The mindfulness boom keeps on booming. As the pandemic continues to change our way of life, people are turning to meditation and mindfulness practices to help them cope with the stress, anxiety, and isolation that social distancing causes. The Washington Post recently reported on a marked spike in meditation app usage—a trend that may only increase as the impact of COVID-19 is felt more acutely around the world. 

For practicing psychotherapists, this may not come as a huge surprise. Scholars have noted that the immense popularity of mainstream mindfulness is due in large part to their successful entrenchment in health care and, especially, psychotherapy. Contemporary therapeutic mindfulness practices are an established feature of the mental health field—studies assessing the clinical effectiveness of mindfulness practices number in the many thousands, and have even become the foundation of entire treatment modalities (e.g., mindfulness-based cognitive therapy). And though it continues to be referred to as a “new fad,” the use of mindfulness practices in psychotherapy is actually decades old.

But many mental health care professionals disagree with the ways mindfulness can be used in psychotherapy. In fact, a robust debate surrounds so-called mindfulness-based interventions (MBIs), dating at least as far back as the 1990s. Many psychotherapists seem to view the very popularity of mindfulness practices as a sign of their superficiality. For them, the practices’ appeal comes at the cost of their co-option within a global capitalism that appropriates rich cultural traditions and then markets them for unwholesome ends in corporate and military sectors. Other therapists harbor resentments that MBIs seem like a juggernaut, eclipsing the other ways that psychotherapists have approached Buddhist traditions. 

If we look farther back into history, we see that the current state of mindfulness was far from inevitable. I explored this history at length in my book Prescribing the Dharma: Psychotherapists, Buddhist Traditions, and Defining Religion, and found that when psychotherapists began taking an interest in Buddhist teachings and practices (not too long after the invention of talk therapy as a discipline), they investigated Buddhist thought as a whole and never seriously considered using actual practices in their clinical work. 

For well over a century now, clinicians have approached Buddhist teachings and practices in surprisingly diverse ways that go far beyond mindfulness. Early talk therapists, most famously Carl Jung, pored over some of the first Buddhist texts to be translated into German or English, believing they held important insights into human psychology. Some colleagues pathologized Buddhist meditative states as based in a narcissistic wish for return to a state of maternal union. Jung, however, advanced a highly romantic interpretation of Buddhist practices as inward-facing means for achieving a self-actualization that required, as he wrote, a “penetration into the ground layers of consciousness.” Early therapists like Jung attended to Buddhist cosmographies and, moreover, to topics like rebirth and nirvana, which they understood to mean escape from the cycle of rebirth. They assumed such concepts were not metaphysical but psychological realities, metaphors that described vital truths about being human.

Psychologists and psychotherapists at the turn of the 20th century thus played a major role in introducing the newly named world religion “Buddhism” to communities in Europe and the United States as a uniquely psychological religion. Jung himself provided introductions to seminal texts such as W.Y. Evans-Wentz’s influential edition of The Tibetan Book of the Dead. When preparing his Introduction to Zen Buddhism for publication in German (and subsequently English), the modern Zen teacher D.T. Suzuki, a Japanese scholar often referred to as the person who brought Zen Buddhism to the West, wrote Jung requesting he contribute a foreword.  

Psychotherapists’ intensive theoretical dialogue with Buddhist thought in general, and Suzuki in particular, continued in the decades that followed. Through the 1950s and 1960s, the US was experiencing a “Zen boom,” in some ways as influential as our present-day mindfulness mania. Growing numbers of psychoanalytic therapists like Karen Horney and Erich Fromm became convinced Zen philosophy could inform therapy. Horney, for example, suggested that Zen teachings offered models for an ideal therapeutic presence she named “wholeheartedness” (a posture some have described as a proto-“mindfulness” at a time when virtually no one was using the term). 

The highwater mark may have been the 1957 meeting Fromm arranged between Suzuki and nearly fifty psychoanalysts at the University of Mexico. The edited volume produced from the gathering’s conversations, Zen and Psychoanalysis, represents therapists’ approaches to Buddhist traditions during this period: intellectual explorations comparing Buddhist and psychoanalytic metapsychologies surrounding, for example, conceptions of the self. Analysts were fascinated by the notion of satori [sudden enlightenment] experiences and wondered if Buddhists were describing phenomena akin to the moments of transformative insight and self-realization awakened by psychotherapy. 

Nonetheless, most psychoanalysts imagined Buddhist practice to be a parallel path to talk therapy and did not actively incorporate Buddhist elements into actual sessions. Yet through the 1970s, communities of humanistic and, a bit later, transpersonal psychotherapists, began to mix together practices from a number of different sources, including Buddhist traditions. Zen meditation practices started to be viewed as viable therapeutic interventions that could be placed alongside yoga poses, Taoist philosophy, and Gestalt therapy’s emphasis on the present moment.  Scientists like Herbert Benson conducted empirical research on techniques such as Transcendental Meditation (TM), helping legitimize them to major medical institutions. These therapists laid the groundwork for taking seriously the healing potential of practices associated with Asian religious traditions. 

The development of mindfulness-based interventions (MBIs) is often seen as arising directly from this trajectory. This is somewhat ironic because the humanistic and transpersonal therapists who paved the way for the incorporation of mindfulness were often highly opposed to what they referred to as the “medical model,” with its emphasis on empiricism and symptom- reduction. 

Fromm was actually a vocal critic of psychotherapy that merely “adjusted” people or helped people cope with suffering he believed was often generated by societal injustice. He had warned his fellow analysts that Suzuki’s Zen, as Fromm wrote in his 1960 collection Zen Buddhism and Psychoanalysis, “is not a ‘technique’ which can be isolated from the premise of Buddhist thinking, of the behavior and ethical values” of Buddhist traditions. Interestingly, late in his life, he learned a style of meditation from the German-born monk Nyanaponika Thera (née Siegmund Feniger) that would today likely be recognized as a mindfulness practice. Fromm came to believe that it was this meditation that, like an authentic psychotherapy, would allow sufferers to cull away conscious and unconscious barriers to self-liberation from the psychic structures that left one vulnerable to submission to politico-economic oppressors.

Contrary to Fromm’s vision, mindfulness practices were initially viewed positively by cognitive behavioral therapists in the 1990s precisely because they believed they could be translated into secular techniques for those who would otherwise be averse to the religious. Even as these clinical techniques became more prevalent, psychotherapists continued to seriously engage with Buddhist philosophy, and many sought to integrate Buddhist and psychotherapeutic frames.

Where earlier comparative analyses often focused on similarities between Buddhist and psychotherapeutic ideas, in the 1980s and 1990s clinicians increasingly observed significant differences, which they often described as incommensurable—such as psychotherapy’s aim of restoring a whole healthy self and the Buddhist concept of non-self. Some sought to resolve these incompatibilities, such as in transpersonal therapist Jack Engler’s famous dictum “you have to be somebody before you can be nobody.” Others have emphasized the need to preserve a differentiation between Buddhism and psychotherapy without subsuming one within the other. Contemporary clinician Pilar Jennings draws on relational psychoanalysis to explain the importance of maintaining differentiation and healthy boundaries in all relationships, including, as she writes in her 2010 book Mixing Minds, the “relationship between Buddhism and psychoanalysis.” Nonetheless, the resulting integrative forms have at times been described as mixtures, new psycho-Buddhist schools uniquely suited to a contemporary culture in the US. 

Many decades since Jung took up the first Buddhist texts to be translated for European consumption, psychotherapists have copious (and far more accurate) resources for their investigation of Buddhist traditions. Therapists’ passion for Buddhist study has even driven some to obtain additional degrees. Well into his career as a psychiatrist, Joe Loizzo earned a PhD in Buddhist studies under the prominent Tibetologist Robert A.F. Thurman. And, perhaps most dramatically, psychotherapists in the US have doubled as founders and leaders of Buddhist communities. In her book American Dharma (2019), Buddhist studies scholar Ann Gleig observed that psychotherapeutic resources are utilized to assist practitioners in clearing psychological obstacles blocking their meditation practice.

The fact remains, however, that even those contemporary therapists who take a more thoroughly integrative approach to Buddhist traditions cannot ignore the impact that mindfulness-based psychotherapies have had on the field. Some, like Loizzo, have simply included mindfulness practices within his larger “Buddhist psychotherapy,” as he has called it. Others have become vocal critics of the mindfulness movement. Psychoanalyst and Zen teacher Barry Magid has strongly critiqued the explicit insertion of Buddhist teachings or practices into clinical sessions; Magid considers it, among other things, an“instrumentalization” of Buddhist practices within a dehumanizing “means-to-end” way of living that is directly counter to his understanding of a Buddhist path. In 2016, Magid and therapist Robert Meikyo Rosenbaum co-edited the book What’s Wrong with Mindfulness (and What Isn’t), in which several clinicians expressed their concern about the decontextualization of mindfulness from Buddhist doctrine, philosophy and ethics.

Yet as therapeutic mindfulness practices reach ever closer to ubiquity, psychotherapists continue to employ a diversity of approaches to Buddhist teachings and practices, and there are multiple perspectives among mindfulness practitioners, too. A decade and a half ago, feminist psychologist Jan Surrey was developing a “relational mindfulness” as a response, in part, to what she perceived to be overly individualistic mindfulness trainings. Her mindfulness practices were framed as essentially relational in nature, holding the capacity to awaken an awareness of one’s interconnectedness to all beings. The peer-reviewed journal Mindfulness devoted its entire first issue of 2020 to what it dubbed “second-generation mindfulness-based interventions,” which, for example, offer an answer to a deracinated mindfulness by teaching “right mindfulness” recontextualized within the larger eightfold path.

Within these perspectives, we also see continuities that extend back through the century-plus history of psychotherapists’ interest in Buddhism. Surrey carries forward a conversation surrounding what Buddhist teachings say about the nature of the self that goes back to Jung. But while some Buddhist psychotherapists (and even some mindfulness practitioners) decry a psychotherapy limited to symptom-reduction and champion recovering the salvific or soteriological aspects of Buddhist practice, they do not strive for a nirvana that is liberation from a literal cycle of rebirth. For clinicians who practice relational-cultural therapy, which focuses on the importance of relationships to well-being, the interrelatedness revealed by the concept of dependent co-arising is not a web of karmic ensnarement one seeks to escape but part of understanding an optimal state of human health and wellness. 

Over the decades, psychotherapists have variously focused on Buddhisms of the Pali canon, D.T. Suzuki’s Zen, or the Dalai Lama’s dialogues with neuroscientists. But, from the first therapists to study Buddhist doctrine to today, contemporary clinicians often begin with the assumption that concepts like rebirth or merit-making are psychological metaphors, though in the lived experience of Buddhist communities across the globe they are often anything but. Cultivating an awareness of the diversity and continuities of psychotherapists’ interactions with Buddhist traditions can hopefully bring us toward an ever more nuanced understanding of the dharma’s role in mental health care. 

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