What Meditation Cannot Cure

Many Westerners, when they encounter the dharma practice, come seeking psychological healing. But meditation was not designed for that purpose. As meditation has grown popular, it has been marketed as a way to address physical and emotional illness, improve work performance, reduce stress, and rewire our brains. I have been a psychotherapist for approximately twenty-five years, working with both meditators and non-meditators. I have also taught meditation within the Theravada tradition to students who clearly could have benefited from therapy. I have seen firsthand the benefits of combining the two. I have also witnessed the pitfalls of believing that meditation can resolve early psychological wounds. No matter how powerful meditation is, that kind of healing falls outside its scope. For that, we have psychotherapy. And when psychotherapy runs parallel to a meditation practice, it can become a potent combination.

In a 1989 article titled “Even the Best Meditators Have Old Wounds to Heal,” Jack Kornfield wrote: “For most people, meditation practice does not ‘take care of everything.’ At best, it is an important part of a complex path of opening and awakening.” At that time, the idea that meditation could not resolve all psychological suffering was widely dismissed in meditation circles. Yet with more research and anecdotal evidence, it has gained increasing acceptance. In 2009, in an article for Buddhadharma titled “Medicate or Meditate,” Roger Walsh, Robin Bitner, Bruce Victor, and Lorena Hillman wrote: “It seems clear that the question of whether meditation and psychotherapy can improve each other has been decided: many people benefit from their combination, and this has been observed by clinicians and demonstrated by research. When old traumas, hurts, and patterns recycle endlessly or make spiritual practice feel oppressive and hopeless, the best answer may not simply be more practice. Instead, psychotherapy may be necessary.”

I practice contemporary psychoanalysis, which means that when I work with a client, we aim to deeply transform the deficient emotional patterns that formed in childhood. As we do this, I also reflect back and encourage the client's authentic self-expression. For example, someone may have learned early on that it is dangerous to feel angry, as it could jeopardize their parents' love. This can leave a person in situations where they are walked over because they lack access to their legitimate anger. In therapy, we would not only discover the root of this difficulty with anger but also encourage its expression, especially in moments when the client might feel angry toward me. Through my steadiness and acceptance of their feeling, the client gains a lived experience of being able to feel angry toward someone who does not retaliate or flee, who accepts their concern. This kind of exchange helps the client develop a healthy, authentic, and vital sense of self.

This aspect of psychological development was not necessary for the Buddha, and healing for this kind of wound was not included in his prescription for the end of suffering.

As the popular story tells us, Siddhartha's father protected him from the world's suffering by keeping him behind the palace walls. This worked until he turned twenty-nine and became curious about what lay beyond. Four times he ventured out with his charioteer. On three of those journeys, he encountered someone who lifted the veil from his eyes: a very old person, a very sick person, and a corpse. These encounters made him understand the inescapable reality of existential suffering. On his fourth outing, Siddhartha met an ascetic, someone who had renounced the material world to live a sacred life and be free from suffering. This last encounter pointed the Buddha-to-be in the direction he would take to achieve final liberation.

Unlike many of us, Siddhartha was raised with absolute care, security, love, respect, protection, and admiration. Though his mother died shortly after his birth, which may have made him more sensitive to the existential suffering he encountered as an adult, he would have developed what is called secure attachment with his aunt, meaning he would have been securely connected to his caregiver. According to developmental psychology, this attachment is necessary for a child to become an adult with a healthy and stable sense of self.

Siddhartha emerged from childhood strong and confident. So much so that he was able to respond to the appearance of the four divine messengers and take immediate action. After his initial shock, he did not become overwhelmed or dissociated; he did not fall into denial. He was determined and set a course of action to become free. In short, he was psychologically whole.

Siddhartha's quest was not an effort to develop a sense of self within conventional reality. We can now see that his quest was actually meant to move his consciousness beyond conventional reality, to transcend existential suffering through the realization of the deathless. The practices he left us reflect this ultimate aim. We can see his strong and healthy sense of self in his ability to listen to his own inner promptings, leave everything he had known, and move forward without doubt. We can also see this later in his journey when, after spending years with yogis engaged in austere practices, he realized that practices like fasting and self-flagellation would not solve the problem of old age, sickness, and death, and he set out on his own path once more. Throughout his journey, the Buddha had his low moments but did not give up. He did not become depressed, anxious, withdrawn, traumatized, or codependent. His sense of self was clearly healthy and intact.

When I practice psychotherapy, I encounter people who were exposed to suffering very early in life. Before their minds could understand what was happening, while their bodies were still vulnerable and growing, and at a time when, for their full physical, emotional, and psychological development, they should have been protected from suffering. They may have experienced challenging family dynamics that include abuse, emotional neglect, and lack of care. They may have had parents who also lacked that parental care and, in turn, turned to their children to meet their own emotional needs. Beyond the family, the culture itself presents us with violence, trauma, and systemic racism. Many of us stand far outside the palace walls.

Children raised this way may be unable to listen to, let alone follow, their inner guide, and unable to act from love and wisdom. Later, this can develop into addiction, depression, anxiety, post-traumatic stress disorder, and other illnesses. So many of us in Western culture wander about who we are, how we fit in, and what our purpose is. We struggle with a negative sense of ourselves while trying to manage the impact of difficult early experiences. In short, we arrive at the doors of spiritual practice with a very different emotional and psychological landscape than the Buddha-to-be. When we begin to practice, we struggle to move beyond the personal suffering that prevents us from living fully within the relative realm, rather than at the point of grappling with existential suffering in order to realize the absolute.

So does meditation help us? If it cannot fully cure psychological suffering, does it offer anything positive? Does it have any healing aspect? The answer is definitely yes. Even though the Buddha did not come to meditation for healing, meditation does offer some relief for psychological afflictions.

When we meditate and develop our concentration through awareness of the breath, it frees us, even if only temporarily, from the thoughts and feelings that have been bombarding us. For some of us, it may be the first time we see that we are not what our thoughts say about us. We see that thoughts arise unbidden, are conditioned by family, teachers, and culture, and do not require us to identify with them. We come to understand that we do not need to be carried along by every form of thought and mental state; we learn that we can make choices in service of our wellbeing. We see the mental path we are about to take and ask ourselves whether it is a path worth taking. As we begin to act from awareness rather than identification with thoughts, we behave more skillfully toward ourselves and others. We learn ways to care for ourselves, to develop compassion, and to practice love.

During longer periods of retreat and silence, the difficult psychological states that have been buried in our psyches can surface to be felt, witnessed, and released. As the practice deepens, meditation allows us to move beyond discursive thinking so we can feel these experiences directly. In these cases, we are freed from old patterns and ways of feeling about ourselves. This directly overlaps with what can happen in a good therapeutic relationship.

However, when we leave the silence and stillness of retreat, we may find it difficult to concentrate and to access deeper patterns again. There are clear reasons for this. Traditionally, difficulty with concentration has been attributed to the five hindrances: desire, aversion, sloth and torpor, restlessness, and doubt. These are all mental states that prevent deeper states of concentration. For some people, these mental states may be compounded by those early psychological wounds we have carried with us. For example, what a meditation teacher might call aversion, a psychotherapist might see as self-deprecation. What a meditation teacher might see as sloth, a psychotherapist might recognize as depression. What a meditation teacher might see as restlessness, a psychotherapist might see as anxiety or PTSD. Because these mental states can be compounded by quite difficult, even traumatic, experiences that occurred before we were developed and able to cope with them, simply naming them as hindrances and feeling their energetic components is usually not enough.

A psychotherapist would see the problem of being unable to access deeper patterns not as a problem of establishing concentration but rather as a psychological defense. Defenses are exactly what they sound like. They protect the self from experiencing painful and often overwhelming memories and feelings. Defenses are unconscious; they happen automatically and without our consent. We may experience a sour mood, a sense of emptiness, difficult behavioral patterns, a lack of clarity, anxiety, depression, phobias, and more, all without knowing about the experiences, beliefs, and feelings that lie at the root of these mental states. On the other hand, if defenses break down, we may find ourselves overwhelmed by painful emotions and sometimes unable to function.

Rather than seeing these mental states as obstacles to deeper concentration, a psychotherapist would see them as experiences that are crying out to be healed. In the protected, confidential space of the therapist-client relationship, the approach would be to explore these experiences. These defenses are seen as a starting point. In shared exploration, the therapist points out and interprets the defenses so they gradually lose their power. As trust is built, the material that lies beyond the defenses can emerge and be processed. In ideal circumstances, the difficult emotions and experiences that were previously unconscious emerge in a protected and gradual way so the client can integrate them without becoming overwhelmed. As these patterns unfold, the psychotherapist not only lends emotional support and encouragement but also serves as a new model for how to respond to these difficulties.

Here is an example of how a psychotherapist might help transform a psychological pattern. When a client begins to feel vulnerable, they may hear a harsh voice from within calling them stupid or weak. With some exploration, we might discover that this voice is exactly how their father treated them when they were a vulnerable child. That voice maintains the status quo; it keeps vulnerable feelings protected. The client calls themselves weak or needy and tries to beat down these feelings with harshness and guilt. But that harsh voice is serving a protective function, as if the vulnerable feelings had overwhelmed the child who did not have a calm parent to help them with them. The psychotherapist interprets the defensive nature of that harsh voice and points out how it no longer serves the client in suppressing their vulnerable feelings. The vulnerable child can be invited to express themselves, and the psychotherapist can respond with care and compassion. Instead of the harshness modeled by their father, a new instance of acceptance is received, and the client learns to treat themselves with kindness.

In this way, secure attachment is formed with the therapist. This is what Siddhartha already possessed when he began his journey toward freedom; it is essential for developing a healthy sense of self. When this does not happen in childhood, we lack it. Where do adults go to meet their unmet dependency needs, their need to have their authentic self mirrored, their true struggles encouraged, their pain protected and met with empathy? Where can adults go to finally grow?

Psychotherapy conducted from a developmental perspective, one that takes into account the need for secure attachment composed of protection, empathy, mirroring, and care for the client's authentic struggles, and the harmful effects that result when this was not offered ideally during childhood, offers a reworking of that development. Clinicians will encourage and support the unfolding of the client's deeper longings, their true interests, and the expression of their talents. Once these are expressed and find their way into the world, those aspects of the self that were frozen in childhood begin to grow again. Developmentally informed psychotherapy, therefore, is not just working through old patterns and belief systems but also a second chance to become the authentic and true person we were meant to be. The inner child we all hear so much about does not have to remain a child, frozen in time forever. With commitment and intention, the client can become an emotionally mature adult. With all its power, this is something that solitary meditation practice cannot provide.

Meditation can, however, help in the therapeutic process. As painful thoughts and feelings emerge in treatment, the meditator will initially be more inclined than a non-meditator to understand that thoughts and feelings are internal phenomena that do not need to be acted upon. This is a crucial step in ending problematic behavior and growing in awareness. This ability, combined with the internalization of the psychotherapist's caring presence, can profoundly change the way a person responds to thoughts and relationships. Also, understanding and seeing deeply the impermanence of mental phenomena can allow a meditator in therapy to experience disturbing thoughts and emotions with less fear and with growing confidence that they will pass. Awareness is strengthened in meditation to the point where we have seen mental states come and go; we are less likely to resist their arising since we know this will delay their passing. Not only that, but when we understand the conditioned nature of phenomena and the absence of self, it nourishes the awareness that thoughts can be emotionally true without being concretely true. This is a crucial distinction for inner work. There is a great difference between believing I am a terrible person and understanding that I feel like a terrible person because of how I was treated in the past.

As meditators, we understand in a deep way that the discursive mind is conditioned and is not who we are in our essence. We become more sensitive and can feel the energetic differences between the chattering mind and the inner voice of wisdom. We know that we possess Buddha nature, a powerful inner guidance system beyond the thinking mind that points us in the direction of wisdom and love.

Having opened and healed many of our wounds in psychotherapy, we no longer use our defenses to protect ourselves from our pain. Without that armor against suffering, we become more sensitive to the world around us. Now, when we meditate, we see more clearly. We go deeper. We internalize the compassionate presence of the psychotherapist in the face of our own suffering, and as a result, we can better express our compassion for ourselves and for others. We mature. We are less taken over by our own fears and pain and are able to turn toward the suffering of others with an open heart. We are more like an open channel for our inner guide. Like the Buddha, we can follow the inner promptings of our life's journey and our potential.

With our karmic patterns modified and transformed, our spiritual practice deepens. Having studied the self, we forget the self and can see the world through less personal lenses. We can deepen our meditation practice and, like the Buddha on his outings from the palace, experience the truths of old age, sickness, and death. We experience insight into these three characteristics: suffering, impermanence, and the absence of self. We recognize the foolishness in trusting that the conditioned realm can bring us lasting happiness and satisfaction. At the same time, we deepen our commitment to developing the heart, to refraining from bringing any additional suffering to ourselves and others, and to cultivating compassion for all beings.

Like the Buddha, we can thus find ourselves inspired to move even further beyond, to release our concern with the known self and to discover what endures beyond the conditioned realm. We can ask what is true beyond the sufferings and desires of the personal self, beyond our stories and circumstances, beyond life and death. Less burdened by the weight of personal suffering, we move forward.

Originally published at lionsroar.com