DT-The Zen of Therapy-Epstein

This dharma talk draws on Mark Epstein’s book, The Zen of Therapy: Uncovering a Hidden Kindness in Life. Although he focuses on therapeutic relationships, his insights are relevant for human relationships in general. As a psychotherapist, Epstein applies lessons from decades of attending meditation retreats to his interactions with patients.

Remembering that the Buddha’s kind and noninterfering attention had a transformative effect on the people around him, Epstein does his best to relate to the innate goodness of every person who comes for therapy. Instead of labeling and pathologizing patients, he asks himself Ram Dass’s crucial question, “Do you see them as already free?”

Epstein sees each patient like a Zen koan or riddle, which has no rational answer, and which inspires contemplation that leads to understanding beyond conceptual thought. When he is engaged in psychotherapy, he is very quiet inside, concentrating benign attention on the person in front of him. Within the safe container of a trustworthy therapeutic relationship, patients can release self-preoccupation and open to explore new dimensions of themselves.

Epstein’s belief in the healing power of awareness allows patients to notice when the ego or superego is not serving their highest purpose. In the light of kind attention, they begin to let go of perfectionism and harsh self-judgment.

On his quest for liberation, the aspiring Buddha decided to stop severe ascetic practices when he had a childhood memory of experiencing wholesome sensory pleasure beneath a rose-apple tree. At the point of starving himself by eating only one grain of rice per day, he accepted a woman’s gift of nourishing milk. He learned that treating himself with kindness was fundamental to transmitting kind attention to all beings. It was only when his body was as strong, healthy, and well-tended as his mind that he attained enlightenment and Buddhahood.

Epstein has the Buddha’s transformation in mind when he describes the attitude underlying the Zen of therapy: “There is more to a person than who they think they are. Sometimes therapy has to act like the unmoving shadow of the rose-apple tree, creating circumstances conducive for unlearning, creativity, and joy.”

Back in 1971, Dr. Donald Winnicott wrote about developing a similar Zen-like therapeutic technique:

It is only in recent years that I have become able to wait and wait… and to avoid breaking up the natural process by making interpretations…. It appals me to think how much deep change I have prevented or delayed… by my personal need to interpret. If only we can wait, the patient arrives at understanding creatively and with immense joy, and I now enjoy this joy more than I used to enjoy the sense of having been clever. I think I interpret mainly to let the patient know the limits of my understanding. The principle is that it is the patient and only the patient who has the answers.

 This patient-centered principle reminds me of what the psychiatrist Stan Grof calls the “inner healer,” the wise part of each person that can be tapped in the process of healing past traumas. Yet, as much as Epstein respects his patients’ capacity for self-healing, he applies to therapy the Buddhist teaching that clinging to fixed views causes suffering. He often questions rigid assumptions and explanations that people have created for themselves.

In his words, “Things that feel fixed, set, permanent, like one’s self-righteous anger, are never as real as they seem. Problems are not hard and fast, selves are not static and motionless, even memory is nothing we can be certain about. The Zen of therapy wants to get things moving again. It wants to open things up, make people less sure of themselves, and in the process release some of the energy that has become stuck in the mud.” Just like with Zen koan practice, irrational breakthroughs can transcend rational explanations and wake us up to inner capacities that we have not recognized beforehand.

A case study from Epstein’s book describes a patient named Jean, a nurse who had been caught writing forbidden prescriptions for opioids. In therapy, she raged at herself for making serious mistakes in judgment and at medical authorities for punishing her with three years of probation. Epstein sensed that if he focused on her derailed career and her broken dreams, he would be pulled into her suffering. Instead, he relied on a koan to point to unforeseen potential in her situation:

One day, Yanguan called to his assistant, “Bring me the rhinoceros fan.” The assistant said, “It is broken.” Yanguan said, “In that case, bring me the rhinoceros.” As the assistant faced the impossibility of this task, his thoughts stopped, and his mind opened beyond doubt and confusion into vast spaciousness. Likewise, when Jean dropped the anger that was paralyzing her, she could surrender to not knowing what was coming next in her life. With expanded vision, she could see beyond her brokenness to glimpse unexpected possibilities for happiness.

Zen teacher John Tarrant explains, “If you have a reason for happiness, then that happiness can be taken away. The person you love could leave, [and] the job could stop being interesting. If you have a reason for loving life, what happens when that reason fails? With koans you may find that life and love are so strong and vivid that they can’t be explained or justified. Koans open a happiness that comes for no good reason. That happiness exists before reasons have appeared in the universe.”

Both Buddhist practice and psychotherapy encourage moving from grievance to gratitude. We learn that we do not have to be defined by our personal histories, even if they entail abuse or neglect. We can find ways to reconcile with aging parents who were unprepared for the sacrifice, discipline and demands of having children. In the spirit of Ram Dass’s statement, “We are all walking each other home,” we are moved to forgive and to appreciate those who, in Epstein’s words, “did or did not care for us before we had any idea of who or what we are.”

The Dalai Lama teaches the foundational Tibetan Buddhist practice of “mother recognition,” imagining all beings as one’s mother:

in order to have a sense of closeness and dearness for others, you must first train in a sense of their kindness through using as a model a person in this lifetime who was very kind to yourself and then extending this sense of gratitude to all beings. Since, in general, in this life your mother was the closest and offered the most help, the process of meditation begins with recognizing all other sentient beings as like your mother.

According to the Dalai Lama’s belief in reincarnation, amidst countless deaths and rebirths, all beings must have had an incarnation as our mother and therefore deserve our gratitude. Even people who have a problematic relationship with their mother and who are skeptical about reincarnation can benefit from some version of this practice.

Epstein relates mother recognition to mindfulness practice, “holding the mind the way a mother holds her baby: attentively, carefully, and lovingly, while not exaggerating or indulging her baby’s distress.” In his view, when we see all beings as our mother, we are reminded of our own capacity to behold ourselves the way a new parent regards her treasured infant child. He says, “Our minds are like children, and mindfulness, like a good therapist or a good-enough parent, ‘holds’ them so that they can come to their senses.”

When our minds come to their senses, we recognize that all people are interrelated. There is a story about 17th century Zen Master Bankei listening to a woman’s long list of complaints about her daughter-in-law. When she finished, he commented, “Long ago, you yourself were a daughter-in-law. Don’t think of her as someone apart from you. Hers is the path you once walked. Her life is an extension of yours into the past.” His words satisfied the woman, and she stopped complaining.

Soon afterward the daughter-in-law came to Zen Master Bankei to complain about her mother-in-law. He listened patiently and then observed, “Someday you yourself will be a mother-in-law. Don’t think of her as someone apart from you. Hers is a path you will take one day. Her life is an extension of yours into the future.” His words calmed the daughter-in-law, and her complaints ceased.

The Zen of therapy aims to loosen people’s identification with what Epstein calls their “known self,” so that they see their self-concepts as merely concepts that have arisen in response to particular conditions and challenges but that have no ultimate reality. It’s possible to let go of preconceptions about ourselves and to make peace with our personal histories without being defined by them. Both meditation and psychotherapy develop our courage and trust to face obstacles that lie within and those imposed from without. Gradually, as we learn to treat ourselves and others with kindness, we soften and move towards inner peace.

Mindfulness practice helps with this loosening process. Once awareness strengthens and the observing mind becomes stronger than whatever it is observing, we can simply “be.” Epstein describes the meditative process of one part of the mind observing another like “me” watching “myself.”

At any moment, the sense of self can fall away and what’s left is spaciousness and liberation—a Zen state of “thusness” or “suchness.” As he says, “When we realize how readily we have misconstrued ourselves, when we stop clinging to our falsely conceived [ideas] of how limited, isolated, and alone we are, when we touch the ground of being, we come home.”