SELF AND LIBERATION: The Jung/Buddhism Dialogue
Edited by Daniel Meckel and Robert L. Moore

Paulist Press: New York, 1992. 338 pp., $19.95 (paper).

Michele Martin

AFTER DECADES of exchange, many Buddhist practitioners and an increasing number of psychologists agree that the two traditions can benefit one another. The ongoing question remains: How? Answers to this depend on a clear knowledge of each other’s position. Within the lungian world, therapists such as lames Hillman and Clarissa Pinkola Estes are creatively questioning and reshaping their inheritance, which includes, however, Jung’s often idiosyncratic writings about the East. This new volume brings together material that allows for a more precise understanding and evaluation of Jung’s relation to what he understood Buddhism to be.

The first section contains Jung’s foreword to D. T. Suzuki’s Introduction to Zen Buddhism, an essay titled “The Psychology of Eastern Meditation,” and Jung’s two commentaries on the Bardo Thodrol (the Tibetan Book of the Dead). These texts are quite uneven in their presentation of Buddhism. Some of Jung’s misunderstandings about the Tibetan tradition can be laid at the feet of Evans-Wentz, whose translation is based on inadequate knowledge of Tibetan and more on Theosophy (i.e., concepts such as Universal Mind, soul, etc.) than Buddhism. Others, however, come from lung’s impetus to bring in support for his own system and yet maintain its autonomy vis-a-vis “the East,” which was for lung a shifting shape of Buddhist-Hindu blend. Jung’s failure to make clear distinctions leads him to distort the main issue—the status of the self—which is defined in radically different terms by these two traditions. Jung may be writing about Buddhism and non-ego, but his operating assumptions fall into a Hindu worldview that includes an ultimately existent self, however subtle it may be.

Jung’s definitions of the ego as I consciousness and the self as a I greater whole that includes the unconscious never get beyond a limited self, because there persists a continual basis for its regeneration—the collective unconscious. This statement would also hold true for other broad concepts, such as Adler’s communal feeling. These ideas are useful in that they extend ego’s awareness, but there remains an expanded group ego, which must also be relinquished. In Buddhism, if one holds on to the existence of any basis or foundation for the self, it will continue to regenerate and one will never be free of suffering. Suffering begins with the concept of self; from this comes the thought of other, and then like or dislike, and so on into the wheel of samsara. Liberation from suffering, for oneself and for others, is the basic goal of Buddhism, but Jung believed that happiness and suffering were necessary. He also held that a certain tension is inherent to the psyche and did not accept that suffering could be overcome. And indeed it cannot be if any clinging to the self, in whatever form, remains.

All these points come out quite clearly in the second section of the book, which makes available for the first time a transcript of the interview between Jung and Shin’ichi Hisamatsu, giving both of their commentaries on the event and two further discussions. Hisamatsu Sensei (1889-1980) was a lay Zen master, famous in Japan for the subtlety and breadth of his insight, his sensitivity to art, and his skill as a calligrapher and master of tea ceremony. His Zen and Fine Arts is a classic in its field. During his first intensive week of practice (sesshin), Hisamatsu Sensei broke through to a profound realization. His attainment was unusual not only for its swiftness, but also be cause he had to free himself from two quite different tendencies: in his youth, he was deeply devoted to Pure Land Buddhism, with its theistic tendencies, and later he became an ardent and skilled student of rational Western philosophy.

After his realization, Hisamatsu Sensei founded a society of study and practice that was open to everyone. The teaching emphasized the interdependence of all humankind and the necessity of engaging in the world to help others. For his students, he created a fundamental koan that encompassed all others: “When you can do nothing, what can you do?” In 1956, Hisamatsu Sensei composed a poem that expressed the essence of his insight:

The Absolutely Negative Solitude:
Everything reliable having
been exhausted,

There is no place between
heaven and earth

To place this mortal body.

The Absolutely Affirmative Solitude: Reliable is the self
that awakes as ‘Won’t rely’
For, free from all,
It has no hindrances.

The Self-effecting Nature of Dharma:
Since this is the I
without hindrances

My self feels at ease just as it is
With sin and death just as they are.

With nothing to rely on, he was free to be with whatever arises.

In 1958, Hisamatsu Sensei travelled to the West, taught at Harvard Divinity School (an appointment arranged by D. T. Suzuki), and met with Paul Tillich, Martin Buber, Gabriel Marcel, Rudolf Bultman, Martin Heidegger, and Carl Jung. Jung’s interlocutor was not an ordinary intellectual but a deeply realized master with a keen mind and awareness of the West. The depth of his knowledge allowed Hisamatsu Sensei to penetrate to the essential point. To quote from their dialogue:

Jung: . . . In short, through liberation, man must be brought to a point where he is free from the compulsion to chase after myriad things or from being controlled by the collective unconscious. . .

Hisamatsu: . . . Do you mean that the collective unconscious is something from which, in its nature, we can free ourselves?

Jung: Yes, it is.

Hisamatsu: What we generally call “self” is the same as the self [Selbst] characterized by you, Professor Jung. But it is only after the emancipation of this self that the “Original Self” of Zen emerges. It is the True Self described in Zen as the Self which is realized in absolute emancipation and without dependence on anything. . . .

Through his deft questioning, Hisamatsu Sensei brought Jung to see the basis of his misunderstanding of the self, but as Jung’s subsequent letter shows, he was unable to finally accept this, perhaps realizing that it would entail significant changes in his own system.

The third section of the book is a collection of nine essays, with those by Harold Coward and Nathan Katz the most interesting. There are areas of convergence between Buddhism and Jung. Once the no-self of Zen, or the true nature of the mind, has been understood, then one can explore the world of active imagination and archetypes, which have correlations with deity meditation in Vajrayana Buddhism (never forgetting, however, that in practice these figures arise out of the empty nature of the mind and dissolve back into it). The subject of mental habitual patterns in Buddhism could also be fruitfully compared to Jung’s latent tendencies, leading into a discussion of the Buddhist science of perception and Jung’s understanding of mental functioning. In the meantime, Self and Liberation performs a great service in bringing together texts that reveal how Jung interpreted Buddhism. Once this relationship becomes clear, then the dialogue can grow deeper to the benefit of both traditions.

Michele Martin practiced with Shin’ichi Hisamatsu’s Zen group in Kyoto and currently translates Buddhist teachings from Tibetan into English.

Translated by Burton Watson
Columbia University Press: New York, 1993. 352 pp., $34.95 (cloth).

Sam Hamill

AN ANTHOLOGY of sermons, stories, and devotionals of remarkable variety, the Lotus Sutra is the fundamental text of Mahayana Buddhism. In addition to containing the complete teachings of the Buddha, it introduces the ideal of the bodhisattva, the Four Noble Truths (that being in the saha-world is suffering; and that by putting into practice the discipline of the Eightfold Path, one may achieve enlightenment), the Eightfold Path itself (right views, right thinking, right speech, right action, right livelihood, right endeavor, right mindfulness, and right meditation), and the twelve-linked chain of codependent origination.

The original text was composed in an undetermined Indian or Central Asian language later translated into Sanskrit in order to gain “respectability.” But the sutra has been revered over the centuries primarily through the translation into Chinese by Kumarajiva in 406 C.E. in the Chinese capital at Ch’ang-an. Burton Watson, like previous translators into English, works from the Kumarajiva Lotus Sutra. He presents verse passages in readable verse and gears his translation to the general reader who may have little or no background in Buddhist studies or Asian literature, achieving a clear, accessible combination of prose and poetry.

Opening with hymns of praise by Maitreya and Manjushri at a vast assembly of bodhisattvas before the Buddha, the introduction reminds us of


who knew that phenomena are marked by tranquility and extinction

each in his respective land

preaching the Law and seeking the Buddha way.


It is very difficult to encounter a Buddha—

you meet one once in a million kalpas.

A certain amount of skepticism is encouraged, as is a certain amount of faith. The fourth chapter, “Belief and Understanding,” presents a famous parable about the “poor son” who resists being returned to his enormously wealthy father’s estate until he is finally approached by servants in rags who offer him a job shoveling manure. Gradually, the son grows less skeptical until he is eventually acknowledged to be the true son and heir, whereupon he thinks, “I originally had no mind to covet or seek such things. Yet now these stores of treasures have come of their own accord!” This is a marvelous (one is tempted to say devilish) spin on the life of Sakyamuni, the prince who rejected his father’s immense wealth. The closing verse for this chapter notes that

With regard to the Law, the Buddhas

are able to exercise complete freedom.

They understand the various desires and joys

of living beings,

as well as their aims and abilities,

and can adjust to what they are capable of,

employing innumerable similes.. .

In another simile, a man must entice his own children from a burning house to save them.

The various paradoxes of the Lotus Sutra have made it a paramount text among Ch’an and Zen sects. Ultimately, the Buddha of the Lotus Sutra taught that although there are many ways through which one may attain enlightenment, each of us already is the Buddha.

It’s easy to stand at some remove and look at the handful of great religio-philosophical wisdom books and forget that the dialogues of Socrates and Confucius and Jesus and Mohammed and the Buddha and the scholar-translators of the Talmud were conversations among real human people. One of the functions of the Lotus Sutra is to remind us that we are made of the same stuff as the Buddha, that we are human. There are many parables.

For nearly forty years, Burton Watson has been translating Chinese and Japanese classics (Chuang-Tzu, the Tso Chuan, Meng Ch’iu, Confucian classics, literary masters such as Han Shan, Ryokan, Gensei, Saigyo, Su Tung-p’o, The Columbia Book of Chinese Poetry) and Buddhist texts (such as Daisaku Ikeda’s interpretive biography, The Living Buddha, and The Flower of Chinese Buddhism). The list could go on and on. He is the preeminent translator of this kind of material in our time, and he brings to his vast scholarship a style that is flexible enough to capture the essence of his source while retaining a direct, uncluttered, and highly readable English that is dependably accurate. His Lotus Sutrawill be the standard translation for a long time. Read it for pleasure and provocation and joy, as well as for wisdom.

Sam Hamill, a Contributing Editor to Tricycle, is a poet, translator, and editor of Copper Canyon Press.

Gyalwa Gendun Druppa, the First Dalai Lama, Translated by Glenn H. Mullin

Snow Lion Publications: Ithaca, New York, 1993. 174 pp. $12.95 (paper).

Rebecca Radner

“TRAINING the Mind in the Great Way,” the seven-point lojong teaching of techniques for spiritual development, is an oral transmission from the First Dalai Lama, Gyalwa Gendun Druppa (1391-1474). The teaching derives from the Indonesian master Serlingpa, four hundred years earlier, through his disciple the venerable Indian teacher Atisha, to Tibet, and thence to the First Dalai Lama, who was brought up with it.

As H.H. the Fourteenth Dalai Lama says in his introduction,

the essential message of the lojong teaching is that if we want to see a better world, we should begin by improving our own mind. . . [it is said] that there are two ways to make the world a comfortable place in which to walk. One way is to cover the world with leather; the other is to put on some shoes.

Saying that he has used lojong as the basis of his practice since childhood, he continues,

we need to train the mind in the bodhisattva ways, in practices that induce the qualities of kindness, love, compassion, tolerance, inner strength, wisdom. . .

This version is beautifully translated by Glenn H. Mullin, who gives the freshness of a contemporary work to a transmission more than five hundred years old.

The teaching falls into two main sections: preliminaries and actual practice. As Mullin’s introduction points out, the two major obstacles to lojong are ego-grasping and self-cherishing; the way to eliminate these obstacles is to cultivate the two kinds of enlightenment mind: “the conventional bodhimind of love and compassion, and the ultimate bodhimind of the wisdom of emptiness.”

The heart of lojong is similar to tonglen, a practice increasingly popular in the West in recent years, in which one breathes in the pain of others and breathes out love and compassion.

This sense of empathy, that at the moment is limited to our small circle of loved ones, must be extended until it encompasses all living beings without any partiality.

We perceive all beings as equal because each has been our mother in a past life.

This important part of the teachings has often been modified for Americans, to whom contemplation of the mother is not automatically a spur to higher feelings. Another way of looking at it comes from this verse, quoted in the text:

The ocean, king of mountains and the mighty continents
Are not heavy burdens to bear when compared
To the burden of not repaying the world’s kindness.

One of the most interesting arguments for exchanging self-cherishing for awareness of others is given here:

You may think, “There is no need for me to be concerned with the well-being of others, for any suffering that they may experience does not increase my happiness. . .”

But as we are in a constant state of change, the self who initiates an action in its own behalf will not be the same as the self who will experience its result. Therefore, it is implied, such a closed system of mind is pointless, even on a selfish level.

Similarly, we can come to see enemies as those who are moved by our own negative karma to hurt us, thereby generating more negative karma; we therefore feel compassion for them. Such a method “enables the practitioner to take any sufferings and hardships that arise as friends.”

This text is far from being a dry description of theoretical states.

During guru yoga, one is advised to call on the guru

many times from the very depth of your heart, until your eyes swim with tears, the hair on your body begins to tremble, and you are barely able to sit still.

Our practice should be inspired, unlike

the way a handful of roasted barley flour thrown into a pot of beer merely floats on the top. Our respect for others should arise from the innermost depths of our being.

This work helps us understand the ways to reach those depths and most skillfully use them for the help of all beings.

Rebecca Radner is a poet, reviewer, and teacher who lives in San Francisco.

William M. Bodiford

Kuroda Institute University of Hawaii Press: Honolulu, 1993. 345 pp., $35.00 (cloth).

Yaigen Daniel Leighton

THIS NEW addition to the fine series of scholarly works on East Asian Buddhism published by the Kuroda Institute (affiliated with the Zen Center of Los Angeles) deserves special attention from Western practitioners. In his quite readable albeit detailed and academic treatment, Bodiford skillfully provides a wealth of information heretofore unavailable in English showing the texture of Soto Zen’s development into a widespread religious institution, currently the largest in Japan. He succeeds in making a good case for the medieval Soto tradition as a legitimate expression of genuine Zen teaching, responsively addressing the spiritual needs of the populace. Bodiford thereby challenges a number oflimiting, common conceptions, e.g., that the later Soto tradition compromised the “pure” original practice and vision of its brilliant founder Dogen (1200-1253) in order to accommodate diluted “popular” Japanese religion. The major role in Soto Zen of koan study and of Mahayana ritual activity are also elaborated. The implications of Bodiford’s reading of japanese Zen history are instructive for American Buddhists seeking to maintain the heart of foreign spiritual traditions while allowing them to adapt and permeate in a new, vastly different culture.

Bodiford traces the formative importance to Soto Zen of the native Japanese mountain ascetic tradition with its shamanistic base and strong sense of sacred landscape and connection to the earth. Along with meditation (usually using visualizations), this tradition featured veneration of numerous local protective spirits and “magical” practices such as rainmaking. Soto Zen was also greatly influenced by the Vajrayana practices of the previously dominant schools of Japanese Buddhism, Shingon and Tendai. This native spiritual context gave Soto Zen a mystical flavor that Western practitioners more commonly associate with Tibetan Buddhism than with Zen, as many of us were first attracted to Zen by dramatic satori stories or by the therapeutic value of zazen, unaware of this “religious” facet. Bodiford shows how the Japanese influences complemented and integrated with the more usually cited inspiration of the classic Chinese Chan tradition, which most Zen scholarship idealizes.

Rather than simply dismissing as degenerate the practice of a Japanese Zen teacher praying for rain by means of performing a traditional Zen transmission ceremony to present a native kami [deity] with a Zen lineage chart, one might more profitably investigate both Zen and Japanese religion by asking, How are traditional Zen (or Buddhist) symbols used or not used in this ceremony?

Bodiford offers evidence that such medieval Soto practices as pacifying demons or ghosts or converting local spirits were often done with clear Zen understanding. For example, a document giving initiation into a particular tradition’s koan understanding stated that the protective nature deities that were given the precepts in ceremonies were actually not external to the practitioner, but are none other than the original mind realized during meditation. Koan language was used to redefine such ceremonies to show that what is truly protective is the implementation of precepts through zazen.

The Soto mystical orientation was particularly vivid in Keizan (1264-1325), three generations after Dogen, who is revered as the second founder of Soto Zen, and from whom most of contemporary Soto Zen descends. In addition to intense zazen practice, Keizan relied on geomancy, astrology, and dream visions. Bodiford describes Keizan’s writings as expressive of

an extremely rich, religious worldview in which the abstract truths of Buddhist doctrine are realized and verified through concrete physical manifestations that can be experienced directly in daily life. For Keizan, Zen experience entailed living in a physical landscape made sacred by the presence of supernatural Buddhist divinities and native Japanese spirits. Keizan’s records illustrate the paradigm shift by which Buddhist meditation subsumed earlier shamanistic views of the spirit world.

Although Keizan is often credited with introducing supernatural elements into Soto Zen, Bodiford clarifies this as simply the prevalent religious context. Along with his emphasis on zazen and the Chinese Chan tradition, Dogen too stressed devotional energy in accord with this mystical outlook. Now famous for his profound philosophical teachings, in his own time Dogen was equally known for impressive rituals he conducted at Eiheiji, the monastery he founded. Lay participants testified that multicolored clouds and celestial gongs and fragrances manifested. During a ceremony for worshiping the sixteen arhats, these legendary figures magically appeared while heavenly flowers rained down.

Along with such esoteric rituals, the medieval Soto monks in the centuries after Dogen definitely maintained strong zazen practice. Rinzai monks who wished to practice meditation often went to study with Soto teachers. More detail about their meditation would have been interesting, but Bodiford focuses on their use of meditative awareness and compassion in accord with the bodhisattva model. The new Zen movement enlisted monks from the common classes, rather than the aristocracy who had controlled the older sects. As they moved into rural areas, Soto monks engaged in public works such as road and bridge building as well as performing rituals, but their success in addressing the religious needs of the populace was based largely on the prestige and integrity of their meditation and strict training.

Extensive koan study was also of central importance in medieval Soto monasteries. Unlike Japanese Rinzai Zen, in which koans were used to create a “mass of doubt” and to induce enlightenment experiences, koan training provided Soto priests with an evocative language for clarifying and accessing Buddhist enlightenment and expressing it in the ritual activities they shared with the laity. Different Soto lineages were often defined by the varying koan curriculums they transmitted. This medieval Soto koan practice is not, as is sometimes claimed, a deviation from Dogen’s teaching, as Dogen himself devotes much of his writings to commentary on the classic koans.

Bodiford elaborates the complex and often problematic role of lineages and transmission in Soto history. The lineages following Keizan were able to become dominant, with a sturdy institutional foundation, due to a system of rotating abbotships at their headquarters temple, Sojiji, a monastery Keizan had established. Aspects of this cooperative network of affiliated subtemples, which cemented the relationship between the evolving branches, may perhaps be a relevant, positive model for proliferating Western Zen communities. However, the shadowy role of feudal loyalties, spiritual politics, and institutional aggrandizement underlying this history is also apparent.

Westerners have already witnessed problems among successors of our own recently established Zen Centers. Keizan’s teacher Gikai, a student of Dogen who later succeeded to Dogen’s primary successor Ejo, left Eiheiji under unclear circumstances. This is commonly referred to as the “third generation dispute,” and is now often interpreted as a disagreement between Gikai, who supposedly wanted to popularize Soto by adding syncretic practices, and other disciples who wanted to adhere strictly to Dogen’s “pure” teaching. Bodiford strongly challenges this interpretation of the events. There is no valid historical evidence for an acrimonious dispute, and in any event, all of Dogen’s various successors were dedicated to following his practice while also engaging in ritual activity adapted to lay patrons. Perhaps all such problems, then and now, boil down to personalities and growing pains, rather than the doctrinal disputes imagined by historians.

One third of the book provides extensive discussion of Dogen’s major disciples along with Ejo and Gikai, revealing the rich diversity of early Soto Zen communities. Giin founded a separate lineage in southern Japan, which remained active until the eighteenth century; the lineage of Jakuen, a Chinese disciple who followed Dogen back to Japan, dominated Eiheiji into the seventeenth century. Another leading disciple, Senne, is notable for his detailed commentaries, which have been crucial to modern understanding of Dogen’s writings and their intricate, playful use of language.

Bodiford gives detailed discussions of the interesting functions of Soto ritual. Precept ordination ceremonies for laypeople as well as monks were an initiatory link back to the Buddha through the lineage, and also helped disseminate ethical teachings and fundamental Zen perspectives. Soto Zen priests were responsible for spreading Buddhist funeral rites throughout Japan, addressing “the great matter of life and death” with insight and compassion while securing a cooperative relationship between the clergy and its lay supporters.

Bodiford’s clear presentation of the complexity of medieval Soto Zen’s development allows us a much fuller understanding of this tradition, and a deeper appreciation for the resources still available in modern Japanese Zen. A broader perspective on the range of these previous adaptations may help Americans gradually find appropriate expressions for imported Buddhist traditions in our own changing culture.

Taigen Daniel Leighton, a Zen priest at Green Gulch Farm in California, is cotranslator of Cultivating the Empty Field: The Silent Illumination of Zen Master Hongzhi.

Li Po and Tu Fu: A Friendship in Poetry

Translated by Sam Hamill
Weatherhill: New York, 1993. 134 pp., $7.95 (paper).

J. P. Seaton

IMG_0002_0SAM HAMILL’S new book of translations of selected poems of China’s two greatest poets, Endless River, pairs forty-five poems by Li Po with forty-five by his younger contemporary, Tu Fu. Hamill does more than simply paint paired portraits of these partners in a legendary friendship, however. With the same deft poetic touch that has brightened his previous Chinese translations (and recent translations from Japanese and Ancient Greek) he has brought to life two poets whose responses to the tumultuous world ofT’ang China may serve as a guide and a consolation for readers in this very similar world of ours.

As the subtitle of Hamill’s book, A Friendship in Poetry, hints, the poems translated here can be read not only as a dialogue between the two poets but also as an exposition of the friendship offered to every human being by each of the poets, and by the translator himself. Both Li Po and Tu Fu see and say quite clearly that life is suffering. Both seek paths toward cessation of that suffering. That Li Po’s path is strewn with wine jars and discarded lovers may make it a problematic one for some. Tu Fu’s commitment to social justice and his passionate attachment to wife and family may be problematic for others. (A few wine jars are scattered there too.) The paradox of the friendship of Li Po and Tu Fu may be resolved in human terms with a few platitudes: opposites attract, younger men look to older men for mentoring or patronage, and sometimes find friendship instead or as well. But such a resolution demeans the men. Hamill’s translations, uncluttered, graceful, always lucid and more than occasionally luminous, let the poets speak for themselves, and certainly for Hamill as well. The “irresponsible” Li Po is accepted as the spirit of poetry incarnate, while the earthbound Tu Fu is appreciated as the greatest (even perhaps the greatest possible) “human” poet. If you crave a conundrum, or a koan, after reading these poems consider whether Li Po is yin to Tu Fu’s yang, or vice versa. The message they transmit across twelve centuries is one of an uncommonly full and balanced humanity.

As Hamill states in his introduction, the two poets spent very little time together, and among the extant poems of each there are more written to other poets than to each other. While highlighting a few pairs of poems written by one for the other, Hamill actually creates a dialogue by choosing pairs of poems that share themes and imagery. Moonlight—or is it Buddha-nature?—links “Mountain Drinking Song” to “Moonlit Night,” while different approaches to social and political problems pair “Old-style Poem” and “The Thatched Hut.” Reading the translator’s mind to find the source of other linkages provides an additional source of enjoyment for the reader.

Hamill has chosen poems that come cleanly into English without notes. He has clearly identified as his target audience the increasing number of readers who are not entering totally new territory when they approach an Asian work of art. His efforts are truly free, in the best of senses, making poems in American English from the poems in the Chinese by judicious pruning and often inspired approximation. His rendering of Li Po’s “Old Dust,” which retains obvious allusions, is simply brilliant. In the same poet’s “Seeing Off a Friend,” where the essence of the poem is far more accessible without its allusions, Hamill simply deletes them. The latter poem is a delight in the original, but for a variety of technical reasons a real monster to render into American English. A version of the poem translated by this reviewer can be found in Francois Cheng’s Chinese Poetic Writing. I prefer Hamill’s.

There are other ways of handling both Li Po and Tu Fu in translation. David Hinton’s Tu Fu (New Directions, 1989) might very well startle the reader who has seen the poet only through Hamill’s eyes. James Cryer’s Li Po, supported in its often gnomic sparsity by the extraordinary calligraphy of Mo Ji-yu (in Bright Moon, Perching Bird, Wesleyan, 1987), shows an aspect of Li Po’s art that Hamill strives only occasionally to capture. For the reader who comes to Li Po and Tu Fu first through Endless River, the translator generously points toward those and other sources of further reading. Finally, and not least, Weatherhill’s Inklings edition is a beautifully designed little book that includes a number of surprisingly high-quality reproductions of Chinese paintings. The price of the book seems to indicate that the publisher, too, is to be counted among the friends of these poets.

J. P. Seaton, Professor of Chinese at the University of North Carolina, Chapel Hill, has published several volumes of Chinese poetry in translation.

LISTENING TO PROZAC: A Psychiatrist Explores Antidepressant Drugs and the Remaking of the Self
Peter D. Kramer
Viking Penguin: New York, 1993. 409 pp., $23.00 (cloth).

William Greenberg

YOU’RE a hard-working, reasonably successful woman in your line of work, but feel socially inadequate, unhappy, and, stuck in an unsatisfying relationship with a married man, now feel significantly depressed. Psychotherapy can’t seem to pull you out, but the antidepressant medication Prozac does. Taking Prozac, however, you also become what you never were before—outgoing, attractive to men, popular, less needy and self-defeating in relationships, and assertive when necessary at work. Discontinuing Prozac months later, the inhibitions, self-doubts, indecisiveness, and lowered self-esteem that were your lifelong personality return. You ironically observe to your psychiatrist, Peter Kramer: “I’m not myself anymore.”

Do you ask for the Prozac again? Would you feel something impure about doing so, relying on a pharmacologic crutch when staunch effort, psychotherapeutic growth, and/or religious practice and revelation were instead appropriate? Would you feel you would just be “drugging yourself”? Another woman does offer that she feels “. . . as if I had been in a drugged state all those years and now I am clearheaded.” But she is telling us she feels clearheaded only on the Prozac. What is going on here?

Psychiatrists have often treated individuals with serious psychiatric conditions, such as manic-depression, acute psychosis, and major depressive episodes, helping those unable to make progress in psychotherapy, or even function adequately, until they were treated with medication. Dr. Kramer has been moved by new observations of Prozac’s positive effects on individuals for whom ten years ago most psychiatrists would never have even thought of prescribing medication. Chronically unhappy but not suffering from major depressive episodes, such people would be told: “Your problems are characterological and pills can’t help; you need long-term psychotherapy.” Our real hopes for such patients, whom we often diagnosed with the label “depressive neurosis,” were often modest: Freud aspired that psychoanalysts should transmute such individuals’ misery “into common unhappiness.” Now, however, we view chronic mild depressions (even if remembered as present from early childhood) as related to other types of depression, and often find such conditions responsive to antidepressants. But are we treating a clear psychiatric disorder or merely personality traits or temperament? Are we indulging in something as cosmetic and artificial as a “nose job”?

Dr. Kramer and some of his patients worry about such a trend. To be sure, this entails drawing a somewhat arbitrary line. We routinely treat other physiological deficiencies with medications (insulin for the diabetic, Synthroid for the hypothyroid, estrogen for the postmenopausal woman), we adorn our appearance with attractive clothing and jewelry and hairdos, change our smells with perfumes, engage in muscle-building exercise (sometimes by anabolic steroids or human growth hormone). We legally enhance our thinking ability or mitigate our anxiety level with the potent pharmacologic agents caffeine, alcohol, and nicotine (and may use amphetamines, cocaine, marijuana, LSD, MDA, etc.). Is there duplicity here? Or is there something less “natural,” perhaps, in a manufactured pill? Our unease must stem in part from the intimate association we make between our personality and our cherished sense of Self. But what if we forget the Self?

My approach to the use of anti-depressant medications, like Dr. Kramer’s, has evolved over the last decade. Trained more in the culture of psychotherapy, I and my colleagues were initially cautious and uneasy when some of those we treated promptly relapsed whenever their medication was stopped, or when we treated mild depression in those just wishing psychotherapy. I now appreciate the demonstrated wider scope of these medications’ potential value, representing an important response to treatable human misery. Like Dr. Kramer, I have found that some of my responding patients have had only what appeared to be problematic personality traits, such as over sensitivity to perceived personal rejection. Dr. Kramer has an articulate voice, and openly and accurately conveys the usually unspoken monologue of a clinician thoughtfully practicing his profession, understanding his patient as an individual, applying the art of psychotherapy, the science of medical psychopharmacology, and relevant ethics. His historical digressions are effectively engaging. He provides a provocative, interesting read.

This book also has faults: its chapters form a collection of case studies and thematic essays not carefully enough woven together to avoid redundancy in the later chapters. Its audience is unclear. It appears to be targeted for the general public (and has been an impressive seller on The New York Times nonfiction list), but it has more than sixty pages of scholarly end notes (unreferenced in the text) and a detailed index. Discursive forays into diagnostic issues, psychopharmacology, psychobiology, sociology, animal ethology, and philosophical ethics may be more than some of the intended readership wish to plow through. Dr. Kramer unreasonably slights the classic antidepressant. The book focuses almost exclusively on Prozac (a drug whose popularity has attracted both idealization and notoriety in its brief career), although similar drugs deserve adequate mention (the author denies a financial interest in Eli Lilly, Prozac’s manufacturer). Moreover, it promotes the impression that these personality “makeovers” are common, but most of our Prozac patients do not undergo such transformations.

What of the future? Will we have “Better Living Through Chemistry”? Kramer can not resist optimism. In “listening” to Prozac he feels the transformed patient may come to recognize new possibilities: “. . . leaving the self light and unencumbered, she may arrive at . . . new understandings about. . . her (human) nature.” I’m reminded of such hopes in a generation first encountering LSD—the results then depended very much on the setting and who was taking the drug, and it was best to have a guide. This comparison is unfair—among other issues Prozac is much less risky, but if you feel such medication may help you, for best results make good use of a guide. This book may serve as an introduction.

William Greenberg is Chief Psychiatrist at Bergen Pines County Hospital in Paramus, New Jersey.

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