A. Hameed Ali: The goals of Eastern spiritual disciplines are those of liberation and enlightenment. The goals of Western psychology change depending on how it is used, by whom, and for whom. Most psychotherapists view psychology as healing, as a way to alleviate mental pathology. That the goal of therapy is to alleviate suffering puts it in the same arena as the Eastern spiritual traditions — although its goals of alleviation rather than liberation make it more limited. However, both traditions are concerned with the study of the human mind and human nature. When this interest becomes central for an individual, both traditions can then be used in a complementary way.
The difference between the two approaches can be seen in the difference between active investigation and passive awareness. Psychological understanding is more actively curious and more actively oriented toward following a thread. On the other hand, vipassana meditation arrives at understanding by the passive awareness of whatever presents itself in the field of consciousness. Both lead to insight, but usually to different kinds of insight. Psychological understanding usually arrives at psychodynamic insights; it understands the present in terms of what happened in the past. Meditation arrives more at existential kinds of insights; it tends to see the nature of the mind’s functioning in the moment without reference to the past. Both are useful, and frequently there is an overlap.
Joseph Goldstein: There are different levels of freedom of mind, and both psychotherapy and meditation can be working toward some aspects of them. There is a level of freedom in our interactions with other people and with the world. To be free on this level a person needs a sense of integrity, confidence, love and connectedness, and an accepting spaciousness of being. Psychotherapy can foster these qualities through many different specific techniques. These qualities are also fostered by life-practices which are the foundation and context for vipassana, such as the nurturing of a generous spirit, an active commitment to morality, and the development of loving kindness and compassion to all beings. Vipassana also addresses this level as it works to purify the mind.
There is another level of freedom which is the complete eradication of greed, hatred and ignorance. These are the roots of all suffering in our lives, and so working on this level addresses the fundamental issues for each and every one of us. This level of freedom can be experienced by anyone through the development of harmonious conduct, strong concentration, and deep intuitive wisdom. These are the components of a genuine path to liberation. This level of liberation is the ultimate goal of vipassana: the progressive eradication of greed, hatred, and ignorance, and the opening to the unconditioned, nibbana.
Sharon Salzberg: Psychotherapy is especially effective with specific emotional and psychological patterns which hinder the quality of one’s life. These can include fear of commitment, inability to acknowledge one’s feelings, incomplete resolution of past traumas, and many of the difficulties of day-to-day relating. Psychotherapeutic techniques are also very appropriate in cases of severe psychological disorders.
Meditation has a more global application. It can reveal an underlying vision of the meaning of life, and provide a direct experience of the nature of reality. As we try to understand what it means to be alive as human beings experiencing birth and death, we need this vision. Because of its comprehensive sphere of inquiry, meditation can give a sustaining power of balance and wisdom with which to meet any life experience.
Roger Walsh: There is, I believe, a “principle of increasing subtlety” such that as people mature psychologically and spiritually and become healthier, their problems and issues become increasingly subtle and so do the most appropriate means of working with them. Thus appropriate treatment strategies might range on a continuum from physical (i.e., drugs for severe disturbances such as psychoses) to psychotherapy to spiritual disciplines (for spiritual and advanced psychotherapeutic work).
Psychotherapy is probably better for dealing with psychopathology, stress and crises, interpersonal skills, and development of specific skills for work in the world, e.g., planning, assertiveness.
Meditation is probably better for spiritual and some advanced psychological work, deep insight into the nature and workings of mind, and the cultivation of specific mental skills, e.g., concentration.
A. Hameed Ali: Good psychotherapy can do many things that meditation is not designed to do. It can address the various neuroses more directly and in ways that are accessible to the neurotic individual. Spiritual practices tend to dissolve ego structures and this is contraindicated for borderline and narcissistic personalities. In other words, psychotherapy is more geared toward bringing the individual to a relatively healthy ego functioning. It is unfortunate that many individuals who need such help go toward spiritual practice with its experiences of dissolution of ego when they need psychotherapy instead in order to strengthen the ego. This can lead to greater suffering, a situation that is becoming increasingly clear.
Meditation practice, on the other hand, is a much more effective means toward seeing the emptiness and meaninglessness of the life of ego in general, especially when the ego is normal and relatively healthy. Meditation practice is far more capable of shifting the values of the individual away from enmeshment in the world and toward the spiritual values of truth, love, compassion and true nature; in this way, meditation is more capable of showing how the function of ego in general tends to produce suffering.
But I believe that the greatest value of meditation is the learning of the capacity to abide in true nature, the Buddha nature, when it is recognized. This is learning to stay in the condition of true spiritual nature. Psychology is not oriented toward this end.
Ram Dass: Good psychotherapy can help one to examine and modify the content of mind, while good meditation practice can help one become mindful of the mechanics of mind.
Daniel Goleman: As they say, there’s a tool for every job. Psychotherapy was designed specifically to deal with neurotic quirks of mind; meditation was designed to liberate. These are not identical tasks: Mentally healthy people are still “deranged” from the Buddha’s point of view, clinging to attachments and samsara. And people well along the path to liberation can still seem quite quirky at the personality level. Whether enlightenment is good for your mental health is still an open question, though the smart money says it is. All depends on what you mean by “enlightened.”
Robert Hall: I think there is a tendency to consider psychology as somehow a lesser discipline than meditation. This tendency is, I believe, based on a superficial understanding of psychology and psychotherapy that I find among a great number of the meditation community. It is not surprising when we consider the general level of psychological development among us.
Over the years, I have noticed that regular meditation practice, alone, has really failed to provide resolution in a number of crucial developmental areas for a large number of us on the spiritual path. I see many serious meditation students struggling very hard with their own sexuality as it relates to power and intimacy issues in relationships. In fact, we have recently seen great upheaval in several meditation communities caused by the confusion in this area coming from spiritual leaders whose meditation practices have failed to remove obstacles to their understandings.
Many people in our own community continue to struggle with an inability to sustain long-term intimate relationships. I frequently speak with people who have been practicing for years and are paralyzed in fear of strong emotion such as anger or grief. Problems with fear of abandonment, betrayal, exposure and loss of autonomy are issues that are common in even the most casual relationships among us. Many people are struggling with the inability to find satisfactory work. There is a lot of just plain loneliness, because of reluctance to trust in the goodwill of others.
As necessary as meditation is to our spiritual work, I don’t think that it can provide solutions to all our human problems, nor was it meant to do so. (The Buddha is reported to have emphasized the importance of sangha.) Psychotherapy, on the other hand, because it is done in the context of relationship, is uniquely suited as a method for clarifying many of our emotional issues that arose originally out of the vicissitudes of important relationships. Learning about our refusal to love and to even acknowledge relationships is best done in the context of a loving relationship. It is a psychological work, and yet a work that is crucial to anyone who is learning surrender to the phenomena of the body/mind.
Michele McDonald: Vipassana has been the foundation for me in living a harmonious life. The practice has made possible the healing I have done within a long-term intimate relationship and therapy. What distinguishes Buddhism is anatta—developing the understanding that there is no solid “I” behind the process of living. We don’t develop an “I” and then dissolve it; mindfulness is truly seeing that there never was, isn’t, and never will be any “I.” There are deeper and deeper levels of understanding this. There is a level on which we see how suffering occurs from moment to moment when we identify with pleasant or unpleasant feelings. When we condemn unpleasant feelings or hold onto pleasant ones, we are out of harmony with the flow of feelings within the stream of life.
What has been important for me is to learn how to apply the teachings of vipassana practice—this understanding of anatta along with a nonjudgmental awareness of each moment—to emotions. We need to find the balance between repression and indulgence—to let fear, anger, grief, hopelessness, terror, rage, come and go without identification, without drowning in them or condemning them into oblivion.
For me, therapy has been complementary to the vipassana practice. Good therapy can nurture an understanding which can melt the walls that prevent one from being intimate and committed in relationships. Therapy can help deepen courage for trust and vulnerability, care and honesty between oneself and another. I discovered at a certain point in my practice some fully repressed memories of abuse from my childhood. When the emotions associated with those memories first began to surface, it was very difficult to experience them without drowning. And I found that the closer I became in my love relationship, the more these emotions came up. The more I could trust, the more loving the connection became between me and my partner, the safer it was for these painful emotions to surface. I found it helpful to work with a therapist so I could learn how to navigate this territory and have this opening and healing process go along at a level that was workable.
Because of my vipassana practice I found it was possible in therapy to be mindful of emotions—even terror and rage—to let them surface without identifying with them. Without the understanding that there is no solid “I” behind the process, I wouldn’t have had the strength to let the emotions come and go. I found that when I experienced difficult emotions mindfully—lit them with understanding and acceptance—they transformed very naturally into a profound compassion and forgiveness for all beings. The teachings of vipassana, acceptance and lack of fear on the part of my therapist, as well as understanding and support from my partner, were all essential to this healing process.
Frances Vaughan: I have found that meditation practice has made me a better therapist. I recommend it as part of training for therapists, particularly insofar as it contributes to attentional training, awareness and clarity of perception. I also find meditation useful for people who are in therapy because it often brings up issues that need attention. Repressed emotional material often surfaces in beginning practice. I think they are complementary forms of self-discovery.
Joseph Goldstein: Yes, it can be helpful for some people to do psychological work before meditation practice. This can create a ground of self-acceptance and psychological strength which facilitates a deeper exploration of the mind. Therapy can also be helpful for some people after meditation to deal with unresolved issues or conflicts which need the support of a therapeutic relationship.
Ram Dass: I am inclined to lead with vipassana practice and utilize its power for liberation or transformation first. However, I see: (1) the way the very intent to do spiritual practices is rooted in psychodynamics, and (2) how we socialize or learn to use a spiritual practice in a way that does not threaten the fabric of ego. So, at times, I find it useful to invite someone (a therapist) to mirror for me the subtle psychodynamics that are distorting the spiritual practices themselves.
Robert Hall: Meditation has been crucial for me in my ongoing effort to learn the use of bare attention in order to see more clearly, to know more of what is actually happening in the body/mind. The ideal of mind-body harmony, stillness of mind, has been given some credibility through regular practice. There have even been hints of the actual possibility of unconditional awareness without the need for directed attention. Certainly, I have learned something of the reality of suffering and the possibility of release from suffering. The deepest experiences of compassion have, for me, come as the direct result of regular sitting practice. These are considerations that are important for virtually anyone who wishes to do service for people. It’s hard for me to imagine working intensely with people without regular sitting practice, since it develops the very qualities that make one an effective helper.
And yet, I find for myself and for many other meditators that the translation of the meditation experience into everyday life and ordinary relationships with others is very difficult. I believe this failure in translation is exactly what we are witnessing in the spiritual community. Projection and transference issues still are largely untouched by longtime practice. Confusion in interpersonal communication and fear of open-hearted surrender to strong feeling is still a persistent occurrence for many of us. This work of translation is precisely where good psychotherapy and psychological understanding can be of greatest benefit, because it helps us discover the natural ease that comes with conscious relationship to everything that exists. Psychology really helps us discover, in action, the boundaries that separate us from what we usually consider to be other. It can help us see that these boundaries are only necessary as creations for the protection of the self.
Much of the fear that still exists in our interactions with each other could be alleviated by a willingness to consider meditation and psychology in partnership. In my work with people, I’ve found that there are those who are just simply unable to practice meditation because of the turmoil and immediacy of fears that are deeply rooted in heavily conditioned belief systems. I don’t even try to introduce those people to meditation practice until there has been some confrontation with those fears in the context of the therapeutic relationship. Often meditation becomes an important part of their lives when things have cooled down a bit. It’s easier to face the truth if you have had some sense of the well-being that comes from another’s unconditional positive regard. Psychotherapy can provide that in the midst of great emotional turmoil. A warm human smile and compassionate touch can be much more conducive to concentration and relaxation than counting the breath at such moments.
A. Hameed Ali: I do not do psychotherapy in my work, but I do use psychological knowledge and technique to investigate the psyche and the nature of reality. This can have a psychotherapeutic effect, but it is not the focus of my work; my work is more oriented toward spiritual liberation. What I have seen with hundreds of students is that when psychological investigation is oriented toward finding out the truth of personal experience instead of focusing on therapy, deep spiritual states tend to manifest. Psychological patterns turn out to be due mostly to ignorance of the presence of true nature at its various levels and this ignorance is intertwined with emotional difficulties arising from childhood experience. Also, for most individuals, it is much easier to deal with spiritual ignorance after the emotional patterns are seen and understood; these emotional conflicts occupy the mind so tenaciously that it usually refuses to look in any genuine way at spiritual truths.
In my work with others I have been able to use psychological understanding all the way to the stage of stream-enterer. Some students actually have had this experience while doing psychological analytic work of a certain kind. Students use meditation practice to complement the psychological work, but this is mostly oriented toward the stabilization of consciousness in whatever state of pure being that is present. Here the student develops and strengthens the spiritual capacities needed for the experience of and the absorption into true nature.
Roger Walsh: I have faith in human ingenuity to use anything as a defense, including meditation. Meditation can be used defensively to withdraw from relationships and the challenges of daily living and as a means of self-aggrandizement.
There is significant clinical data to suggest that in some people meditation can induce or exacerbate psychological problems, though usually only temporarily. The range of these problems includes anxiety, depersonalization, confusion and lowered self-esteem, and depression secondary to a sense of doing badly in the practice. The most severe reactions are temporary psychoses which are most common in people with a prior history of such disorders doing intensive practice. They tend to clear rapidly when meditation is reduced and medications are taken.
The extent to which meditation can heal psychological problems is one of the research questions of our time. Actually the real question is what specific types of meditation can heal which specific psychological problems to what degree in which people. In other words, the psychological effects of meditation are likely to depend on many factors including the type of and duration of meditation and the individual practicing it. More generally, the big question is which aspects of personality and being does meditation affect and which does it not. One of the interesting findings of Dan Brown and Jack Engler’s Rorschach studies of meditators was that even those who had reached stream entry still had detectable psychological conflicts although these did seem to be somewhat encapsulated and did not seem to be particularly disruptive. Only at the penultimate non-return stage were psychological conflicts not found.
Sharon Salzberg: With respect to meditation practice contributing to specific psychological problems, a distinction should be made between intensive meditation practice and daily practice. Intensive practice, because it is done in an atmosphere of silence and aloneness, can sometimes magnify painful psychological conflicts. Unless there is sufficient balance of mind to work with the intensity of this pain, it would be better to be in a less austere environment. People often find, however, that a regular daily practice is a stabilizing factor even when experiencing deeply rooted psychological problems.
Meditation practice works with psychological problems in a variety of ways. It fosters a spaciousness of mind and openness of heart within which these problems don’t loom so large and are not so oppressive. Meditation can also help uncover the actual roots of our suffering which are more fundamental and universal than an individual or personal history.
Daniel Goleman: Meditation can be a marvelous place to hide from emotional storms. I remember hiding in a good meditation every morning from the fact that my first marriage was disintegrating. A daily practice that is strong on the one-pointedness side can leave you feeling moderately blissed, and insulate you from the palpable pain of difficulties like a troubled relationship.
On the other hand, meditation can also tune you into the signals of trouble, and so make you better able to deal with it—it depends largely on how you choose to use practice: to hide or to open more fully to truth.
Beyond that, meditation is a specific remedy for a large class of psychological troubles where anxiety or depression is the main symptom. I suspect it operates on a biochemical level, but there’s no data on that yet.
Frances Vaughan: The biggest problem I have seen with meditators who are not psychologically sophisticated is the assumption that sitting will heal psychological problems. Western psychology has developed some very effective tools for working with psychological issues. Trying to use meditation as a substitute for psychotherapy can lead to suppression and exacerbation of psychological difficulties in certain cases. It can reinforce neurotic coping styles (e.g., suppressing anger rather than learning to communicate effectively) and it can also contribute to excessive withdrawal in individuals who have difficulty coping with the world. It can be an avoidance of personal growth. On the other hand, with appropriate guidance meditation can contribute to psychological healing by turning attention to inner experience and training awareness.
Ram Dass: If one sees a person becoming a meditator instead of becoming free, one may entertain the diagnosis that the meditative practice is reinforcing certain psychodynamics. There is a deadening quality to such meditation practice.
Another way in which meditation can affect psychological functioning is by forcing to the surface deeper dynamics which then may result in acting-out behavior or serious psychopathology. This usually only happens when the will for practice is so inordinately strong that it overrides the defense mechanisms which prevent unwieldy psychological stuff from rising to the surface. And of course this very “will” is usually psychological in nature. I say “usually” because I certainly allow for the possibility that such will can arise from spiritual karma in which the psychology plays only an incidental role.
Meditation can, and often does, make psychological problems either irrelevant, or less compelling. By cultivating spacious awareness through meditation, one is often able to witness one’s own psychodynamics in a way that allows them to change—quite often for the better.
Sharon Salzberg: People might use the word “liberation” in many different ways. The Buddha used it to mean the end of craving, hatred and ignorance, the end of suffering, the realization of the unborn, undying state of nibbana. When asked questions about what leads to this liberation, the Buddha replied that any practice will lead there which includes all aspects of the Eightfold Noble Path, that is, the fulfillment of morality, concentration and wisdom. This is the guideline the Buddha offered. If we use this guideline we can each assess the range of any pursuit. Please consider for yourselves whether therapy encompasses the Eightfold Path or not, whether meditation encompasses it or not.
A. Hameed Ali: Neither therapy nor meditation leads to liberation. What leads to liberation is the existence of Buddha-nature. It is this ultimate reality and truth that liberates the mind when it reveals itself to it. Any practice is good if it helps toward such manifestation. But we must not forget the role of sincerity and objectivity, amongst other things, without which any practice is useless.
Meditation was devised as a means toward liberation, for it is part of a system that conceptualizes liberation and true nature. Therapy, on the other hand, has a different orientation, that of the amelioration of mental suffering; so it is not concerned with liberation. But if psychological understanding is oriented toward the investigation of truth, then it is possible for it to be used as a spiritual practice. We must remember that meditation practice is itself based on some kind of psychology, that of the Abhidhamma. And we must remember that meditation is only one kind of spiritual practice. Also, ultimately, what is spiritual understanding apart from psychological understanding? Both are understanding of the mind, and if either one of the two goes deep enough it will have to reach the ultimate truth—unless no such thing exists or there is more than one ultimate truth.
Ram Dass: Anything can be the condition for liberation. Techniques don’t liberate. Techniques provide sets and settings in which individuals, when they are ready, become liberated.
Joseph Goldstein: There is a Buddhist psychology called the Abhidhamma which is a comprehensive model of human nature. It describes in great detail all the different elements of mind and body, and how they relate and interact with one another. It is a very clean expression of how life unfolds, free of the idea of an unchanging self. What makes it distinctive is that it describes in psychological terms a map of spiritual development.
A. Hameed Ali: Buddhist psychology is mostly existential and phenomenological; it investigates mind as it happens in the present, from moment to moment. Hence it is suited to meditation practice, which is oriented toward awareness of the content of mind in the moment. Western psychology is predominantly psychodynamic; it investigates how the content of the mind at the moment is dictated by the specifics of what happened in the past. So it takes the time dimension into consideration much more than Buddhist psychology. Also, it focuses on the particulars of mental phenomena, the specifically personal emotional and mental patterns. On the other hand, Buddhist psychology focuses on the universal tendencies of the mind, universal to all minds, like desire, attachment and so on.
In my work I have developed a way of investigating mental phenomena that is both psychodynamic and universal. This method, which I call the Diamond Approach, discerns psychological constellations that have psychodynamic causes but are universal to all minds.
Ram Dass: I find in Buddhist psychology a far more subtle mapping of the functioning of the mind than I find in Western psychology. I find the trap in Western psychology is the root belief “cogito, ergo sum” (I think, therefore I am). It fails to acknowledge awareness independent of identification with thought.
The techniques of investigation of Buddhist and Western psychologies differ—which leads to the emergence of different systems. Western psychology, in its attempt to be an “objective science” applies the laws of the scientific method, narrowly defined—i.e., demanding public and reproducible data. This has spawned behaviorism which creates a system based on studying us from outside in. Buddhist psychology, on the other hand, uses introspective data derived through meditation and thus spawns a system based on studying us from inside out.
Frances Vaughan: Transpersonal psychology is definitely the field of Western psychology that is most relevant to spiritual practice. It offers a developmental model of psychological and spiritual development that supports the importance of both psychological health and spiritual practice. It also offers a spectrum model of consciousness that includes levels described in Buddhism. It emphasizes the importance of integrating physical, emotional, mental, existential and spiritual aspects of well-being for health and wholeness.
Ram Dass: What interests me very much is the new class of practitioners who are emerging—who have personally engaged in deep meditative practices and then train and function in the role of a therapist-guide. Because they are least likely to be entrapped by their role, they are least likely to entrap the client in the role of client, or any specific psychodynamic. Thus the therapy is an optimally spacious environment in which the client, when she or he is ready, can give up the root identification that causes suffering. So I recommend that everyone seek the Buddha as their therapist.
A. Hameed Ali: I believe that Western psychology has an important contribution to make to the situation of spiritual practice. This has recently begun to be recognized. This psychology is a specifically Western development, a modern outgrowth of the Western spiritual and philosophical tradition. I see in it the Western soul, trying to emerge anew, in new forms of experience and understanding, after it has been virtually buried. This tradition existed for thousands of years—in the Hellenistic tradition, the Platonic and Neoplatonic movements and the various prophetic religions. The spiritual investigation of the psyche or soul was its main concern. This was dampened for many reasons, and was almost eradicated by modern scientific thought. I see psychology as one of the potent ways this tradition is trying to emerge, in new forms but with a specifically Western flavor, where everyday life is not separate from spiritual realization.
This Western spirit is obviously aided by the migrating Eastern traditions, and reminded by them of its deeper true nature. This is already making Western psychology deepen beyond mere therapy, and toward the investigation of the greater expanses of the human mind.